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Lucas Franki is an associate editor for MDedge News, and has been with the company since 2014. He has a BA in English from Penn State University and is an Eagle Scout.
Only 1.5% of individuals at high risk of opioid overdose receive naloxone
The vast majority of individuals at high risk for opioid overdose do not receive naloxone, despite numerous opportunities, according to Sarah Follman and associates from the University of Chicago.
In a retrospective study published in JAMA Network Open, the study authors analyzed data from individuals in the Truven Health MarketScan Research Database who had ICD-10 codes related to opioid use, misuse, dependence, and overdose. Data from Oct. 1, 2015, through Dec. 31, 2016, were included; a total of 138,108 high-risk individuals were identified as interacting with the health care system nearly 1.2 million times (88,618 hospitalizations, 229,680 ED visits, 298,058 internal medicine visits, and 568,448 family practice visits).
Of the 138,108 individuals in the study, only 2,135 (1.5%) were prescribed naloxone during the study period. Patients who had prior diagnoses of both opioid misuse/dependence and overdose were significantly more likely to receive naloxone than were those who only had a history of opioid dependence (odds ratio, 2.32; 95% confidence interval, 1.98-2.72; P less than .001). In addition, having a history of overdose alone was associated with a decreased chance of receiving naloxone, compared with those with a history of opioid misuse alone (OR, 0.73; 95% CI, 0.57-0.94; P = .01).
Other factors that significantly reduced the odds of receiving naloxone included being aged 30-44 years and being from the Midwest or West. Factors that reduced the odds include having received treatment for opioid use disorder, visiting a detoxification facility, receiving other substance use disorder treatment; and having received outpatient care from a pain specialist, psychologist, or surgeon.
“Most individuals at high risk of opioid overdose do not receive naloxone through direct prescribing,” Ms. Follman and associates wrote. “Clinicians can address this gap by regularly prescribing naloxone to eligible patients. To address barriers to prescribing, hospital systems and medical schools can support clinicians by improving education on screening and treating substance use disorders, clarifying legal concerns, and developing policies and protocols to guide implementation of increased prescribing.
No conflicts of interest were reported; one coauthor reported receiving a grant from the National Institutes of Health.
SOURCE: Follman S et al. JAMA Netw Open. 2019 May 3. doi: 10.1001/jamanetworkopen.2019.3209.
The vast majority of individuals at high risk for opioid overdose do not receive naloxone, despite numerous opportunities, according to Sarah Follman and associates from the University of Chicago.
In a retrospective study published in JAMA Network Open, the study authors analyzed data from individuals in the Truven Health MarketScan Research Database who had ICD-10 codes related to opioid use, misuse, dependence, and overdose. Data from Oct. 1, 2015, through Dec. 31, 2016, were included; a total of 138,108 high-risk individuals were identified as interacting with the health care system nearly 1.2 million times (88,618 hospitalizations, 229,680 ED visits, 298,058 internal medicine visits, and 568,448 family practice visits).
Of the 138,108 individuals in the study, only 2,135 (1.5%) were prescribed naloxone during the study period. Patients who had prior diagnoses of both opioid misuse/dependence and overdose were significantly more likely to receive naloxone than were those who only had a history of opioid dependence (odds ratio, 2.32; 95% confidence interval, 1.98-2.72; P less than .001). In addition, having a history of overdose alone was associated with a decreased chance of receiving naloxone, compared with those with a history of opioid misuse alone (OR, 0.73; 95% CI, 0.57-0.94; P = .01).
Other factors that significantly reduced the odds of receiving naloxone included being aged 30-44 years and being from the Midwest or West. Factors that reduced the odds include having received treatment for opioid use disorder, visiting a detoxification facility, receiving other substance use disorder treatment; and having received outpatient care from a pain specialist, psychologist, or surgeon.
“Most individuals at high risk of opioid overdose do not receive naloxone through direct prescribing,” Ms. Follman and associates wrote. “Clinicians can address this gap by regularly prescribing naloxone to eligible patients. To address barriers to prescribing, hospital systems and medical schools can support clinicians by improving education on screening and treating substance use disorders, clarifying legal concerns, and developing policies and protocols to guide implementation of increased prescribing.
No conflicts of interest were reported; one coauthor reported receiving a grant from the National Institutes of Health.
SOURCE: Follman S et al. JAMA Netw Open. 2019 May 3. doi: 10.1001/jamanetworkopen.2019.3209.
The vast majority of individuals at high risk for opioid overdose do not receive naloxone, despite numerous opportunities, according to Sarah Follman and associates from the University of Chicago.
In a retrospective study published in JAMA Network Open, the study authors analyzed data from individuals in the Truven Health MarketScan Research Database who had ICD-10 codes related to opioid use, misuse, dependence, and overdose. Data from Oct. 1, 2015, through Dec. 31, 2016, were included; a total of 138,108 high-risk individuals were identified as interacting with the health care system nearly 1.2 million times (88,618 hospitalizations, 229,680 ED visits, 298,058 internal medicine visits, and 568,448 family practice visits).
Of the 138,108 individuals in the study, only 2,135 (1.5%) were prescribed naloxone during the study period. Patients who had prior diagnoses of both opioid misuse/dependence and overdose were significantly more likely to receive naloxone than were those who only had a history of opioid dependence (odds ratio, 2.32; 95% confidence interval, 1.98-2.72; P less than .001). In addition, having a history of overdose alone was associated with a decreased chance of receiving naloxone, compared with those with a history of opioid misuse alone (OR, 0.73; 95% CI, 0.57-0.94; P = .01).
Other factors that significantly reduced the odds of receiving naloxone included being aged 30-44 years and being from the Midwest or West. Factors that reduced the odds include having received treatment for opioid use disorder, visiting a detoxification facility, receiving other substance use disorder treatment; and having received outpatient care from a pain specialist, psychologist, or surgeon.
“Most individuals at high risk of opioid overdose do not receive naloxone through direct prescribing,” Ms. Follman and associates wrote. “Clinicians can address this gap by regularly prescribing naloxone to eligible patients. To address barriers to prescribing, hospital systems and medical schools can support clinicians by improving education on screening and treating substance use disorders, clarifying legal concerns, and developing policies and protocols to guide implementation of increased prescribing.
No conflicts of interest were reported; one coauthor reported receiving a grant from the National Institutes of Health.
SOURCE: Follman S et al. JAMA Netw Open. 2019 May 3. doi: 10.1001/jamanetworkopen.2019.3209.
FROM JAMA NETWORK OPEN
Empty words, Captain Bacteria, and the perils of vampire facials
And now, 37 words from our sponsor
If you’re looking for gluten-free news of the health and medical sciences that’s low in sugar, we here at LOTME Farms promise to use no artificial colors or flavors to tell you about a study of the health claims on cereal boxes.
Researchers identified 37 such claims that appeared on the boxes of 460 different breakfast cereals and grouped them into four categories: adding positives (high fiber, probiotics), not adding negatives (GMO free, no high-fructose corn syrup), removing negatives (low cholesterol, no trans fat), and not removing positives (made with whole grains, fresh).
What they found is that words matter: None of the 37 claims explicitly said that the product inside would make people healthier or help them lose weight, but that was how respondents interpreted them. There is, of course, a reason none of the products claimed to improve health. “The correlation between the type of ‘healthy’ claim made and the actual nutritional quality of the breakfast cereal was almost zero,” investigator Pierre Chandon said.
This is, perhaps, not such a surprise. But we here at the pure, all-natural LOTME deal with facts, which are low in calories and contain no artificial growth hormones, and we would never insult (NEW LOTME LIGHT! NO ARTIFICIAL SWEETENERS!) our wholesome, low-fat readers by resorting (TRY FRESH LOTME ORGANIC!) to hyperbole or doublespeak. Not a chance (MMM … HOMEMADE LOTME).
