Yoke's Fresh Market Issues Voluntary Cheese Recall - FDA Safety Alerts & Drug Recalls

Out of an abundance of caution and with an emphasis on customers' wellness and safety, Yoke's Fresh Market is proactively recalling two types of Colby cheese due to a potential contamination of Listeria monocytogenes.

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Lipari Foods Issues Voluntary Recall of Various Bulk and Retail Cheese Products Due to Possible Health Risk - FDA Safety Alerts & Drug Recalls

Lipari Foods, LLC has issued a voluntary recall of various bulk and retail cheeses manufactured by Deutsch Kase Haus due to potential contamination of Listeria monocytogenes. Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

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FDA approves Xermelo for carcinoid syndrome diarrhea - FDA Press Releases

The U.S. Food and Drug Administration today approved Xermelo (telotristat ethyl) tablets in combination with somatostatin analog (SSA) therapy for the treatment of adults with carcinoid syndrome diarrhea that SSA therapy alone has inadequately controlled.

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Allergy Alert Issued in Two Massachusetts Whole Foods Market Stores for Undeclared Pecans in King Cakes - FDA Safety Alerts & Drug Recalls

Whole Foods Market® stores in Arlington, MA and Brookline, MA are issuing an allergy alert to recall Cream Cheese King Cakes sold between February 4 and February 26, due to an in-store labeling error.

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Supporting Comprehensive and Innovative Care for Children: Request for Information on a Potential Pediatric Alternative Payment Model - CMS Blog

February 27, 2017

By Patrick Conway, M.D., M.Sc., Acting Administrator, Centers for Medicare & Medicaid Services; Deidre Gifford, M.D., M.P.H., Deputy Director, Center for Medicaid and CHIP Services; Ellen-Marie Whelan, N.P., Ph.D., Chief Population Health Officer, Center for Medicaid and CHIP Services; and Alex Billioux, M.D., D.Phil., Director, Division of Population Health Incentives and Infrastructure, Center for Medicare & Medicaid Innovation

In partnership with states and providers, the Centers for Medicare & Medicaid Services (CMS) plays a leading role in safeguarding the health of America’s future by providing coverage for more than one in three American children[1]. Through Medicaid and the Children’s Health Insurance Program’s (CHIP) mandatory and optional benefits, children receive access to a spectrum of comprehensive and preventive health care services aimed at providing a sound start for lifelong health. As a result, children enrolled in Medicaid and CHIP lead the nation in participation in preventive care and access to needed care[2].

CMS and states have also demonstrated consistent commitment to improving the health of children through care redesign and innovation in programs such as Medicaid Health Homes, the Medicaid Innovation Accelerator Program, and models tested under the Center for Medicare and Medicaid Innovation (Innovation Center), including the State Innovation Models Initiative and Strong Start for Mothers and Newborns Initiative. To build on those efforts, the Innovation Center, in partnership with the Center for Medicaid and Chip Services (CMCS), is releasing a Request for Information (RFI) today seeking input on the design of alternative payment models focused on improving the health of children and youth covered by Medicaid and CHIP. As the insurer of a third of the nation’s children and a leader in health care innovation, CMS is uniquely positioned to improve the health of America’s children.

We know there is more to health than health care alone, and for children, factors such as sound nutrition, safe living environments, responsive adult caregivers, and nurturing social relationships are especially critical for healthy growth and development. Inadequate or inconsistent access to these factors can have physical and behavioral impacts that reverberate throughout a child’s life course as he or she grows into adulthood. Some children and youth enrolled in Medicaid and CHIP, especially those that are high-need and high-risk, may experience barriers to accessing the optimal combination of child-focused programs and services that are available to address these critical factors. Through the RFI, we are seeking input on approaches to improve the quality and reduce the cost of care for children and youth enrolled in Medicaid and CHIP. In particular, we are exploring concepts that encourage pediatric providers to collaborate with health-related social service providers (e.g., early childhood development programs, child welfare services, and home and community based service providers) at the state and local levels and share accountability for health outcomes for children and youth enrolled in Medicaid and CHIP.

CMS seeks input through the RFI from the broad community of child and youth-focused stakeholders on concepts critical to addressing the comprehensive health needs of children and youth, such as:

• Opportunities and impediments to extending and enhancing integrated service model concepts like accountable care organizations (ACOs) to the pediatric population;
• Flexibilities and supports states and providers may need in order to offer such models of care to a state’s pediatric population; and
• Approaches for states and providers to coordinate Medicaid and CHIP benefits and waivers with other health-related social services for children and youth.

Investing in child health can provide lifelong benefits and improve the nation’s health. We look forward to front-end comments from our state partners and other stakeholders who share our dedication to improving the health of our nation’s children.

For more information on the RFI, please visit: http://ift.tt/2mwn8Xw. To be assured consideration, RFI comments must be received by March 28, 2017.

[1] Department of Health and Human Services. 2015 Annual Report on the Quality of Care for Children in Medicaid and CHIP. February, 2016. http://ift.tt/2huLelF

[2] See CHIPRA Mandated Evaluation of the Children’s Health Insurance Program: Final Findings, available at

http://ift.tt/2mwnzkx; Kreider AR, French B, Aysola J, Saloner B, Noonan KG, Rubin DM. Quality of Health Insurance Coverage and Access to Care for Children in Low-Income Families. JAMA Pediatr. 2016;170(1):43-51. doi:10.1001/jamapediatrics.2015.3028

 

Filed under: Uncategorized

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Endo Pharmaceuticals Inc. Issues Voluntary Nationwide Recall for One Lot of Edex® (alprostadil for injection) 10 mcg 2 Pack Carton Due to Potential Lack of Sterility Assurance - FDA Safety Alerts & Drug Recalls

Endo International plc (NASDAQ / TSX: ENDP) today announced that one of its operating companies, Endo Pharmaceuticals Inc. based in Malvern, Pennsylvania, is voluntarily recalling one lot of Edex® (alprostadil for injection) 10 mcg to the consumer level. This product recall is due to the detection by Endo of a defect in the crimp caps used in the manufacture of the subject product lot.

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Whole Foods Market recalls “Our Chefs’ Own” Spinach Orzo Salad due to undeclared tree nut allergen - FDA Safety Alerts & Drug Recalls

Whole Foods Market® is recalling “Our Chefs’ Own” Spinach Orzo Salad sold in stores in Massachusetts, Connecticut, New Hampshire, Maine and Rhode Island due to an undeclared tree nut allergen. Only Spinach Orzo Salad with PLU 61159 and a “sold on” date of February 24 or before is included in this recall. The effected salad was sold from the chef cases or in prepackaged containers.

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Inappropriate Medication in Non-Hospitalized Patients With Renal Insufficiency: A Systematic Review - American Geriatric Society

Objectives

Renal insufficiency is common among older patients and, accordingly, renally excreted drugs may require an adjustment in dosage for them. Rates of non-adherence to renal dosing guidelines range from 19% to 70% across all settings, with the highest rate occurring in outpatient care. However, there is a paucity of research in this field. The main objective of this systematic review is to assess how often drugs are inappropriately prescribed in non-hospitalized patients with renal insufficiency.

Design

A systematic literature search was performed. Data were identified from three electronic databases: PubMed, CINAHL, and Scopus. Studies were included if they reported quantitative data on inappropriate drug use with respect to renal function in non-hospitalized patients.

Results

Our search strategy resulted in 2,403 hits, of which 18 articles satisfied the criteria for inclusion. Mean estimated glomerular filtration rate ranged from 36.0 to 60.4 mL/min. Prevalence of renally inappropriate drug use ranged from 1% to 37% in outpatient settings other than nursing homes, and from 6% to 43% in nursing homes. Eight of the studies we included identified predictors for use of drugs inappropriate for kidney function. Most frequently determined risk factors were increasing age and a high number of prescribed drugs.

Conclusion

Lack of dose adjustment for renal impairment seems to be a common problem, even in outpatients. However, the differences in methodologies used in these studies hampered any direct comparison. Accepted and comparable standards regarding the drugs included in the studies as well as estimation of renal function would be beneficial.

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Predictors of Posttraumatic Stress Symptoms and Association with Fear of Falling After Hip Fracture - American Geriatric Society

Objectives

To determine whether fall-related hip fracture, alone or in the presence of Fear of Falling, is likely to induce PTSD in an elderly population.

Design

A longitudinal prospective study of patients admitted for hip fracture.

Setting

Eight St. Louis, Missouri, area hospitals.

Participants

Individuals aged 60 and older admitted for surgical hip fracture repair after a fall (N = 456).

Measurements

Rates of partial and full posttraumatic stress disorder (pPTSD and fPTSD) were compared with rates of FoF. PTSD and FoF were assessed 4 and 12 weeks after surgery. Baseline characteristics including depression, stress, pain, cognitive functioning, and anesthesia type were also analyzed as potential predictors of PTSD symptoms 12 weeks after surgery.

Results

No participants met criteria for fPTSD at 4 or 12 weeks, and rates of pPTSD were low 12 weeks after surgery (7.4%), in contrast to high rates of FoF symptoms at the same time point (58.5%). Higher ratings of stress and depressive symptoms at baseline were associated with higher levels of PTSD symptoms 12 weeks after surgery.

Conclusions

Hip fracture, despite its considerable morbidity, does not induce fPTSD and infrequently induces pPTSD. Individuals with higher rates of stress and depressive symptoms after hip fracture repair may be more likely to develop PTSD symptoms.

