FDA Designates Medtronic Worldwide Voluntary Field Action on HVAD(TM) System Controllers and DC Adapters as Class I Recall - FDA Safety Alerts & Drug Recalls

Medtronic plc (NYSE: MDT) announced today that the U.S. Food and Drug Administration (FDA) has classified the company's recently initiated voluntary field action related to its HVAD(TM) System Controllers (serial numbers lower than CON300000) and DC Adapters (all serial numbers for product code 1435) as a Class I recall.

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FDA approves new combination treatment for acute myeloid leukemia - FDA Press Releases

The U.S. Food and Drug Administration today approved Rydapt (midostaurin) for the treatment of adult patients with newly diagnosed acute myeloid leukemia (AML) who have a specific genetic mutation called FLT3, in combination with chemotherapy. The drug is approved for use with a companion diagnostic, the LeukoStrat CDx FLT3 Mutation Assay, which is used to detect the FLT3 mutation in patients with AML.

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Urban Remedy Issues Voluntary Recall of Mislabeled Non-Dairy Spiced Golden Milk Due to Undeclared Allergen - FDA Safety Alerts & Drug Recalls

Urban Remedy is voluntarily recalling Non-Dairy Spiced Golden Milk that was mislabeled as cold pressed apple juice. The products were sold in select Whole Foods Market stores in Arizona, California and Nevada and contained tree nut (cashew) allergens that were not listed on the product labels. People who have an allergy or severe sensitivity to tree nuts run the risk of serious or life-threatening allergic reaction if they consume these products.

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Falls in the Aging Population - Geriatrics

The number of people living beyond 65 years of age is increasing rapidly and they are at increased risk of falls. Falls-related injuries and hospitalizations are steadily increasing. Falls can lead to fear of falling, loss of independence, institutionalization, and death, inevitably posing a significant burden to the health care system. Therefore, screening of people at risk of falls and comprehensive assessment of older people at high risk of falls are critical steps toward prevention. This review evaluates the current knowledge relating to falls, with particular focus on rapid screening, assessment, and strategies to prevent falls in the community.

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Lords Organics Recalls Ginger Powder Because Of Possible Health Risk - FDA Safety Alerts & Drug Recalls

LORDS ORGANICS is recalling Ginger Powder Product from AGF Organic Veda, because it has the potential to be contaminated with Salmonella, 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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Survival, Functional Status, and Eating Ability After Percutaneous Endoscopic Gastrostomy Tube Placement for Acute Stroke - American Geriatric Society

Objectives

To determine the long-term survival and independence of individuals with stroke and percutaneous endoscopic gastrostomy (PEG) tube placement.

Design

Retrospective cohort study.

Setting

A longitudinal nationally representative community-based sample of older adults.

Participants

Individuals with stroke who had a PEG tube placed (N = 174, mean age 79, 51% female, 29% African American).

Measurements

Functional status before incident stroke was determined based on data from the Health and Retirement Study (HRS), a national longitudinal survey of community-dwelling older adults, from 1993 to 2012. Hospitalizations for stroke and PEG placement were determined according to Medicare claims. HRS participants were interviewed, and outcomes of survivors interviewed in the 2 years after hospitalization are described. Survival and functional and eating ability of the cohort were examined. Groups were compared according to age and prestroke functional disability in activities of daily living (ADLs) because it was hypothesized that ADL disability would predict worse outcomes.

Results

In the 2 years after hospitalization, overall mortality was 66%. Fifteen participants survived and regained independent ADL function (9%). Of those who survived to a follow-up interview, 33 (56%) could not eat independently, and 31 (53%) required assistance to walk across the room. Age of 85 and older was associated with worse outcomes (10% vs 29% at 2 years, P < .001), but baseline ADL disability was not.

Conclusion

In this community-based sample, individuals who had had a stroke and a PEG tube placed had high mortality, and survivors were unlikely to be functional or mobile or to recover eating ability after hospitalization. A palliative care discussion including goals of care should occur before PEG tube placement is considered.

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Caregiving for Older Adults with Obesity in the United States - American Geriatric Society

Objectives

To determine the difference in receipt of activity of daily living (ADL) assistance between obese and normal-weight older adults.

Design

Retrospective cohort study.

Setting

National Health and Aging Trends Study, 2011–2015.

Participants

U.S. adults aged 65 and older with ADL disability and a body mass index (BMI) of 18.5 kg/m² or greater (N = 5,612)

Measurements

BMI was classified as normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), or obese (≥30.0 kg/m²). Primary outcome was self-reported receipt of help with specific ADLs. Models were adjusted for demographic characteristics (age, sex, race), degree of need (self-reported general health, severity of disability), household resources (income, marriage, people in household, number of children), and cognitive status (dementia, proxy respondent).

Results

Obese with disabilities had lower rates of receiving assistance with walking inside (odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.50–0.81), walking outside (OR = 0.76, 95% CI = 0.59–0.97), toileting (OR = 0.68, 95% CI = 0.52–0.89), and getting in and out of bed (OR = 0.67, 95% CI = 0.50–0.87) than normal-weight older adults after adjustment for respondent demographic characteristics. Level of need and cognitive status partially explained the associations. In fully adjusted models, older adults with obesity still had significantly lower odds of receiving assistance in getting in and out of bed than normal weight adults (OR = 0.69, 95% CI = 0.49–0.98).

Conclusion

Older adults with obesity are less likely to receive assistance for ADL disabilities than their normal-weight counterparts—an important concern because of ongoing demographic changes in the United States.

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Phoenix Food, LLC Announces Voluntary Recall Of Dip Trio Mix Due To Possible Health Risk - FDA Safety Alerts & Drug Recalls

Phoenix Food, LLC (the company) of Canton, Texas announced it is voluntarily recalling select Dip Trio Mixes due to the potential presence of Salmonella in the seasoning packet. Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

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FDA approves first treatment for a form of Batten disease - FDA Press Releases

The U.S. Food and Drug Administration today approved Brineura (cerliponase alfa) as a treatment for a specific form of Batten disease. Brineura is the first FDA-approved treatment to slow loss of walking ability (ambulation) in symptomatic pediatric patients 3 years of age and older with late infantile neuronal ceroid lipofuscinosis type 2 (CLN2), also known as tripeptidyl peptidase-1 (TPP1) deficiency.

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FDA expands approved use of Stivarga to treat liver cancer - FDA Press Releases

The U.S. Food and Drug Administration today expanded the approved use of Stivarga (regorafinib) to include treatment of patients with hepatocellular carcinoma (HCC or liver cancer) who have been previously treated with the drug sorafenib. This is the first FDA-approved treatment for a liver cancer in almost a decade.