Now, who’s up for a bowl of Froot Loops?
Captain Bacteria: Civil War
In the never-ending struggle of bacteria versus the world, Clostridium difficile has become a particularly stubborn foe. It is far more likely to be resistant to antibiotics, and the antibiotics that can do the job are either incredibly expensive or destroy the patient’s entire microbiota. However, we may have a new ally in the fight against C. diff: other bacteria.
Specifically, we’re talking about fecal transplants. According to an article published in the Journal of the American Osteopathic Association, the wide variety of bacteria that get transferred into the body along with the poop can block C. diff’s ability to germinate and produce the toxins that affect the human body. The treatment is especially beneficial for patients with C. diff whose microbiotas have been compromised by some other treatment, like chemotherapy, antibiotics, or proton pump inhibitors.
We here at LOTME would like to take a moment to salute the brave bacteria in our guts, fighting the good fight against those who would do us harm, and to the fecal transplants that let our own bacteria join the battle. Poop, you never let us down!
Dracula side effects
The Kim Kardashian effect is having dire ramifications. Back in 2013, the social media influencer posted a photo of herself getting a “vampire facial” – a dermatologic procedure in which a person’s own blood is injected into their face as a way to freshen and rejuvenate their skin. At least they aren’t drinking it.
Vampire facials have skyrocketed in popularity since, despite the ick factor. Unfortunately, it seems to be as dangerous as an encounter with a real vampire: Recently, two people in New Mexico were diagnosed with HIV after getting vampire facials.
The New Mexico Department of Health noted that both cases have been traced to the same spa, which was shut down in 2018 after at least three government agencies noted its lack of attention to hygiene and cleanliness. Warning to all: Just because a Kardashian does it doesn’t mean you should, too.
Shave that beard, Fido
The adage “a dog’s mouth is cleaner than a person’s” is getting an upgrade and this time it’s backed by science. A clinic in Zurich looked at the pathogenic microorganisms that reside in men’s beards and dogs’ fur and guess what – the beards were dirtier.
Despite beards’ manly cache among Millennials and hipsters, the results many have some reaching for the razor. The clinicians took a look at the bacterial load of colony-forming units of human-pathogenic microorganisms, and compared samples of beards and dog’s necks (since dogs don’t have beards, but how cute would that be?). They found high microbial counts in all beard samples, but only 23 of 30 dogs’ hair samples. Half of the human subjects carried so much bacteria that they were in danger of illness, the researchers noted.
Does this mean men are dirty? Or are dogs clean? The clinicians didn’t survey the men on their habits so it could be likely that they spend lots of time rolling around in the grass or drinking water from the toilet. More research is definitely needed here.
And now, 37 words from our sponsor
If you’re looking for gluten-free news of the health and medical sciences that’s low in sugar, we here at LOTME Farms promise to use no artificial colors or flavors to tell you about a study of the health claims on cereal boxes.
Researchers identified 37 such claims that appeared on the boxes of 460 different breakfast cereals and grouped them into four categories: adding positives (high fiber, probiotics), not adding negatives (GMO free, no high-fructose corn syrup), removing negatives (low cholesterol, no trans fat), and not removing positives (made with whole grains, fresh).
What they found is that words matter: None of the 37 claims explicitly said that the product inside would make people healthier or help them lose weight, but that was how respondents interpreted them. There is, of course, a reason none of the products claimed to improve health. “The correlation between the type of ‘healthy’ claim made and the actual nutritional quality of the breakfast cereal was almost zero,” investigator Pierre Chandon said.
This is, perhaps, not such a surprise. But we here at the pure, all-natural LOTME deal with facts, which are low in calories and contain no artificial growth hormones, and we would never insult (NEW LOTME LIGHT! NO ARTIFICIAL SWEETENERS!) our wholesome, low-fat readers by resorting (TRY FRESH LOTME ORGANIC!) to hyperbole or doublespeak. Not a chance (MMM … HOMEMADE LOTME).
Now, who’s up for a bowl of Froot Loops?
Captain Bacteria: Civil War
In the never-ending struggle of bacteria versus the world, Clostridium difficile has become a particularly stubborn foe. It is far more likely to be resistant to antibiotics, and the antibiotics that can do the job are either incredibly expensive or destroy the patient’s entire microbiota. However, we may have a new ally in the fight against C. diff: other bacteria.
Specifically, we’re talking about fecal transplants. According to an article published in the Journal of the American Osteopathic Association, the wide variety of bacteria that get transferred into the body along with the poop can block C. diff’s ability to germinate and produce the toxins that affect the human body. The treatment is especially beneficial for patients with C. diff whose microbiotas have been compromised by some other treatment, like chemotherapy, antibiotics, or proton pump inhibitors.
We here at LOTME would like to take a moment to salute the brave bacteria in our guts, fighting the good fight against those who would do us harm, and to the fecal transplants that let our own bacteria join the battle. Poop, you never let us down!
Dracula side effects
The Kim Kardashian effect is having dire ramifications. Back in 2013, the social media influencer posted a photo of herself getting a “vampire facial” – a dermatologic procedure in which a person’s own blood is injected into their face as a way to freshen and rejuvenate their skin. At least they aren’t drinking it.
Vampire facials have skyrocketed in popularity since, despite the ick factor. Unfortunately, it seems to be as dangerous as an encounter with a real vampire: Recently, two people in New Mexico were diagnosed with HIV after getting vampire facials.
The New Mexico Department of Health noted that both cases have been traced to the same spa, which was shut down in 2018 after at least three government agencies noted its lack of attention to hygiene and cleanliness. Warning to all: Just because a Kardashian does it doesn’t mean you should, too.
Shave that beard, Fido
The adage “a dog’s mouth is cleaner than a person’s” is getting an upgrade and this time it’s backed by science. A clinic in Zurich looked at the pathogenic microorganisms that reside in men’s beards and dogs’ fur and guess what – the beards were dirtier.
Despite beards’ manly cache among Millennials and hipsters, the results many have some reaching for the razor. The clinicians took a look at the bacterial load of colony-forming units of human-pathogenic microorganisms, and compared samples of beards and dog’s necks (since dogs don’t have beards, but how cute would that be?). They found high microbial counts in all beard samples, but only 23 of 30 dogs’ hair samples. Half of the human subjects carried so much bacteria that they were in danger of illness, the researchers noted.
Does this mean men are dirty? Or are dogs clean? The clinicians didn’t survey the men on their habits so it could be likely that they spend lots of time rolling around in the grass or drinking water from the toilet. More research is definitely needed here.
And now, 37 words from our sponsor
If you’re looking for gluten-free news of the health and medical sciences that’s low in sugar, we here at LOTME Farms promise to use no artificial colors or flavors to tell you about a study of the health claims on cereal boxes.
Researchers identified 37 such claims that appeared on the boxes of 460 different breakfast cereals and grouped them into four categories: adding positives (high fiber, probiotics), not adding negatives (GMO free, no high-fructose corn syrup), removing negatives (low cholesterol, no trans fat), and not removing positives (made with whole grains, fresh).
What they found is that words matter: None of the 37 claims explicitly said that the product inside would make people healthier or help them lose weight, but that was how respondents interpreted them. There is, of course, a reason none of the products claimed to improve health. “The correlation between the type of ‘healthy’ claim made and the actual nutritional quality of the breakfast cereal was almost zero,” investigator Pierre Chandon said.
This is, perhaps, not such a surprise. But we here at the pure, all-natural LOTME deal with facts, which are low in calories and contain no artificial growth hormones, and we would never insult (NEW LOTME LIGHT! NO ARTIFICIAL SWEETENERS!) our wholesome, low-fat readers by resorting (TRY FRESH LOTME ORGANIC!) to hyperbole or doublespeak. Not a chance (MMM … HOMEMADE LOTME).