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Statin Use and 25-Hydroxyvitamin D Blood Level Response to Vitamin D Treatment of Older Adults - American Geriatric Society

Objectives

To determine whether statin use alters response of 25-hydroxyvitamin D (25(OH)D) level to vitamin D treatment.

Design

Pooled analysis.

Setting

Three double-blind randomized controlled trials that tested different doses of vitamin D.

Participants

Participants of three trials (N = 646; mean age 76.3 ± 8.4, 65% female).

Measurements

In all three trials, 25(OH)D status and statin use were assessed repeatedly over time (baseline, 6 and 12 months). Repeated-measures analysis was used to compare 25(OH)D response to vitamin D treatment at baseline and 6 and 12 months of statin users and nonusers, controlling for age, sex, body mass index, Charlson Comorbidity Index, vitamin D dose, trial, and season.

Results

At baseline, 17.5% were statin users, and 65% were vitamin D deficient (25(OH)D < 20 ng/mL). Baseline 25(OH)D levels did not differ significantly between groups at baseline (18.8 for statin users, 17.2 ng/mL for nonusers, P = .07), but according to the longitudinal analyses, the total increase over 12 months in 25(OH)D concentration was significantly lower in statin users (13.1 ng/L) than nonusers (15.9 ng/mL; 21.4% difference; P = .009).

Conclusion

Of persons aged 60 and older at high risk of vitamin D deficiency, statin users had a 21.4% smaller increase in 25(OH)D serum concentrations over time than nonusers, independent of vitamin D dose and other covariates.

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Anti-fungal activity of Ctn[15–34], the C-terminal peptide fragment of crotalicidin, a rattlesnake venom gland cathelicidin - Journal of Antibiotics

Anti-fungal activity of Ctn[15–34], the C-terminal peptide fragment of crotalicidin, a rattlesnake venom gland cathelicidin

The Journal of Antibiotics 70, 231 (March 2017). doi:10.1038/ja.2016.135

Authors: Carolina Sidrim P Cavalcante, Cláudio B Falcão, Raquel OS Fontenelle, David Andreu & Gandhi Rádis-Baptista

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Antimicrobial activity and interactions of cationic peptides derived from Galleria mellonella cecropin D-like peptide with model membranes - Journal of Antibiotics

Antimicrobial activity and interactions of cationic peptides derived from Galleria mellonella cecropin D-like peptide with model membranes

The Journal of Antibiotics 70, 238 (March 2017). doi:10.1038/ja.2016.134

Authors: José Oñate-Garzón, Marcela Manrique-Moreno, Steven Trier, Chad Leidy, Rodrigo Torres & Edwin Patiño

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In vitro and in vivo activities of the diazabicyclooctane OP0595 against AmpC-derepressed Pseudomonas aeruginosa - Journal of Antibiotics

In vitro and in vivo activities of the diazabicyclooctane OP0595 against AmpC-derepressed Pseudomonas aeruginosa

The Journal of Antibiotics 70, 246 (March 2017). doi:10.1038/ja.2016.150

Authors: Akihiro Morinaka, Yuko Tsutsumi, Keiko Yamada, Yoshihiro Takayama, Shiro Sakakibara, Toshihiko Takata, Takao Abe, Takeshi Furuuchi, Seiichi Inamura, Yoshiaki Sakamaki, Nakako Tsujii & Takashi Ida

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Angucycline antibiotic waldiomycin recognizes common structural motif conserved in bacterial histidine kinases - Journal of Antibiotics

Angucycline antibiotic waldiomycin recognizes common structural motif conserved in bacterial histidine kinases

The Journal of Antibiotics 70, 251 (March 2017). doi:10.1038/ja.2016.151

Authors: Yoko Eguchi, Toshihide Okajima, Naoya Tochio, Yoichi Inukai, Riko Shimizu, Shuhei Ueda, Shoko Shinya, Takanori Kigawa, Tamo Fukamizo, Masayuki Igarashi & Ryutaro Utsumi

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Antibacterial effect of antibiotic-loaded SBA-15 on biofilm formation by Staphylococcus aureus and Staphylococcus epidermidis - Journal of Antibiotics

Antibacterial effect of antibiotic-loaded SBA-15 on biofilm formation by Staphylococcus aureus and Staphylococcus epidermidis

The Journal of Antibiotics 70, 259 (March 2017). doi:10.1038/ja.2016.154

Authors: Anna Aguilar-Colomer, Juan Carlos Doadrio, Concepción Pérez-Jorge, Miguel Manzano, Maria Vallet-Regí & Jaime Esteban

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In vitro antibacterial activity of α-methoxyimino acylide derivatives against macrolide-resistant pathogens and mutation analysis in 23S rRNA - Journal of Antibiotics

In vitro antibacterial activity of α-methoxyimino acylide derivatives against macrolide-resistant pathogens and mutation analysis in 23S rRNA

The Journal of Antibiotics 70, 264 (March 2017). doi:10.1038/ja.2016.148

Authors: Hiroyuki Sugiyama, Ippei Yoshida, Mayumi Ueki, Katsuhiko Tanabe, Akira Manaka & Keiichi Hiramatsu

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Identification of pyripyropene A as a promising insecticidal compound in a microbial metabolite screening - Journal of Antibiotics

Identification of pyripyropene A as a promising insecticidal compound in a microbial metabolite screening

The Journal of Antibiotics 70, 272 (March 2017). doi:10.1038/ja.2016.155

Authors: Ryo Horikoshi, Kimihiko Goto, Masaaki Mitomi, Kazuhiko Oyama, Toshiaki Sunazuka & Satoshi Ōmura

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Effects of two 6-quinolinyl chalcones on the integrity of plasma membrane of Paracoccidioides brasiliensis - Journal of Antibiotics

Effects of two 6-quinolinyl chalcones on the integrity of plasma membrane of Paracoccidioides brasiliensis

The Journal of Antibiotics 70, 277 (March 2017). doi:10.1038/ja.2016.156

Authors: Nívea P de Sá, Patrícia S Cisalpino, Luciana C Tavares, Leandro Espíndola, Beatriz M Borelli, Paulo JS Barbeira, Gabriele de Matos Cardoso Perdigão, Elaine M Souza-Fagundes, Carlos A Rosa, Moacir G Pizzolatti & Susana Johann

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Anti-folates potentiate bactericidal effects of other antimicrobial agents - Journal of Antibiotics

Anti-folates potentiate bactericidal effects of other antimicrobial agents

The Journal of Antibiotics 70, 285 (March 2017). doi:10.1038/ja.2016.159

Authors: Kun Li, Xu-de Wang, Shan-shan Yang, Jing Gu, Jiao-yu Deng & Xian-En Zhang

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Studies at the ionizable position of cephalosporins and penicillins: hydroxamates as substitutes for the traditional carboxylate group - Journal of Antibiotics

Studies at the ionizable position of cephalosporins and penicillins: hydroxamates as substitutes for the traditional carboxylate group

The Journal of Antibiotics 70, 292 (March 2017). doi:10.1038/ja.2016.149

Authors: Mark W Majewski, Patricia A Miller & Marvin J Miller

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Isolation and identification of new macrocyclic lactones from a genetically engineered strain Streptomyces bingchenggensis BCJ60 - Journal of Antibiotics

Isolation and identification of new macrocyclic lactones from a genetically engineered strain Streptomyces bingchenggensis BCJ60

The Journal of Antibiotics 70, 297 (March 2017). doi:10.1038/ja.2016.130

Authors: Jiansong Li, Shaoyong Zhang, Hui Zhang, Haiyan Wang, Ji Zhang, Anliang Chen, Jidong Wang & Wensheng Xiang

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A new cytotoxic and anti-fungal C-glycosylated benz[α]anthraquinone from the broth of endophytic Streptomyces blastomycetica strain F4-20 - Journal of Antibiotics

A new cytotoxic and anti-fungal C-glycosylated benz[α]anthraquinone from the broth of endophytic Streptomyces blastomycetica strain F4-20

The Journal of Antibiotics 70, 301 (March 2017). doi:10.1038/ja.2016.126

Authors: He Yan, Yang Li, Xing Y Zhang, Wan Y Zhou & Tao J Feng

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Re-identification of the ascofuranone-producing fungus Ascochyta viciae as Acremonium sclerotigenum - Journal of Antibiotics

Re-identification of the ascofuranone-producing fungus Ascochyta viciae as Acremonium sclerotigenum

The Journal of Antibiotics 70, 304 (March 2017). doi:10.1038/ja.2016.132

Authors: Yasuaki Hijikawa, Motomichi Matsuzaki, Shigeo Suzuki, Daniel Ken Inaoka, Ryoko Tatsumi, Yasutoshi Kido & Kiyoshi Kita

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Screening of NCI-DTP library to identify new drug candidates for Borrelia burgdorferi - Journal of Antibiotics

Screening of NCI-DTP library to identify new drug candidates for Borrelia burgdorferi

The Journal of Antibiotics 70, 308 (March 2017). doi:10.1038/ja.2016.131

Authors: Venkata Raveendra Pothineni, Dhananjay Wagh, Mustafeez Mujtaba Babar, Mohammed Inayathullah, R Edward Watts, Kwang-Min Kim, Mansi B Parekh, Abhijit Achyut Gurjarpadhye, David Solow-Cordero, Lobat Tayebi & Jayakumar Rajadas

