France Bans Free Refills On Sweetened Drinks.

reports France has banned “free refills of sodas and other sugary drinks,” the country’s latest attempt to fight a “relentless rise in the national obesity rate.” The ban applies to “sodas, milk, sports drinks and ‘vegetable nectars and similar products, provided that these beverages contain added sugars or synthetic sweeteners.’” The law has had a mixed reception, with some people supporting the effort and others saying that the government “might as well put scales in front of each fast-food joint.” https://www.nytimes.com/2017/01/27/world/europe/france-soda-refill-ban.html?_r=0

IV Glucose May Cut Labor Times in First-Time Moms Reduced labor time without increased complication rates

The Kaplan-Meier survival curve was also significant for the glucose group, meaning women in the intervention group delivered faster, Paré said at the presentation. In fact, the portion of patients who delivered within 2 hours and 20 minutes was 19% vs 8% in the control group. After 7.5 hours, three-quarters of the patients in the intervention group had delivered as opposed to 61% of the controls. When examining individual stages of labor, there was a trend towards significance for the group receiving glucose, though the results did not actually reach significance. http://www.medpagetoday.com/MeetingCoverage/SMFM/62804?xid=nl_mpt_DHE_2017-01-30&eun=g721819d0r&pos=2

Maternal, Fetal Death Rates Higher on Weekends But no "July effect" observed for obstetrics, researchers say

http://www.medpagetoday.com/MeetingCoverage/SMFM/62805?xid=nl_mpt_DHE_2017-01-30&eun=g721819d0r&pos=0

Skittles candy for cows

Red Skittles spilled onto a Wisconsin highway earlier this week were reportedly on their way to a farm to feed cattle, as an alternative to corn. Candy is said to be a way to "provide cheap carbs" to cows, but can also indirectly add to rising diabetes and obesity rates through consumption of the animals' resulting high-sugar byproducts. (CNN) http://www.medpagetoday.com/Endocrinology/GeneralEndocrinology/62783?xid=nl_mpt_DHE_2017-01-28&eun=g721819d0r&pos=4

Curbing Antibiotics Tied to Britain's Drop in C.Diff Limiting fluoroquinolones urged as control cornerstone

Restricting the use of fluoroquinolone antibiotics was more effective than measures such as "deep cleans" of hospitals in reducing the incidence of Clostridium difficile (C. diff) in Oxfordshire and Leeds, England, researchers reported. Antibiotics such as ciprofloxacin killed non-resistant C. diff bugs in the gut, enabling drug-resistant C. diffi bugs to thrive and inviting the rapid growth of resistant C. difficile, according to Derrick Crook, MBBCh, of the University of Oxford, and colleagues. National prescribing of fluoroquinolone and cephalosporin was highly correlated with incidence of C. diff infections (cross-correlations >0.88), by contrast with total antibiotic prescribing (cross-correlations <0.59) by 2006, they wrote in Lancet Infectious Diseases. http://www.medpagetoday.com/gastroenterology/generalgastroenterology/62719?xid=nl_mpt_DHE_2017-01-27&eun=g721819d0r&pos=11

6 Million Visits for ADHD by U.S. Kids Each Year Medications prescribed or continued in 80% of visits

Using ICD diagnoses codes, the researchers determined that about 29% of children who had ADHD office visits had any additional mental health disorder, including episodic mood disorder (7%); anxiety, dissociative, and somatoform disorder (7%); and disturbance of emotions specific to childhood and adolescence (4%). http://www.medpagetoday.com/psychiatry/adhd-add/62717?xid=nl_mpt_DHE_2017-01-27&eun=g721819d0r&pos=8

Researchers Report Two Experiments Growing Human Replacement Organs In Animals.

“Biologists are reporting two significant advances” this week in “replacing a patient’s diseased organs with ones derived from that person’s own cells, and grown in an animal host.” One team of researchers, led by Jun Wu and Juan Carlos Izpisua Belmonte at the Salk Institute, “has shown for the first time that human stem cells can contribute to forming the tissues of a pig, despite the 90 million years of evolution between the two species.” Meanwhile, a second group, led by Tomoyuki Yamaguchi and Hideyuki Sato of the University of Tokyo and Hiromitsu Nakauchi of Stanford, “has reversed diabetes in mice by inserting pancreas glands composed of mouse cells that were grown in a rat.” One report was published in Cell and the other was published in Nature. The AP (1/26, Ritter) reports, “The Salk team is working on making humanized pancreases, hearts and livers in pigs. The animals would grow those organs in place of their own, and they’d be euthanized before the organ is removed.” Scientists “used human stem cells, which are capable of producing a wide variety of specialized cells. They injected pig embryos made in the lab with three to 10 of those cells apiece, and implanted the embryos into sows.” After about three weeks of development, “186 embryos were removed and examined.” The cells “generated the precursors of muscle, heart, pancreas, liver and spinal cord tissue in the embryos.” They said they would test “ways to focus human cells on making specific tissues while avoiding any contribution to the brain, sperm or eggs.” The AP adds, “Ethics experts were also impressed by the results.” http://hosted.ap.org/dynamic/stories/U/US_SCI_PIG_HUMAN_EMBRYOS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT

Adiposity, Not Cardiorespiratory Fitness And Free Fat Mass Index, Strongly Associated With Components Of Metabolic Syndrome, Researchers Say.