Now, who’s up for a bowl of Froot Loops?
Captain Bacteria: Civil War
In the never-ending struggle of bacteria versus the world, Clostridium difficile has become a particularly stubborn foe. It is far more likely to be resistant to antibiotics, and the antibiotics that can do the job are either incredibly expensive or destroy the patient’s entire microbiota. However, we may have a new ally in the fight against C. diff: other bacteria.
Specifically, we’re talking about fecal transplants. According to an article published in the Journal of the American Osteopathic Association, the wide variety of bacteria that get transferred into the body along with the poop can block C. diff’s ability to germinate and produce the toxins that affect the human body. The treatment is especially beneficial for patients with C. diff whose microbiotas have been compromised by some other treatment, like chemotherapy, antibiotics, or proton pump inhibitors.
We here at LOTME would like to take a moment to salute the brave bacteria in our guts, fighting the good fight against those who would do us harm, and to the fecal transplants that let our own bacteria join the battle. Poop, you never let us down!
Dracula side effects
The Kim Kardashian effect is having dire ramifications. Back in 2013, the social media influencer posted a photo of herself getting a “vampire facial” – a dermatologic procedure in which a person’s own blood is injected into their face as a way to freshen and rejuvenate their skin. At least they aren’t drinking it.
Vampire facials have skyrocketed in popularity since, despite the ick factor. Unfortunately, it seems to be as dangerous as an encounter with a real vampire: Recently, two people in New Mexico were diagnosed with HIV after getting vampire facials.
The New Mexico Department of Health noted that both cases have been traced to the same spa, which was shut down in 2018 after at least three government agencies noted its lack of attention to hygiene and cleanliness. Warning to all: Just because a Kardashian does it doesn’t mean you should, too.
Shave that beard, Fido
The adage “a dog’s mouth is cleaner than a person’s” is getting an upgrade and this time it’s backed by science. A clinic in Zurich looked at the pathogenic microorganisms that reside in men’s beards and dogs’ fur and guess what – the beards were dirtier.
Despite beards’ manly cache among Millennials and hipsters, the results many have some reaching for the razor. The clinicians took a look at the bacterial load of colony-forming units of human-pathogenic microorganisms, and compared samples of beards and dog’s necks (since dogs don’t have beards, but how cute would that be?). They found high microbial counts in all beard samples, but only 23 of 30 dogs’ hair samples. Half of the human subjects carried so much bacteria that they were in danger of illness, the researchers noted.
Does this mean men are dirty? Or are dogs clean? The clinicians didn’t survey the men on their habits so it could be likely that they spend lots of time rolling around in the grass or drinking water from the toilet. More research is definitely needed here.
Patient education material often fails to meet readability standards
Most of the online patient education materials provided by eight nationally recognized ob.gyn. societies are written at levels above the readability guidelines set by the American Medical Association, National Institutes of Health, and Department of Health & Human Services, according to Fatimah Z. Fahimuddin, MD, of the University of California, San Francisco, Fresno, and her associates.
According to the AMA, NIH, and HHS, all patient education material should be written at or below a sixth-grade reading level.
In a study published in Obstetrics & Gynecology, the investigators analyzed the readability of 410 online patient education documents from the American Association of Gynecologic Laparoscopists, the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, the American Urogynecologic Society, the Association of Reproductive Health Professionals, the Society of Gynecologic Oncology, the Society for Maternal-Fetal Medicine, and Voices for Pelvic Floor Disorders.
The mean Flesch-Kincaid Grade Level score was 8.9 for the 69 obstetrics-related documents analyzed; for the 341 gynecology-related documents, the mean score was 8.7. The American Urogynecologic Society had the most readable documents, with a mean grade level score of 6.4; the American Association of Gynecologic Laparoscopists had the least readable, with a mean grade level score of 12.7. For the other three readability scales utilized in the analysis, mean scores generally ranged in the 8th-12th grade reading levels.
“It is not surprising that writing patient education materials at an appropriate reading level is difficult. With readability scales utilizing syllable count, common words such as ‘menstruation,’ ‘uterus,’ and ‘contractions’ will lead to higher readability scores. Thus, higher reading levels in both specialties is seen and expected,” the investigators wrote. Measures such as the addition of glossaries to define words and visuals to illustrate complex procedures would be helpful for reading comprehension and have been used by other medical societies.
The study authors reported no conflicts of interest.
SOURCE: Fahimuddin FZ et al. Obstet Gynecol. 2019;133:888-94.
Most of the online patient education materials provided by eight nationally recognized ob.gyn. societies are written at levels above the readability guidelines set by the American Medical Association, National Institutes of Health, and Department of Health & Human Services, according to Fatimah Z. Fahimuddin, MD, of the University of California, San Francisco, Fresno, and her associates.
According to the AMA, NIH, and HHS, all patient education material should be written at or below a sixth-grade reading level.
In a study published in Obstetrics & Gynecology, the investigators analyzed the readability of 410 online patient education documents from the American Association of Gynecologic Laparoscopists, the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, the American Urogynecologic Society, the Association of Reproductive Health Professionals, the Society of Gynecologic Oncology, the Society for Maternal-Fetal Medicine, and Voices for Pelvic Floor Disorders.
The mean Flesch-Kincaid Grade Level score was 8.9 for the 69 obstetrics-related documents analyzed; for the 341 gynecology-related documents, the mean score was 8.7. The American Urogynecologic Society had the most readable documents, with a mean grade level score of 6.4; the American Association of Gynecologic Laparoscopists had the least readable, with a mean grade level score of 12.7. For the other three readability scales utilized in the analysis, mean scores generally ranged in the 8th-12th grade reading levels.
“It is not surprising that writing patient education materials at an appropriate reading level is difficult. With readability scales utilizing syllable count, common words such as ‘menstruation,’ ‘uterus,’ and ‘contractions’ will lead to higher readability scores. Thus, higher reading levels in both specialties is seen and expected,” the investigators wrote. Measures such as the addition of glossaries to define words and visuals to illustrate complex procedures would be helpful for reading comprehension and have been used by other medical societies.
The study authors reported no conflicts of interest.
SOURCE: Fahimuddin FZ et al. Obstet Gynecol. 2019;133:888-94.
Most of the online patient education materials provided by eight nationally recognized ob.gyn. societies are written at levels above the readability guidelines set by the American Medical Association, National Institutes of Health, and Department of Health & Human Services, according to Fatimah Z. Fahimuddin, MD, of the University of California, San Francisco, Fresno, and her associates.
According to the AMA, NIH, and HHS, all patient education material should be written at or below a sixth-grade reading level.
In a study published in Obstetrics & Gynecology, the investigators analyzed the readability of 410 online patient education documents from the American Association of Gynecologic Laparoscopists, the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, the American Urogynecologic Society, the Association of Reproductive Health Professionals, the Society of Gynecologic Oncology, the Society for Maternal-Fetal Medicine, and Voices for Pelvic Floor Disorders.
The mean Flesch-Kincaid Grade Level score was 8.9 for the 69 obstetrics-related documents analyzed; for the 341 gynecology-related documents, the mean score was 8.7. The American Urogynecologic Society had the most readable documents, with a mean grade level score of 6.4; the American Association of Gynecologic Laparoscopists had the least readable, with a mean grade level score of 12.7. For the other three readability scales utilized in the analysis, mean scores generally ranged in the 8th-12th grade reading levels.
“It is not surprising that writing patient education materials at an appropriate reading level is difficult. With readability scales utilizing syllable count, common words such as ‘menstruation,’ ‘uterus,’ and ‘contractions’ will lead to higher readability scores. Thus, higher reading levels in both specialties is seen and expected,” the investigators wrote. Measures such as the addition of glossaries to define words and visuals to illustrate complex procedures would be helpful for reading comprehension and have been used by other medical societies.