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8′-epimer of herbicidin F and its congeners from Streptomyces sp. YIM 66142 - Journal of Antibiotics

8′-epimer of herbicidin F and its congeners from Streptomyces sp. YIM 66142

The Journal of Antibiotics 70, 313 (March 2017). doi:10.1038/ja.2016.133

Authors: Ju-Cheng Zhang, Ya-Bin Yang, Guang-Yi Chen, Xiao-Zhan Li, Ming Hu, Bang-Yan Wang, Bao-Hui Ruan, Hao Zhou, Li-Xing Zhao & Zhong-Tao Ding

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Revisiting unexploited antibiotics in search of new antibacterial drug candidates: the case of MSD-819 (6-chloro-2-quinoxalinecarboxylic acid 1,4-dioxide) - Journal of Antibiotics

Revisiting unexploited antibiotics in search of new antibacterial drug candidates: the case of MSD-819 (6-chloro-2-quinoxalinecarboxylic acid 1,4-dioxide)

The Journal of Antibiotics 70, 317 (March 2017). doi:10.1038/ja.2016.140

Authors: Nicola Ooi & Alex J O'Neill

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Quinoline and naphthalene derivatives from Saccharopolyspora sp. YIM M13568 - Journal of Antibiotics

Quinoline and naphthalene derivatives from Saccharopolyspora sp. YIM M13568

The Journal of Antibiotics 70, 320 (March 2017). doi:10.1038/ja.2016.142

Authors: Mingwei Sun, Jinhuan Ou, Wenjun Li & Chunhua Lu

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Identification of new geldanamycin derivatives from unexplored microbial culture extracts using a MS/MS library - Journal of Antibiotics

Identification of new geldanamycin derivatives from unexplored microbial culture extracts using a MS/MS library

The Journal of Antibiotics 70, 323 (March 2017). doi:10.1038/ja.2016.143

Authors: Jae Kyoung Lee, Jae-Hyuk Jang, Dong-Jin Park, Chang-Jin Kim, Jong Seog Ahn, Bang Yeon Hwang & Young-Soo Hong

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Arabilin overcomes resistance to AR-targeted therapy - Journal of Antibiotics

Arabilin overcomes resistance to AR-targeted therapy

The Journal of Antibiotics 70, 328 (March 2017). doi:10.1038/ja.2016.162

Authors: Takahiro Fujimaki, Shun Saito & Masaya Imoto

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Biphenyl ether derivatives with protein tyrosine phosphatase 1B inhibitory activity from the freshwater fungus Phoma sp. - Journal of Antibiotics

Biphenyl ether derivatives with protein tyrosine phosphatase 1B inhibitory activity from the freshwater fungus Phoma sp.

The Journal of Antibiotics 70, 331 (March 2017). doi:10.1038/ja.2016.147

Authors: Deiske A Sumilat, Hiroyuki Yamazaki, Syu-ichi Kanno, Ryo Saito, Yuta Watanabe & Michio Namikoshi

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Manzana Products Co., Inc. Issues Voluntary Recall of Apple Sauces Due to Potential Presence of Foreign Material - FDA Safety Alerts & Drug Recalls

Manzana Products Co., Inc. is voluntarily recalling three different types of Trader Joe's Unsweetened Apple Sauces due to the potential presence of glass pieces.

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Lakeview Cheese and Bashas’ Family of Stores Issue Voluntary Cheese Recall - FDA Safety Alerts & Drug Recalls

Out of an abundance of caution and with an emphasis on customers’ wellness and safety, Lakeview Cheese and Bashas’ Family of Stores are proactively recalling various types of Colby cheese due to a potential contamination of Listeria monocytogenes. It’s important to note that no illnesses have been reported to date.

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Avella Specialty Pharmacy Issues Voluntary Nationwide Recall of all Sterile Products Produced at Advanced Pharma Houston Location from September 1, 2016 through February 16, 2017 Due to Potential Inaccuracy of Latex Free Label Reference - FDA Safety Alerts & Drug Recalls

Advanced Pharma, Inc. d/b/a Avella of Houston is conducting a voluntary recall of all unexpired sterile injectable products labeled “latex free” that were produced at Advanced Pharma, Inc.’s Houston location between September 1, 2016 and February 16, 2017 to the user level (hospitals and institutions) because such products may contain synthetic latex and/or natural latex. Avella and Advanced Pharma have been unable to confirm with clarity whether its “latex free” label statements are accurate in all cases and are therefore conducting this recall in an abundance of caution.

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Inroads into Polypharmacy: Moving Forward with Tools, Deprescribing, and Philosophical Reflection - Geriatrics

Clinicians who care for older adults and strive to improve quality of care wrestle with the ongoing burden of polypharmacy and the balance between underprescribing and overprescribing. In addition, the ability for patients to purchase medications online and through channels that do not carefully monitor quality or quantity of drugs is likely to continue to increase and complicate polypharmacy-related problems.

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Geriatric Polypharmacy - Geriatrics

Being a clinical provider in today’s health care environment has become complex with more levels of care to negotiate. Who is caught in the middle of this complexity? Senior citizens. As we evolve into the new quality model, new problems and complexities occur. Numerous protocols and guidelines necessitate the initiation of drugs for given diagnoses and aggressive treatments. This article discusses geriatric polypharmacy from 2 practitioners' viewpoints: Zhe Chen, MD, discusses the point of view of a physician provider, and Anthony Buonanno, MD, discusses providers’ roles in their own families.

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Medication Reconciliation in Long-Term Care and Assisted Living Facilities - Geriatrics

The transitions of care process involves pharmacists and other members of the health care team who are in a position to collect, review, and analyze medications lists to help improve health care outcomes. Medication reconciliation is a complex process especially when providing care to elderly population due to increased medication use, the movement of the patient from one health care setting to another, the number of acute and chronic illnesses, and the intervention of multiple health care providers in different facilities. The use of electronic health records can provide many benefits.

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The Role of Patient Preferences in Deprescribing - Geriatrics

Polypharmacy and the use of inappropriate medications has become an increasing problem globally. Deprescribing has gained attention as a means to rationalize medication use. Deprescribing interventions have been shown to be generally feasible and safe; in the few studies in which patient preferences are assessed, such interventions also seem to be acceptable to patients. Qualitative studies suggest that patients are interested in reducing medications, may need education about their medications to facilitate deprescribing, and highly value communication with their providers around deprescribing. This article focuses on patient preferences for deprescribing and highlights practical recommendations to overcome barriers to deprescribing.

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Body Mass Index, Waist Circumference, and Mortality in a Large Multiethnic Postmenopausal Cohort—Results from the Women's Health Initiative - American Geriatric Society

Objectives

To determine whether the relationship between anthropometric measurements of obesity and mortality varies according to age, race, and ethnicity in older women.

Design

Prospective cohort study of multiethnic postmenopausal women.

Setting

Women's Health Initiative (WHI) observational study and clinical trials in 40 clinics.

Participants

Postmenopausal women aged 50–79 participating in WHI (N = 161,808).

Measurements

Baseline height, weight, and waist circumference (WC) were measured, and body mass index (BMI) was calculated based on height and weight. Demographic, health, and lifestyle data from a baseline questionnaire were used as covariates. The outcome was adjudicated death (n = 18,320) during a mean follow-up of 11.4 ± 3.2 years.

Results

Hazard ratios (HRs) and 95% confidence intervals (95% CIs) indicated that ethnicity and age modified (P < .01) the relationship between obesity and mortality. Underweight was associated with higher mortality, but overweight or slight obesity was not a risk factor for mortality in most ethnic groups except for Hispanic women in the obesity I category (HR = 1.42, 95% CI = 1.04–1.95). BMI was not or was only weakly associated with mortality in individuals aged 70–79 (HR = 0.90, 95% CI = 0.85–0.95 for overweight; HR = 0.98, 95 CI = 0.92–1.06 for obese I; HR = 1.11, 95% CI = 1.00–1.23 for obese II; HR = 1.08, 95% CI = 0.92–1.26 for obese III). In contrast, higher central obesity measured using WC was consistently associated with higher mortality in all groups.

Conclusion

Underweight is a significant risk factor for mortality in older women, and healthy BMI ranges may need to be specific for age, race, and ethnicity. The findings support a consistent relationship between central obesity and mortality.

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Kusher LLC Issues Allergy Alert on Undeclared Egg and Milk in Cookies - FDA Safety Alerts & Drug Recalls

Kusher LLC of Fife, Washington is recalling the following cookies due to undeclared milk and egg. People who have an allergy or severe sensitivity to milk and egg may run the risk of serious or life-threatening allergic reaction if they consume these products.

