Latest News


Each news article below shows only part of the news story. To view the full story, click on Read More below the story. 

  • August 29, 2016 8:06 AM | Ashley Monson (Administrator)

    August 26, 2016

    On August 11th NCCPA announced that effective immediately, self-assessment CME and PI-CME are no longer required. What does this mean for PAs?

    In 2014 NCCPA began transitioning PAs to a 10-year certification maintenance process that incorporated requirements for self-assessment and performance improvement (PI) CME credit. With the first PAs who transitioned to the new 10-year process facing a December 2016 logging deadline, NCCPA evaluated the self-assessment and PI-CME options currently available to PAs and determined they were insufficient to maintain self-assessment and PI-CME as requirements.

    For many PAs, self-assessment and PI-CME were only on the horizon, not demanding attention until they transitioned to the new 10-year process at some point in the next few years. Other PAs, however, have already expended resources participating in self-assessment and PI-CME activities.

    PAs who have already completed self-assessment or PI-CME activities will still be able to log these and will actually receive an additional benefit. Acknowledging the evidence of the positive impact of self-assessment and PI-CME on outcomes, NCCPA also announced new incentives for completing self-assessment and PI-CME activities: PAs will receive an additional 50% weighting for all self-assessment credits logged with NCCPA and the first 20 PI-CME credits logged during every two-year cycle will now be doubled.

    For those PAs who have already completed and logged self-assessment and PI-CME activities, the additional credit weighting will be applied retroactively. Changes will be reflected in the NCCPA’s logging system and individual PA dashboards at some point during the next few months.  

    PAs should be aware that the additional weighting for self-assessment and PI-CME activities applies only to NCCPA certification. States that require CME for license renewal purposes do not apply any additional weighting for self-assessment or PI-CME. For state license purposes, PAs must claim those credits exactly as awarded on their CME certificates.

    Many PAs have questions about these changes, how and when it will affect them, and how it relates to them and their own career path. You can find the answers to many common questions in our Certification Maintenance FAQ.

    AAPA will continue to provide and accredit high quality, affordable self-assessment and PI-CME activities to keep PAs ahead of the curve as healthcare moves toward a value-based system. With the new weighted logging system, PAs now have an additional incentive to participate in these interactive and impactful activities. 

    - See more at: https://www.aapa.org/twocolumn.aspx?id=6442451548#sthash.Ld6A1VVT.dpuf


  • August 25, 2016 9:04 AM | Ashley Monson (Administrator)

    Centers for Disease Control and Prevention 
    Everyone has a role to play in protecting their community from viruses spread by mosquitoes, like Zika. It is especially important to protect pregnant women from getting Zika because infection during pregnancy can cause microcephaly and other serious birth defects. Pregnant women can take certain steps to protect themselves and their pregnancy from Zika, such as avoiding travel to areas with Zika, protecting themselves from mosquito bites, and protecting against sexual transmission.

    Using an Environmental Protection Agency-registered insect repellent, treating clothing and gear with permethrin, and controlling mosquitoes inside and outside the home can protect against mosquito bites. Condoms (and other barriers to protect against infection) can reduce the chance of getting Zika from sex. Pregnant women who have recently traveled or who have a partner who traveled to an area with Zika should talk to their healthcare provider about their travel even if they don't feel sick. Share information with other moms-to-be about how to protect your pregnancy from Zika virus infection!

  • August 23, 2016 8:13 AM | Ashley Monson (Administrator)

    Postmenopausal women with osteoporosis assigned once-daily abaloparatide injection experienced a lower rate of vertebral and nonvertebral fractures during 18 months vs. those assigned teriparatide or a placebo, according to results from a randomized controlled trial.

    “This new medication, abaloparatide, can build bone mass very quickly in both the spine and the hip which are the two most important sites for osteoporosis-related fractures,” Felicia Cosman, MD, medical director of the clinical research center at Helen Hayes Hospital, senior clinical director of the National Osteoporosis Foundation and professor of medicine at Columbia University, told Endocrine Today. “The result of this bone building is a rapid reduction in the occurrence of fractures in both the spine as well as the rest of the skeleton. This represents a great potential treatment for osteoporosis-afflicted patients for the future.”