The study authors reported no conflicts of interest.
SOURCE: Fahimuddin FZ et al. Obstet Gynecol. 2019;133:888-94.
FROM OBSTETRICS & GYNECOLOGY
8-week yoga wellness program feasible, beneficial in ob.gyn trainees
A yoga-based wellness program was associated with reductions in blood pressure and measures of depersonalization in a pilot study of ob.gyn. trainees, according to Shilpa Babbar, MD, of Saint Louis University, and associates.
The wellness program consisted of weekly 1-hour yoga classes over an 8-week period as well as weekly physical and nutritional challenges. The 29 people recruited to participate had their blood pressures, heart rates, and weights measured at baseline; they also took the abbreviated Maslach Burnout Inventory, the Depression Anxiety Stress Scale, and the Five Facet Mindfulness Questionnaire. These tests were repeated after the 8-week study period.
Of the 29 people who were recruited, 25 completed the study and 26 attended at least one class. Those who completed the program attended a mean of 3.8 classes, and 68% of participants attended at least half of the classes; no participant attended all classes. Participation in the weekly challenges was slightly less common, with 80% of participants engaging in at least one nutrition challenge and 60% of participants engaging in at least one physical challenge.
After the program had ended, participants had a significant decrease in the depersonalization component of burnout (P = .04), anxiety (P = .02), and systolic (P = .01) and diastolic (P = .01) blood pressures. In addition, those who attended more than 50% of classes had significantly lower systolic and diastolic blood pressures, compared with those who attended less frequently (P = .02 and P = .04, respectively). Participants also expressed increased camaraderie, appreciation, motivation, and overall training experience in a postprogram survey.
“ and overall health care system performance,” the investigators concluded.
One coauthor reported consulting with Health Insights Collaborative; no other conflicts of interest were reported.
SOURCE: Babbar S et al. Obstet Gynecol. 2019 May;133(5):994-1001.
A yoga-based wellness program was associated with reductions in blood pressure and measures of depersonalization in a pilot study of ob.gyn. trainees, according to Shilpa Babbar, MD, of Saint Louis University, and associates.
The wellness program consisted of weekly 1-hour yoga classes over an 8-week period as well as weekly physical and nutritional challenges. The 29 people recruited to participate had their blood pressures, heart rates, and weights measured at baseline; they also took the abbreviated Maslach Burnout Inventory, the Depression Anxiety Stress Scale, and the Five Facet Mindfulness Questionnaire. These tests were repeated after the 8-week study period.
Of the 29 people who were recruited, 25 completed the study and 26 attended at least one class. Those who completed the program attended a mean of 3.8 classes, and 68% of participants attended at least half of the classes; no participant attended all classes. Participation in the weekly challenges was slightly less common, with 80% of participants engaging in at least one nutrition challenge and 60% of participants engaging in at least one physical challenge.
After the program had ended, participants had a significant decrease in the depersonalization component of burnout (P = .04), anxiety (P = .02), and systolic (P = .01) and diastolic (P = .01) blood pressures. In addition, those who attended more than 50% of classes had significantly lower systolic and diastolic blood pressures, compared with those who attended less frequently (P = .02 and P = .04, respectively). Participants also expressed increased camaraderie, appreciation, motivation, and overall training experience in a postprogram survey.
“ and overall health care system performance,” the investigators concluded.
One coauthor reported consulting with Health Insights Collaborative; no other conflicts of interest were reported.
SOURCE: Babbar S et al. Obstet Gynecol. 2019 May;133(5):994-1001.
A yoga-based wellness program was associated with reductions in blood pressure and measures of depersonalization in a pilot study of ob.gyn. trainees, according to Shilpa Babbar, MD, of Saint Louis University, and associates.
The wellness program consisted of weekly 1-hour yoga classes over an 8-week period as well as weekly physical and nutritional challenges. The 29 people recruited to participate had their blood pressures, heart rates, and weights measured at baseline; they also took the abbreviated Maslach Burnout Inventory, the Depression Anxiety Stress Scale, and the Five Facet Mindfulness Questionnaire. These tests were repeated after the 8-week study period.
Of the 29 people who were recruited, 25 completed the study and 26 attended at least one class. Those who completed the program attended a mean of 3.8 classes, and 68% of participants attended at least half of the classes; no participant attended all classes. Participation in the weekly challenges was slightly less common, with 80% of participants engaging in at least one nutrition challenge and 60% of participants engaging in at least one physical challenge.
After the program had ended, participants had a significant decrease in the depersonalization component of burnout (P = .04), anxiety (P = .02), and systolic (P = .01) and diastolic (P = .01) blood pressures. In addition, those who attended more than 50% of classes had significantly lower systolic and diastolic blood pressures, compared with those who attended less frequently (P = .02 and P = .04, respectively). Participants also expressed increased camaraderie, appreciation, motivation, and overall training experience in a postprogram survey.
“ and overall health care system performance,” the investigators concluded.
One coauthor reported consulting with Health Insights Collaborative; no other conflicts of interest were reported.
SOURCE: Babbar S et al. Obstet Gynecol. 2019 May;133(5):994-1001.
FROM OBSTETRICS & GYNECOLOGY
FDA approves new etanercept biosimilar, Eticovo
The Food and Drug Administration has approved Eticovo (etanercept-ykro), a biosimilar of Enbrel (etanercept), for the treatment of several different rheumatologic and dermatologic conditions.
FDA approval was based in part on the results of a phase 3 trial in which 596 patients with moderate to severe rheumatoid arthritis uncontrolled by methotrexate received either Eticovo or Enbrel. The American College of Rheumatology 20% response rate after 24 weeks was 78.1% for Eticovo and 80.3% for Enbrel; the two drugs were statistically equivalent. Both groups had statistically equivalent rates of treatment-emergent adverse events (55.2% vs. 58.2%).
According to the label, Eticovo is a tumor necrosis factor blocker approved for the treatment of rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis in patients aged 4 years or older. The most common adverse events associated with the drug include infections and injection site reactions.
Eticovo is the second etanercept biosimilar approved by the FDA. The first FDA-approved etanercept biosimilar, etanercept-szzs (Erelzi), is currently facing a legal challenge from Amgen, the manufacturer of Enbrel.
The Food and Drug Administration has approved Eticovo (etanercept-ykro), a biosimilar of Enbrel (etanercept), for the treatment of several different rheumatologic and dermatologic conditions.
FDA approval was based in part on the results of a phase 3 trial in which 596 patients with moderate to severe rheumatoid arthritis uncontrolled by methotrexate received either Eticovo or Enbrel. The American College of Rheumatology 20% response rate after 24 weeks was 78.1% for Eticovo and 80.3% for Enbrel; the two drugs were statistically equivalent. Both groups had statistically equivalent rates of treatment-emergent adverse events (55.2% vs. 58.2%).
According to the label, Eticovo is a tumor necrosis factor blocker approved for the treatment of rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis in patients aged 4 years or older. The most common adverse events associated with the drug include infections and injection site reactions.
Eticovo is the second etanercept biosimilar approved by the FDA. The first FDA-approved etanercept biosimilar, etanercept-szzs (Erelzi), is currently facing a legal challenge from Amgen, the manufacturer of Enbrel.
The Food and Drug Administration has approved Eticovo (etanercept-ykro), a biosimilar of Enbrel (etanercept), for the treatment of several different rheumatologic and dermatologic conditions.
FDA approval was based in part on the results of a phase 3 trial in which 596 patients with moderate to severe rheumatoid arthritis uncontrolled by methotrexate received either Eticovo or Enbrel. The American College of Rheumatology 20% response rate after 24 weeks was 78.1% for Eticovo and 80.3% for Enbrel; the two drugs were statistically equivalent. Both groups had statistically equivalent rates of treatment-emergent adverse events (55.2% vs. 58.2%).