Adiposity was strongly associated with components of metabolic syndrome, including insulin resistance, visceral fat volume and liver fat percentage, whereas cardiorespiratory fitness and free fat mass index were only weakly or nonsignificantly associated with the same parameters,” researchers found after analyzing “data from two cross-sectional samples of healthy adult monozygotic and dizygotic twins: the GEMINAKAR twin study, recruited through the population-based Danish Twin Registry (n = 996), and TwinFat, based on two Finnish, population-based studies of five consecutive birth cohorts of twins (n = 309).” http://www.healio.com/endocrinology/cardiometabolic-disorders/news/in-the-journals/%7B84a6cd81-aed6-4dea-bb94-949c3bcdf8bb%7D/adiposity-not-cardiorespiratory-fitness-associated-with-metabolic-health

Lupus Patients Less Inclined to Stick with Meds More than half reported non-adherence

In several of the studies, factors associated with non-adherence also were described. These included lower education level, depression, and polypharmacy. "Altogether, this systematic review confirms that the burden of non-adherence is substantial and significant in SLE," the researchers stated. They pointed out that the studies that used self-report data reported lower rates of non-adherence, which may relate to social desirability bias and thus may represent an overestimation of adherence. http://www.medpagetoday.com/Rheumatology/Lupus/62732?xid=nl_mpt_DHE_2017-01-26&eun=g721819d0r&pos=1

Diabetes Appears To Be Third-Leading Cause Of Death After Heart Disease And Cancer, Research Suggests.

reports that “the hidden toll of diabetes” may factor into “the backward sliding of American mortality,” researchers concluded after examining data from the “National Health Interview Study and the National Health and Nutrition Examination Survey” to ascertain “whether they could estimate how often diabetes might be the primary but overlooked cause of death.” http://www.vox.com/policy-and-politics/2017/1/25/14383580/diabetes-americans-dying-earlier-mortality

Limiting Antibiotics In Hospitals May Help Control Deadly Infections, Study Suggests.

reports that a study published in The Lancet suggests that limiting the use of antibiotics in hospitals may be even more useful at controlling Clostridium difficile than washing hands. British researchers found that the regions in England “where fluoroquinolone antibiotics were used widely, the more virulent and deadly resistant strains of C. diff became the dominant type of infection.” However, “in areas where antibiotic use was restricted, infections with resistant strains largely disappeared, leaving only people infected with milder, and more easily treatable, nonresistant strains.” https://www.nytimes.com/2017/01/25/well/live/limiting-antibiotics-curbs-deadly-hospital-infections.html?_r=0

US Consumption Rate For Sugar Drinks Still “Well Above” Recommended Limit, According To CDC.

reports the rate at which Americans consume sugary beverages has “stalled at well above the recommended limit” after a decade of decrease, according to new statistics from the CDC. While researchers are uncertain as to the precise cause of the leveling off, there are several possible explanations, including that “Americans may be turning in growing numbers to teas, flavored waters and other energy drinks with plenty of sugar added.” In addition, it’s possible “the initial decline in sugary-beverage consumption came among Americans who were particularly receptive to changing their behavior, such as upper-income individuals,” which “leaves a soda-drinking population whose habits are changing more slowly.” https://www.washingtonpost.com/news/wonk/wp/2017/01/26/americans-were-making-a-lot-of-progress-cutting-back-on-sugary-drinks-now-thats-stopped/?utm_term=.bd516cdea94a

Americans In Certain Parts Of The US Are Dying From Cancer At Increasing Rates, Research Indicates.

Cancer death rates are surging in some regions of the U.S. even as fatalities steadily decline nationwide, a new study suggests. Overall, the U.S. death rate from cancer has dropped about 20 percent from 1980 to 2014, the study found. Cancer fatalities now account for about 192 deaths for every 100,000 people in the U.S., down from 240 per 100,000 at the start of the study period. But in some parts of the country where poverty, obesity and smoking are more common, rates of death from cancer are going up. "Known cancer risk factors – smoking, diet, and obesity, among others – combined with poor prevention programs may increase cancer cases," said senior study author Dr. Christopher Murray of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle. "Unequal access to and quality of care are likely contributors to cancer mortality disparities, and the lack of early detection for some cancers and lack of specialized treatment can be deadly," Murray added by email. http://www.reuters.com/article/us-health-us-cancer-mortality-idUSKBN1582MZ

Sepsis Overlooked as Major Readmission Driver Topped all conditions

Sepsis accounted for more unplanned hospital readmissions than any of the four conditions included in a national quality monitoring program, according to a review of 14 million hospitalizations. Of more than 1 million hospitalizations associated with unplanned readmission, 12.2% of the readmissions involved sepsis. Among the four conditions included in the Centers for Medicare and Medicaid Services (CMS) monitoring program, heart failure accounted for the most readmissions (6.7%). Unplanned readmissions associated with sepsis also had the longest and most costly hospitalizations, Florian Mayr, MD, of the University of Pittsburgh Medical Center, reported here at the Society of Critical Care Medicine meeting. http://www.medpagetoday.com/MeetingCoverage/SCCM/62707?xid=nl_mpt_DHE_2017-01-25&eun=g721819d0r&pos=0