    Cosman, Paul D. Miller, MD, FACP, medical director of the Colorado Center for Bone Research, and colleagues , and colleagues analyzed data from 2,463 menopausal women participating in the ACTIVE trial, a phase 3, double blind, randomized controlled study conducted at 28 sites in 10 countries (mean age, 69 years). Participants had a bone mineral density T-score of up to –2.5 and greater than –5 at the lumbar spine or femoral neck, together with evidence of at least two mild vertebral fractures or one moderate vertebral fracture, or a low-trauma fracture of the forearm, humerus, sacrum, pelvis, hip, femur or tibia within 5 years. Women older than 65 years without fracture history were included if BMD T-score was –3 or less and at least –5 at the lumbar spine or femoral neck (mean femoral neck T-score, –2.1). Researchers assigned women to daily injections of abaloparatide (Radius Health; 80 µg; n = 824); open-label teriparatide (Forteo, Eli Lilly; 20 µg; n = 818) or placebo (n = 821) for 18 months. The primary endpoint was the percentage of women with new vertebral fractures in the abaloparatide vs. placebo groups; secondary endpoints included BMD change at total hip, femoral neck and lumbar spine and time to first incident of vertebral fracture in the abaloparatide vs. placebo groups.

    Researchers found that participants in the abaloparatide group experienced fewer morphometric vertebral fractures during the study period (n = 4; 0.58%) vs. the teriparatide group (n = 6; 0.84%) and placebo group (n = 30; 4.22%). Comparing abaloparatide with placebo, the RR for new vertebral fracture was 0.14 (95% CI, 0.05-0.39); HR for nonvertebral fracture was 0.57 (95% CI, 0.32-1).

    When compared with placebo, participants assigned to abaloparatide also saw increases in BMD from baseline during the 18-month period at the total hip (4.18% vs. –0.1%), femoral neck (3.6% vs. –0.43%) and lumber spine (11.2% vs. 0.63%).

    Serious, treatment-emergent adverse events were similar between abaloparatide, teriparatide and placebo groups (9.7%, 10% and 11%, respectively). Overall incidence of hypercalcemia was lower in the abaloparatide group vs. teriparatide group (3.4% vs. 6.4%) at any time during the study. Researchers did not observe evidence of increased cardiovascular risk associated with hypercalcemia in the abaloparatide group.

    Cosman noted that the findings apply to women with a fracture history, as well as those with very low bone mass who have not had fractures; however, more research is needed on the drug’s effect on other groups.

    “We need to continue evaluate abaloparatide in other clinical settings,” Cosman said. “We would like to see if this medication is just as efficatious in men, for example, and how efficatious it is in people who have been on other osteoporosis therapies.”

    Drug developer Radius Health submitted a new drug application to the FDA for abaloparatide on March 30. The company submitted a marketing authorization application in Europe on Nov. 17.

    “We are honored to have these findings published in JAMA, and are encouraged by the totality of data collected to date which demonstrate that abaloparatide, if approved, could have a significant impact in improving outcomes for women with postmenopausal osteoporosis,” Lorraine A. Fitzpatrick, MD, chief medical officer of Radius, said in a press release. “We look forward to presenting additional scientific information about abaloparatide as part of theAmerican Society for Bone Mineral Research (ASBMR) Annual Meeting in Atlanta, Georgia September 16-19, 2016.” – by Regina Schaffer

    Disclosure: The study was funded by Radius Health. Miller reports serving on scientific advisory boards for AgNovos, Amgen, Eli Lilly, Merck, Radius Health, Roche, and Ultragenyx; receiving research grants from Alexion, Amgen, Boehringer Ingelheim, Daiichi-Sankyo, Eli Lilly, Immunodiagnostics, Merck, Merck Serono, National Bone Health Alliance, Novartis, Radius Health, Regeneron, Roche Diagnostics and Ultragenyx; and serving on data safety committees for Allergan and the Grunenthal Group. Please see the full study for the other authors’ relevant financial disclosures.

    Source: Miller PD, et al. JAMA. 2016;doi:10.1001/jama.2016.11136.


  • August 09, 2016 8:38 AM | Ashley Monson (Administrator)

    by Diana Swift 
    Contributing Writer

    The European League Against Rheumatism (EULAR) has published comprehensive recommendations on reproductive health and family planning for women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS) – conditions that largely affect women of childbearing age.

    "Reproductive issues are of paramount importance for women with systemic lupus erythematosus and/or antiphospholipid syndrome and should be addressed on a regular basis by healthcare providers," wrote Angela Tincani, MD, of the University of Brescia in Italy, and colleagues, in Annals of the Rheumatic Diseases.

    The new EULAR guidelines, initially presented last year at the organization's annual meeting in Rome,"recognize an implicit need for change in the mindset of health professionals, shifting from caution against pregnancy towards embracement of pregnancy," the authors stated. Research on the long-term health status of the offspring of affected mothers has been generally reassuring, although sparse, the authors noted, but potentially relatedneurodevelopmental disorders need to be confirmed.