According to the label, Eticovo is a tumor necrosis factor blocker approved for the treatment of rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis in patients aged 4 years or older. The most common adverse events associated with the drug include infections and injection site reactions.
Eticovo is the second etanercept biosimilar approved by the FDA. The first FDA-approved etanercept biosimilar, etanercept-szzs (Erelzi), is currently facing a legal challenge from Amgen, the manufacturer of Enbrel.
ICYMI: NIH renames, streamlines gene therapy committee
The National Institutes of Health has released an amended guideline on research involving gene therapy.
As part of the streamlining process, the Recombinant DNA Advisory Committee has been renamed as the Novel and Exceptional Technology and Research Advisory Committee to better align with the committee’s original intention – following and providing advice on safety and ethical issues associated with emerging biotechnologies, according to a statement from Francis S. Collins, MD, PhD, director of the NIH.
We previously covered this story; find our coverage at the link below.
The National Institutes of Health has released an amended guideline on research involving gene therapy.
As part of the streamlining process, the Recombinant DNA Advisory Committee has been renamed as the Novel and Exceptional Technology and Research Advisory Committee to better align with the committee’s original intention – following and providing advice on safety and ethical issues associated with emerging biotechnologies, according to a statement from Francis S. Collins, MD, PhD, director of the NIH.
We previously covered this story; find our coverage at the link below.
The National Institutes of Health has released an amended guideline on research involving gene therapy.
As part of the streamlining process, the Recombinant DNA Advisory Committee has been renamed as the Novel and Exceptional Technology and Research Advisory Committee to better align with the committee’s original intention – following and providing advice on safety and ethical issues associated with emerging biotechnologies, according to a statement from Francis S. Collins, MD, PhD, director of the NIH.
We previously covered this story; find our coverage at the link below.
Gaps exist in rotavirus vaccination coverage in young U.S. children
falling short of the Healthy People 2020 goal of 80% complete vaccination, according to Bethany K. Sederdahl, MPH, and her associates at Emory University, Atlanta.
In an analysis published in Pediatrics of data from 14,571 children included in the 2014 National Immunization Survey, 71% of children received full vaccination for rotavirus, 15% received partial vaccination, and 14% received no vaccination. Children whose mothers were not college graduates, lived in households with at least four children, or were uninsured at any point had an increased likelihood of being unvaccinated; African American children also faced an increased risk of being unvaccinated.
Among the unvaccinated, 72% had at least one missed opportunity according to the Advisory Committee on Immunization Practices schedule, and 83% had at least one missed opportunity according to the World Health Organization schedule. For the partially vaccinated, 54% at least one missed opportunity according to the ACIP schedule, and 96% had at least one missed opportunity according to the WHO schedule. While poorer socioeconomic conditions were associated with the risk of being unvaccinated, children who were partially vaccinated and who missed vaccination opportunities according to the ACIP-recommended schedule were more likely to have mothers with a college degree or an income of more than $75,000.
According to the investigators, if all missed opportunities for vaccination according to the ACIP schedule were addressed, coverage would improve from 71% to 81%; if all opportunities according to the WHO schedule were addressed, coverage would increase to 94%.
“Low rotavirus vaccine uptake may be attributable to both socioeconomic barriers and possibly vaccine hesitancy. Understanding the barriers to rotavirus vaccine uptake and developing effective public health measures to promote vaccine use will be essential to reducing rotavirus morbidity in the United States,” Ms. Sederdahl and her associates wrote.
The study received no external funding. One coauthor reported receiving personal fees from AbbVie, funds to conduct clinical research from Merck, and that his institution receives funds to conduct clinical research from MedImmune, Regeneron, PaxVax, Pfizer, Merck, Novavax, Sanofi Pasteur, and Micron Technology.
SOURCE: Sederdahl BK et al. Pediatrics. 2019 Apr 25. doi: 10.1542/peds.2018-2498.
falling short of the Healthy People 2020 goal of 80% complete vaccination, according to Bethany K. Sederdahl, MPH, and her associates at Emory University, Atlanta.
In an analysis published in Pediatrics of data from 14,571 children included in the 2014 National Immunization Survey, 71% of children received full vaccination for rotavirus, 15% received partial vaccination, and 14% received no vaccination. Children whose mothers were not college graduates, lived in households with at least four children, or were uninsured at any point had an increased likelihood of being unvaccinated; African American children also faced an increased risk of being unvaccinated.
Among the unvaccinated, 72% had at least one missed opportunity according to the Advisory Committee on Immunization Practices schedule, and 83% had at least one missed opportunity according to the World Health Organization schedule. For the partially vaccinated, 54% at least one missed opportunity according to the ACIP schedule, and 96% had at least one missed opportunity according to the WHO schedule. While poorer socioeconomic conditions were associated with the risk of being unvaccinated, children who were partially vaccinated and who missed vaccination opportunities according to the ACIP-recommended schedule were more likely to have mothers with a college degree or an income of more than $75,000.
According to the investigators, if all missed opportunities for vaccination according to the ACIP schedule were addressed, coverage would improve from 71% to 81%; if all opportunities according to the WHO schedule were addressed, coverage would increase to 94%.
“Low rotavirus vaccine uptake may be attributable to both socioeconomic barriers and possibly vaccine hesitancy. Understanding the barriers to rotavirus vaccine uptake and developing effective public health measures to promote vaccine use will be essential to reducing rotavirus morbidity in the United States,” Ms. Sederdahl and her associates wrote.
The study received no external funding. One coauthor reported receiving personal fees from AbbVie, funds to conduct clinical research from Merck, and that his institution receives funds to conduct clinical research from MedImmune, Regeneron, PaxVax, Pfizer, Merck, Novavax, Sanofi Pasteur, and Micron Technology.
SOURCE: Sederdahl BK et al. Pediatrics. 2019 Apr 25. doi: 10.1542/peds.2018-2498.
falling short of the Healthy People 2020 goal of 80% complete vaccination, according to Bethany K. Sederdahl, MPH, and her associates at Emory University, Atlanta.
In an analysis published in Pediatrics of data from 14,571 children included in the 2014 National Immunization Survey, 71% of children received full vaccination for rotavirus, 15% received partial vaccination, and 14% received no vaccination. Children whose mothers were not college graduates, lived in households with at least four children, or were uninsured at any point had an increased likelihood of being unvaccinated; African American children also faced an increased risk of being unvaccinated.
Among the unvaccinated, 72% had at least one missed opportunity according to the Advisory Committee on Immunization Practices schedule, and 83% had at least one missed opportunity according to the World Health Organization schedule. For the partially vaccinated, 54% at least one missed opportunity according to the ACIP schedule, and 96% had at least one missed opportunity according to the WHO schedule. While poorer socioeconomic conditions were associated with the risk of being unvaccinated, children who were partially vaccinated and who missed vaccination opportunities according to the ACIP-recommended schedule were more likely to have mothers with a college degree or an income of more than $75,000.
According to the investigators, if all missed opportunities for vaccination according to the ACIP schedule were addressed, coverage would improve from 71% to 81%; if all opportunities according to the WHO schedule were addressed, coverage would increase to 94%.
“Low rotavirus vaccine uptake may be attributable to both socioeconomic barriers and possibly vaccine hesitancy. Understanding the barriers to rotavirus vaccine uptake and developing effective public health measures to promote vaccine use will be essential to reducing rotavirus morbidity in the United States,” Ms. Sederdahl and her associates wrote.
The study received no external funding. One coauthor reported receiving personal fees from AbbVie, funds to conduct clinical research from Merck, and that his institution receives funds to conduct clinical research from MedImmune, Regeneron, PaxVax, Pfizer, Merck, Novavax, Sanofi Pasteur, and Micron Technology.