Rapid Sepsis Assessment Highly Accurate Outside ICU

http://www.medpagetoday.com/CriticalCare/Sepsis/62581?xid=nl_mpt_Weekly_Education_2017-01-25&eun=g5883165d1r

Drug-Resistant Gonorrhea Finally Gets Attention Abandonment of routine MIC testing in 1990s now seen as a mistake

After months of painstaking lab work, Alan Katz, MD, MPH, and his team were surprised. Their culturing and analyzing bacteria samples in his Hawaii clinic showed that seven patients were carrying strains of gonorrhea with increased resistance to the current -- and only -- treatment regimen for a sexually transmitted disease that affects an estimated 800,000 Americans each year. As Katz, who heads the research team at the Hawaii State Department of Health's Diamond Head STD Clinic, related to MedPage Today, the individuals were successfully treated, but what about the next time? "OMG, we might be closer to treatment failure than we thought," he said. The cluster, identified earlier this year, is the first group of gonorrhea infections in the U.S. to show increased resistance to both of the last two drugs approved to be used against it: ceftriaxone and azithromycin. Katz's alarming discovery is the latest development in a situation so concerning that the Centers for Disease Control and Prevention (CDC) declared gonorrhea one of three urgent antibiotic resistance threats in the United States (the other two are Clostridium Difficile and Carbapenem-Resistant Enterobacteriaceae). Two-drug therapy already failed with a patient in the U.K, and the worry is that this could become commonplace. http://www.medpagetoday.com/InfectiousDisease/STDs/62660?xid=nl_mpt_DHE_2017-01-23&eun=g721819d0r&pos=4

Cervical Cancer Still a Killer "Mortality gap" among black and white woman particularly striking

http://www.medpagetoday.com/HematologyOncology/CervicalCancer/62674?xid=NL_MBstandard_2017-01-23&eun=g721819d0r

Breath Testing for IBS: Consensus Guidelines Coming Positives, negatives, and pitfalls remain

Breath testing for digestive disorders from lactose intolerance to Helicobacter pylori infection has been around for some time, and the use is increasing. But lack of standardization in indications, preparation, methodology, and interpretation have led to heterogeneity in clinical practice and research. Evidence-based data on the testing's utility in irritable bowel syndrome (IBS) specifically have been few, and the application varies widely among gastroenterologists. There are plenty of data substantiating that food poisoning triggers the bacterial hypertrophy that leads to IBS, he explained. "Neurotoxicity from food poisoning leads to bacterial buildup and causes a neuropathy of the gut," but overgrowth can also result from other conditions leading to intestinal stasis, including bariatric surgery, blind loops, adhesions, and Crohn's disease strictures. One area of discordance is the choice of testing substrate -- glucose or lactulose. Glucose is absorbed so easily it never reaches the colon, Pimentel noted. "If the glucose test is positive, most agree there's bacterial overgrowth in the small intestine, so some more conservative clinicians use glucose because a positive glucose test is very definitive. On the other hand, you miss overgrowth in the second half of the small bowel." The methane gas testing component of the breath test becomes extremely useful, since the presence of intestinal methane in addition to hydrogen will dictate therapy, Pimentel emphasized. "We published a double-blind study showing that if you have methane, which is linked to IBS-constipation, you need to add neomycin to rifaximin to have efficacy. Methane slows the gut, so if an IBS patient is constipated, a breath test become very important." http://www.medpagetoday.com/reading-room/aga/lower-gi/62608?xid=nl_mpt_DHE_2017-01-20&eun=g721819d0r&pos=4

Antibiotic-Resistant Bacteria Growing Problem Worldwide.

Smallpox, syphilis, plague, cholera – some of the planet’s most notorious scourges dramatically expanded their reach thanks to unsuspecting travelers. With a record 3.77 billion air passengers worldwide last year, new disease-causing microbes have never traversed the planet faster. The recent case in Reno, Nevada of a woman who died from a rare bacterial infection is a tragic reminder. She picked up a variant of a germ called Klebsiella pneumoniae, probably while she was treated in India for a leg fracture and hip infection, Washoe County health authorities said last week. Tests found the bacterium was resistant to 26 antibiotics. In fact, no available drug could stop it from poisoning her bloodstream weeks after she was admitted to the hospital in Nevada. A Klebsiella pneumoniae bacterium under a scanning electron microscope. Source: Janice Carr/Centers for Disease Control and Prevention. The fatal case fits a pattern doctors in North America, Europe and Australia have observed for more than a decade: travelers who have spent time in India have an especially high risk of returning home with unwanted germs. Most often, the drug-evading bugs are ingested in fecally contaminated food or water, and take up residence in the intestines, where they are incorporated into the body’s normal bacterial flora. The stowaways can be dangerous if they escape from the bowel into other tissues, like the bladder or bloodstream. https://www.bloomberg.com/news/articles/2017-01-19/superbug-stowaways-india-travel-boom-spreads-dangerous-microbes

Research Does Not Support Premise Of Breakfast As Weight-Loss Aid. THIS CONCLUSION CHANGES MONTHLY

reports that cereal manufacturers have long promoted the “belief that eating breakfast can help keep us thin and bring other benefits,” partly by paying for studies – many of which use questionable methodology or have inherent limitations – that “seem to support the idea.” In fact, in a 2013 review of “dozens of studies examining the premise,” researchers concluded that “popular opinion” about eating breakfast as a weight-loss aid “outweighed the scientific evidence.” Moreover, “disclosures about who paid for the research became the norm only in recent years, so it’s unclear how much of the literature on breakfast and weight from past decades was funded by breakfast food makers.” https://www.washingtonpost.com/national/health-science/can-breakfast-help-keep-us-thin-nutrition-science-is-tricky/2017/01/19/7ccddb3e-de61-11e6-8902-610fe486791c_story.html?utm_term=.6b9ac1deb83b Breakfast” can consist of any number of possibilities, whether it’s cold pizza, yogurt or an egg sandwich and be added calories for the day if another meal size later is not reduced to keep daily calories from increasing..

