Month: February 2018

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What is Pneumococcal Disease?

Pneumococcal disease is an infection caused by the Streptococcus pneumoniae (S. pneumoniae) bacterium, also known as pneumococcus. Infection can result in pneumonia, infection of the blood (bacteremia/sepsis), middle-ear infection (otitis media), or bacterial meningitis.

The World Health Organization (WHO) says that pneumococcal disease is the world’s number 1 vaccine-preventable cause of death among infants and children younger than 5 years of age.

There are two main types of pneumococcal diseases:

1) Non-invasive pneumococcal diseases

These may be less serious than invasive pneumococcal disease and occur outside the major organs or the blood. S. pneumoniae can spread from the nasopharynx (nose and throat) to the upper and lower respiratory tract and can cause:

  • Otitis media – middle ear infection. Inflammation of the middle ear, typically with accumulation of fluid in the middle ear, swelling of the eardrum, earache. If the eardrum is perforated drainage of pus into the ear canal.
  • Non-bacteremic pneumonia – infection of the lower respiratory tract without detectable spread of organisms to the blood stream

2) Invasive pneumococcal diseases (IPD)

These tend to be more serious and occur inside a major organ, or in the blood. Examples of IPDs include:

  • Bacteremia (sepsis) – bacterial infection of the blood. Bacteremia refers to the presence of live bacteria in the blood, while sepsis means a blood infection which is associated with capillary leak, shock and an increased risk of mortality.
  • Meningitis – inflammation of the meninges. The meninges are the three membranes that cover the brain and the spinal cord.
  • Bacteremic pneumonia – inflammation of one or both lungs, with pneumococcus in the bloodstream.

Pneumococcal Disease Burden

According to the WHO, up to 1.6 million people die each year globally as a result of pneumococcal diseases – about half of them are children younger than 5 years of age in developing countries. WHO classes pneumococcal disease as a major cause of mortality and morbidity.
(Morbidity = illness, disease. Mortality = death).

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America’s kids are obese and it’s getting worse

Junk food, lack of exercise to blame for rise in childhood obesity

Obesity is worsening in American kids, researchers reported Monday.

And the most severe obesity is hitting more and more very small children — those under the age of 5, they found.

Experts blame a society that continues to push junk food despite the overwhelming evidence about its dangers, and the lack of access to exercise.

More than 40 percent of 16 to 19-year-olds are obese, the team at Duke University, Wake Forest University and elsewhere found. But worse, 26 percent of 2 to 5-year-olds were overweight and more than 15 percent were obese, they reported in the journal Pediatrics.

“Despite previous reports that obesity in children and adolescents has remained stable or decreased in recent years, we found no evidence of a decline in obesity prevalence at any age,” the team, led by Duke’s Asheley Cockrell Skinner, wrote.

And it looks like efforts to turn things around are gaining little headway.

“Despite intense focus on reducing the U.S. childhood obesity epidemic over the past two decades, our progress remains unclear,” they added.

For instance, former first lady Michelle Obama’s “Let’s Move” campaign aimed to encourage exercise and healthy eating, while various states, cities and local authorities have tried to encourage exercise and to make junk food sweetened soft drinks less appealing and available.

It’s not that the efforts have failed because they are of no use, the team added. It’s because they are nowhere near enough. “More resources are clearly necessary,” they wrote.

And television shows stressing crash diets do not help.

“There are few long-term studies of obesity development or treatment outcomes because this work is occurring in a Biggest Loser environment, with the focus being on short-term changes in weight that we are only beginning to see as an erroneous pursuit in adult populations,” they wrote.

It’s not as if the threat of obesity is not understood, said Dr. David Ludwig, a specialist in weight gain at Boston Children’s Hospital. “The obesity epidemic threatens to shorten life expectancy in the United States and bankrupt the health care system,” Ludwig wrote in a commentary.

“We have deep knowledge of the biological drivers of obesity, which include poor diet quality, excessive sedentary time, inadequate physical activity, stress, sleep deprivation, perinatal factors, and probably environmental endocrine-disrupting chemicals,” Ludwig added.

“What is lacking is an effective strategy to address these drivers with sufficient intensity, consistency, and persistence. It is not enough for a child to receive more healthful meals at school (which is not always the case) if she encounters a gantlet of junk food after school and in the home.”

Parents often do not help, either. A report published earlier this month in the journal Health Promotion Practice found 53 percent of parents in Arkansas did not believe reports cautioning them that their children were obese.