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Environmental surfaces used in entry-day corralling likely contribute to the spread of influenza A virus in swine at agricultural fairs

Environmental surfaces used in entry-day corralling likely contribute to the spread of influenza A virus in swine at agricultural fairs

Emerging Microbes & Infections 6, e10 (February 2017). doi:10.1038/emi.2016.138

Authors: Sarah E Lauterbach, Michele M Zentkovich, Sarah W Nelson, Jacqueline M Nolting & Andrew S Bowman

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Metataxonomics reveal vultures as a reservoir for Clostridium perfringens

Metataxonomics reveal vultures as a reservoir for Clostridium perfringens

Emerging Microbes & Infections 6, e9 (February 2017). doi:10.1038/emi.2016.137

Authors: Xiangli Meng, Shan Lu, Jing Yang, Dong Jin, Xiaohong Wang, Xiangning Bai, Yumeng Wen, Yiting Wang, Lina Niu, Changyun Ye, Ramon Rosselló-Móra & Jianguo Xu

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Louisiana drug and dietary supplement maker ordered to cease operations due to federal violations - FDA Press Releases

On Friday, U.S. District Judge Robert G. James for the U.S. District Court for the Western District of Louisiana entered a consent decree of permanent injunction against Pick and Pay Inc./Cili Minerals, a manufacturer and distributor of drugs and dietary supplements, and its owner, Anton S. Botha, requiring the business to immediately cease operations until it comes into compliance with federal laws.

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Bee International issues Allergy Alert on Undeclared Milk in “Plastic Heart Tubes with Chocolate Lentils” - FDA Safety Alerts & Drug Recalls

Bee International, Inc. of Chula Vista, CA is recalling its 1.7oz. Plastic Heart Tubes with Chocolate Lentils because they may contain undeclared milk protein. People who have allergies to milk may run the risk of serious or life-threatening allergic reaction if they consume this product.

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Organic Herbal Supply, Inc. Announces a Voluntary Nationwide Recall of XtraHRD Natural Male Enhancement Capsules - FDA Safety Alerts & Drug Recalls

Organic Herbal Supply, Inc. announced today that it is conducting a voluntary nationwide recall of all lots of XtraHRD Natural Male Enhancement capsules. FDA analysis has found the product to contain Tadalafil. Tadalafil is a FDA-approved drug used as treatment for male Erectile Dysfunction (ED). The active drug ingredients are not listed on the label for this product. To date, no adverse events have been reported.

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Effect of Physical Activity versus Health Education on Physical Function, Grip Strength and Mobility - American Geriatric Society

Background

Physical activity (PA) reduces the rate of mobility disability, compared with health education (HE), in at risk older adults. It is important to understand aspects of performance contributing to this benefit.

Objective

To evaluate intervention effects on tertiary physical performance outcomes.

Design

The Lifestyle Interventions and Independence for Elders (LIFE) was a multi-centered, single-blind randomized trial of older adults.

Setting

Eight field centers throughout the United States.

Participants

1635 adults aged 78.9 ± 5.2 years, 67.2% women at risk for mobility disability (Short Physical Performance Battery [SPPB] <10).

Interventions

Moderate PA including walking, resistance and balance training compared with HE consisting of topics relevant to older adults.

Outcomes

Grip strength, SPPB score and its components (balance, 4 m gait speed, and chair-stands), as well as 400 m walking speed.

Results

Total SPPB score was higher in PA versus HE across all follow-up times (overall P = .04) as was the chair-stand component (overall P < .001). No intervention effects were observed for balance (overall P = .12), 4 m gait speed (overall P = .78), or grip strength (overall P = .62). However, 400 m walking speed was faster in PA versus HE group (overall P =<.001). In separate models, 29% of the rate reduction of major mobility disability in the PA versus HE group was explained by change in SPPB score, while 39% was explained by change in the chair stand component.

Conclusion

Lower extremity performance (SPPB) was significantly higher in the PA compared with HE group. Changes in chair-stand score explained a considerable portion of the effect of PA on the reduction of major mobility disability–consistent with the idea that preserving muscle strength/power may be important for the prevention of major mobility disability.

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Can Braden Score Predict Outcomes for Hospitalized Heart Failure Patients? - American Geriatric Society

Background

Braden score is a routine assessment of pressure ulcer risk hypothesized to identify the frail phenotype.

Objectives

To investigate the predictive utility of the Braden score on outcomes of inpatients with heart failure (HF).

Design

Retrospective cohort study.

Setting

An academic medical center between January 1, 2012 and June 30, 2013.

Participants

642 inpatients with a primary diagnosis of HF (ICD-9 428).

Measurements

The primary predictor was Braden score. Primary outcome was 30-day mortality. Additional outcomes included 30-day readmission, length of stay (LOS), and discharge destination. Multivariable methods were used to determine the association between the primary predictor and each outcome adjusted for patient demographics and clinical variables.

Results

Mean admission and discharge Braden scores were 19.5 ± 2.3 (SD) (range = 9–23) and 20.0 ± 1.9 (range = 11–23), respectively (P < .0001). Mean age was 61.8 ± 16.2 years (range = 19–101). The 30-day mortality rate was 4.4%, 30-day readmission rate was 16.2%, mean LOS was 7.0 ± 8.7 days, and 78.2% were discharged home. After adjustment, higher (better) Braden score was significantly associated with decreased 30-day mortality (discharge Braden AOR 0.81 (95% CI 0.66–0.996)), and decreased average LOS (admission Braden β −0.52 days (P = .0002)). Higher discharge Braden score was significantly associated with discharge to home (AOR 1.66 (95% CI 1.42–1.95)). Braden score was not significantly associated with 30-day readmission.

Conclusion

Braden score is an independent predictor of mortality, LOS, and discharge destination among inpatients with HF. Further exploration of the use of Braden scores to identify inpatients who might benefit from specialized intervention is warranted.

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Predicting Mortality up to 14 Years Among Community-Dwelling Adults Aged 65 and Older - American Geriatric Society

Objectives

Extended validation of an index predicting mortality among community-dwelling US older adults.

Design/Setting

Examination of the performance of a previously developed index in predicting 10- and 14-year mortality among respondents to the 1997–2000 National Health Interview Surveys (NHIS) using the original development and validation cohorts. Follow-up mortality data are now available through 2011.

Participants

16,063 respondents from the original development cohort and 8,027 respondents from the original validation cohort. All participants were community dwelling and ≥65 years old.

Measurements

We calculated risk scores for each respondent based on the presence or absence of 11 factors (function, illnesses, behaviors, demographics) that make up the index. Using the Kaplan Meier method, we computed 10- and 14-year mortality estimates for the development and validation cohorts to examine model calibration. We examined model discrimination using the c-index.

Results

Participants in the development and validation cohorts were similar. Participants with risk scores 0–4 had 23% risk of 14-year mortality whereas respondents with risk scores (13+) had 89% risk of 14-year mortality. The c-index of the model in both cohorts was 0.73 for predicting 10-year mortality and 0.72 for predicting 14-year mortality. Overall, 18.4% of adults 65–74 years and 60.2% of adults ≥75 years have >50% risk of mortality in 10 years.

Conclusions

Our index demonstrated excellent calibration and discrimination in predicting 10- and 14-year mortality among community-dwelling US adults ≥65 years. Information on long-term prognosis is needed to help clinicians and older adults make more informed person-centered medical decisions and to help older adults plan for the future.

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Families Caring for an Aging America Need Palliative Care - American Geriatric Society

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MDS Foods Inc, of Massillon, OH is Expanding the Current Recall to include Products Identified by Deutsch Kase Haus, LLC of Middlebury, Indiana from their 02/15/2017 Product Recall - FDA Safety Alerts & Drug Recalls

Deutsch Kase Haus, LLC of Middlebury, Indiana, supplied MDS Foods with cheeses that have been found to be contaminated with the pathogenic organism Listeria Monocytogenes which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women. At the time of this release, no illnesses have been reported.

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Los Angeles, CA. Chapis Spice & Tea. Today Announced a Recall/Amendment to the Bread Crumbs and Seasoned Bread Crumbs Distributed on or after 11/10/2017 – 02-16/2017 - FDA Safety Alerts & Drug Recalls

This follows notification from our supplier, that there were undeclared allergens in the “regular” Natural Bread Crumbs manufactured on 11/01/17. Allergens such as, Wheat, Milk, Eggs, Tree Nuts, and, Soybean.

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Synergy Rx Pharmacy Issues a Voluntary Nationwide Recall of the Products Listed Below due to a Lack of Quality Assurance - FDA Safety Alerts & Drug Recalls

San Diego, CA, Synergy Rx Pharmacy is voluntarily recalling the following non-sterile products; Sublingual Tablets, HCG and HCG with resveratrol Human Chorionic Gonadoptropin), Non Sterile Dermatology creams all strengths (retinoic acid creams, hydroquinine creams, bleaching creams), Numbing Creams, acne creams, hair growth serums with minoxidil, betamethasone creams and Chemical Peels (salicylic acid peels, trichoracetic acid peels, glycolic acid peels, Jessners Peels, custom peels solutions) to the retail level due to a lack of quality assurance.

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Licata Enterprises Asks For Volunary Recall of Multiple Vitamin Because of A Possible Fish Allergen Health Risk - FDA Safety Alerts & Drug Recalls

Licata Enterprieses of Huntington Beach, California is recalling its The Supreme One / Theravits 100 multiple vitamin (all lots) due to the discovery of a confusing labeling issue which could cause cause individuals allergic to fish oils to ingest the product in error. The product contains Vitamin A (partially from fish liver oil) which is clearly stated in the Supplement Facts portion of the label; however, another part of some labels also incorrectly state “... contains no common allergens” leading some with fish allergies to believe the product is safe for them. Further, the separate Allergen statement contains fish is missing.