People With T1D May Show Digestive System Changes Not Seen In People Without T1D, Research Suggests.

People with type 1 diabetes [T1D] show changes in their digestive system that aren’t seen in people who don’t have the autoimmune disease,” investigators found. “Those changes include different gut bacteria and inflammation in the small intestine.” These “differences may play a role in the development of type 1 diabetes, the researchers said.” HealthDay adds, “Out of every 1,000 adult Americans, between one and five have type 1 diabetes, according to the Endocrine Society.” https://consumer.healthday.com/diabetes-information-10/type-i-diabetes-news-182/study-ties-inflammation-gut-bacteria-to-type-1-diabetes-718839.html

Sitting Too Much May Be Linked To Shorter Telomeres, Study Suggests.

reports that investigators “assessed nearly 1,500 older women.” The investigators “found that women who sat for more than 10 hours a day and got less than 40 minutes of moderate-to-vigorous physical activity daily had shorter telomeres,” which “are caps on the end of DNA strands that protect chromosomes from deterioration.” They took blood samples from nearly 1,500 older women enrolled in the Women’s Health Initiative, a long-term study of chronic diseases in post-menopausal women, and focused on the telomeres: the tips of the tightly packed DNA in every cell. Previous studies have found that as cells divide and age, they lose bits of the telomeres, so the length of this region can be a marker for how old a cell (and indirectly the person the cells belong to) is. The researchers compared telomere length to how much the women exercised, to see if physical activity affected aging. http://time.com/4637898/sitting-aging-sedentary/

WOW esearchers Having Difficulty Reproducing Five Highly Influential Cancer Experiments.

reports a series of studies to be published Thursday reveals problems with “reproducibility” in the field of cancer biology. In particular, the “‘Reproducibility Project: Cancer Biology,’ a collaboration of the Charlottesville, Va.-based Center for Open Science and the Palo Alto, Calif.-based Science Exchange, attempted to replicate five highly influential mouse experiments.” Three of the attempts “failed or were inconclusive. The other two found somewhat similar results, though with smaller effects.” https://www.washingtonpost.com/news/speaking-of-science/wp/2017/01/18/researchers-struggle-to-replicate-5-influential-cancer-experiments-from-top-labs/?utm_term=.e9e84eb4f57e

Congressional Budget Office, some 18 million Americans would lose healthcare coverage in the first year if major provisions of the Affordable Care Act were repealed,

says in a front-page article that pressure is mounting on the GOP after a new analysis from the CBO said that “at least 18 million people could lose health insurance in the first year if Congress repeals the Affordable Care Act without” a replacement. Democrats were quick to use the report “to discredit Republican efforts to repeal Obamacare and rally Americans who are insured under the program.” The article highlights comments by a number of lawmakers, both Republican and Democrat, about the repeal and replacement process. http://hosted.ap.org/dynamic/stories/U/US_CONGRESS_HEALTH_OVERHAUL?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2017-01-17-14-24-54

Exercise May Extend Survival in Metastatic Colon Cancer Progression, survival hazards improved with moderate activitiy

Patients who engaged in at least 5 hours of non-vigorous physical activity a week had a 25% reduction in the hazard for survival. With 4 or more hours of weekly activity, the survival hazard improved by 20%. As little as 30 minutes of daily activity reduced the risk of disease progression and death. The findings are particularly noteworthy because the activity level evaluated in the study did not set the bar unrealistically high for patients with metastatic colorectal cancer, Other studies showed that the risk of developing colorectal cancer decreases as physical activity increases. Similar data have been reported for other types of cancer. I do not see where the how/why it helps. http://www.medpagetoday.com/MeetingCoverage/MGICS/62582?xid=nl_mpt_DHE_2017-01-18&eun=g721819d0r&pos=2

Author Blames Nutritionists’ Beliefs Regarding Calories For Rise In Obesity, Diabetes Rates.

op-ed that “to the sugar industry, the nutritionists’ dogmatic belief that obesity is a calorie overconsumption problem and a calorie is a calorie has been the gift that keeps on giving,” even as obesity and diabetes rates are burgeoning. Current scientific consensus “holds that obesity is caused ‘by a lack of energy balance,’ as the National Institutes of Health website explains – in other words, by our taking in more calories than we expend.” According to Taubes, as “long as nutrition and obesity authorities insist that this is true, then the sugar industry can rightfully defend its product on the basis that the calories from sugar are no better nor worse” than other calories. Taubes concluded, “We can’t have it both ways.” https://www.nytimes.com/2017/01/13/opinion/sunday/big-sugars-secret-ally-nutritionists.html?_r=0