    To optimize the care of these patients, a multidisciplinary international team developed guidelines using an evidence-based approach further refined by expert consensus. "Several 'unmet needsin the management of reproductive and other women's health issues may impact on personal relationships and the decision to have children," Tincani and her associates wrote. Among these concerns are pregnancy's effect on maternal disease, the impact of disease activity on fetal health, and the safety of medications during pregnancy and lactation.

    "I applaud these efforts – the guidelines are so comprehensive, going from prepregnancy to pregnancy and menopause – and they are generally in harmony with the way we practice medicine in the United States," said Jane E. Salmon, MD, from the Hospital for Special Surgery in New York City, in an interview with MedPage Today.

    "The issue of pregnancy and prepregnancy counseling should be front and center at the time of lupus diagnosis. From our work in the PROMISSE study it is clear that among women who have inactive disease – even with a history of renal disease – and are on low doses of prednisone and have very low proteinuria levels, 80%-plus can have uncomplicated pregnancies."

    Salmon noted that today's thinking is a far cry from earlier times when lupus was considered related exclusively to female hormones, and that in the hyper-feminizing state of pregnancy "the same bad players will be amplified at much higher levels and lupus will flare.

    "We've shown now that if lupus is in remission when you get pregnant, flares are uncommon and de novo renal disease will not occur in women who did not have it before," she said.

    The EULAR committee highlighted a variety of needs to be addressed in SLE/APS pregnancy, including preconception counseling and risk stratification to prevent unwanted complications. These needs included balancing the use of hormonal contraception or replacement therapy against the risks of thrombosis or teratogenesis; counseling patients about fertility preservation and the gestational effects of active disease, especially lupus nephritis; and the potential negative impact on fertility of immunosuppressive drugs and alkylating agents such as cyclophosphamide.

    The committee members recommended a discussion about family planning to be held as early as possible after SLE/APS diagnosis. Planning includes risk stratification for potential adverse obstetrical outcomes, with consideration of disease activity, the autoantibody profile, previous vascular and pregnancy morbidity, hypertension, and drug use.

    The guidelines also emphasize the benefits of hydroxychloroquine to reduce the risk of flares and minimize the likelihood of poor obstetrical outcomes, as well as the use of antiplatelets or anticoagulants.

    Salmon noted that some of the EULAR data on risk stratification are not very strong, although there are compelling data to suggest that hydroxychloroquine taken before and during pregnancy is safe and results in better outcomes. "In a U.S. woman with inactive disease who is not on hydroxychloroquine, a physician would be hard-pressed to justify adding another drug to her regimen," she said. In addition, the data for giving aspirin to patients at preeclampsia risk are also not very strong, but the toxicity is low and it could be of significant benefit.

    Patients with stable or inactive disease who are at low risk of thrombosis can safely use hormonal contraception and hormone-replacement therapy for menopausal symptoms, and can safely undergo assisted reproduction.

    The authors recommended validating protocols for assisted reproduction techniques in SLE/APS patients, who have assisted reproductive technology success rates similar to those of women in the general population.

    The guidelines also called for expanding predictive biomarkers for maternal disease activity during SLE pregnancy, with a focus on predicting preeclampsia, and gestational monitoring for placental insufficiency with fetal growth restriction to determine the best time for delivery and to reduce perinatal morbidity and mortality.

    In addition, the authors noted that data are needed to establish the cost effectiveness of intensive surveillance with fetal echocardiography in patients with positive anti-Ro/Sjögren's-syndrome-related antigen A (SSA) and anti-La/SSB antinuclear autoantibodies and who had no previous child with congenital heart block.

    For fetal monitoring, Doppler ultrasonography and fetal biometry can be considered, particularly in the third trimester, to screen for placental insufficiency and fetuses small for gestational age.

    "I am not sure all physicians in the U.S. have the ability to do Doppler ultrasound and biometric parameters, so it's important to stratify by risk and balance resources in an equitable way," Salmon said.

    In terms of general prenatal care, as with women in the general population, the guidelines advise supplementation with calcium, vitamin D, and folic acid for patients with SLE and/or APS -- in particular, for those showing low circulating levels of 25-OH vitamin D in trimester one and receiving glucocorticoids and/or heparin, which have detrimental effects on bone mass.

    "These recommendations are an opportunity to change attitudes, provide guidance on intervention, and perhaps stimulate rheumatologists to stratify patients by risk and make sure high-risk patients are monitored by someone with expertise in this area," Salmon said.