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Dutch Valley Food Distributors, Schlabach Branch Announces a Voluntary Nationwide Recall of Assorted Cheese Items for Potential Listeria Monocytogenes - FDA Safety Alerts & Drug Recalls

Dutch Valley Food Distributors, Schlabach branch is issuing a recall on various Cheeses and cheese containing items due to the potential for it to be contaminated with Listeria monocytogenes. Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

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Biery Cheese Company Recalls Various Types Of Specialty Longhorn Colby Cheeses Due To Possible Listeria Monocytogenes Contamination - FDA Safety Alerts & Drug Recalls

Biery Cheese Co. is voluntarily recalling specialty Longhorn Colby cheese due to potential contamination of Listeria monocytogenes. Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

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Isolation Precautions Use for Multidrug-Resistant Organism Infection in Nursing Homes - American Geriatric Society

Objectives

To examine factors associated with isolation precaution use in nursing home (NH) residents with multidrug-resistant organism (MDRO) infection.

Design

Retrospective, cross-sectional analysis.

Setting

Nursing homes with Centers for Medicare and Medicaid Services’ certification from October 2010 to December 2013.

Participants

Elderly, long-stay NH residents with positive MDRO infection assessments.

Measurements

Data were obtained from the Minimum Data Set (MDS) 3.0, Certification and Survey Provider Enhanced Reporting, and Area Health Resource File. Multivariable regression with facility fixed effects was conducted.

Results

The sample included 191,816 assessments of residents with MDRO infection, of which isolation use was recorded in 12.8%. Of the NHs reporting MDRO infection in the past year, 31% used isolation at least once among residents with MDRO infection. Resident characteristics positively associated with isolation use included locomotion (23.6%, P < .001) and eating (17.9%, P < .001) support. Isolation use was 14.3% lower in those with MDRO history (P < .001). Residents in NHs that had received an infection control–related citation in the past year had a greater probability of isolation use (3.4%, P = .02); those in NHs that had received a quality-of-care citation had lower probability of isolation use (−3.3%, P = .03).

Conclusion

This is the first study to examine the new MDS 3.0 isolation and MDRO items. Isolation was infrequently used, and the proportion of isolated MDRO infections varied between facilities. Inspection citations were related to isolation use in the following year. Further research is needed to determine whether and when isolation should be used to best decrease risk of MDRO transmission and improve quality of care.

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Infrequent Use of Isolation Precautions in Nursing Homes: Implications for an Evolving Population - American Geriatric Society

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Ditos Issues Allergy Alert on Undeclared Milk and Soy in Heart Plastic Platter Strawberries W/Dip with Chocolate Frosting and Heart Plastic Platter Mixed Fruit W/Dip with Chocolate Frosting - FDA Safety Alerts & Drug Recalls

DITOS of Anchorage, Alaska is recalling 50 cases of Heart Plastic Platter Strawberries w/ Dip with Chocolate Frosting 32oz, and 30 cases of Heart Plastic Platter Mixed Fruit w/ Dip with Chocolate Frosting 40oz, because it contains undeclared soy and milk. People who have an allergy or severe sensitivity to soy and/or milk run the risk of serious or life-threatening allergic reaction if they consume these products.

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Saputo Inc. Recalls Certain Gouda Cheese Products Due to Potential Contamination of Listeria Monocytogenes - FDA Safety Alerts & Drug Recalls

Saputo Inc. (Saputo), is voluntarily recalling certain Gouda cheese products in the United States after having been notified by Deutsch Kase Haus, LLC of Middlebury, Indiana that some specialty Gouda cheese products that it supplied to Saputo’s Green Bay, Wisconsin facility may have been contaminated with Listeria monocytogenes.

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Effects of Different Types of Exercise on Body Composition, Muscle Strength, and IGF-1 in the Elderly with Sarcopenic Obesity - American Geriatric Society

Objectives

To investigate the influence of resistance training (RT), aerobic training (AT), or combination training (CT) interventions on the body composition, muscle strength performance, and insulin-like growth factor 1 (IGF-1) of patients with sarcopenic obesity.

Design

Randomized controlled trial.

Setting

Community center and research center.

Participants

Sixty men and women aged 65–75 with sarcopenic obesity.

Intervention

Participants were randomly assigned to RT, AT, CT, and control (CON) groups. After training twice a week for 8 weeks, the participants in each group ceased training for 4 weeks before being examined for the retention effects of the training interventions.

Measurements

The body composition, grip strength, maximum back extensor strength, maximum knee extensor muscle strength, and blood IGF-1 concentration were measured.

Results

The skeletal muscle mass (SMM), body fat mass, appendicular SMM/weight %, and visceral fat area (VFA) of the RT, AT, and CT groups were significantly superior to those of the CON group at both week 8 and week 12. Regarding muscle strength performance, the RT group exhibited greater grip strength at weeks 8 and 12 as well as higher knee extensor performance at week 8 than that of the other groups. At week 8, the serum IGF-1 concentration of the RT group was higher than the CON group, whereas the CT group was superior to the AT and CON groups.

Conclusion

Older adults with sarcopenic obesity who engaged in the RT, AT, and CT interventions demonstrated increased muscle mass and reduced total fat mass and VFA compared with those without training. The muscle strength performance and serum IGF-1 level in trained groups, especially in the RT group, were superior to the control group.

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Apples and Oranges: Four Definitions of Multiple Chronic Conditions and their Relationship to 30-Day Hospital Readmission - American Geriatric Society

Objectives

To determine the extent of agreement between four commonly used definitions of multiple chronic conditions (MCCs) and compare each definition's ability to predict 30-day hospital readmissions.

Design

Retrospective cohort study.

Setting

National Medicare claims data.

Participants

Random sample of Medicare beneficiaries discharged from the hospital from 2005 to 2009 (n = 710,609).

Measurements

Baseline chronic conditions were determined for each participant using four definitions of MCC. The primary outcome was all-cause 30-day hospital readmission. Agreement between MCC definitions was measured, and sensitivities and specificities for each definition's ability to identify patients experiencing a future readmission were calculated. Logistic regression was used to assess the ability of each MCC definition to predict 30-day hospital readmission.

Results

The sample prevalence of hospitalized Medicare beneficiaries with two or more chronic conditions ranged from 18.6% (Johns Hopkins Adjusted Clinical Groups (ACG) Case-Mix System software) to 92.9% (Medicare Chronic Condition Warehouse (CCW)). There was slight to moderate agreement (kappa = 0.03–0.44) between pair-wise combinations of MCC definitions. CCW-defined MCC was the most sensitive (sensitivity 95.4%, specificity 7.4%), and ACG-defined MCC was the most specific (sensitivity 32.7%, specificity 83.2%) predictor of being readmitted. In the fully adjusted model, the risk of readmission was higher for those with chronic condition Special Needs Plan (c-SNP)-defined MCCs (odds ratio (OR) = 1.50, 95% confidence interval (CI) = 1.47–1.52), Charlson Comorbidity Index–defined MCCs (OR = 1.45, 95% CI = 1.42–1.47), ACG-defined MCCs (OR = 1.22, 95% CI = 1.19–1.25), and CCW-defined MCCs (OR = 1.15, 95% CI = 1.11–1.19) than for those without MCCs.

Conclusion

MCC definitions demonstrate poor agreement and should not be used interchangeably. The two definitions with the greatest agreement (CCI, c-SNP) were also the best predictors of 30-day hospital readmissions.

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Multicenter Validation of an MMSE-MoCA Conversion Table - American Geriatric Society

Background

Accumulating evidence points to the superiority of the MoCA over the MMSE as a cognitive screening tool. To facilitate the transition from the MMSE to the MoCA in clinical and research settings, authors have developed MMSE-MoCA conversion tables. However, it is unknown whether a conversion table generated from Alzheimer's disease (AD) patients would apply to patients with other dementia subtypes like vascular dementia or frontotemporal dementia. Furthermore, the reliability and accuracy of MMSE-MoCA conversion tables has not been properly evaluated.

Method

We retrospectively examined the MMSE-MoCA relationship in a large multicenter sample gathered from 3 Memory Clinics in Quebec, Canada (1492 patients). We produced an MMSE-MoCA conversion table using the equi-percentile method with log-linear smoothing. We then cross-validated our conversion table with the ADNI dataset (1202 patients) and evaluated its accuracy for future predictions.

Results

The MMSE-MoCA conversion table is consistent with previously published tables and has an intra-class correlation of 0.633 with the ADNI sample. However, we found that the MMSE-MoCA relationship is significantly modified by diagnosis (P < .01), with dementia subtypes associated with a dysexecutive syndrome showing a trend towards higher MMSE than other dementia syndromes for a given MoCA score. The large width of 95% confidence interval (CI) for a new prediction suggests questionable reliability for clinical use.

Conclusion

In this study, we validated a conversion table between MMSE and MoCA using a large multicenter sample. Our results suggest caution in interpreting the tables in heterogeneous clinical populations, as the MMSE-MoCA relationship may be different across dementia subtypes.

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The Effect of Treatment of Anemia with Blood Transfusion on Delirium: A Systematic Review - American Geriatric Society

Objectives

Treating the precipitating factors of delirium is the mainstay of the prevention and treatment of delirium. We aim to investigate the role of anemia and blood transfusion within the multicomponent prevention and treatment strategy of delirium.

Design

Systematic review.

Setting

We included cohort studies or Randomized Controlled Trials (RCTs) that considered blood transfusion as treatment for delirium or risk factor, and had delirium as outcome.