CRE Superbug May Be More Widespread In US Hospitals Than Previously Thought, Study Suggests.

reports that carbapenem-resistant Enterobacteriaceae (CRE), a class of “a dangerous type of superbug,” appears to have “more ways to evade antibiotics than have been currently identified, and that these bugs share their tricks readily across the families of bacteria that make up this grouping,” research suggests. What’s more, the new study’s findings “suggest these bacteria may be spreading more stealthily than existing surveillance can detect.” reports a new study suggests that the carbapenem-resistant Enterobacteriaceae (CRE) superbug may be more “widespread in US hospitals than previously thought and needs to be more closely monitored.” HealthDay says, “CDC Director Dr. Tom Frieden has called CRE ‘nightmare bacteria’ due to their resistance to carbapenems, which are last-resort antibiotics used to treat drug-resistant infections.” In the study, “the researchers also discovered that CRE has a wide range of genetic traits that make it resistant to antibiotics and that these traits are easily transferred between various CRE species.” The findings were published in the journal Proceedings of the National Academy of Sciences. https://consumer.healthday.com/infectious-disease-information-21/bacteria-960/superbug-may-be-more-widespread-than-thought-718687.html

Even Though Non-Nutritive Sweeteners May Help In Weight Loss, Animal Studies Raise Concerns About Risks.

provided an overview of research into “non-nutritive sweeteners.” While “controlled trials” indicate they may “sometimes help in weight loss...observational and animal studies raise concerns about their risks.” The article also quoted from the US Dietary Guidelines Advisory Committee’s 2015 report, which concluded, “There is insufficient evidence to recommend the use of low-calorie sweeteners as a strategy for long-term weight loss and weight maintenance.” Because “the long-term effects of low-calorie sweeteners are still uncertain, those sweeteners should not be recommended for use as a primary replacement/substitute for added sugars in foods and beverages.” http://endocrinenews.endocrine.org/sweet-lowdown-artificial-sweeteners-weight-gain/

Wearable Sensors May One Day Help Detect Illnesses, Research Suggests.

“By equipping 60 people with several activity monitors,” investigators “collected close to 2 billion measurements, including heart rate, sleep, fitness, weight, skin temperature and blood oxygen levels.” With this data, “they showed it is possible to identify abnormal changes in a person’s typical vital signs, which could signal a change in their health.” The AP (1/12, Neergaard) reports, for instance, the researchers “detected variations in heart rate patterns that could tell the difference between study participants with...insulin resistance” and healthy individuals. The AP points out that “interest in wearable sensors is growing along with efforts to personalize medicine. http://time.com/4598194/wearable-fitness-tracker-cold-flu/

Rural Americans More Likely To Die From Leading Causes Of Death Than Their Urban Counterparts, Research Indicates.

reports that “among their conclusions,” the investigators “found that in rural areas,” approximately “half of deaths from unintentional injury and chronic lower respiratory disease were potentially excess deaths, compared with about 39 percent and 31 percent in metropolitan areas.” Meanwhile, “rural areas...may have less access to health care and engage in habits that may increase their risk of death, such as not wearing car seat belts, not exercising, smoking cigarettes, and carrying excess weight. that a study from the CDC indicates “rural Americans are more likely to die from heart disease, cancer and the three other leading causes of death than their urban counterparts.” These “five top causes of death – heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke – accounted for 62 percent of the total...deaths in the” US “in 2014.” https://www.washingtonpost.com/news/to-your-health/wp/2017/01/12/rural-americans-more-likely-to-die-from-top-5-causes-of-death/?utm_term=.3a421ca22c5b

Association Of Hypoglycemia With Atherosclerosis Now Extended To Insulin-Treated Patients With Type 2 Diabetes.

These data support that hypoglycemia by itself seem to be a contributing factor for atherosclerosis," Mita and colleagues indicated. The researchers suggest several mechanisms may underlie the atherosclerotic changes associated with hypoglycemic episodes, including changes in blood constituents, inflammation, and coagulation and fibrinolysis that may result from defense responses to hypoglycemia. - See more at: http://www.mdmag.com/medical-news/hypoglycemic-episodes-linked-to-atherosclerosis-in-type-2-diabetes#sthash.qc2cWyLJ.dpuf http://www.mdmag.com/medical-news/hypoglycemic-episodes-linked-to-atherosclerosis-in-type-2-diabetes

U.S. Restaurant Menus for Kids Still Short on Nutrition Voluntary program to boost food quality barely followed

http://www.medpagetoday.com/PrimaryCare/DietNutrition/62445?xid=nl_mpt_DHE_2017-01-13&eun=g721819d0r&pos=9

Anti-TNFs Cut MI Risk in RA A decrease of 39% in risk seen with TNF inhibition

Patients with rheumatoid arthritis who were treated with tumor necrosis factor (TNF) inhibitors had a decreased risk of myocardial infarction (MI) compared with those receiving conventional disease-modifying anti-rheumatic drugs (DMARDs), a large observational study found. The crude incidence rate of first MI was 35 (95% CI 30-40) per 10,000 patient-years among patients receiving TNF inhibitors compared with 56 (95% CI 46-73) among those receiving conventional synthetic DMARDs, according to Kimme L. Hyrich, MD, PhD, of the University of Manchester in England, and colleagues. This risk may be associated with the underlying inflammation, and because TNF inhibition decreases inflammation, the treatment might also influence MI risk. Some earlier studies found a lower risk with anti-TNF treatment, although others found similar risks with conventional DMARD therapy. In addition, most earlier studies addressed only short-term (1 to 2-year) risks. http://www.medpagetoday.com/Rheumatology/Arthritis/62492?xid=nl_mpt_DHE_2017-01-13&eun=g721819d0r&pos=4