SOURCE: Sederdahl BK et al. Pediatrics. 2019 Apr 25. doi: 10.1542/peds.2018-2498.
FROM PEDIATRICS
Texans’ rattler diet, recycled humans, and, ahem, Puber
Endgame for arachnophobia
We think Tony Stark would like this creative solution for spider and ant phobias. Comic book movies have now infiltrated every aspect of culture, including serious scientific research. And let’s be honest – more than one scientist has been inspired to go into their fields by Bruce Banner, Stark, or maybe even Doctor Octopus (no judgment).
A group of (possibly mad) scientists has tested exposure therapy for spider and ant phobias in people by showing participants the Spider-Man and Ant-Man movies. While the viewing material may not be totally scientifically accurate, researchers found that watching seven seconds of Spider-Man 2 or Ant-Man reduced spider and ant phobia by 20%.
The participants were specifically exposed to ants and spiders in the context of the movies, so surprisingly the phobia reduction had nothing to do with Tobey Maguire or Paul Rudd.
Old poop, new discovery
Here at LOTME, we like us some good bathroom humor. And don’t worry, we won’t ever change. In this week’s edition of the Wonderful World of Poop, we take you to Texas, 1,500 years ago. The sky was bigger, the air was fresher, and the humans of the Lower Pecos region were as hardcore as you can get. A recent re-examination of coprolite samples taken from the region found one interesting chunk of poop-rock that contained an entire rattlesnake.
Now, the presence of snake bits in early human poo is not that crazy; people ate (and still eat) snakes. The appearance of a centimeter-long fang, scales, and bones, however, did take the researchers by surprise. Why would someone eat a snake? Was it an ancient way to inoculate against snake venom? Or perhaps crunchy snake fangs were the world’s earliest version of a Cheeto?
In fact, researchers hypothesized that this dietary behavior was not normal for the people of the Lower Pecos, and most likely was more ceremonial. You know, the casual eating-a-full-snake ceremony.
Will Texans embrace this ceremony of their past and start chomping on rattlers? Who’s to say? All we know is that poop is the gift that keeps on giving.
A new way to soil yourself
If you’re reading this, we can say with some certainty that you managed to survive another Tax Day. Congratulations! But there’s still Benjamin Franklin’s other ultimate certainty of life. You know … the big sleep, the last roundup, assume room temperature, buy the farm, shuffle off this mortal coil, give up the ghost, and so on.
What are you going to do about that?
A big question, for sure, so let’s just focus on the earthly remains. A company called Recompose has a new alternative to burial and cremation, something they’ve dubbed “natural organic reduction” and others have described as “human composting” or “accelerated decomposition.” In a pilot project last year at Washington State University in Pullman, the Recompose process transformed the bodies of six donors to soil in 4-7 weeks, AP reported.
The company says that natural organic reduction is much more environmentally friendly than current practices, creating a cubic yard of soil per person, and that “friends and family are welcome to take some (or all) home to grow a tree or a garden.”
A garden sounds nice, or maybe something indoors. Just think of the potted plant possibilities: daisies (to push up), a Venus flytrap (the organic reduction continues), some poison ivy (a gift for people you don’t like), or maybe roses. Who wouldn’t want to come out of death smelling like a rose?
San Francisco vs. illegal dumping
Maybe you’re not quite ready to commit to using human remains as compost to fertilize your garden. Perhaps you want to start off only using human poop as fertilizer, see how that goes before sprinkling Grandma all over your tulips.
Well, if you’re looking for a sweet deal, we’re certain San Francisco can work something out with you because, in the past 7 years, incidence of human feces in public places within the city has quintupled, rising from 5,500 reported cases in 2011 to 28,100 cases in 2018.
The problem, likely related to an increasing homeless population who can’t afford San Francisco’s exorbitant rental prices and have limited access to public restrooms, is so bad that the city commissioned a “Poop Patrol” in the summer of 2018 to wipe down some of the poorer, more suspect neighborhoods.
While the upstanding members of the Poop Patrol are almost certainly doing a fine job, it’s probably safe to say that human fecal clean-up is an industry ripe for disruption.
We look forward to the inevitable Silicon Valley start-up and for the media to hail it as “Uber, but for poop.”
Endgame for arachnophobia
We think Tony Stark would like this creative solution for spider and ant phobias. Comic book movies have now infiltrated every aspect of culture, including serious scientific research. And let’s be honest – more than one scientist has been inspired to go into their fields by Bruce Banner, Stark, or maybe even Doctor Octopus (no judgment).
A group of (possibly mad) scientists has tested exposure therapy for spider and ant phobias in people by showing participants the Spider-Man and Ant-Man movies. While the viewing material may not be totally scientifically accurate, researchers found that watching seven seconds of Spider-Man 2 or Ant-Man reduced spider and ant phobia by 20%.
The participants were specifically exposed to ants and spiders in the context of the movies, so surprisingly the phobia reduction had nothing to do with Tobey Maguire or Paul Rudd.
Old poop, new discovery
Here at LOTME, we like us some good bathroom humor. And don’t worry, we won’t ever change. In this week’s edition of the Wonderful World of Poop, we take you to Texas, 1,500 years ago. The sky was bigger, the air was fresher, and the humans of the Lower Pecos region were as hardcore as you can get. A recent re-examination of coprolite samples taken from the region found one interesting chunk of poop-rock that contained an entire rattlesnake.
Now, the presence of snake bits in early human poo is not that crazy; people ate (and still eat) snakes. The appearance of a centimeter-long fang, scales, and bones, however, did take the researchers by surprise. Why would someone eat a snake? Was it an ancient way to inoculate against snake venom? Or perhaps crunchy snake fangs were the world’s earliest version of a Cheeto?
In fact, researchers hypothesized that this dietary behavior was not normal for the people of the Lower Pecos, and most likely was more ceremonial. You know, the casual eating-a-full-snake ceremony.
Will Texans embrace this ceremony of their past and start chomping on rattlers? Who’s to say? All we know is that poop is the gift that keeps on giving.
A new way to soil yourself
If you’re reading this, we can say with some certainty that you managed to survive another Tax Day. Congratulations! But there’s still Benjamin Franklin’s other ultimate certainty of life. You know … the big sleep, the last roundup, assume room temperature, buy the farm, shuffle off this mortal coil, give up the ghost, and so on.
What are you going to do about that?
A big question, for sure, so let’s just focus on the earthly remains. A company called Recompose has a new alternative to burial and cremation, something they’ve dubbed “natural organic reduction” and others have described as “human composting” or “accelerated decomposition.” In a pilot project last year at Washington State University in Pullman, the Recompose process transformed the bodies of six donors to soil in 4-7 weeks, AP reported.
The company says that natural organic reduction is much more environmentally friendly than current practices, creating a cubic yard of soil per person, and that “friends and family are welcome to take some (or all) home to grow a tree or a garden.”
A garden sounds nice, or maybe something indoors. Just think of the potted plant possibilities: daisies (to push up), a Venus flytrap (the organic reduction continues), some poison ivy (a gift for people you don’t like), or maybe roses. Who wouldn’t want to come out of death smelling like a rose?
San Francisco vs. illegal dumping
Maybe you’re not quite ready to commit to using human remains as compost to fertilize your garden. Perhaps you want to start off only using human poop as fertilizer, see how that goes before sprinkling Grandma all over your tulips.
Well, if you’re looking for a sweet deal, we’re certain San Francisco can work something out with you because, in the past 7 years, incidence of human feces in public places within the city has quintupled, rising from 5,500 reported cases in 2011 to 28,100 cases in 2018.
The problem, likely related to an increasing homeless population who can’t afford San Francisco’s exorbitant rental prices and have limited access to public restrooms, is so bad that the city commissioned a “Poop Patrol” in the summer of 2018 to wipe down some of the poorer, more suspect neighborhoods.