    The authors reported no conflicts of interest.

    • Reviewed by F. Perry Wilson, MD, MSCEAssistant Professor, Section of Nephrology, Yale School of Medicine and Dorothy Caputo, MA, BSN, RN, Nurse Planner

    LAST UPDATED 08.08.2016

    • Primary Source

    Annals of the Rheumatic Diseases

    Source Reference: Andreoli L, et al "EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome" Ann Rheum Dis 2016; DOI: 10.1136/annrheumdis-2016-209770.


  • August 05, 2016 11:22 AM | Ashley Monson (Administrator)

    August is National Breastfeeding Month, hosted by the United States Breastfeeding Committee to advocate for the policy and practice changes needed to build a “landscape of breastfeeding support.” Breastfeeding has numerous health benefits for infants, children and mothers, yet only 27 percent of U.S. babies meet the American Academy of Pediatrics recommendation of breastfeeding for the first 12 months of their lives.

    Briana J. Jegier, PhD, of APHA’s Breastfeeding Forum, spoke to Public Health Newswire on why breastfeeding is such a critical public health issue and what all Americans can do to promote it.

    Q: Simply put, why is breastfeeding so important for public health?

    A: Breastfeeding, including breast milk feeding, is a fundamental public health strategy because of its ability to improve the well-being of families, communities, and society. When compared with alternatives, breast milk is widely available, inexpensive, and is associated with improved short- and long-term health outcomes, economic savings, and environmental benefits. Emerging research demonstrates that breast milk plays a fundamental role in programming the gut microbiome’s ability to respond to diseases ranging from infectious (e.g. gastroenteritis) to chronic (e.g diabetes). In fact, breast milk is the only source of human milk oligosaccharides (HMOs) which laboratory studies demonstrate act as both a protective and decoy agent when we fight disease. Collectively, breastfeeding and breast milk are core to public health as increasing exposure to both provide an opportunity to improve all facets of health and to provide families and communities with an optimal start.

    Q: Nationally, nearly 80 percent of mothers have breastfed their babies, but only 50 percent are breastfeeding at six months. What are the barriers to sustained breastfeeding?

    A: Breastfeeding barriers are multifaceted but generally fall into three interconnected categories: inadequate education, insufficient support, and systemic undervaluing of breastfeeding. Families encounter these barriers throughout the prenatal period and birth hospital stay: they do not receive information and support necessary to make fully informed decisions about breastfeeding, they experience practices that obstructs breastfeeding intentions, and healthcare systems undermine the value of breastfeeding by exposing families to commercial formula advertisements. Barriers to breastfeed become all-the-more stark after hospital discharge. Although 80 percent of families initiate breastfeeding, only 60 percent are still exclusively breastfeeding after just 7 days. This dramatic drop continues through the first 6 months. At 6 months, only 20 percent of families are still exclusively breastfeeding in spite of professional recommendations that exclusive breastfeeding be supported and protected throughout this period.

    Inadequate education begins in elementary school and continues through university. Evidence-based infant feeding and lactation education is not systematically provided at any level, including in undergraduate, graduate, and postgraduate health professions programs. Without adequate education and training, under-informed families seek help from under-prepared providers; this creates a perfect storm for the perpetuation of myths, inadvertent breastfeeding sabotage, and over recommendation of breast milk alternatives as a blanket solution to any challenge. Moreover, this lack of education and training means that healthcare systems provide insufficient breastfeeding support. Shortages of trained, qualified lactation support professionals and communities devoid of policies, practices, and places that support breastfeeding leave too many families without resources they need to fulfill their breastfeeding intentions. Finally, and perhaps most important, breastfeeding is systemically undervalued. National conversations continue to characterize breastfeeding as a lifestyle choice rather than the life-saving, evidence-based intervention it is. Without appropriate value, requiring adequate education and developing comprehensive breastfeeding support – particularly paid family leave and adoption of the WHO code – will continue to face uphill battles.

    Q: This is the fifth anniversary of The Surgeon General’s Call to Action to Support Breastfeeding. What progress have we seen since then, and how is our Breastfeeding Forum advocating for more?