Cigna Dropping Coverage Of EpiPen.

reports, “CVS Health said Thursday that it would sell a generic version of an EpiPen competitor for a lower list price in a bid to tap into a groundswell of public resentment over skyrocketing drug costs, including fresh attacks by President-elect Donald Trump.” CVS said it will instead “sell the generic version of Impax Laboratories’ Adrenaclick treatment for $109.99 per two-pack before potential discounts, or about one-third the initial $300 list price of pharmaceutical giant Mylan’s new generic EpiPen.” http://www.usatoday.com/story/money/2017/01/12/cvs-health-mylan-epipen-injector-impax-adrenaclick-donald-trump/96479776/

Organ Transplants In The US Increased Nine Percent Between 2015 And 2016, UNOS Says.

reported that the increase “can be mostly attributed to an expanding number of deceased donors.” Approximately “82% (or 27,628) of the transplants involved organs from deceased donors,” with “the remaining 18% (or 5,978)...performed with organs from living donors.” Last year, “a total of 19,057 kidney transplants occurred, followed by 7,841 liver transplants, 3,191 heart transplants and 2,327 lung transplants.” http://www.cnn.com/2017/01/09/health/organ-donation-2016/

Migraine Tied to Perioperative Stroke Risk 30-day ischemic stroke risk higher for those with migraine with aura

Migraine patients had nearly twice the risk of an ischemic stroke within the first month after surgery than those without the headache disorder, researchers reported. That risk was higher for those who had migraine with aura, but was elevated regardless of whether patients had aura or not (aOR 2.61 and aOR 1.62, respectively), Matthias Eikermann, MD, PhD, of Massachusetts General Hospital (MGH), and colleagues reported online in The BMJ. "There are 60 million surgeries every year, and the baseline stroke risk is one in 1,000," Eikermann told MedPage Today. "If migraine [with aura] increases that risk almost three-fold ... you're talking about thousands of strokes each year. This is a relevant observation that needs to be explored further." Richard Lipton, MD, of Albert Einstein College of Medicine in New York, a migraine specialist who was not involved in the study, called it "well-designed" and suggested that migraineurs needing surgery should not panic about the findings. http://www.medpagetoday.com/Neurology/Strokes/62453?xid=nl_mpt_DHE_2017-01-11&eun=g721819d0r&pos=3

Packing Workouts Into One Or Two Days Per Week May Be As Beneficial As Working Out Every Day, Study Suggests.

reports that the study indicated “the risk of death from all causes was about 30 percent lower for weekend warriors, compared with adults who maintained a sedentary lifestyle.” Meanwhile, weekend “warriors had a 40 percent lower risk of cardiovascular death and an 18 percent lower risk for cancer-related death.” The data also indicated that “the mortality rates of weekend warriors were” approximately “the same as those who claimed to exercise more than two days a week but for shorter durations.” http://www.newsweek.com/weekend-warrior-recommended-daily-exercise-workouts-20-minutes-540467

Enteroviruses May Play Key Role In Triggering T1D, Study Indicates.

reports a study published online in Diabetologia “joins decades of research suggesting that enteroviruses, which include over 100 individual virus types, may play a key role in triggering type 1 diabetes [T1D].” After collecting “stool samples from more than 400 young children to look for enteroviruses,” researchers found that kids “who tested positive for multiple autoantibodies were more likely to have been infected with an enterovirus than children who had a similar genetic risk for diabetes.” Enteroviruses are attracted to “insulin-producing cells in the pancreas.” The study authors “believe the virus establishes a chronic infection in these cells, possibly leading to inflammation and self-attacking antibodies.” http://www.cnn.com/2017/01/09/health/diabetes-type-1-enterovirus-disease-study/index.html

Ebola Can Linger, Perhaps Replicate in Lungs Patient showed virus in lungs 5 days after blood clearance

http://www.medpagetoday.com/InfectiousDisease/Ebola/62398?xid=nl_mpt_DHE_2017-01-09&eun=g721819d0r&pos=4

This Year’s Flu Season Is Worse Than Last, CDC Says.

reported that New York City and New Jersey in particular “are being hit hard compared to other areas.” Oregon “is also seeing a high level of flu symptoms, said federal epidemiologist Lynnette Brammer.” Brammer “said while it’s too early to tell if the annual flu vaccine is effective, it closely matches the strains of flu commonly in circulation, which suggests it will be effective.” http://www.usatoday.com/story/news/nation/2017/01/06/flu-cases-hit-us-coastal-cities-hard-particularly-nyc/96249856/

Black Americans Underrepresented In Diabetes Drug Safety Trials, Research Suggests.

published in The Lancet Diabetes and Endocrinology suggested that black patients “may be far less likely to be included in drug safety trials,” despite the fact that diabetes is almost twice as prevalent in black Americans as in white Americans. Researchers pointed out that black people constituted less than five percent of participants in seven diabetes drug safety trials. According to Reuters, “about 13 percent of black people in the U.S. have diabetes, compared with 7.6 percent of white Americans.” http://www.reuters.com/article/us-health-race-diabetes-trials-idUSKBN14Q2FZ

