Current News in Medicine

Tuesday, October 27, 2015

Is the CDC Right on Pneumococcal Vax Recs?

Last year, the CDC made a substantial change in its pneumococcal vaccine recommendations for older adults: rather than recommending a single dose of the pneumococcal polysaccharide 23 (PPSV23), they began recommending both the pneumococcal conjugate vaccine (PCV13) followed 12 months later by PPSV23. At first blush, the new recommendations struck us as complex, but they seemed logical. Who wouldn't support a new vaccine that could reduce the burden of a very serious condition among older adults? We were particularly compelled because PPSV23, although proven to be effective in younger patients, is less well tested in the elderly. But upon closer inspection, we began to have doubts about the wisdom of the new guidelines -- which we have outlined in detail in a viewpoint published this week inJAMA Internal Medicine. Our biggest concern is that the benefits that were demonstrated in the only randomized controlled trial of PCV13, called the CAPiTA trial are likely not applicable in the U.S. http://www.medpagetoday.com/Blogs/SlowMedicine/54307?xid=nl_mpt_DHE_2015-10-27&eun=g721819d0r

Meat Is Linked to Higher Cancer Risk, W.H.O. Report Finds

http://www.nytimes.com/2015/10/27/health/report-links-some-types-of-cancer-with-processed-or-red-meat.html?_r=0

Monday, October 26, 2015

Do Gut Bugs Put the Brakes on Myelination?

Microbe-free mice have hypermyelination of the prefrontal cortex. Gut bacteria may play a role in regulating myelination in the prefrontal cortex (PFC), researchers reported here. Microbe-free mice had greater expression of myelin-related genes and hypermyelination in the PFC compared with control animals, Alan Hoban, PhD, of University College Cork in Ireland, and colleagues presented at a poster session at the Society for Neuroscience meeting here. Advertisement "These animals have no microbiota, so it could be that a lack of signals from the gut aren't check-pointing oligodendrocytes, since we saw with the hypermyelinated fibers was they had so many more wraps of myelin," Hoban told MedPage Today. "That means the oligodendrocytes may be excessively turning, and whatever is missing from the gut signaling to the brain is not telling them to stop -- but that's a very broad interpretation," he cautioned. http://www.medpagetoday.com/MeetingCoverage/SFN/54276?xid=nl_mpt_DHE_2015-10-26&eun=g721819d0r

Nursing Groups, Some Safety Experts Say Inadequate Nurse Staffing Is A Widespread Problem In US Hospitals.

“Nursing groups and some safety experts say inadequate nurse staffing is a widespread problem in US hospitals,” contending that inadequate staffing is “a key factor in poor quality of care, higher rates of readmission, infection and mortality, lower patient satisfaction and staff burnout.” Some even call for “state and federal legislation...to address the issue.” Modern Healthcare focused on a particular case of a “large pressure ulcer” found last March on a patient at the Hazard ARH Regional Medical Center in Kentucky. A “federal investigation” revealed that the patient had not been moved and turned adequately over a period of days because “the hospital...was understaffed.” As a result, the CMS “placed Hazard ARH in ‘immediate jeopardy’ of losing Medicare funding due to failure to provide adequate staffing.” http://www.modernhealthcare.com/article/20151024/MAGAZINE/310249979/got-enough-nurses-nurse-groups-cite-kentucky-case-to-support-push

Approximately Half Of All Surgeries May Involve Some Type Of Medication Error Or Unintended Drug Side Effects, Research Suggests.

reports that approximately “half of all surgeries involve some kind of medication error or unintended drug side effects, if” research performed “at one of America’s most prestigious academic medical centers is any indication.” This “rate, calculated by researchers from the anesthesiology department at Massachusetts General Hospital who observed 277 procedures there, is startlingly high compared with those in the few earlier studies.” The findings were published in Anesthesiology. http://www.bloomberg.com/news/articles/2015-10-25/health-medication-errors-happen-in-half-of-all-surgeries