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National Minority Health Month: Bridging Observance and Action to Achieve Health Equity - CMS Blog

By Cara V. James, PhD, Director, CMS Office of Minority Health 

Each April we observe National Minority Health Month. This year’s theme is, Bridging Health Equity Across Communities. This theme acknowledges the important role that social determinants of health play in individual and community well-being. It also evokes action and activity  around health equity. For it is not enough for us to simply observe National Minority Health Month and share statistics on long-standing health and health care disparities. We should strive to move the needle by reducing these disparities and improving health care quality and outcomes for all. As this National Minority Health Month comes to a close, we still have work to do, and I’m hoping each of us can take a moment and consider the following question:

What will it take to achieve health equity?

CMS has adopted a health equity framework that focuses on increasing understanding and awareness of disparities, developing and disseminating solutions, and implementing sustainable action. As we have sought to implement this framework, we have identified a number of areas that need to be considered when addressing a specific disparity– the social determinants of health, data, and the seven “A’s”.
First and foremost, we need to acknowledge there is a problem to be addressed. We need to agree on the goal and identify what resources will be necessary to meet it. Resources can be difficult to come by, so determining how the goal aligns with existing priorities may be key. Next we must decide what actions do we need to take to achieve our goal? Are we already doing some or all of them?

Seven A’s for Addressing Health Equity

1. Acknowledge there is a problem to be addressed.
2. Agree on the goal, and identify what resources are necessary to meet it.
3. Align the goal with existing priorities.
4. Determine what actions are needed to achieve the goal.
5. Create alliances to implement the actions.
6. Analyze progress, and adjust the plan as necessary.
7. Have shared accountability for reaching the goal.

 

We know that health equity cannot be achieved by a single individual or organization, so forging alliances and working together is critical. We also know that we must be able to measure our progress. Having data and doing analysis of it are important for the development, assessment, and revision of our health equity plan. The last of the A’s requires us to be accountable and ask the question – what happens if we do not reach our goal? There shouldn’t be one person or organization responsible for the success or failure of a plan, but a shared accountability.

While we are considering each of the seven A’s, we must also consider the myriad of social factors that influence health and well-being of individuals and the communities in which they reside. Whether we refer to them as social risk factors or social determinants of health, we know that things such as socioeconomic position, race, ethnicity, cultural context, gender, social relationships, and residential and community context affect our health more than the care we receive from our health care providers. We must consider these factors as we think about our goals, the actions we need to take, and the alliances we forge.

The CMS Office of Minority Health is helping to embed these actions across CMS and HHS. For example, we routinely share HEDIS and CAHPS quality measures stratified by race, ethnicity, and gender, providing health plans with actionable data to innovate and prioritize health equity and quality improvement activities. Organizations participating in the Accountable Health Communities Model will be montoring disparities as they link beneficiaries with commmunity services. We are working with our sister agency, the Health Resources and Services Administration’s, Federal Office of Rural Health Policy on a Chronic Care Management Education and Outreach Campaign. The campaign is focused on professionals and consumers in underserved rural areas, and racial and ethnic minorities. We are also collaborating with organizations outside the federal government to help reduce readmissions among racially and ethnically diverse beneficiaries, and to develop their own plans for achieving health equity.

As we continue on our path to equity, we encourage you to consider the seven A’s, the role of social risk factors, and the importance of data in your day-to-day activities. Recommit every day to the ultimate goal of achieving health equity by bridging observance and action during the remainder of National Minority Health Month and throughout the year.

To learn more about achieving health equity and other activities underway at the CMS Office of Minority Health, visit: go.cms.gov/omh. 

Filed under: Uncategorized

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Foreword celebrating the career of Professor Satoshi Ōmura - Journal of Antibiotics

Foreword celebrating the career of Professor Satoshi Ōmura

The Journal of Antibiotics 70, 455 (May 2017). doi:10.1038/ja.2017.25

Author: Kuniaki Tatsuta

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Achievements of Professor Satoshi Ōmura - Journal of Antibiotics

Achievements of Professor Satoshi Ōmura

The Journal of Antibiotics 70, 457 (May 2017). doi:10.1038/ja.2017.36

Author: Kazuro Shiomi

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The ups and downs of drug discovery: the early history of Fidaxomicin - Journal of Antibiotics

The ups and downs of drug discovery: the early history of Fidaxomicin

The Journal of Antibiotics 70, 492 (May 2017). doi:10.1038/ja.2016.157

Author: James B McAlpine

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Ivermectin: enigmatic multifaceted ‘wonder’ drug continues to surprise and exceed expectations - Journal of Antibiotics

Ivermectin: enigmatic multifaceted ‘wonder’ drug continues to surprise and exceed expectations

The Journal of Antibiotics 70, 495 (May 2017). doi:10.1038/ja.2017.11

Author: Andy Crump

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Genus Kitasatospora, taxonomic features and diversity of secondary metabolites - Journal of Antibiotics

Genus Kitasatospora, taxonomic features and diversity of secondary metabolites

The Journal of Antibiotics 70, 506 (May 2017). doi:10.1038/ja.2017.8

Author: Yōko Takahashi

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Endophytic actinomycetes: promising source of novel bioactive compounds - Journal of Antibiotics

Endophytic actinomycetes: promising source of novel bioactive compounds

The Journal of Antibiotics 70, 514 (May 2017). doi:10.1038/ja.2017.20

Authors: Atsuko Matsumoto & Yōko Takahashi

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The antibiotic resistance crisis, with a focus on the United States - Journal of Antibiotics

The antibiotic resistance crisis, with a focus on the United States

The Journal of Antibiotics 70, 520 (May 2017). doi:10.1038/ja.2017.30

Authors: Evan Martens & Arnold L Demain

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Nature nurtures the design of new semi-synthetic macrolide antibiotics - Journal of Antibiotics

Nature nurtures the design of new semi-synthetic macrolide antibiotics

The Journal of Antibiotics 70, 527 (May 2017). doi:10.1038/ja.2016.137

Authors: Prabhavathi Fernandes, Evan Martens & David Pereira

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The master regulator PhoP coordinates phosphate and nitrogen metabolism, respiration, cell differentiation and antibiotic biosynthesis: comparison in Streptomyces coelicolor and Streptomyces avermitilis - Journal of Antibiotics

The master regulator PhoP coordinates phosphate and nitrogen metabolism, respiration, cell differentiation and antibiotic biosynthesis: comparison in Streptomyces coelicolor and Streptomyces avermitilis

The Journal of Antibiotics 70, 534 (May 2017). doi:10.1038/ja.2017.19

Authors: Juan F Martín, Antonio Rodríguez-García & Paloma Liras

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Tyropeptins, proteasome inhibitors produced by Kitasatospora sp. MK993-dF2 - Journal of Antibiotics

Tyropeptins, proteasome inhibitors produced by Kitasatospora sp. MK993-dF2

The Journal of Antibiotics 70, 542 (May 2017). doi:10.1038/ja.2017.9

Authors: Isao Momose & Takumi Watanabe

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Message from a long-time friend: congratulations on Emeritus Professor Satoshi Ōmura’s accomplishments - Journal of Antibiotics