Researchers calculate obesity using Body Mass Index or BMI, a ratio of height to weight. For children, BMI is measured by their height and weight compared to the norm for children the same age.

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Where’s the Flu? New Apps Can Pinpoint Illness Outbreaks

New apps are using social media, doctors’ reports, and crowdsourcing to keep track of the spread of illnesses such as the flu, strep throat, and mononucleosis.

Worried about catching the flu? Minimizing your risk could be as simple as checking your smartphone.

A new mobile app called Doctors Report Illness Tracker collects data on a variety of diseases from 1 million doctors’ offices nationally. Users can search destinations by zip code to get information on the prevalence of the flu and other illnesses, including strep, bronchitis, pneumonia, conjunctivitis, mononucleosis, common cold and cold symptoms, sinusitis, croup, Lyme disease, ear infections, MRSA, RSV, and gastroenteritis.

App creator Dan Shaw said parents whose children have a travel soccer game can use the app to determine if there’s a flu outbreak in the town they’re visiting, for example.

“The Doctors Report website and app is for everyone, from parents of young children trying to avoid illnesses like strep, or senior citizens and people with chronic conditions like asthma who try hard to manage their exposure to health risks, to just someone planning a business trip or a vacation,” said Shaw. “Doctors themselves can benefit by having ready access to fresh information they can use to advise patients.”

The data used by the app, which currently has about 3,000 installed users according to Apptopia, comes from “the everyday process of patients visiting their doctor at an office, clinic, or hospital setting,” Shaw told Healthline.

Doctors Report looks at about 70 percent of all healthcare claims data submitted to private and government payers, Shaw noted.

Nearly all doctors and healthcare providers contribute information to the database, which includes diagnosis data from nearly 1 billion doctors’ visits annually.

Sickweather monitors social media sites such as Facebook and Twitter for posts on illness, including mentions of the flu or common cold.

“Crowdsourcing gives you a more well-rounded picture of what’s going on in each area,” Graham Dodge, chief executive officer of Sickweather, told Healthline. “People can be complaining about symptoms weeks before they see a doctor, so there’s a two- to four-week window of opportunity to capture information on people who are experiencing illness.”

Dodge said the “sick zone” reports delivered to app users are based on data from about 6 million social media accounts, as well as subscribers to the Weather Channel (whose national flu map is generated from Sickweather data) and reports from app users themselves.

Apptopia reported that the Sickweather app, launched in 2013 on iOS and 2014 on Android, has about 95,000 regular monthly users.

Kinsa, a maker of digital thermometers, recently launched Kinsa Insights, which gathers temperature and fever data from its devices to predict illness trends.

Kinsa officials said Insight’s predictive prowess equals that of the Centers for Disease Control and Prevention (CDC). Plus, it’s in real time rather than the two- to six-week lag common with other reporting systems.

Flu Near You is a voluntary, crowdsourced database of flu activity that’s also searchable by zip code.

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FluMist May Be Coming Back. Will it Work Better?

Feb. 22, 2018 — FluMist, the inhaled flu vaccine, may be on its way back to doctors’ offices in the U.S.

The influential Advisory Committee on Immunization Practices (ACIP) voted 12-2 on Wednesday to put the nasal spray back on its list of available vaccines.

The vote comes during a lengthy and punishing flu season in the U.S., where the effectiveness of available flu vaccines was low for most age groups. Only young children have seen substantial protection against the most common strain of the flu this year.

It was a guarded “yes,” given that doctors won’t know for sure if it works better than before — or better than other vaccine options — until it’s widely used again during an actual flu season.

he committee first voted to remove the word “recommended” from its statement, which is formally known as a recommendation. Instead, members voted simply to say FluMist was an option.

The ACIP has been burned by FluMist before.

In 2014, the committee advised doctors to choose FluMist over injectable vaccines for healthy children after data seemed to suggest that it was more effective for them.

The committee backed off that statement in 2015 after studies showed that the inhaled vaccine was less effective that the shot. In 2016, the ACIP took the added step of saying FluMist wasn’t recommended at all because it hardly worked. That effectively ended insurance reimbursement for this option.

FluMist has been in the doghouse for two flu seasons: 2016-2017 and 2017-2018.

The committee voted after hearing new data from the MedImmune, the manufacturer of FluMist, and seeing the CDC’s comprehensive meta-analysis — a study of studies — on the effectiveness of FluMist and flu shots in the U.S. and Europe.