Mouse Study Explores Whether Delaying Breast Growth May Be Helpful In Reducing Diabetes Risk.

http://www.medicaldaily.com/delaying-early-breast-development-and-other-ways-lower-type-2-diabetes-risk-407891 “scientists explore whether delaying breast growth may be helpful in reducing the risk of” diabetes. The study “revealed a way to stop the premature growth of breasts without having to stop puberty altogether.” Working with mice, researchers identified “an immune molecule named ACKR2” that “prevents...macrophages from moving into the breasts until the female is old enough.” The study authors “hope that the identification of this molecule could help them predict which young children will enter puberty early, and then slow down the process.”

Changing the Paradigm on Obesity New AACE/ACE statement shifts focus from weight to adiposity

http://www.medpagetoday.com/Blogs/LifestyleMedicine/62368?xid=nl_mpt_DHE_2017-01-06&eun=g721819d0r&pos=1

NIH Panel Recommends Early Peanut Introduction for High-Risk Infants Babies as young as 4 months can be exposed to peanuts

Early peanut introduction was shown to dramatically reduce the risk for allergic sensitization in high-risk infants in the landmark LEAP trial. The new guidelines are largely based on findings from the 2015 study, which showed early introduction of peanut protein to be associated with an 81% reduction in peanut allergy among high-risk children. Infants with severe eczema, egg allergy, or both are considered to have a high risk for peanut and other food allergies. The revised guidelines recommend that parents or caregivers introduce peanut-containing foods as early as 4-6 months to high-risk babies who have already started solid foods, after evaluation by the baby's healthcare provider or a specialist. The expert panel recommended that evaluation with peanut-specific IgE measurement, skin prick testing, or both be "strongly considered before the introduction of peanut to determine if peanut should be introduced and, if so, the preferred method of introduction." "To minimize a delay in peanut introduction for children who may test negative, testing for peanut-specific IgE may be the preferred initial approach in certain healthcare settings, such as family medicine, pediatrics, or dermatology practices, in which skin prick http://www.medpagetoday.com/AllergyImmunology/Allergy/62357?xid=nl_mpt_DHE_2017-01-06&eun=g721819d0r&pos=4

Creatine: Should Adolescents Be Taking It?

http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/62342?xid=nl_mpt_DHE_2017-01-05&eun=g721819d0r&pos=4

US News Ranks “Best Diets” For 2017.

“Press Room” blog reports the release its rankings of this year’s “Best Diets.” The blog reports that “for the seventh year in a row, the DASH diet has been rated Best Diet Overall, followed by the Mediterranean diet, up from fourth place last year.” The “MIND diet, second last year, comes in third, and is followed by a four-way tie for fourth place: the Flexitarian diet, Mayo Clinic Diet, the TLC diet and Weight Watchers.” “Picture of Health” blog reports the “DASH diet” was “created to help reverse high blood pressure without medication, but has since been lauded for being a healthy eating plan for anyone.” The diet “includes fruits, vegetables, low fat or no fat dairy, whole grains, lean meats, fish, poultry, nuts and beans.” http://www.usnews.com/info/blogs/press-room/articles/2017-01-04/us-news-reveals-best-diets-rankings-for-2017

Type 1 And Type 2 Diabetes Associated With Increased Incidences Of Conjunctivitis And Antimicrobial Prescriptions, Research Suggests.

reports, “Type 1 and type 2 diabetes are associated with increased incidences of conjunctivitis and antimicrobial prescriptions, but hyperglycemia does not appear to be associated with ocular infections,” researchers found after analyzing data on “incident eye infections in 48,584 adults with diabetes (3,273 with type 1 diabetes) and 938,440 adults without diabetes.” The findings (pdf) were published online in Diabetes Care. http://www.healio.com/endocrinology/diabetes/news/in-the-journals/%7Bf92e0e9e-9bf3-4ce4-b7ca-cbabe362f56a%7D/diabetes-status-not-glycemic-control-associated-with-conjunctivitis-incidence “The higher incidence of conjunctivitis and prescriptions for ocular antimicrobial agents in people with diabetes may be explained in part by an increased propensity in this population to consult a doctor and to receive prescriptions,” the researchers wrote. “Even given this possibility, these data support the hypothesis that conjunctivitis is more common in people with diabetes; however, hyperglycemia does not appear to be a major predisposing factor to ocular infections.” – by Regina Schaffer

Exercise Nonresponders” May Benefit From Changing Exercise Routines, Study Suggests.