    A: Significant strides have been made on each of the 20 action items included in the Surgeon General’s Call. Breastfeeding rates continue to rise and the number of children born in facilities that are designated as Baby-Friendly has risen from roughly 3 percent in 2007 to 17.9 percent in 2016. This rise is in part due to programs supported by public health entities, including CDC and NACCHO, and led by our Breastfeeding Forum members that have enabled facilities to receive the support they need to receive Baby-Friendly designation.  Breastfeeding coalitions and public health departments across the US have also created state specific designations that recognize businesses, childcare facilities, and healthcare providers that adopt baby and breastfeeding friendly practices. We also see a bigger and more vibrant USBC that has built coalitions with partners, including APHA, to form work groups that address each of the 20 areas and other emerging breastfeeding issues. Finally, we have seen increases in funding initiatives and organizations dedicated to increasing lactation professional diversity and availability.

    The Breastfeeding Forum in partnership with other APHA sections has worked to promote the Surgeon General’s Call. We have revised APHA policy to incorporate the call and we have worked with our colleagues to ensure that new policies consider the impact of breastfeeding on the issues they address. We have also worked with APHA leaders to revise disaster preparedness fact sheets to ensure they reflect evidence-based information for breastfeeding families. Currently, we are developing a public health policy to address the growing practice of milk sharing.  We are also utilizing technology to increase collaboration (e.g. webinars, twitter chats) throughout the year. Finally, we have prioritized developing diversity in our membership so that all voices are at the table as we address the challenges faced in breastfeeding and public health.


  • August 05, 2016 11:20 AM | Ashley Monson (Administrator)

    The nation’s top medical research agency has begun testing a Zika vaccine.

    U.S. government researchers with the National Institutes of Health announced Wednesday that they have begun clinical trials. The study marks the group’s first attempt at a vaccine to fight the mosquito-borne disease.

    There is currently no vaccine or treatment for Zika, which can cause severe brain-related birth defects if a mother is infected while pregnant.

    The virus has mostly been reported in South America, Central America and the Caribbean, although officials announced last week that mosquitoes have apparently started spreading the disease on the U.S. mainland.

    Zika prompts MTA plans for use of bug-killing larvicide

    At least 15 people in Florida are feared to have been infected through mosquito bites.

    Florida said it would make Zika testing available to all pregnant women at county health departments statewide at no cost.

    Monday, May 23, 2016 file photo

    Researchers are testing a Zika vaccine that could prevent infection.

     (FELIPE DANA/AP)

    Federal health officials have taken the unprecedented step of directing pregnant women to avoid parts of Miami where people have tested positive for Zika.

    Additionally, more than 1,650 cases of the disease have been reported across the U.S., nearly all the result of travel to a Zika-stricken country or sex with someone who was infected abroad.

    Pregnant women warned to avoid Miami neighborhood as Zika spreads

    “A safe and effective vaccine to prevent Zika virus infection and the devastating birth defects it causes is a public health imperative,” National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci said in a statement.

    The vaccine trial will use at least 80 volunteers to test a drug intended to prevent infection.

    U.S. vaccine maker Inovio Pharmaceuticals in June won U.S. Food and Drug Administration approval to begin testing its Zika vaccine on humans.

    A Miami-Dade County mosquito control worker sprays around a home in the Wynwood area of Miami on Monday. At least 15 people in Florida may have been infected.

    A Miami-Dade County mosquito control worker sprays around a home in the Wynwood area of Miami on Monday. At least 15 people in Florida may have been infected.

     (ALAN DIAZ/AP)

    It began its clinical trial last month, aiming to enroll 40 healthy adult volunteers in Miami, Philadelphia and Quebec City.

    But funding for the preventative measure could become an issue moving forward.

    President Obama in February asked the Republican-led Congress for about $1.9 billion in emergency funds to combat the disease domestically and abroad, but lawmakers have so far not passed funding legislation.

    A $1.1 billion compromise failed after Republicans in the House of Representatives attached language that would place restrictions on abortion and defund part of Obama’s signature 2010 health care law.

    With News Wire Services



  • August 05, 2016 11:19 AM | Ashley Monson (Administrator)

    Charlan D. Kroelinger, PhD
    Division of Reproductive Health
    National Center for Chronic Disease Prevention and Health Promotion
    CDC

    MedicalResearch.com: What is the background for this study? What are the main findings?

    Response: Zika virus infection during pregnancy can cause microcephaly and other severe fetal brain defects. Doctors have also found other problems in pregnancies and among infants infected with Zika virus before birth, such as absent or poorly developed brain structures, defects of the eye, hearing deficits, and impaired growth. Nearly half of all pregnancies in the United States are unintended. Increased access to birth control may lead to reductions in unintended pregnancies, which may result in fewer adverse pregnancy and birth outcomes in the context of a Zika virus outbreak.