Message from a long-time friend: congratulations on Emeritus Professor Satoshi Ōmura’s accomplishments

The Journal of Antibiotics 70, 551 (May 2017). doi:10.1038/ja.2017.43

Author: James B McAlpine

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Enhanced dereplication of fungal cultures via use of mass defect filtering - Journal of Antibiotics

Enhanced dereplication of fungal cultures via use of mass defect filtering

The Journal of Antibiotics 70, 553 (May 2017). doi:10.1038/ja.2016.145

Authors: Noemi D Paguigan, Tamam El-Elimat, Diana Kao, Huzefa A Raja, Cedric J Pearce & Nicholas H Oberlies

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Naphthacemycins, novel circumventors of β-lactam resistance in MRSA, produced by Streptomyces sp. KB-3346-5. I. The taxonomy of the producing strain, and the fermentation, isolation and antibacterial activities - Journal of Antibiotics

Naphthacemycins, novel circumventors of β-lactam resistance in MRSA, produced by Streptomyces sp. KB-3346-5. I. The taxonomy of the producing strain, and the fermentation, isolation and antibacterial activities

The Journal of Antibiotics 70, 562 (May 2017). doi:10.1038/ja.2017.28

Authors: Atsushi Fukumoto, Yong-Pil Kim, Atsuko Matsumoto, Yoko Takahashi, Makoto Suzuki, Hideyuki Onodera, Hiroshi Tomoda, Hidehito Matsui, Hideaki Hanaki, Masato Iwatsuki, Satoshi Ōmura & Kazuro Shiomi

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Naphthacemycins, novel circumventors of β-lactam resistance in MRSA, produced by Streptomyces sp. KB-3346-5. II. Structure elucidation - Journal of Antibiotics

Naphthacemycins, novel circumventors of β-lactam resistance in MRSA, produced by Streptomyces sp. KB-3346-5. II. Structure elucidation

The Journal of Antibiotics 70, 568 (May 2017). doi:10.1038/ja.2017.29

Authors: Atsushi Fukumoto, Yong-Pil Kim, Masato Iwatsuki, Tomoyasu Hirose, Toshiaki Sunazuka, Hideaki Hanaki, Satoshi Ōmura & Kazuro Shiomi

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Total synthesis of (±)-naphthacemycin A9, possessing both antibacterial activity against methicillin-resistant Staphylococcus aureus and circumventing effect of β-lactam resistance - Journal of Antibiotics

Total synthesis of (±)-naphthacemycin A9, possessing both antibacterial activity against methicillin-resistant Staphylococcus aureus and circumventing effect of β-lactam resistance

The Journal of Antibiotics 70, 574 (May 2017). doi:10.1038/ja.2016.141

Authors: Tomoyasu Hirose, Yasuhiro Kojima, Hidehito Matsui, Hideaki Hanaki, Masato Iwatsuki, Kazuro Shiomi, Satoshi Ōmura & Toshiaki Sunazuka

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Kribellosides, novel RNA 5′-triphosphatase inhibitors from the rare actinomycete Kribbella sp. MI481-42F6 - Journal of Antibiotics

Kribellosides, novel RNA 5′-triphosphatase inhibitors from the rare actinomycete Kribbella sp. MI481-42F6

The Journal of Antibiotics 70, 582 (May 2017). doi:10.1038/ja.2016.161

Authors: Masayuki Igarashi, Ryuichi Sawa, Manabu Yamasaki, Chigusa Hayashi, Maya Umekita, Masaki Hatano, Toshinobu Fujiwara, Kiyohisa Mizumoto & Akio Nomoto

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Isomethoxyneihumicin, a new cytotoxic agent produced by marine Nocardiopsis alba KM6-1 - Journal of Antibiotics

Isomethoxyneihumicin, a new cytotoxic agent produced by marine Nocardiopsis alba KM6-1

The Journal of Antibiotics 70, 590 (May 2017). doi:10.1038/ja.2016.152

Authors: Takashi Fukuda, Misaki Takahashi, Kenichiro Nagai, Enjuro Harunari, Chiaki Imada & Hiroshi Tomoda

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Antarlides F–H, new members of the antarlide family produced by Streptomyces sp. BB47 - Journal of Antibiotics

Antarlides F–H, new members of the antarlide family produced by Streptomyces sp. BB47

The Journal of Antibiotics 70, 595 (May 2017). doi:10.1038/ja.2017.6

Authors: Shun Saito, Takahiro Fujimaki, Watanalai Panbangred, Ryuichi Sawa, Yasuhiro Igarashi & Masaya Imoto

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Elmenols C-H, new angucycline derivatives isolated from a culture of Streptomyces sp. IFM 11490 - Journal of Antibiotics

Elmenols C-H, new angucycline derivatives isolated from a culture of Streptomyces sp. IFM 11490

The Journal of Antibiotics 70, 601 (May 2017). doi:10.1038/ja.2016.158

Authors: Yixizhuoma, Naoki Ishikawa, Mohamed S Abdelfattah & Masami Ishibashi

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Simamycin (5′-O-geranyluridine): a new prenylated nucleoside from Streptomyces sp. - Journal of Antibiotics

Simamycin (5′-O-geranyluridine): a new prenylated nucleoside from Streptomyces sp.

The Journal of Antibiotics 70, 607 (May 2017). doi:10.1038/ja.2016.163

Authors: Yasuhiro Igarashi, Takayuki Kyoso, Youngju Kim & Tsutomu Oikawa

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Fradiamine A, a new siderophore from the deep-sea actinomycete Streptomyces fradiae MM456M-mF7 - Journal of Antibiotics

Fradiamine A, a new siderophore from the deep-sea actinomycete Streptomyces fradiae MM456M-mF7

The Journal of Antibiotics 70, 611 (May 2017). doi:10.1038/ja.2017.26

Authors: Yasuhiro Takehana, Maya Umekita, Masaki Hatano, Chiaki Kato, Ryuichi Sawa & Masayuki Igarashi

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Characterization of bafilomycin biosynthesis in Kitasatospora setae KM-6054 and comparative analysis of gene clusters in Actinomycetales microorganisms - Journal of Antibiotics

Characterization of bafilomycin biosynthesis in Kitasatospora setae KM-6054 and comparative analysis of gene clusters in Actinomycetales microorganisms

The Journal of Antibiotics 70, 616 (May 2017). doi:10.1038/ja.2017.33

Authors: Ayako Nara, Takuya Hashimoto, Mamoru Komatsu, Makoto Nishiyama, Tomohisa Kuzuyama & Haruo Ikeda

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Incubation of 2-methylisoborneol synthase with the intermediate analog 2-methylneryl diphosphate - Journal of Antibiotics

Incubation of 2-methylisoborneol synthase with the intermediate analog 2-methylneryl diphosphate