Participants

Hospitalized patients above 55 years old.

Measurements

We searched MEDLINE from 1946 through November 2014. Quality assessment and data extraction were performed systematically.

Results

We included 23 studies (n = 29,471). The majority of the studies (n = 22) had a limited quality and for one study quality was uncertain. Two studies evaluated the association between transfusion strategy and postoperative delirium and found no association. Twenty-one studies investigated blood transfusion as a risk factor for delirium. In four of the 21 studies it could be assumed that delirium occurred after transfusion. One of these studies stated that transfusion was a significant risk factor for subsequent delirium (odds ratio (OR) = 3.68, 95% confidence interval (CI) = 1.32–10.94). The other three studies found no association between transfusion and delirium. In the remaining 17 studies, it was not clear whether delirium occurred before or after transfusion, so no conclusion could be drawn on the role of transfusion in delirium development.

Conclusion

The majority of the included studies was not suited to answer the research question properly as the time course of the beginning of delirium as to transfusion was lacking. Our review shows that there is no good quality evidence available for blood transfusion to be a risk factor for delirium or to be a preventive or treatment option.

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Veggie Noodle Co. Recalls Butternut Spirals Due to Possible Health Risk - FDA Safety Alerts & Drug Recalls

Veggie Noodle Co. of Austin, Texas is voluntarily recalling a limited quantity of Butternut Spirals due to possible contamination with Listeria monocytogenes. Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

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FDA approves new psoriasis drug - FDA Press Releases

The U.S. Food and Drug Administration today approved Siliq (brodalumab) to treat adults with moderate-to-severe plaque psoriasis. Siliq is administered as an injection.

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The FDA is issuing this recall notice from the Canadian Food Inspection Agency to alert U.S. consumers who may have purchased these products in Canada not to eat or serve them. The products under recall were manufactured specifically for the Canadian marketplace. - Updated Food Recall Warning - PC Organics brand baby food pouches recalled due to potential presence of dangerous bacteria - FDA Safety Alerts & Drug Recalls

The food recall warning issued on February 3, 2017 has been updated to include additional products. This additional information was identified during the Canadian Food Inspection Agency's (CFIA) food safety investigation. Loblaw Companies Limited is recalling PC Organics brand baby food pouches from the marketplace because they may permit the growth of Clostridium botulinum.

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Allergen Alert Expansion: Legendary Baking Issues Allergy Alert - Almonds And Egg In Salted Caramel Chocolate Almond Pie - Allergens Not Declared In Ingredient List - FDA Safety Alerts & Drug Recalls

Legendary Baking of Denver, CO, has expanded its recall of 34 ounce packages of Private Selection Salted Caramel Chocolate Almond Pie because the almonds and eggs were not listed in the ingredient statement. People who have allergies to almonds and eggs run the risk of serious or life-threatening allergic reaction if they consume these products.

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Guggisberg Cheese, Inc. Recalls Various Colby Type Cheeses due to Possible Listeria Monocytogenes Contamination - FDA Safety Alerts & Drug Recalls

Out of an abundance of caution and with an emphasis on its customers’ wellness and safety, Guggisberg Cheese Inc. is recalling various types of Colby type cheeses and sizes due to a potential contamination of Listeria monocytogenes.

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Mutation in clpC1 encoding an ATP-dependent ATPase involved in protein degradation is associated with pyrazinamide resistance in Mycobacterium tuberculosis

Mutation in clpC1 encoding an ATP-dependent ATPase involved in protein degradation is associated with pyrazinamide resistance in Mycobacterium tuberculosis

Emerging Microbes & Infections 6, e8 (February 2017). doi:10.1038/emi.2017.1

Authors: Shuo Zhang, Jiazhen Chen, Wanliang Shi, Peng Cui, Jia Zhang, Sanghyun Cho, Wenhong Zhang & Ying Zhang

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Multilocus sequence typing identifies an avian-like Chlamydia psittaci strain involved in equine placentitis and associated with subsequent human psittacosis

Multilocus sequence typing identifies an avian-like Chlamydia psittaci strain involved in equine placentitis and associated with subsequent human psittacosis

Emerging Microbes & Infections 6, e7 (February 2017). doi:10.1038/emi.2016.135

Authors: Martina Jelocnik, James Branley, Jane Heller, Shane Raidal, Susan Alderson, Francesca Galea, Melinda Gabor & Adam Polkinghorne

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Neonatal pigs are susceptible to experimental Zika virus infection

Neonatal pigs are susceptible to experimental Zika virus infection

Emerging Microbes & Infections 6, e6 (February 2017). doi:10.1038/emi.2016.133

Authors: Joseph Darbellay, Kenneth Lai, Shawn Babiuk, Yohannes Berhane, Aruna Ambagala, Colette Wheler, Donald Wilson, Stewart Walker, Andrew Potter, Matthew Gilmour, David Safronetz, Volker Gerdts & Uladzimir Karniychuk

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Against The Grain Pet Food Voluntarily Recalls One Lot of Pulled Beef Due to Potential Adulteration with Pentobarbital - FDA Safety Alerts & Drug Recalls

Out of an abundance of caution, Against the Grain Pet Food is voluntarily recalling one lot of Against the Grain Pulled Beef with Gravy Dinner for Dogs that was manufactured and distributed in 2015. The 12 oz. Against the Grain Pulled Beef with Gravy Dinner for Dogs that is being voluntarily recalled, due to the potential presence of pentobarbital, has an expiration date of December 2019, a lot number of 2415E01ATB12, and the second half of the UPC code is 80001 (which can be found on the back of the product label).

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Synergy Rx Pharmacy Issues Voluntary Nationwide Recall of All Lots of HCG (Human Chorionic Gonadotropin)Freeze Dried Vials Due to a Lack of Sterility Assurance - FDA Safety Alerts & Drug Recalls

Synergy Rx Pharmacy is voluntarily recalling all lots of Human Chorionic Gonadotropin (HCG) 5,000 units/vial and 11,000 units/vial to the retail level due to a lack of sterility assurance. Administration of a drug product intended to be sterile that is not sterile could result in serious infections that may be life-threatening.

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Polypharmacy Reduction Strategies - Geriatrics

There is no single definition of polypharmacy. Use of 5 or more medications commonly is used. An alternative, quantitative definition, such as use of more medications than clinically indicated or use of unnecessary or harmful prescribing, has been proposed. Protocols or algorithms to improve polypharmacy and prescribing in older adults have been developed. The American Geriatrics Society (AGS) Beers Criteria and Screening Tool of Older People’s Prescriptions (STOPP) explicit criteria reflect elements that are common across protocols and algorithms. Concepts in AGS Beers and STOPP can be incorporated into polypharmacy reduction strategies to improve outcomes of care for older adults.

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Geriatric Polypharmacy - Geriatrics

This article highlights the significant health impact of falls among older adults. An emphasis is placed on the vital role of the pharmacist, regardless of practice setting, in assessing and reducing falls risk for this growing population. In addition, the importance of a stepwise comprehensive approach to falls assessment by pharmacists in collaboration with other clinicians is elucidated.

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Centers for Medicare and Medicaid Services Support for Medication Therapy Management (Enhanced Medication Therapy Management) - Geriatrics

In 2006, Medicare beneficiaries began receiving prescription coverage benefits through Part D of the Medicare benefit. Medicare Part D plans must provide medication therapy (MTM) services. MTM services aim to improve medication use and are targeted toward eligible beneficiaries, determined by morbidity, prescription use, and anticipated cost of prescription use. Now, 10 years after the start of Medicare Part D, several changes have been made to the program's design. This article focuses on changes related to MTM and the impact that these changes have and will continue to have on Medicare beneficiaries and medication use.

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Sargento Recalls Select Products - FDA Safety Alerts & Drug Recalls

Deutsch Kase Haus, LLC of Middlebury, Ind. has notified Sargento Foods Inc. that a specialty Longhorn Colby cheese they supplied to Sargento must be recalled due to a potential contamination of Listeria monocytogenes. No illnesses have been reported.

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Choice Farms LLC Recalls Very Limited Quantity of Mushrooms Stuffed with Cheese Supplied by a Third Party that may have the potential for Listeria monocytogenes Contamination - FDA Safety Alerts & Drug Recalls

Choice Farms LLC is initiating a very limited voluntary recall of stuffed mushrooms because the mushrooms may contain a cheese component which a third party supplier advised has the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stuffiness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

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Country Fresh Recalls Various Cooking And Snacking Products Due To Possible Health Risk - FDA Safety Alerts & Drug Recalls

Following the Sargento Cheese Company recall where select Sargento branded cheeses were recalled due to the potential of being contaminated with Listeria monocytogenes, Country Fresh, LLC. of Conroe, Texas, is recalling 2,552 cases of various cooking and snacking products (product descriptions attached), that contained Sargento branded cheeses because they have the potential to be contaminated with Listeria monocytogenes. Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

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Cousins Products LLC Issues Allergy Alert and Voluntary Recall on 16oz Creole Tomato Dressing, Best by Date 05/18/17, due to Undeclared Milk - FDA Safety Alerts & Drug Recalls

Tomato Salad Dressing

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MDS Foods Inc. - Food Safety Press Release - FDA Safety Alerts & Drug Recalls

MDS Foods Inc., of Massillon, OH is recalling multiple products some of which were found to be contaminated with the bacteria Listeria monocytogenes and other products which may have the potential to be contaminated with the bacteria. Deutsch Kase Haus, LLC of Middlebury, Indiana, supplied MDS Foods with Colby and Colby Jack minihorn cheeses that have been found to be contaminated with the pathogenic organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

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Meijer Recalls Meijer Brand Colby and Colby Jack Deli Cheeses Because of Possible Health Risk - FDA Safety Alerts & Drug Recalls

Meijer is announcing a recall of its Meijer Brand Colby Cheese and Colby Jack Cheese sold exclusively through its deli counters due to a potential contamination with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, a Listeria monocytogenes infection can cause miscarriages and stillbirths among pregnant women.