    A new report from CDC estimates that use of highly effective, reversible forms of birth control, called long-acting reversible contraception (LARC), which includes intrauterine devices (IUDs) and implants, remains lower than use of moderate or less effective methods such as oral contraceptive pills and condoms, although contraception use varied across states and by age group and race/ethnicity.

    CDC scientists used data from four state-based surveillance systems to estimate contraception use for non-pregnant and postpartum women at risk for unintended pregnancy and sexually active female high school students who live in states with the potential for local Zika virus transmission. Less than one in four sexually active women of reproductive age and fewer than one in 10 sexually active female high school students reported using LARC. A higher percentage of postpartum women reported LARC use. Moderately effective and less effective contraceptive methods, including pills, patches, rings, injections, condoms and other barrier methods, were used more frequently than highly effective methods. These estimates are of concern because the most commonly used methods of contraception are not as effective at preventing unintended pregnancy.

    MedicalResearch.com: What should readers take away from your report?

    Response: Efforts to increase availability of and access to the full range of FDA-approved contraceptive methods, especially highly effective methods, can reduce unintended pregnancies among women who wish to delay or avoid pregnancy and may lead to fewer adverse pregnancy and birth outcomes during a Zika virus outbreak. In areas with potential Zika virus transmission, the full range of FDA-approved contraceptive methods, including LARC, should be available and accessible for women and couples who want to delay or avoid pregnancy. States and local jurisdictions can implement strategies to increase access to contraceptive services to reduce unintended pregnancies among women who may be exposed to Zika virus.

    MedicalResearch.com: What recommendations do you have for future research as a result of this study?

    Response: CDC collects surveillance data from states to better understand behaviors and experiences of adults and youth in the U.S. and territories. All of these surveillance systems regularly publish reports on health behaviors. In this report, only 39 of the 41 states with the potential for local Zika virus transmission had data from at least one surveillance system, suggesting a continued need for ongoing collection of state-level data on contraceptive use.

    MedicalResearch.com: Is there anything else you would like to add?
    Response:  Effective contraception use is a primary strategy to prevent poor pregnancy and birth outcomes linked to Zika infection during pregnancy. Barriers to the access and availability of contraception may include high device costs, limited provider reimbursement, lack of training for providers serving women and female adolescents on insertion and removal of LARC, provider lack of knowledge and misperceptions about LARC, limited availability of youth friendly services that address adolescent confidentiality concerns, limited client-centered counseling, and low consumer awareness of the range of contraceptive methods available. State and local jurisdictions can implement strategies to remove barriers to the access and availability of highly effective long acting reversible contraception (LARC).
    MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

    Citation:
    Boulet SL, D’Angelo DV, Morrow B, et al. Contraceptive Use Among Nonpregnant and Postpartum Women at Risk for Unintended Pregnancy, and Female High School Students, in the Context of Zika Preparedness — United States, 2011–2013 and 2015. MMWR Morb Mortal Wkly Rep. ePub: 2 August 2016.
    DOI: http://dx.doi.org/10.15585/mmwr.mm6530e2.

    Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

    More Medical Research Interviews on MedicalResearch.com



  • August 05, 2016 11:17 AM | Ashley Monson (Administrator)

    The cervical stitch is a common procedure used to prevent preterm birth. Breaking research concludes that the size of the thread used can make a significant difference to the outcome for the infant.

    A small change in cervical stitch thread size could save lives.

    An estimated 1 in 10 American babies are born prematurely.

    Being born before the 37-week mark is the greatest contributor to infant death and a leading cause of long-term neurological disabilities.

    Preterm births are triggered by the cervix opening too early and allowing the baby to enter the birth canal.

    Women who are considered at high risk of miscarriage or preterm birth often undergo the cervical stitch procedure, also known as cervical cerclage.

    The cervical stitch procedure involves stitching the entrance to the cervix closed with a piece of thread; globally, more than 2 million women have this intervention each year.

    Not only does the procedure help the cervix stay closed and delay labor, but it also acts as a barrier to prevent potentially harmful bacteria from traveling through the cervix and into the womb.

    Although the exact causes of preterm births are not known, bacterial infection is considered a potential factor; therefore, increasing the strength of the natural barrier helps minimize the risk.

    Cervical stitch thread size

    Surgeons completing the cervical stitch procedure use one of two types of thread. The first is a thin, 1-millimeter diameter, fishing line-like thread called monofilament; the other is a thicker thread, around 5 millimeters thick, woven from smaller threads, resembling a shoe lace.

    Currently, the thicker thread is used in around 80 percent of cervical stitch procedures, predominantly because it is considered to be sturdier and more efficient at holding the cervix closed.