The Journal of Antibiotics 70, 625 (May 2017). doi:10.1038/ja.2017.24

Authors: Wayne KW Chou, Colin A Gould & David E Cane

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Cyclization mechanism of phomopsene synthase: mass spectrometry based analysis of various site-specifically labeled terpenes - Journal of Antibiotics

Cyclization mechanism of phomopsene synthase: mass spectrometry based analysis of various site-specifically labeled terpenes

The Journal of Antibiotics 70, 632 (May 2017). doi:10.1038/ja.2017.27

Authors: Sandip S Shinde, Atsushi Minami, Zhi Chen, Tetsuo Tokiwano, Tomonobu Toyomasu, Nobuo Kato, Takeshi Sassa & Hideaki Oikawa

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Molecular beacons to identify gifted microbes for genome mining - Journal of Antibiotics

Molecular beacons to identify gifted microbes for genome mining

The Journal of Antibiotics 70, 639 (May 2017). doi:10.1038/ja.2017.1

Author: Richard H Baltz

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Development of a new air-stable structure-simplified nafuredin-γ analog as a potent and selective nematode complex I inhibitor - Journal of Antibiotics

Development of a new air-stable structure-simplified nafuredin-γ analog as a potent and selective nematode complex I inhibitor

The Journal of Antibiotics 70, 647 (May 2017). doi:10.1038/ja.2017.16

Authors: Masaki Ohtawa, Shiho Arima, Risa Shimizu, Naomi Hanatani, Eri Shimizu, Kazuro Shiomi, Kiyoshi Kita, Satoshi Ōmura & Tohru Nagamitsu

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Synthesis and antibacterial activity of novel lincomycin derivatives. II. Exploring (7S)-7-(5-aryl-1,3,4-thiadiazol-2-yl-thio)-7-deoxylincomycin derivatives - Journal of Antibiotics

Synthesis and antibacterial activity of novel lincomycin derivatives. II. Exploring (7S)-7-(5-aryl-1,3,4-thiadiazol-2-yl-thio)-7-deoxylincomycin derivatives

The Journal of Antibiotics 70, 655 (May 2017). doi:10.1038/ja.2016.139

Authors: Ko Kumura, Yoshinari Wakiyama, Kazutaka Ueda, Eijiro Umemura, Takashi Watanabe, Megumi Kumura, Takuji Yoshida & Keiichi Ajito

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Lipophilic teicoplanin pseudoaglycon derivatives are active against vancomycin- and teicoplanin-resistant enterococci - Journal of Antibiotics

Lipophilic teicoplanin pseudoaglycon derivatives are active against vancomycin- and teicoplanin-resistant enterococci

The Journal of Antibiotics 70, 664 (May 2017). doi:10.1038/ja.2017.2

Authors: Zsolt Szűcs, Ilona Bereczki, Magdolna Csávás, Erzsébet Rőth, Anikó Borbás, Gyula Batta, Eszter Ostorházi, Réka Szatmári & Pál Herczegh

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Thiazomycin, nocathiacin and analogs show strong activity against clinical strains of drug-resistant Mycobacterium tuberculosis - Journal of Antibiotics

Thiazomycin, nocathiacin and analogs show strong activity against clinical strains of drug-resistant Mycobacterium tuberculosis

The Journal of Antibiotics 70, 671 (May 2017). doi:10.1038/ja.2016.165

Authors: Sheo B Singh, Libo Xu, Peter T Meinke, Natalia Kurepina, Barry N Kreiswirth, David B Olsen & Katherine Young

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The synthesis and evaluation of the antiproliferative activity of deacidified GEX1A analogues - Journal of Antibiotics

The synthesis and evaluation of the antiproliferative activity of deacidified GEX1A analogues

The Journal of Antibiotics 70, 675 (May 2017). doi:10.1038/ja.2016.166

Authors: Takamichi Imaizumi, Hiroshi Nakagawa, Ran Hori, Yasuo Watanabe, Shiro Soga, Kyoichiro Iida & Hideyuki Onodera

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Our Local Bounty Recalls Organic Basil Pesto With Watercress Because of Possible Health Risk - FDA Safety Alerts & Drug Recalls

Our Local Bounty of Rogue River, Oregon is recalling 312 (8.5oz) containers of the Farming Fish brand Organic Basil Pesto with Watercress, because it 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, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

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McCain Foods USA, Inc. Expands Voluntary Recall of Frozen Hash Browns to include Wegman’s Retail Brand Due to Possible Health Risk - FDA Safety Alerts & Drug Recalls

McCain Foods USA, Inc. announced today it is expanding the voluntary recall of retail, frozen hash brown products that may contain golf ball materials, specifically hard plastic or rubber pieces, that despite our stringent supply standards may have been inadvertently harvested with potatoes used to make this product. Consumption of these products may pose a choking hazard or other physical injury to the mouth. There have been no reported injuries associated with the consumption of this product.

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CMS’ Ongoing Commitment to Minority Health - CMS Blog

April 26, 2017

By: Seema Verma, Administrator, Centers for Medicare & Medicaid Services (CMS)

As many of you know, April is National Minority Health Month, and it’s a privilege to be Administrator at the Centers for Medicare & Medicaid Services (CMS) and take part in the observance. This year’s theme is “Bridging Health Equity Across Communities”. At CMS we have an extraordinary opportunity to improve health outcomes for the over 100 million people that we serve every day. Our primary mission is to make healthcare accessible and affordable for all Americans.

During this important month, we continue our efforts to raise awareness about disparities, and provide tools and resources to support actions to address them. In addition to our ongoing work to address these disparities through efforts like the CMS Equity Plan for Improving Quality in Medicare, the CMS Office of Minority Health released new Medicare Advantage (MA) data on racial and ethnic disparities in care. The data helps us understand the connections between a person’s race, ethnicity, and gender and the health care that they receive.

Two new reports focus on the treatment and patient care experiences for a variety of conditions. The first report looks at racial and ethnic disparities by gender and examines differences between black, Hispanic, Asian and Pacific Islander and white MA beneficiaries in rates of colorectal cancer screening, treatment for chronic lung disease and other conditions as well as their ability to access needed care.

The second report looks at racial and ethnic minorities, people with disabilities, members of the lesbian, gay, bisexual, and transgender community, and rural populations in quality of treatment for certain conditions among MA beneficiaries. It shows that women receive better treatment for chronic lung disease and rheumatoid arthritis and are more likely than men to receive proper follow-up care after being hospitalized for a mental health disorder.

This tremendous research can only point out the problems. We need healthcare professionals, stakeholder organizations, researchers, and community groups to use these CMS reports, along with our other tools and resources, to develop interventions for racially and ethnically diverse Medicare beneficiaries. 

Through transparency, flexibility, and innovation, we will use every available tool to improve the Medicare program and promote the availability of high value and efficiently-provided care for all beneficiaries. We do this, by working together with plans, providers and the patients we serve to find ways to reduce the disparities highlighted in these reports and find effective health solutions that work for all communities and all Americans.