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PetSmart Voluntarily Recalls Single Lot of Grreat Choice® Canned Dog Food Due to Possible Health Risk - FDA Safety Alerts & Drug Recalls

PetSmart has issued a voluntary recall of one production lot of its Grreat Choice® Adult Dog Food sold on PetSmart.com, Pet360.com, PetFoodDirect.com and in nationwide PetSmart retail stores. This product is being voluntarily recalled as a precautionary measure due to metal contamination that could potentially be a choking hazard to pets.

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Adverse Events Associated with Antipsychotic Use in Hospitalized Older Adults After Cardiac Surgery - American Geriatric Society

Objectives

To evaluate in-hospital adverse events associated with typical and atypical antipsychotic medications (APMs) after cardiac surgery.

Design

Retrospective cohort study.

Setting

Nationwide inpatient database, 2003 to 14.

Participants

Individuals (mean age 70) newly treated with oral atypical (n = 2,580) or typical (n = 1,126 APMs) after coronary artery bypass grafting or valve surgery (N = 3,706).

Measurements

In-hospital mortality, arrhythmia, pneumonia, use of brain imaging (surrogate for oversedation and neurological events), and length of stay after drug initiation

Results

In the propensity score–matched cohort, median treatment duration was 3 days (interquartile range (IQR) 1–6 days) for atypical APMs and 2 days (IQR 1–3 days) for typical APMs. There were no large differences in in-hospital mortality (atypical 5.4%, typical 5.3%; risk difference (RD) = 0.1%, 95% confidence interval (CI) = −2.1 to 2.3%), arrhythmia (2.0% vs 2.2%; RD = 0.0%; 95% CI = −1.4 to 1.4%), pneumonia (16.1% vs 14.5%; RD = 1.6%, 95% CI = −1.9 to 5.0%), and length of stay (9.9 days vs 9.3 days; mean difference = 0.5 days, 95% CI = −1.2 to 2.2). Use of brain imaging was more common after initiating atypical APMs (17.3%) than after typical APMs (12.4%; RD = 4.9%, 95% CI = 1.4–8.4).

Conclusion

In hospitalized individuals who underwent cardiac surgery, short-term use of typical APMs was associated with risks of adverse events similar to those with atypical APMs. Moreover, greater use of brain imaging associated with atypical APMs suggests that these drugs may cause oversedation or adverse neurological events. Because of the low event rates, the analysis could not exclude modest differences in adverse events between atypical and typical APMs.

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Study of Individualization and Bias in Nursing Home Fall Prevention Practices - American Geriatric Society

Objectives

Little is known about how nursing home staff use resident characteristics to individualize care delivery or whether care is affected by implicit bias.

Design

Randomized factorial clinical vignette survey.

Setting

Sixteen nursing homes in North Carolina.

Participants

Nursing, rehabilitation, and social services staff (n = 433).

Measurements

Vignettes describing hypothetical residents were generated from a matrix of clinical and demographic characteristics. Resident age, race and gender were suggested by a photo. Participants completed up to four randomly assigned vignettes (n = 1615), rating the likelihood that 12 fall prevention activities would be used for the resident. Fixed and random effects mixed model analysis examined the impact of vignette resident characteristics and staff characteristics on four intervention categories.

Results

Staff reported a higher likelihood of fall prevention activities in all four categories for residents with a prior fall (0.2–0.5 points higher, 10 point scale, P < 0.05), but other risk factors did not affect scores. There was little evidence of individualization; only dementia increased the reported likelihood of environmental modification (0.3, P < 0.001, 95% CI 0.2–0.5). Individualization did not vary with staff licensure category or clinical experience. Registered nurses consistently reported higher likelihoods of all fall prevention activities than did licensed practical nurses, unlicensed staff and other professional staff (1.0–2.7 points, P < 0.001 to 0.005). There was a small degree of implicit racial bias; staff indicated that environmental modification would be less likely to occur in otherwise identical vignettes including a photo of a black rather than a white resident (−0.2 points, 95% CI −0.3 to −0.1).

Conclusion

Nursing home staff report a standardized approach to fall prevention without individualization. We found a small impact from implicit racial bias that should be further explored.

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FDA approves drug to treat Duchenne muscular dystrophy - FDA Press Releases

The U.S. Food and Drug Administration today approved Emflaza (deflazacort) tablets and oral suspension to treat patients age 5 years and older with Duchenne muscular dystrophy (DMD), a rare genetic disorder that causes progressive muscle deterioration and weakness. Emflaza is a corticosteroid that works by decreasing inflammation and reducing the activity of the immune system.

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Ruth’s Salad Charlotte NC Expands Recall of Ruth’s Salads Pimento Spreads due to Possible Health Risk. May Contain Listeria Monocytogenes - FDA Safety Alerts & Drug Recalls

Ruth’s Salads Charlotte, NC is expanding the recall of Ruth’s Salads Pimento Cheese Spreads packed in Chester, SC. The products involved include: Ruth’s Original Pimento Spread 7oz; Ruth’s Original Pimento Spread 12 oz.; Ruth’s Original Pimento Spread 24 oz.; Ruth’s Old Fashion Pimento Spread 16 oz.; Ruth’s Jalapeno Pimento Spread 12 oz.; Ruth’s Lite Pimento Spread 12 oz.; and Ruth’s Cream Cheese with Pineapple-Pecans 12 oz.

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Federal judge approves consent decree with California dietary supplement distributor, Regeneca Worldwide - FDA Press Releases

A California dietary supplement distributor has been ordered by a federal court to stop selling its products, which were found to contain unsafe ingredients including 1, 3-dimethylamylamine (DMAA).

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Long-term Metformin Therapy and Monitoring for Vitamin B12 Deficiency Among Older Veterans - American Geriatric Society

Objective

To examine the association between long-term metformin therapy and serum vitamin B12 monitoring.

Design

Retrospective cohort study.

Setting

A single Veterans Affairs Medical Center (VAMC), 2002–2012.

Participants

Veterans 50 years or older with either type 2 diabetes and long-term metformin therapy (n = 3,687) or without diabetes and no prescription for metformin (n = 13,258).

Measurements

We determined diabetes status from outpatient visits, and defined long-term metformin therapy as a prescription ≥500 mg/d for at least six consecutive months. We estimated the proportion of participants who received a serum B12 test and used multivariable logistic regression, stratified by age, to evaluate the association between metformin use and serum B12 testing.

Results

Only 37% of older adults with diabetes receiving metformin were tested for vitamin B12 status after long-term metformin prescription. The mean B12 concentration was significantly lower in the metformin-exposed group (439.2 pg/dL) compared to those without diabetes (522.4 pg/dL) (P = .0015). About 7% of persons with diabetes receiving metformin were vitamin B12 deficient (<170 pg/dL) compared to 3% of persons without diabetes or metformin use (P = .0001). Depending on their age, metformin users were two to three times more likely not to receive vitamin B12 testing compared to those without metformin exposure, after adjusting for sex, race and ethnicity, body mass index, and number of years treated at the VAMC.

Conclusion

Long-term metformin therapy is significantly associated with lower serum vitamin B12 concentration, yet those at risk are often not monitored for B12 deficiency. Because metformin is first line therapy for type 2 diabetes, clinical decision support should be considered to promote serum B12 monitoring among long-term metformin users for timely identification of the potential need for B12 replacement.

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Transcatheter Aortic Valve Replacement in the Care of Older Persons with Aortic Stenosis - American Geriatric Society

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Legendary Baking Issues Allergy Alert-Almonds and Egg in Salted Caramel Chocolate Almond Pie Allergens Declared but Listed Under “May Contain” - FDA Safety Alerts & Drug Recalls

Legendary Baking of Denver, CO, is recalling its 34 ounce packages of Private Selection Salted Caramel Chocolate Almond Pie because the almonds and eggs were listed under “may contains” instead of “contains”. People who have allergies to almonds and eggs run the risk of serious or life-threatening allergic reaction if they consume these products.

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Improving the Electronic Capture of Advance Care Directives in a Healthcare Delivery System - American Geriatric Society

Objectives

To determine the effectiveness of a multifaceted quality improvement intervention in outpatient clinics at an integrated healthcare delivery system on capture rate of advance directives (ADs) in the electronic medical record (EMR).

Design

Interrupted time series analysis with control groups between January 2010 and June 2015.

Setting

Oncology, nephrology, and primary care outpatient clinics in an integrated healthcare delivery system.

Participants

All individuals aged 65 and older with at least one office visit in any outpatient clinic in the care delivery system (n = 77,350 with 502,446 office visits).

Intervention

A series of quality improvement interventions to improve rates of advance care planning discussions and capture of those discussions in the EMR between 2010 and 2014.