While the upstanding members of the Poop Patrol are almost certainly doing a fine job, it’s probably safe to say that human fecal clean-up is an industry ripe for disruption.
We look forward to the inevitable Silicon Valley start-up and for the media to hail it as “Uber, but for poop.”
Endgame for arachnophobia
We think Tony Stark would like this creative solution for spider and ant phobias. Comic book movies have now infiltrated every aspect of culture, including serious scientific research. And let’s be honest – more than one scientist has been inspired to go into their fields by Bruce Banner, Stark, or maybe even Doctor Octopus (no judgment).
A group of (possibly mad) scientists has tested exposure therapy for spider and ant phobias in people by showing participants the Spider-Man and Ant-Man movies. While the viewing material may not be totally scientifically accurate, researchers found that watching seven seconds of Spider-Man 2 or Ant-Man reduced spider and ant phobia by 20%.
The participants were specifically exposed to ants and spiders in the context of the movies, so surprisingly the phobia reduction had nothing to do with Tobey Maguire or Paul Rudd.
Old poop, new discovery
Here at LOTME, we like us some good bathroom humor. And don’t worry, we won’t ever change. In this week’s edition of the Wonderful World of Poop, we take you to Texas, 1,500 years ago. The sky was bigger, the air was fresher, and the humans of the Lower Pecos region were as hardcore as you can get. A recent re-examination of coprolite samples taken from the region found one interesting chunk of poop-rock that contained an entire rattlesnake.
Now, the presence of snake bits in early human poo is not that crazy; people ate (and still eat) snakes. The appearance of a centimeter-long fang, scales, and bones, however, did take the researchers by surprise. Why would someone eat a snake? Was it an ancient way to inoculate against snake venom? Or perhaps crunchy snake fangs were the world’s earliest version of a Cheeto?
In fact, researchers hypothesized that this dietary behavior was not normal for the people of the Lower Pecos, and most likely was more ceremonial. You know, the casual eating-a-full-snake ceremony.
Will Texans embrace this ceremony of their past and start chomping on rattlers? Who’s to say? All we know is that poop is the gift that keeps on giving.
A new way to soil yourself
If you’re reading this, we can say with some certainty that you managed to survive another Tax Day. Congratulations! But there’s still Benjamin Franklin’s other ultimate certainty of life. You know … the big sleep, the last roundup, assume room temperature, buy the farm, shuffle off this mortal coil, give up the ghost, and so on.
What are you going to do about that?
A big question, for sure, so let’s just focus on the earthly remains. A company called Recompose has a new alternative to burial and cremation, something they’ve dubbed “natural organic reduction” and others have described as “human composting” or “accelerated decomposition.” In a pilot project last year at Washington State University in Pullman, the Recompose process transformed the bodies of six donors to soil in 4-7 weeks, AP reported.
The company says that natural organic reduction is much more environmentally friendly than current practices, creating a cubic yard of soil per person, and that “friends and family are welcome to take some (or all) home to grow a tree or a garden.”
A garden sounds nice, or maybe something indoors. Just think of the potted plant possibilities: daisies (to push up), a Venus flytrap (the organic reduction continues), some poison ivy (a gift for people you don’t like), or maybe roses. Who wouldn’t want to come out of death smelling like a rose?
San Francisco vs. illegal dumping
Maybe you’re not quite ready to commit to using human remains as compost to fertilize your garden. Perhaps you want to start off only using human poop as fertilizer, see how that goes before sprinkling Grandma all over your tulips.
Well, if you’re looking for a sweet deal, we’re certain San Francisco can work something out with you because, in the past 7 years, incidence of human feces in public places within the city has quintupled, rising from 5,500 reported cases in 2011 to 28,100 cases in 2018.
The problem, likely related to an increasing homeless population who can’t afford San Francisco’s exorbitant rental prices and have limited access to public restrooms, is so bad that the city commissioned a “Poop Patrol” in the summer of 2018 to wipe down some of the poorer, more suspect neighborhoods.
While the upstanding members of the Poop Patrol are almost certainly doing a fine job, it’s probably safe to say that human fecal clean-up is an industry ripe for disruption.
We look forward to the inevitable Silicon Valley start-up and for the media to hail it as “Uber, but for poop.”
Soft bedding most common source of accidental suffocation in infants
according to research published in Pediatrics.
Alexa B. Erck Lambert, MPH, of DB Consulting Group in Silver Spring, Md., and her associates conducted an analysis of 1,812 cases of sudden unexpected infant death (SUID) in children aged 1 year or less included in a Centers for Disease Control and Prevention registry. Of those 1,812 SUID cases, 250 (14%) were classified as accidental suffocation.
Airway obstruction by soft bedding was by far the most common mechanism of accidental suffocation, contributing to death in 69% of cases. Overlay was attributed in 19% of cases and wedging was attributed in 12%. The median age for soft bedding, overlay, and wedging death was 3 months, 2 months, and 6 months, respectively. The majority of cases were male (55%), born after at least 37 weeks’ gestation (81%), non-Hispanic white or African American (74%), and insured by Medicaid (70%).
In deaths attributed to soft bedding, 49% occurred while the infant was in an adult bed, 92% occurred while the infant was in a nonsupine position, and 34% occurred while a blanket was obstructing the airway. While infants aged 5-11 months were twice as likely to have had a blanket obstructing their airway as infants aged 0-4 months (55% vs. 27%), younger infants were twice as likely to have had a pillow or couch cushion obstructing their airway (25% vs. 11%).
Of the 51 overlay deaths, 71% occurred in an adult’s bed, 51% were found nonsupine, and 41% were found in a bed with more than one adult. Most deaths were attributed to neck or chest compression, rather than nose or mouth obstruction. Of the 33 wedging deaths, 45% were sharing a sleep surface and 73% were in an adult bed; the most common objects the infant was wedged between were a mattress and wall.
“The safest place for infants to sleep is on their backs, on an unshared sleep surface, in a crib or bassinet in the caregivers’ room, and without soft bedding in their sleep area,” the investigators wrote. “Improving our understanding of the characteristics and risk factors ... of suffocation deaths by mechanism of airway obstruction can inform the development of more targeted strategies to prevent these injuries and deaths.”
The authors reported no potential conflicts of interest. Ms. Erck Lambert was supported by a contract her employer and the Centers for Disease Control and Prevention. Meghan Faulkner’s agency also received funds from the Centers for Disease Control and Prevention.
SOURCE: Erck Lambert AB et al. Pediatrics. 2019 Apr 22. doi: 10.1542/peds.2018-3408.
according to research published in Pediatrics.
Alexa B. Erck Lambert, MPH, of DB Consulting Group in Silver Spring, Md., and her associates conducted an analysis of 1,812 cases of sudden unexpected infant death (SUID) in children aged 1 year or less included in a Centers for Disease Control and Prevention registry. Of those 1,812 SUID cases, 250 (14%) were classified as accidental suffocation.
Airway obstruction by soft bedding was by far the most common mechanism of accidental suffocation, contributing to death in 69% of cases. Overlay was attributed in 19% of cases and wedging was attributed in 12%. The median age for soft bedding, overlay, and wedging death was 3 months, 2 months, and 6 months, respectively. The majority of cases were male (55%), born after at least 37 weeks’ gestation (81%), non-Hispanic white or African American (74%), and insured by Medicaid (70%).
In deaths attributed to soft bedding, 49% occurred while the infant was in an adult bed, 92% occurred while the infant was in a nonsupine position, and 34% occurred while a blanket was obstructing the airway. While infants aged 5-11 months were twice as likely to have had a blanket obstructing their airway as infants aged 0-4 months (55% vs. 27%), younger infants were twice as likely to have had a pillow or couch cushion obstructing their airway (25% vs. 11%).