 

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Filed under: Uncategorized

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Varying effects of common tuberculosis drugs on enhancing clofazimine activity in vitro

Varying effects of common tuberculosis drugs on enhancing clofazimine activity in vitro

Emerging Microbes & Infections 6, e28 (April 2017). doi:10.1038/emi.2017.24

Authors: Shuo Zhang, Wanliang Shi, Jie Feng, Wenhong Zhang & Ying Zhang

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Identification of drug candidates that enhance pyrazinamide activity from a clinical compound library

Identification of drug candidates that enhance pyrazinamide activity from a clinical compound library

Emerging Microbes & Infections 6, e27 (April 2017). doi:10.1038/emi.2017.23

Authors: Hongxia Niu, Chao Ma, Peng Cui, Wanliang Shi, Shuo Zhang, Jie Feng, David Sullivan, Bingdong Zhu, Wenhong Zhang & Ying Zhang

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Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016

Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016

Emerging Microbes & Infections 6, e26 (April 2017). doi:10.1038/emi.2017.11

Authors: Kai Michaelis, Jürgen J Wenzel, Klaus Stark & Mirko Faber

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Precision immunomedicine

Precision immunomedicine

Emerging Microbes & Infections 6, e25 (April 2017). doi:10.1038/emi.2017.22

Authors: Tianlei Ying, Yumei Wen & Dimiter S Dimitrov

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Zika virus infection reprograms global transcription of host cells to allow sustained infection

Zika virus infection reprograms global transcription of host cells to allow sustained infection

Emerging Microbes & Infections 6, e24 (April 2017). doi:10.1038/emi.2017.9

Authors: Shashi Kant Tiwari, Jason Dang, Yue Qin, Gianluigi Lichinchi, Vikas Bansal & Tariq M Rana

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Vector competence and transovarial transmission of two Aedes aegypti strains to Zika virus

Vector competence and transovarial transmission of two Aedes aegypti strains to Zika virus

Emerging Microbes & Infections 6, e23 (April 2017). doi:10.1038/emi.2017.8

Authors: Chun-xiao Li, Xiao-xia Guo, Yong-qiang Deng, Dan Xing, Ai-juan Sun, Qin-mei Liu, Qun Wu, Yan-de Dong, Ying-mei Zhang, Heng-duan Zhang, Wu-chun Cao, Cheng-feng Qin & Tong-yan Zhao

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Global and local environmental changes as drivers of Buruli ulcer emergence

Global and local environmental changes as drivers of Buruli ulcer emergence

Emerging Microbes & Infections 6, e22 (April 2017). doi:10.1038/emi.2017.7

Authors: Marine Combe, Camilla Jensen Velvin, Aaron Morris, Andres Garchitorena, Kevin Carolan, Daniel Sanhueza, Benjamin Roche, Pierre Couppié, Jean-François Guégan & Rodolphe Elie Gozlan

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FDA takes action against 14 companies for selling illegal cancer treatments - FDA Press Releases

The U.S. Food and Drug Administration today posted warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat or cure cancer. The products are marketed and sold without FDA approval, most commonly on websites and social media platforms.

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Accuracy of Current Diagnostic Criteria for Acute Bacterial Infection in Older Adults in the Emergency Department - American Geriatric Society

Objectives

To compare the accuracy of the Loeb criteria, emergency department (ED) physicians’ diagnoses, and Centers for Disease Control and Prevention (CDC) guidelines for acute bacterial infection in older adults with a criterion standard expert review.

Design

Prospective, observational study.

Setting

Urban, tertiary-care ED.

Participants

Individuals aged 65 and older in the ED, excluding those who were incarcerated, underwent a trauma, did not speak English, or were unable to consent.

Measurements

Two physician experts identified bacterial infections using clinical judgement, participant surveys, and medical records; a third adjudicated in cases of disagreement. Agreement and test characteristics were measured for ED physician diagnosis, Loeb criteria, and CDC surveillance guidelines.

Results

Criterion-standard review identified bacterial infection in 77 of 424 participants (18%) (18 (4.2%) lower respiratory, 19 (4.5%) urinary tract (UTI), 22 (5.2%) gastrointestinal, 15 (3.5%) skin and soft tissue). ED physicians diagnosed infection in 71 (17%), but there were 33 with under- and 27 with overdiagnosis. Physician agreement with the criterion standard was moderate for infection overall and each infection type (κ = 0.48–0.59), but sensitivity was low (<67%), and the negative likelihood ratio (LR(-)) was greater than 0.30 for all infections. The Loeb criteria had poor sensitivity, agreement, and LR(–) for lower respiratory (50%, κ = 0.55; 0.51) and urinary tract infection (26%, κ = 0.34; 0.74), but 87% sensitivity (κ = 0.78; LR(–) 0.14) for skin and soft tissue infections. CDC guidelines had moderate agreement but poor sensitivity and LR(–).

Conclusion

Emergency physicians often under- and overdiagnose infections in older adults. The Loeb criteria are useful only for diagnosing skin and soft tissue infections. CDC guidelines are inadequate in the ED. New criteria are needed to aid ED physicians in accurately diagnosing infection in older adults.

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Neuroprotective Diets Are Associated with Better Cognitive Function: The Health and Retirement Study - American Geriatric Society

Objectives

To evaluate the association between the Mediterranean diet (MedDiet) and the Mediterranean-DASH diet Intervention for Neurodegeneration Delay (MIND diet) and cognition in a nationally representative population of older U.S. adults.

Design

Population-based cross-sectional study.

Setting

Health and Retirement Study.

Participants

Community-dwelling older adults (N = 5,907; mean age 67.8 ± 10.8).

Measurements

Adherence to dietary patterns was determined from food frequency questionnaires using criteria determined a priori to generate diet scores for the MedDiet (range 0–55) and MIND diet (range 0–15). Cognitive performance was measured using a composite test score of global cognitive function (range 0–27). Linear regression was used to compare cognitive performance according to tertiles of dietary pattern. Logistic regression was used to examine the association between dietary patterns and clinically significant cognitive impairment. Models were adjusted for age, sex, race, educational attainment, and other health and lifestyle covariates.

Results

Participants with mid (odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.71–1.02, P = .08) and high (OR 0.65, 95% CI = 0.52–0.81, P < .001) MedDiet scores were less likely to have poor cognitive performance than those with low scores in fully adjusted models. Results for the MIND diet were similar. Higher scores in each dietary pattern were independently associated with significantly better cognitive function (P < .001) in a dose-response manner (P _trend < .001).

Conclusion

In a large nationally representative population of older adults, greater adherence to the MedDiet and MIND diet was independently associated with better cognitive function and lower risk of cognitive impairment. Clinical trials are required to elucidate the role of dietary patterns in cognitive aging.