    A group of researchers from the Department of Surgery and Cancer at Imperial College London, United Kingdom, set out to investigate which of the two threads was most medically beneficial.

    The results are published this week in the journal Science Translational Medicine.

    "Our current study suggests the thick multifilament thread is associated with increased risk of complications. Even after factoring in the age and overall health of the patient."

    Lead author Prof. Phillip Bennett

    Why thread size matters

    The researchers looked at 671 women from five U.K. hospitals over the past 10 years, all of whom had undergone the cervical stitch procedure. Roughly half had the thin monofilament, and the others had the thicker shoelace thread.

    The rate of intrauterine death (death of the fetus before birth) in normal pregnancy is around 0.5 percent. In the thinner thread group, that figure was 5 percent, and in the shoelace group, it jumped up to 15 percent.

    When the team investigated the preterm birth rate - which is 7 percent within the general population - they found that the thicker, shoelace thread was associated with a 28 percent rate, whereas the thinner thread was just 17 percent.

    As a follow-up investigation, the team, led by Prof. Bennett, followed another 50 women. Half of these women used the thinner thread, the others used the wider type. The women were monitored at 4, 8, and 16 weeks with an ultrasound scan and an analysis of bacteria collected using vaginal swabs.

    It was found that the women who were given the thicker thread had an increased inflammation of the cervix and increased blood flow to the region; this change is associated with the cervix opening prior to labor.

    At the start of the study, all of the women had a similar collection of naturally occurringLactobacillus. However, after 4 weeks, the group with the thicker thread were found to have more "potentially dangerous" bacteria around their cervix and inside the vagina.

    These new bacteria are:

    "[...] associated with poor outcomes during pregnancy, like preterm birth and infection in babies. Women who received the thinner thread maintained normal levels of harmless Lactobacillus bacteria in the birth canal or cervix."

    Dr. David MacIntyre, scientific lead

    Testing bacterial growth

    As a third prong to the study, the team investigated how easily bacteria could grow on the two sizes of thread. Summarizing the tests, Dr. MacIntyre says: "We found potentially dangerous bacteria grew more easily on the thicker thread. This may be because bacteria can latch onto the woven structure of the thick thread more easily than the smooth, thin thread."

    The conclusions drawn from the study are that, on a global basis, by switching from thicker to thinner thread, 170,000 premature births and 172,000 intrauterine deaths could be prevented.

    To test these findings more thoroughly, a further study using 900 patients is already underway, organized by the University of Birmingham, U.K.

    Any medical discovery that can simply, cheaply, and effectively save lives is a game-changer. Jane Brewin, chief executive of Tommy's - a charity dedicated to children's health - says: "The really good news is that a safe and proven treatment to prevent preterm birth has just been made safer by this new finding."

    Learn more about the benefits of breast-feeding preterm babies.

    Written by Tim Newman



  • August 04, 2016 1:14 PM | Ashley Monson (Administrator)

    APHA Get Ready fact sheet — Zika virus: How to keep your family safe

    Mosquitoes are more than just an itchy nuisance. They can also pass on diseases. One of those diseases is Zika. You can take steps to help protect yourself, your family and your community from Zika.

    What is Zika?

    flu


    Download and share PDF

    Zika is a disease caused by a virus. It’s mainly spread to people by mosquitoes. When an infected mosquito bites you, it can pass on the virus and make you sick.

    Zika illness is usually very mild. You may get symptoms such as a rash, fever, red eyes or joint pain, which usually go away within a week. According to the Centers for Disease Control and Prevention, only about 20 percent of people who are infected with Zika will get sick. 

    Some reports link Zika to Guillain-Barré, a rare condition that causes nerve damage, but CDC hasn’t confirmed that connection. It’s very rare for anyone to die from Zika.

    Zika and pregnant women

    The main health concern with Zika is the virus’ effect in pregnant women. If a woman is infected with Zika, she can pass the virus to her fetus. The virus can cause microcephaly and other serious brain, eye or hearing problems in the fetus. Microcephaly is a birth defect in which a baby is born with a small head and other possible developmental problems.

    Because of these concerns, pregnant women shouldn’t travel to areas where Zika virus is being spread, CDC says. Pregnant women in areas with Zika transmission should take care to protect themselves from mosquitoes.

    How else is Zika spread?

    Zika virus can also be spread via sex. CDC is advising that men who may have been exposed to Zika and have pregnant partners wear condoms during sex or that they abstain from sexual activity.
    There are concerns that Zika may be spread via blood. The Food and Drug Administration says that people who may have been exposed to the virus should not donate blood for at least four weeks to be sure they don’t pass Zika to others.