Of the 51 overlay deaths, 71% occurred in an adult’s bed, 51% were found nonsupine, and 41% were found in a bed with more than one adult. Most deaths were attributed to neck or chest compression, rather than nose or mouth obstruction. Of the 33 wedging deaths, 45% were sharing a sleep surface and 73% were in an adult bed; the most common objects the infant was wedged between were a mattress and wall.
“The safest place for infants to sleep is on their backs, on an unshared sleep surface, in a crib or bassinet in the caregivers’ room, and without soft bedding in their sleep area,” the investigators wrote. “Improving our understanding of the characteristics and risk factors ... of suffocation deaths by mechanism of airway obstruction can inform the development of more targeted strategies to prevent these injuries and deaths.”
The authors reported no potential conflicts of interest. Ms. Erck Lambert was supported by a contract her employer and the Centers for Disease Control and Prevention. Meghan Faulkner’s agency also received funds from the Centers for Disease Control and Prevention.
SOURCE: Erck Lambert AB et al. Pediatrics. 2019 Apr 22. doi: 10.1542/peds.2018-3408.
according to research published in Pediatrics.
Alexa B. Erck Lambert, MPH, of DB Consulting Group in Silver Spring, Md., and her associates conducted an analysis of 1,812 cases of sudden unexpected infant death (SUID) in children aged 1 year or less included in a Centers for Disease Control and Prevention registry. Of those 1,812 SUID cases, 250 (14%) were classified as accidental suffocation.
Airway obstruction by soft bedding was by far the most common mechanism of accidental suffocation, contributing to death in 69% of cases. Overlay was attributed in 19% of cases and wedging was attributed in 12%. The median age for soft bedding, overlay, and wedging death was 3 months, 2 months, and 6 months, respectively. The majority of cases were male (55%), born after at least 37 weeks’ gestation (81%), non-Hispanic white or African American (74%), and insured by Medicaid (70%).
In deaths attributed to soft bedding, 49% occurred while the infant was in an adult bed, 92% occurred while the infant was in a nonsupine position, and 34% occurred while a blanket was obstructing the airway. While infants aged 5-11 months were twice as likely to have had a blanket obstructing their airway as infants aged 0-4 months (55% vs. 27%), younger infants were twice as likely to have had a pillow or couch cushion obstructing their airway (25% vs. 11%).
Of the 51 overlay deaths, 71% occurred in an adult’s bed, 51% were found nonsupine, and 41% were found in a bed with more than one adult. Most deaths were attributed to neck or chest compression, rather than nose or mouth obstruction. Of the 33 wedging deaths, 45% were sharing a sleep surface and 73% were in an adult bed; the most common objects the infant was wedged between were a mattress and wall.
“The safest place for infants to sleep is on their backs, on an unshared sleep surface, in a crib or bassinet in the caregivers’ room, and without soft bedding in their sleep area,” the investigators wrote. “Improving our understanding of the characteristics and risk factors ... of suffocation deaths by mechanism of airway obstruction can inform the development of more targeted strategies to prevent these injuries and deaths.”
The authors reported no potential conflicts of interest. Ms. Erck Lambert was supported by a contract her employer and the Centers for Disease Control and Prevention. Meghan Faulkner’s agency also received funds from the Centers for Disease Control and Prevention.
SOURCE: Erck Lambert AB et al. Pediatrics. 2019 Apr 22. doi: 10.1542/peds.2018-3408.
FROM PEDIATRICS
Ixekizumab posts positive results in phase 3 nr-axSpA trial
Eli Lilly has announced positive results from COAST-X, a 52-week, placebo-controlled, phase 3 trial evaluating ixekizumab (Taltz) in biologic disease-modifying antirheumatic drug–naive patients with nonradiographic axial spondyloarthritis (nr-axSpA).
Ixekizumab met the primary endpoint of statistically significant improvement in nr-axSpA symptoms as measured by Assessment of Spondyloarthritis International Society 40 response at both week 16 and week 52, compared with patients who received placebo. The drug also met all secondary endpoints, including significant improvement in Ankylosing Spondylitis Disease Activity Score, significant improvement in Bath Ankylosing Spondylitis Disease Activity, proportion of patients achieving low disease activity, significant improvement in sacroiliac joint inflammation as assessed by MRI, and significant improvement in 36-Item Short Form Health Survey Physical Component Summary score.
The safety profile of ixekizumab was broadly similar to what has been seen in previous phase 3 trials; the most common adverse events include injection site reactions, upper respiratory tract infections, nausea, and tinea infections, the company said.
“Nonradiographic axSpA is a challenging diagnosis that is not only missed in clinics, but also has limited treatment options for physicians to offer patients. The COAST-X results offer compelling evidence that Taltz could provide a much-needed new alternative if approved for this patient population,” Atul A. Deodhar, MD, professor of medicine at Oregon Health & Science University, Portland, and clinical investigator for the COAST program, said in the press release.
Find the full press release on the Eli Lilly website.
Eli Lilly has announced positive results from COAST-X, a 52-week, placebo-controlled, phase 3 trial evaluating ixekizumab (Taltz) in biologic disease-modifying antirheumatic drug–naive patients with nonradiographic axial spondyloarthritis (nr-axSpA).
Ixekizumab met the primary endpoint of statistically significant improvement in nr-axSpA symptoms as measured by Assessment of Spondyloarthritis International Society 40 response at both week 16 and week 52, compared with patients who received placebo. The drug also met all secondary endpoints, including significant improvement in Ankylosing Spondylitis Disease Activity Score, significant improvement in Bath Ankylosing Spondylitis Disease Activity, proportion of patients achieving low disease activity, significant improvement in sacroiliac joint inflammation as assessed by MRI, and significant improvement in 36-Item Short Form Health Survey Physical Component Summary score.
The safety profile of ixekizumab was broadly similar to what has been seen in previous phase 3 trials; the most common adverse events include injection site reactions, upper respiratory tract infections, nausea, and tinea infections, the company said.
“Nonradiographic axSpA is a challenging diagnosis that is not only missed in clinics, but also has limited treatment options for physicians to offer patients. The COAST-X results offer compelling evidence that Taltz could provide a much-needed new alternative if approved for this patient population,” Atul A. Deodhar, MD, professor of medicine at Oregon Health & Science University, Portland, and clinical investigator for the COAST program, said in the press release.
Find the full press release on the Eli Lilly website.
Eli Lilly has announced positive results from COAST-X, a 52-week, placebo-controlled, phase 3 trial evaluating ixekizumab (Taltz) in biologic disease-modifying antirheumatic drug–naive patients with nonradiographic axial spondyloarthritis (nr-axSpA).
Ixekizumab met the primary endpoint of statistically significant improvement in nr-axSpA symptoms as measured by Assessment of Spondyloarthritis International Society 40 response at both week 16 and week 52, compared with patients who received placebo. The drug also met all secondary endpoints, including significant improvement in Ankylosing Spondylitis Disease Activity Score, significant improvement in Bath Ankylosing Spondylitis Disease Activity, proportion of patients achieving low disease activity, significant improvement in sacroiliac joint inflammation as assessed by MRI, and significant improvement in 36-Item Short Form Health Survey Physical Component Summary score.
The safety profile of ixekizumab was broadly similar to what has been seen in previous phase 3 trials; the most common adverse events include injection site reactions, upper respiratory tract infections, nausea, and tinea infections, the company said.
“Nonradiographic axSpA is a challenging diagnosis that is not only missed in clinics, but also has limited treatment options for physicians to offer patients. The COAST-X results offer compelling evidence that Taltz could provide a much-needed new alternative if approved for this patient population,” Atul A. Deodhar, MD, professor of medicine at Oregon Health & Science University, Portland, and clinical investigator for the COAST program, said in the press release.
Find the full press release on the Eli Lilly website.