reports so-called “nonresponders” may benefit from “switching to another” exercise routine, according to a study published in PLOS One. The article explains that past research has found that nonresponders do not benefit from certain exercise routines, but researchers found in the new study that nonresponders may benefit from different exercise routines. The study suggests that if a person is not benefiting from an exercise routine, then switching to another one may be beneficial. http://www.nytimes.com/2017/01/03/well/move/is-your-workout-not-working-maybe-youre-a-non-responder.html The studies showed that, on aggregate, endurance training increased people’s endurance. But when the researchers examined individual outcomes, the variations were staggering. Some people had improved their endurance by as much as 100 percent, while others had actually become less fit, even though they were following the same workout routine. Age, sex and ethnicity had not mattered, the researchers noted. Young people and old had been outliers, as had women and men, black volunteers and white. Interestingly, nonresponse to endurance training ran in families, the researchers discovered, suggesting that genetics probably plays a significant role in how people’s bodies react to exercise. About a third of the people had failed to show much if any improvement in one of the measures of fitness after three weeks of endurance training. Similarly, about a third had not improved their fitness much with interval training. And after each type of workout, some participants were found to be in worse shape. Those who had shown little response to endurance training generally showed a robust improvement after the interval sessions, and vice versa. The question is how to determine which form of exercise best fits you. The answer, Dr. Gurd says, is simple trial and error. Before beginning a new exercise routine, he says, measure your fitness. You can do this by briskly walking up several flights of stairs or quickly stepping onto and off a box three or four times. Then check your pulse. This is your baseline number. Now start working out. Walk. Jog. Attend interval training or spin classes. After about a month, Dr. Gurd says, repeat the stair or step test. Your pulse rate should be slower now. Your workout sessions should also be feeling easier. If not, you may be a nonresponder to your current exercise routine. In that case, switch things up, Dr. Gurd recommends. If you have primarily been walking, maybe try sprinting up a few flights of stairs and walking back down, which is a simple form of interval training.

Researchers Discover Possible Molecular Mechanism Responsible For Premenstrual Dysphoric Disorder.

reports researchers at the National Institutes of Health have discovered the “molecular mechanisms that could be responsible for symptoms of a severe form of premenstrual syndrome,” Premenstrual dysphoric disorder (PMDD). They found that “turning off estrogen and progesterone in test subjects made the symptoms [of PMDD] disappear,” suggesting that that PMDD occurs with cellular response to the hormones. Researchers hope a concrete biological cause for the disorder can open the door to improved treatment. http://www.usatoday.com/story/news/2017/01/03/report-discovery-could-mean-hope-better-pms-treatment/96138814/

Pre-Eclampsia Linked To Retinal Problems Later In Life, Study Suggests.

reports pre-eclampsia has been tied to eye problems for women “later in life,” according to a new study published in Obstetrics and Gynecology. Researchers found that women with pre-eclampsia during pregnancy were 1.6 times more likely to suffer from retinal detachment, and almost twice as likely to suffer from other retinal diseases, later in life, when compared to women who were pregnant without pre-eclampsia. http://www.nytimes.com/2017/01/03/well/family/pregnancy-complication-tied-to-eye-problems-later-in-life.html?_r=0

Studies Examine Role Thyroid Disease Plays In Miscarriages.

In a piece focusing on miscarriages in women with thyroid problems, Fox News (1/3) reports on its website that “women with hypothyroidism who took thyroid hormone replacement therapy and who had thyroid-stimulating hormone (TSH) levels of about 2.5mU/L in early pregnancy had an increased risk of miscarriage, according to” findings published in the Journal of Clinical Endocrinology & Metabolism. The piece adds, “Autoimmune thyroid disease, which is the most common autoimmune disorder in women of childbearing age and affects between 5 to 15 percent of women...can also be a cause of miscarriage,” research published in the Journal of Obstetrics and Gynecology found. http://www.foxnews.com/health/2017/01/03/thyroid-problems-may-be-to-blame-for-miscarriages-experts-warn.html

Diet Rich In Magnesium May Help Reduce Risk Of Heart Disease, Diabetes, Research Review Suggests.

reported that a “research review” published online in BMC Medicine suggests “a diet rich in magnesium...may help lower the risk of chronic health problems like heart disease and diabetes.” Investigators “analyzed data on dietary magnesium and chronic disease from 40 studies published from 1999 to 2016 on more than one million people.” The data indicated that “compared with people who had the lowest levels of magnesium in their diets, people who got the most magnesium were 10 percent less likely to develop heart disease, 12 percent less likely to have a stroke and 26 percent less likely to develop diabetes.” http://www.reuters.com/article/us-health-diet-magnesium-idUSKBN14J1DG

How Parental Obesity Affects Children's Development Study takes first look at effect of father's obesity

Maternal and paternal obesity are each linked to specific delays in early childhood development among both singletons and twins, according to a study published online in Pediatrics. Maternal obesity (body mass index [BMI] of 30 or more) was associated with delays in fine motor development (aOR 1.67; 95% CI 1.12 to 2.47), compared with normal or underweight mothers (BMI <25), even after adjusting for paternal BMI (aOR 1.67; 95% CI 1.11 to 2.52). Conversely, paternal obesity was linked to an increased risk of "failing the personal-social domain" (i.e., not achieving the skills necessary for emotional and social competence; aOR 1.75, 95% CI 1.13 to 2.71) compared with children of normal-weight fathers, although the association was attenuated after adjusting for maternal obesity (aOR 1.71, 95% CI 1.08 to 2.70), concluded Edwina H. Yeung, PhD, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and colleagues. Additionally, children whose father and mother were obese (both parents with BMI ≥35) took longer to develop problem-solving skills (aOR 2.93, 95% CI 1.09 to 7.85). http://www.medpagetoday.com/Pediatrics/Obesity/62318?xid=nl_mpt_DHE_2017-01-03&eun=g721819d0r&pos=1