    How can I prevent or treat Zika?

    There are no vaccines or treatments for Zika, other than caring for symptoms. The best way to avoid Zika is to not get bitten by mosquitoes.

    Here are some steps CDC recommends:

    • When outdoors, wear approved repellents with DEET. Follow all directions on the label.
    • Wear long-sleeved shirts and pants. Treat your clothing with the chemical repellent permethrin or buy pre-treated clothes. 
    • Stay in places with screens on windows and doors that keep mosquitoes out

    You can also play a part by getting rid of places where mosquitoes breed around your home. The Environmental Protection Agency says you should get rid of standing water in rain gutters, tires, buckets, plastic covers, toys and containers where mosquitoes might lay eggs.

    It’s also a good idea to empty and change water in bird baths, rain barrels and potted plant trays at least once a week, EPA says. Water in swimming pools should be circulated and treated.

    What else is known?

    Zika virus is spread by a type of mosquito called Aedes. These kinds of mosquitoes also spread dengue and chikungunya. So preventing mosquito bites and mosquito breeding makes sense for many reasons.

    For more tips on Zika, visit www.apha.org/zika and www.cdc.gov/zika.

    Updated July 29, 2016

    Spanish version
    Read and share this fact sheet in Spanish. For more tips to fight the bite, visit the Get Ready mosquito page.

    More Get Ready fact sheets
    Read more fact sheets from Get Ready in English and Spanish and add your logo.


  • August 04, 2016 11:40 AM | Ashley Monson (Administrator)

    (CNN) — The National Institute of Allergy and Infectious Diseases has injected two human volunteers with an experimental DNA-based Zika vaccine, Director Anthony Fauci announced today, a month ahead of its projected schedule for vaccine development.

    "If it's a home run, we'll know pretty quickly,"

    Fauci said, adding that if it is successful, phase 2 trials could begin as early as January.

    Human trials of another DNA-based vaccine created by Inovio Pharmaceuticals started in Miami a few days ago, but Fauci stressed that those DNA inserts are diIJerent from the ones the his agency is using.

    "This vaccine includes a small piece of DNA with genes that code for Zika-virus proteins,"

    Fauci said. It's injected via a coil spring injector into the deltoid muscle of the arm, where the body's cells read the DNA and create virus-like particles that should activate the immune system to create antibodies. A total of 80 volunteers ages 18 to 35 will receive the vaccine by the end of August at three study sites in Bethesda, Maryland, Baltimore and Atlanta.

    The volunteers will be broken into three groups that will receive the same dose at diIJerent intervals over a 20-week period. After the first injection, volunteers will be required to return for follow-up visits over a 44-week period to monitor their health. The agency stressed the safety of the vaccine, noting that

    "DNA vaccines do not contain infectious material -- so they cannot cause a vaccinated individual to become infected with Zika -- and have been shown to be safe in previous clinical trials for other diseases."

    If preliminary results show eIJectiveness, Fauci said, the National Institute of Allergy and Infectious Diseases has enough doses of the vaccine on hand to move from phase 1 to phase 2 trials. However, it does not have enough money to plan and administer the phase 2 study, he said, adding that Congress needs to act on the Obama administration's request for additional funding to fight Zika.

    That sentiment was echoed today by White House press secretary Josh Earnest: "If Republicans continue to obstruct funding for the Zika virus, then that's going to limit our ability to rapidly develop the kind of vaccine that, next summer or the summer after that, could start protecting the American people from the Zika virus and limit the risk associated with this particular disease."

     A volunteer receives the first dose of an experimental Zika vaccine. Related Article: CDC issues historic travel warning over Miami Zika outbreak Join the conversation See the latest news and share your comments with CNN Health on Facebook and Twitter. particular disease." If phase 2 happens as planned, Fauci said, he thought the earliest the vaccine might be used would be in early 2017, with FDA approval.

    "The target of the vaccine will be women of childbearing age and their sexual partners," he said, "to protect their unborn children from birth defects." Zika has been shown to be responsible for an alarming increase in microcephaly, in which babies are born with small brains and heads, as well as other hearing, vision and developmental disorders.

    Because it's well-known that Zika does the most damage in the first trimester of a pregnancy, Fauci stressed that vaccinating girls before they reach puberty in areas hard-hit by Zika is the ultimate goal. "In the real world, women are most vulnerable before they even know they are pregnant," he said. "So we need to vaccinate as young as we can possibly get them."


Powered by Wild Apricot Membership Software