MedImmune said it had fixed a problem with one of the “A” strains included in the vaccine. The new version includes a different H1N1 strain — A /Slovenia — which appeared to boost the numbers of antibodies kids made to fight the flu in a small clinical trial that compared the new FluMist formula with the old one. It also appeared to increase viral “shedding” in kids who got the new version.

Just like a dog or cat sheds hair, the human body gives off, or “sheds,” flu virus when infected. FluMist contains weakened, but live flu strains that infect the body enough to provoke a response from the immune system, but aren’t meant to make a person sick.

The manufacturer argued that more viral shedding suggested that the virus was activating the immune systemmore strongly than previous versions. They also noted that FluMist continues to work well for children in the U.K. and Europe.

“We always have to make decisions based on the best available science that we have,” said committee member Edward Belongia, MD, director of the Center for Clinical Epidemiology and Population Health at the Marshfield Clinic Research Institute. “It looks like they’ve found the source of the problem,” he said. He voted to restore FluMist to the list of available options.

Committee member Henry Bernstein, DO, a pediatrician at Cohen Children’s Medical Center in New Hyde Park, NY, was one of the “no” votes. He said he wasn’t convinced that viral shedding was a good test of flu protection.

“I’m worried that we had two strikes, and [the 2018-2019 flu season] would be the third strike,” he said.

Other members were swayed by CDC data that showed that vaccine coverage dipped 2% in children after FluMist was cast aside.

For some kids, they reasoned, FluMist might be the only way they’d be immunized at all.

“This is not an easy decision,” Cynthia Pellegrini, senior vice president of public policy and government affairs for the March of Dimes, said during the discussion before the vote.

“Let’s put it out there and let clinicians and parents decide what to give their kids,” she said. She voted yes.

 

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“Basic” plasma donor requirements to donate:

Donor safety, as well as the safety of the therapies made from plasma donations is of primary importance. You will need to visit a plasma collection center to determine if you are eligible to donate.
In general:

  • Plasma donors should be at least 18 years old
  • Plasma donors should weigh at least 110 pounds or 50 kilograms
  • Must pass a medical examination
  • Complete an extensive medical history screening
  • Test non-reactive for transmissible viruses including hepatitis and HIV
  • Follow a recommended diet including 50 to 80 grams of daily protein

Before donating plasma it is important to:

  • Drink plenty of water or juice to be fully hydrated
  • Notify center personnel if you have had recent surgery
  • Notify center personnel if you have obtained a tattoo or piercing within the past 12 months
  • Notify center personnel if you are taking medication or are under a doctor’s care for any medical condition

Because the need for plasma is so great, we are looking for committed donors. It is only after two satisfactory health screenings and negative test results within six months that you may receive Qualified Donor status. Until you have met this requirement, your plasma will not be used to manufacture therapies. This is important to help ensure the quality and safety of the therapies that patients need to treat life-threatening diseases.

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Red Cell Antibodies:

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Have you been told you have an “a-typical” antibody? Have you been deferred as a blood or plasma donor due to it?  We are looking for patients who have been identified as having one of the many red cells that there are.  We need participants to donate plasma so that their antibodies can be used in further research as well as manufacturing into controls for test kits to diagnose others like yourself.    Below is just a list of some of the red cells we are currently looking for:

Participants are compensated for their donations and if travel is involved we take care of all travel related expenses so there is no cost to you and you still earn your compensation while you are donating.  Also, since it’s a plasmapheresis procedure and you get your red cells back thru the process you are able to donate more frequently than say a blood drive.  Plasma donors are able to donate 2x per week with one day off between donations.

Basic Qualifications:

  • Must be 18-65 Years in age
  • Must weigh at least 110lbs or more
  • MUST be HIV/HCV & HBV negative

 

Anti-c
Anti-C
Anti-cW
Anti-D
Anti-D Slide
Anti-D/C
Anti-E
Anti-Fya
Anti-Fyb
Anti-Jka
Anti-K
Anti-Kpb
Anti-Lea
Anti-Lea/Leb
Anti-M
Anti-s
Anti-S
Anti-U
Anti-Vel
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Are you taking Coumadin/Warfarin?

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Are you currently taking Coumadin or Warfarin?  Do you live in Indianapolis or the surrounding cities?  We need patients currently taking this medication to donate plasma to help others.

To learn more please visit http://www.accessclinical.com or call 800-510-4003 and ask for Robert to assist you.