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Party Animal Statement on Cocolicious - FDA Safety Alerts & Drug Recalls

On April 13, a retailer in Texas notified us that their customer had presented samples of our 13-ounce-can Cocolicious Beef & Turkey dog food (Lot #0136E15204 04, best by July 2019) and 13-ounce-can Cocolicious Chicken & Beef dog food (Lot #0134E15 237 13, best by August 2019) to a testing lab, and that the results had tested positive for pentobarbital.

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Soylent Issues Allergy Alert On Potential Undeclared Milk in Soylent 1.8 Powder - FDA Safety Alerts & Drug Recalls

Soylent, Los Angeles, CA is voluntarily recalling 890 boxes of Soylent 1.8 Powder, because it may contain undeclared milk. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they consume these products.

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Good Cop, Better Cop: Evaluation of a Geriatrics Training Program for Police - American Geriatric Society

Objectives

To develop, implement, and evaluate a training program in aging-related health for police officers.

Design

Cross-sectional.

Setting

Crisis intervention training program for police officers in San Francisco.

Participants

Police officers attending one of five 2-hour trainings (N = 143).

Intervention

A lecture on aging-related health conditions pertinent to police work followed by three experiential trainings on how it feels to be “old.”

Measurements

Participants evaluated the quality of the training and the likelihood that they would apply new knowledge to their work and rated their knowledge using a retrospective pre–post evaluation. In open-ended responses, participants reported work-related changes they anticipated making in response to the training.

Results

All 143 participants completed the evaluation. Eighty-four percent reported interacting with older adults at least monthly; 45% reported daily interactions. Participants rated the training quality at 4.6/5 and the likelihood they would apply new knowledge to their work at 4.4/5. Retrospective pre–post knowledge scores increased for all domains, including how to identify aging-related health conditions that can affect safety during police interactions (2.9/5 to 4.2/5; P < .001). In open-ended responses, participants anticipated having more empathy for and awareness of aging-related conditions and greater ability to provide older adults with appropriate community referrals.

Conclusion

A brief training in aging-related health significantly increased police officers’ self-reported knowledge and skills. Clinicians have an important opportunity to help enhance safe and effective community policing for older adults.

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Studies of Physician-Patient Communication with Older Patients: How Often is Hearing Loss Considered? A Systematic Literature Review - American Geriatric Society

Hearing loss is remarkably prevalent in the geriatric population: one-quarter of adults aged 60–69 and 80% of adults aged 80 years and older have bilateral disabling loss. Only about one in five adults with hearing loss wears a hearing aid, leaving many vulnerable to poor communication with healthcare providers. We quantified the extent to which hearing loss is mentioned in studies of physician-patient communication with older patients, and the degree to which hearing loss is incorporated into analyses and findings. We conducted a structured literature search within PubMed for original studies of physician-patient communication with older patients that were published since 2000, using the natural language phrase “older patient physician communication.” We identified 409 papers in the initial search, and included 67 in this systematic review. Of the 67 papers, only 16 studies (23.9%) included any mention of hearing loss. In six of the 16 studies, hearing loss was mentioned only; in four studies, hearing loss was used as an exclusion criterion; and in two studies, the extent of hearing loss was measured and reported for the sample, with no further analysis. Three studies examined or reported on an association between hearing loss and the quality of physician-patient communication. One study included an intervention to temporarily mitigate hearing loss to improve communication. Less than one-quarter of studies of physician-elderly patient communication even mention that hearing loss may affect communication. Methodologically, this means that many studies may have omitted an important potential confounder. Perhaps more importantly, research in this field has largely overlooked a highly prevalent, important, and remediable influence on the quality of communication.

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The Common Sense of Considering the Senses in Patient Communication - American Geriatric Society

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#GeriMedJC: The Twitter Complement to the Traditional-Format Geriatric Medicine Journal Club - American Geriatric Society

Twitter is a public microblogging platform that overcomes physical limitations and allows unrestricted participation beyond academic silos, enabling interactive discussions. Twitter-based journal clubs have demonstrated growth, sustainability, and worldwide communication, using a hashtag (#) to follow participation. This article describes the first year of #GeriMedJC, a monthly 1-hour live, 23-hour asynchronous Twitter-based complement to the traditional-format geriatric medicine journal club. The Twitter moderator tweets from the handle @GeriMedJC; encourages use of #GeriMedJC; and invites content experts, study authors, and followers to participate in critical appraisal of medical literature. Using the hashtag #GeriMedJC, tweets were categorized according to thematic content, relevance to the journal club, and authorship. Third-party analytical tools Symplur and Twitter Analytics were used for growth and effect metrics (number of followers, participants, tweets, retweets, replies, impressions). Qualitative analysis of follower and participant profiles was used to establish country of origin and occupation. A semistructured interview of postgraduate trainees was conducted to ascertain qualitative aspects of the experience. In the first year, @GeriMedJC has grown to 541 followers on six continents. Most followers were physicians (43%), two-thirds of which were geriatricians. Growth metrics increased over 12 months, with a mean of 121 tweets, 25 participants, and 105,831 impressions per journal club. Tweets were most often related to the article being appraised (87.5%) and ranged in thematic content from clinical practice (29%) to critical appraisal (24%) to medical education (20%). #GeriMedJC is a feasible example of using social media platforms such as Twitter to encourage international and interprofessional appraisal of medical literature.

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Rapid Depression Assessment in Geriatric Patients - Geriatrics

Depression is common in geriatric patients, especially in those with multiple comorbidities and polypharmacy. Depression in older adults is often underdiagnosed and undertreated. Initial screening for depression can easily be accomplished in the waiting room. Yet the clinical interview still remains the gold standard for diagnosing geriatric depression. Key components of the clinical interview are observant watching of the patient for the subtle signs of depression. Clinical interview should be done with sensitivity to the importance of privacy. Illicit substances and medical conditions may significantly contribute. Suicide assessment should be done in a step wise manner.

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Hummingbird Wholesale Issues Allergy Alert on Undeclared Hazelnut in Organic Cocoa-dusted Chocolate Ginger - FDA Safety Alerts & Drug Recalls

Hummingbird Wholesale of Eugene, Oregon is recalling 5lbs of Organic Cocoa-Dusted Chocolate Ginger, because it may contain undeclared hazelnut. People who have an allergy or severe sensitivity to hazelnut run the risk of serious or life-threatening allergic reaction if they consume these products.

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McCain Foods USA, Inc. Recalls Frozen Southern Style Hash Browns Due to Possible Health Risk. Product is Sold and Distributed Under The Roundy’s and Harris Teeter Retail Brands. - FDA Safety Alerts & Drug Recalls

McCain Foods USA, Inc. announced today it is voluntarily recalling retail, frozen hash brown products that may be contaminated with extraneous golf ball materials, that despite our stringent supply standards may have been inadvertently harvested with potatoes used to make this product. Consumption of these products may pose a choking hazard or other physical injury to the mouth.