Measurements

Capture rate of ADs in the EMR.

Results

Visits in the intervention primary care clinic were twice as likely to mention ADs in the EMR (53.4%) than visits in nonintervention primary care clinics (26.5%). Visits in the intervention oncology clinic were more than eight times as likely to mention ADs in the EMR (49.3% vs 6.0%), and visits in the intervention nephrology clinic were 2.5 times as likely to mention ADs (15.4% vs 6.0%) than visits in other specialty clinics.

Conclusions

A series of quality improvement interventions to increase discussions about advance care planning and capture of advance care directives in the EMR significantly increased the rate of capture in primary care and specialty care outpatient settings.

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Exela Pharma Sciences, LLC Issues Voluntary Nationwide Recall of Ibuprofen Lysine Injection, 20 Mg/2 Ml (10 Mg/Ml) Due to Particulate Matter - FDA Safety Alerts & Drug Recalls

Exela Pharma Sciences, LLC (“Exela”), in association with marketer X-Gen Pharmaceuticals, Inc. (“X-Gen”), is voluntarily recalling lot number PLND1613 of Ibuprofen Lysine Injection, 20 mg /2 mL (10 mg/mL), vials to the hospital or user level. Some of the vials have been found to contain particulate matter.

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Fred Meyer Stores Issues Allergy Alert on Fred Meyer 100% Whole Wheat Bread due to Undeclared Milk - FDA Safety Alerts & Drug Recalls

Fred Meyer Stores has recalled the 16 oz Fred Meyer 100% Whole Wheat Bread sold in its retail stores because the product may contain nonfat dry milk not listed on the label. People who have an allergy or severe sensitivity to milk run the risk of a serious or life-threatening allergic reaction if they consume this product.

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Geriatricians: The Super Specialists - American Geriatric Society

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Response to John E. Morley about “The Future Role of Geriatrics” - American Geriatric Society

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The Future Role of Geriatrics: Building Local Coalitions to Demonstrate Value - American Geriatric Society

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Kingsway Trading Inc. Recalls “Xanthium & Siler Combo (Bi Yan Pian) Dietary Supplement” because it Contains Banned Ephedra Alkaloids - FDA Safety Alerts & Drug Recalls

Kingsway Trading Inc. of Brooklyn, NY is recalling its 1.06 oz (30g) bottles of “Well Balance Xanthium & Siler Combo (Bi Yan Pian)” Batch No. 130401 & Batch No. 150201 because they contain the presence of undeclared Ephedra Herba (ma huang), an FDA banned item. Dietary supplements containing ephedrine alkaloids pose a risk of serious adverse events, including heart attack, stroke, and death, and that these risks are unreasonable in light of any benefits that may result from the use of these products under their labeled conditions of use, or under ordinary conditions of use if the labeling is silent.

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Natriuretic Peptides in Older Patients With Heart Failure: A Look Into the Seeds of Time - American Geriatric Society

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Aging in Sub-Saharan Africa: Sub-par? - American Geriatric Society

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PTSD, Psychotropic Medication Use, and the Risk of Dementia Among US Veterans: A Retrospective Cohort Study - American Geriatric Society

Objective

To determine the associations between PTSD, psychotropic medication use, and the risk for dementia.

Design

Retrospective cohort.

Participants

Nationwide sample of US veterans (N = 417,172) aged ≥56 years during fiscal year (FY) 2003 without a diagnosis of dementia or mild cognitive impairment at baseline (FY02-03) and ≥1 clinical encounter every 2 years during follow-up (FY04-12).

Measures

Demographic characteristics; diagnosis of PTSD, dementia, and medical and psychiatric comorbidity (defined by ICD-9 codes); and psychotropic medication use including selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), novel antidepressants (NA), benzodiazepines (BZA), and atypical antipsychotics (AA). Cox proportional hazard models examined for associations between PTSD diagnosis, psychotropic medication use, and risk for a dementia diagnosis.

Results

PTSD diagnosis significantly increased the risk for dementia diagnosis (HR = 1.35; [95% CI = 1.27–1.43]). However, there were significant interactions between PTSD diagnosis and use of SSRIs (P < .001), NAs (P = .014), and AAs (P < .001) on the risk for dementia diagnosis. HR for dementia diagnosis among veterans diagnosed with PTSD and not using psychotropic medications was 1.55 [1.45–1.67]. Among veterans diagnosed with PTSD prescribed SSRI, SNRI, or AA, HR for dementia diagnosis varied by drug class use ranging from 1.99 for SSRI to 4.21 for AA, relative to veterans without a PTSD diagnosis and no psychotropic medication receipt. BZAs or SNRIs use at baseline was associated with a significantly increased risk for dementia diagnosis independent of a PTSD diagnosis.

Conclusion

PTSD diagnosis is associated with an increased risk for dementia diagnosis that varied with receipt of psychotropic medications. Further research would help to delineate if these findings are due to differences in PTSD severity, psychiatric comorbidity, or independent effects of psychotropic medications on cognitive decline.

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Cognitive Differences between Men and Women who Fracture their Hip and Impact on Six-Month Survival - American Geriatric Society

Objectives

There is limited research in cognition and its relationship to mortality after hip fracture among men compared to women. Therefore, the goals of this study were to: (1) compare men and women who fractured their hip on cognition after hospital discharge, and (2) examine the impact of cognition on the differential risk of 6-month mortality between men and women post fracture.

Design

Prospective cohort study.

Setting

Eight hospitals in Baltimore, Maryland.

Participants

Frequency matched 168 male and 171 female hip fracture patients, ages 65 or older, living in the community before fracture.

Measurements

Cognition assed by Modified Mini-Mental State Examination (3MS, and derived MMSE score), Hooper Visual Organization test (HVOT), and Trail-making test (Trails A & B) within 22 days of hospital admission, and 6-month mortality.

Results

Men had more impaired cognitive scores on 3MS, MMSE, HVOT, and Trails A (P < .05) at baseline. These statistically significant differences between men and women remained on MMSE and HVOT after controlling for pre-fracture dementia, in-hospital delirium, age, education, race, and comorbidity. Men had higher 6-month mortality rates (HR = 4.4, P < .001). Cognitive measures were also significantly associated with mortality, including 3MS, HVOT, and Trails B. Among the cognitive measures, higher 3MS was most protective for mortality (HR = 0.98, P < .001), both unadjusted and adjusted for other cognitive scales, comorbidity, delirium, and pre-existing dementia. The highest mortality was among men with 3MS<78, with 26.3% dying within 6 months. The effects of cognition on mortality did not differ by sex.

Conclusion

Men display greater levels of cognitive impairment within the first 22 days of hip fracture than women, and cognitive limitations increase the risk of mortality in both men and women.

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Starway Inc. Issues an Alert on Undeclared Sulfites in Peony Mark Brand Dried Lily Flower - FDA Safety Alerts & Drug Recalls

Starway Incorporated, located at 137 Grattan Street, Brooklyn, NY, 11237, is recalling Peony Mark Brand Dried Lily Flower because the product contains undeclared sulfites. People who have severe sensitivity to sulfites run the risk of serious or life threatening allergic reactions if they consumer this product.

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Quality Indicators of Drug Use and Risk of Pneumonia in Older Adults without Dementia - American Geriatric Society

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Reply to: Quality Indicators of Drug Use and the Risk of Pneumonia in Older Adults without Dementia - American Geriatric Society

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Guarding Against Overtesting, Overdiagnosis, and Overtreatment of Older Adults: Thinking Beyond Imaging and Injuries to Weigh Harms and Benefits - American Geriatric Society

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Response to Christopher Callahan About “Geriatricians: More Than Superspecialists?” - American Geriatric Society

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Effect of Physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study - American Geriatric Society

Background/Objectives

To test the hypothesis that a long-term structured, moderate intensity physical activity (PA) program is more effective than a health education (HE) program in reducing the risk of s elf-reported dependency and disability in basic activities of daily living (BADLs), disability in instrumental ADLs (IADL), and mobility disability.

Design

The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, single-blinded randomized trial.

Setting

University-based research clinic.

Participants

Thousand six hundred and thirty five sedentary men and women aged 70–89 years, who had functional limitations, defined as a score ≤9 on the Short Physical Performance Battery.

Intervention

Participants were randomized to a structured, moderate intensity PA program (n = 818) that included aerobic, resistance, and flexibility exercises or to a HE program (n = 817).

Measurements

All outcomes were derived by self-report using periodic interviews that asked about the degree of difficulty and receipt of help during the past month. Dependency was defined as “receiving assistance” or “unable” to do ≥1 activities. Disability was defined as having “a lot of difficulty” or “unable” doing ≥1 activities. Severe disability was defined as reporting difficulty or being unable to perform ≥3 activities.

Results

Over an average follow-up of 2.6 years, the cumulative incidence of BADL dependency was 15.2% among PA and 15.1% among HE participants (HR = 1.0, 95% CI = 0.78–0.1.3). Intervention groups had similar rates of incident BADL disability, IADL disability and reported mobility disability. Reporting severe mobility disability (HR = 0.78, 95% CI = 0.64–0.96) and ratings of difficulty on mobility tasks were reduced in the PA group.

Conclusion

A structured physical activity intervention reduces reported severe mobility disability and difficulty on mobility tasks, but not BADL and IADL disability in older adults with functional limitations.

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