To Qualify:

  1. Must be 18-64 years in age
  2. Must weigh at least 110lbs or more
  3. MUST be HIV/HCV/HBV Negative

INR Ranges needed for this program include:

INF 2-3 %

INR 3-4 %

INR > 4%

 

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CNN Exclusive: California launches investigation following stunning admission by Aetna medical director

(CNN)California’s insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care.

California Insurance Commissioner Dave Jones expressed outrage after CNN showed him a transcript of the testimony and said his office is looking into how widespread the practice is within Aetna.
“If the health insurer is making decisions to deny coverage without a physician actually ever reviewing medical records, that’s of significant concern to me as insurance commissioner in California — and potentially a violation of law,” he said.
Aetna, the nation’s third-largest insurance provider with 23.1 million customers, told CNN it looked forward to “explaining our clinical review process” to the commissioner.
The California probe centers on a deposition by Dr. Jay Ken Iinuma, who served as medical director for Aetna for Southern California from March 2012 to February 2015, according to the insurer.
During the deposition, the doctor said he was following Aetna’s training, in which nurses reviewed records and made recommendations to him.
Jones said his expectation would be “that physicians would be reviewing treatment authorization requests,” and that it’s troubling that “during the entire course of time he was employed at Aetna, he never once looked at patients’ medical records himself.”
“It’s hard to imagine that in that entire course in time, there weren’t any cases in which a decision about the denial of coverage ought to have been made by someone trained as a physician, as opposed to some other licensed professional,” Jones told CNN.
“That’s why we’ve contacted Aetna and asked that they provide us information about how they are making these claims decisions and why we’ve opened this investigation.”
The insurance commissioner said Californians who believe they may have been adversely affected by Aetna’s decisions should contact his office.
Members of the medical community expressed similar shock, saying Iinuma’s deposition leads to questions about Aetna’s practices across the country.
“Oh my God. Are you serious? That is incredible,” said Dr. Anne-Marie Irani when told of the medical director’s testimony. Irani is a professor of pediatrics and internal medicine at the Children’s Hospital of Richmond at VCU and a former member of the American Board of Allergy and Immunology’s board of directors.
“This is potentially a huge, huge story and quite frankly may reshape how insurance functions,” said Dr. Andrew Murphy, who, like Irani, is a renowned fellow of the American Academy of Allergy, Asthma and Immunology. He recently served on the academy’s board of directors.
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Texas mom dies from flu after skipping on meds deemed too costly: report

A Texas mother of two died Sunday from flu complications after reportedly deciding that the $116 medication to treat the virus was too costly.

Heather Holland, a second-grade teacher at Ikard Elementary School in Weatherford, Texas, died following complications of flu, leaving behind her husband Frank Holland and two children, a daughter, 10, and a son, 7.

She reportedly started to feel sick a week ago and was going to pick up flu medication. Her husband said she decided not to purchase the medication because she thought the $116 price tag was too high, according to the Weatherford Democrat.

“She wouldn’t go get medicine because she’s a mama. Mamas are tough. She just kept going. She had a job; she had kids,” Holland’s pastor, Clark Bosher, told Fox 4. “I think any mom does that. I don’t think she is being irresponsible. I don’t think she thought she was that sick. It happened so quick.”

The husband picked up the drugs himself on Thursday after finding out she skipped on them, but it was too late and she ended up in the intensive care unit at a hospital on Friday.

“Friday night, things escalated and she ended up in the ICU,” he told the outlet. “The doctors got the blood cultures back and they had to put her on dialysis early Saturday.”

She died Sunday morning. “I have to be strong for the kids but it’s still surreal, it hasn’t all set in,” Frank Holland said. “We’ve been together a long time, over half my life. She’s my best friend, my soulmate, my everything.”

He described her as a passionate teacher who “loved helping people, helping the kids, and the kids loved her.” On the school’s website page, Heather Holland wrote: “I am really enjoying my kiddos. We are working hard on reading, writing and learning to quickly compose and decompose numbers.”

TRAGIC FACES OF THE DEADLY US FLU OUTBREAK

This season’s deadly flu season has reportedly taken the lives of hundreds of Americans across the country.

The Centers for Disease Control and Prevention acting Director Dr. Anne Schuchat said the center has seen “increased influenza-like activity, more hospitalizations and tragically, more flu-associated deaths in children and adults.”

Over 60 children have died from the virus this season and there are no signs the spread of the flu will soon to cease. The state of Louisiana, is on track to having some 1,000 flu-related deaths this season, according to medical officials.