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Frito-Lay Recalls Jalapeño Flavored Lay’s Kettle Cooked Potato Chips and Jalapeño Flavored Miss Vickie’s Kettle Cooked Potato Chips Due to Potential Presence of Salmonella - FDA Safety Alerts & Drug Recalls

Frito-Lay today announced it is voluntarily recalling select Jalapeño Flavored Lay’s Kettle Cooked potato chips and Jalapeño Flavored Miss Vickie’s Kettle Cooked potato chips due to the potential presence of Salmonella in the seasoning.

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Hospira Issues a Voluntary Nationwide Recall For One Lot Of 25% Dextrose Injection, USP (Infant) Due To The Presence of Particulate Matter - FDA Safety Alerts & Drug Recalls

Hospira, Inc., a Pfizer company, is voluntarily recalling one lot of 25% Dextrose Injection, USP, (Infant) pre-filled syringe to the hospital/user level due to the presence of particulate matter, identified as human hair, found within an internal sample syringe.

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H-E-B Voluntarily Issues a Precautionary Recall H-E-B and Hill Country Fare sandwich bread with a best buy date of April 29th or earlier being recalled for potential rubber in the product - FDA Safety Alerts & Drug Recalls

H-E-B, committed to the quality of its products, is voluntarily issuing a precautionary recall for H-E-B and Hill Country Fare sandwich bread with a best by date of April 29 or earlier due to the possible presence of a single piece of rubber in the product. This was an isolated incident. Bread purchased in the San Antonio area, Rio Grande Valley, Laredo and Corpus Christi stores is not impacted by this recall.

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C.O. Truxton, Inc. Issues Voluntary Nationwide Recall of Phenobarbital 15 mg Tablets, USP due to Labeling Error on Declared Strength - FDA Safety Alerts & Drug Recalls

Bellmawr, New Jersey, C.O. Truxton, Inc. is voluntarily recalling lot 70952A of Phenobarbital Tablets, USP, 15 mg, to the consumer/user level. The manufacturer received a confirmed customer complaint that a bottle labeled as phenobarbital 15 mg was found to contain phenobarbital 30 mg tablets.

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FDA statement from Douglas Throckmorton, M.D., deputy center director for regulatory programs, Center for Drug Evaluation and Research, on new warnings about the use of codeine and tramadol in children & nursing mothers - FDA Press Releases

The health and safety of children is a top priority at the FDA, which is why today we are requiring a series of changes to the labeling of two types of opioid medications in order to help better protect children from serious risks associated with these medicines – codeine (found in some prescription pain and cough medicines and some over-the-counter cough medicines) and tramadol (found in some prescription pain medicines).

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Family and Other Unpaid Caregivers and Older Adults with and without Dementia and Disability - American Geriatric Society

Objectives

To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provide; and to estimate associations between the numbers of tasks and caregiver burden.

Design

Nationally representative surveys of caregivers and older adults in the United States.

Setting

2011 National Health and Aging Trends Study and National Study of Caregiving.

Participants

Community-dwelling older adults and their family caregivers, who were selected on the basis of having assisted with mobility, self-care, household activities, transportation, or medical tasks.

Measurements

Caregiver burden (emotional, physical, financial difficulties) and restrictions on social participation.

Results

Although much larger proportions of older adults with dementia and disability (98.4%, n = 1.0 million) and dementia but not disability (95.5%, n = 1.3 million) received caregiving assistance, the largest absolute number of individuals receiving assistance were older adults without dementia or disability (4.0 million). Within each caregiver group, caregivers provided assistance with at least one task across domains of activity of daily living and instrumental activity of daily living–related assistance (>98%), health systems logistics (>70%), and health management (>50%). There was a significant linear association between number of tasks provided and risk of burden in virtually all caregiver groups and domains of assistance.

Conclusion

Caregivers of care recipients without dementia or disability accounted for the largest absolute number of helpers. These caregivers, similar to caregivers of care recipients with dementia or disability, delivered a broad spectrum of health-related tasks and experienced caregiver burden and restrictions on social participation. Findings support the need for interventions that address the needs of caregivers who have not typically been defined as high risk.

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Low-Dose Aspirin Use and Cognitive Function in Older Age: A Systematic Review and Meta-analysis - American Geriatric Society

Objectives

To investigate whether low-dose aspirin (<300 mg/d) can influence the onset of cognitive impairment or dementia in observational studies and improve cognitive test scores in randomized controlled trials (RCTs) in participants without dementia.

Design

Systematic review and meta-analysis.

Setting

Observational and interventional studies.

Participants

Individuals with no dementia or cognitive impairment initially.

Measurements

Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for the maximum number of covariates from each study, were used to summarize data on the incidence of dementia and cognitive impairment in observational studies. Standardized mean differences (SMDs) were used for cognitive test scores in RCTs.

Results

Of 2,341 potentially eligible articles, eight studies were included and provided data for 36,196 participants without dementia or cognitive impairment at baseline (mean age 66, 63% female). After adjusting for a median of three potential confounders over a median follow-up period of 6 years, chronic use of low-dose aspirin was not associated with onset of dementia or cognitive impairment (5 studies, N = 26,159; OR = 0.82, 95% CI = 0.55–1.22, P = .33, I² = 67%). In three RCTs (N = 10,037; median follow-up 5 years), the use of low-dose aspirin was not associated with significantly better global cognition (SMD=0.005, 95% CI=–0.04–0.05, P = .84, I² = 0%) in individuals without dementia. Adherence was lower in participants taking aspirin than in controls, and the incidence of adverse events was higher.

Conclusion

This review found no evidence that low-dose aspirin buffers against cognitive decline or dementia or improves cognitive test scores in RCTs.

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Efficacy and Safety of Mechanical Thrombectomy in Older Adults with Acute Ischemic Stoke - American Geriatric Society

Objectives

To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischemic stroke.

Design

Retrospective cohort study.

Setting

Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy.

Participants

Elderly adults treated for acute ischemic stroke (N = 219).

Measurements

Participants were divided into two groups based on their age (n = 62, ≥80; n = 157, <80). Baseline and procedural characteristics, safety outcomes such as intracranial hemorrhage (ICH) and mortality and efficacy outcomes such as successful reperfusion and 3-month good clinical outcome of the two groups were compared. Mutivariable analysis was performed to identify predictors of clinical outcome.

Results

Intravenous thrombolysis was more frequent (67.7% vs 52.8%, P = .04), and onset to reperfusion time was shorter (318.7 ± 128.7 vs 282 ± 53.5, P = .02) in participants aged 80 and older, but no between-group differences were found in terms of successful reperfusion (69% vs 63%, P = .4), good clinical outcome (30.6% vs 34.3%, P = .6), any (37% vs 37.5%, P > .99) or symptomatic (11% vs 14%, P = .6) ICH, or mortality (40.3% vs 29.2%, P = .14). Multivariable analysis revealed that, in the older group, onset National Institute of Health Stroke Scale (NIHSS) score (odds ratio (OR) = 0.65, 95% confidence interval (CI) = 0.44–0.96, P = .03) and 24-hour clinical improvement (OR = 141.13, 95% CI = 2.96–6,720.7, P = .01) were independent predictors of 3-month functional independence.

Conclusion

These findings suggest that endovascular treatment for stroke in selected elderly adults could be safe and effective. Major determinants of outcome in this subgroup of elderly patients are presentation NIHSS score and 24-hour clinical improvement.

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Integrating Frailty Research into the Medical Specialties—Report from a U13 Conference - American Geriatric Society

Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, human immunodeficiency virus care, and nephrology, and in the behavioral and social sciences. Lack of a consensus definition, proliferation of measurement tools, inadequate understanding of the biology of frailty, and lack of validated clinical algorithms for frail individuals hinders incorporation of frailty assessment and frailty research into the specialties. In 2015, the American Geriatrics Society, the National Institute on Aging (NIA), and the Alliance for Academic Internal Medicine held a conference for awardees of the NIA-sponsored Grants for Early Medical/Surgical Specialists Transition into Aging Research program to review the current state of knowledge regarding frailty in the subspecialties and to highlight examples of integrating frailty research into the medical specialties. Research questions to advance frailty research into specialty medicine are proposed.

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A Survey of Women's Awareness of and Reasons for Lack of Postfracture Osteoporotic Care - American Geriatric Society

Objectives

To identify women's beliefs and other factors associated with lack of osteoporosis (OP) pharmacotherapy (OP-RX) during the 6 months after a fragility fracture, including the woman's perspective on fracture risk, OP, and treatment.

Design

Cross-sectional.

Setting

Group Health Cooperative, a mixed-model delivery system.

Participants

Female Group Health Cooperative enrollees aged 55 and older with an OP-related fracture according to diagnostic and procedure codes from January 1, 2013, to March 30, 2014 (N = 985).

Measurements

OP-RX and participant characteristics were ascertained from electronic health records including medications dispensed. A mailed survey was used to obtain data on health behaviors; OP-related history; concern about, knowledge of, and perceived risk of future fracture; beliefs about OP-RX; sources of information on OP; postfracture discussions with providers; and provider recommendations.

Results

The response rate was 73%. Of 634 eligible respondents, 84% did not undergo OP-RX during the 6 months after fracture. Fewer than 20% of women thought that OP caused their fracture, 52% did not think they were at risk of future fracture, and 75% did not think or know whether OP-RX reduces risk of fracture. Knowledge about OP and the benefits of treatment was higher in the 16% of women who underwent OP-RX after their fracture. Women reported low levels of engagement with their healthcare providers regarding OP and fracture risk management.

Conclusion

These findings suggest low awareness about OP and its contribution to fracture risk, lack of understanding about the benefits of pharmacotherapy, and limited discussion about OP with primary care physicians. Information about individual's beliefs and knowledge gaps can help design targeted patient and provider education to improve treatment rates.

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Characteristics and Incidence of Chronic Illness in Community-Dwelling Predominantly Male U.S. Veteran Centenarians - American Geriatric Society

Objectives

To assess the incidence of chronic illness and its effect on veteran centenarians.

Design

Retrospective longitudinal cohort study.

Setting

United States Veterans Affairs Corporate Data Warehouse (CDW).

Participants

Community-dwelling veterans born between 1910 and 1915 who survived to at least age 80 (N = 86,892; 31,121 octogenarians, 52,420 nonagenarians, 3,351 centenarians).

Measurements

The Kaplan–Meier method was used to estimate cumulative incidence of chronic conditions according to age group. Incidence rates were compared using the log-rank test. Cox proportional hazards models were used to estimate unadjusted hazard ratios.

Results

Ninety-seven percent of Centenarians were male, 88.0% were white, 31.8% were widowed, 87.5% served in World War II, and 63.9% did not have a service-related disability. The incidence rates of chronic illnesses were higher in octogenarians than centenarians (atrial fibrillation, 15.0% vs 0.6%, P < .001; heart failure, 19.3% vs 0.4%, P < .001; chronic obstructive pulmonary disease, 17.9% vs 0.6%, P < .001; hypertension, 29.6% vs 3.0%, P < .001; end-stage renal disease, 7.2% vs 0.1%, P < .001; malignancy, 14.1% vs 0.6%, P < .001; diabetes mellitus, 11.1% vs 0.4%, P < .001; stroke, 4.6% vs 0.4%, P < .001) and in nonagenarians than centenarians (atrial fibrillation, 13.2% vs 3.5%, P < .001; heart failure, 15.8% vs 3.3%, P < .001; chronic obstructive pulmonary disease, 11.8% vs 3.5%, P < .001; hypertension, 27.2% vs 12.8%, P < .001; end-stage renal disease, 11.9% vs 4.5%, P < .001; malignancy, 8.6% vs 2.3%, P < .001; diabetes mellitus, 7.5% vs 2.2%, P < .001; and stroke, 3.5% vs 1.3%, P < .001).

Conclusion

In a large cohort of predominantly male community-dwelling elderly veterans, centenarians had a lower incidence of chronic illness than those in their 80s and 90s, demonstrating similar compression of morbidity and extension of health span observed in other studies.

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La Granja INC. Recalls Mango Flavored Ice cream Because of Possible Health Risk - FDA Safety Alerts & Drug Recalls

La Granja INC of Doraville Georgia is recalling 4000 units of Hand crafted Paleteria, Mango Flavored Ice cream, because it has the potential to be contaminated with Salmonella Enteritidis, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy individuals may suffer only short-term symptoms pain and diarrhea. Long term complications can include severe arthritis.

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Organic Herbal Supply Issue Voluntary Nationwide Recall Of All Lots Of Various Supplements For Male And Female Sexual Enhancement Due To Undeclared Tadalafil And Flibanserin - FDA Safety Alerts & Drug Recalls

Organic Herbal Supply, Inc. announced today that it is conducting a voluntary nationwide recall of all lots of Uproar, Cummor, Zrect, Monkey Business, Xrect, Rectalis, Tornado, Zdaily, BigNHard, Enhancerol Natural Male Enhancement capsules. FDA analysis has found the products to contain Tadalafil. Tadalafil is a FDA-approved drug used as treatment for male Erectile Dysfunction (ED), the presence of tadalafil in these male enhancement products renders it an unapproved drug for which safety and efficacy have not been established and, therefore, subject to recall. Organic Herbal Supply is also recalling Zrect for Women and LabidaMAX. FDA analysis has found these two products contain Flibanserin, an FDA-approved prescription drug for Hypoactive Sexual Desire Disorder (HSDD) in women. There have been no reports of illness to date.

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A National Survey on the Effect of the Geriatric Academic Career Award in Advancing Academic Geriatric Medicine - American Geriatric Society

A workforce that understands principles of geriatric medicine is critical to addressing the care needs of the growing elderly population. This will be impossible without a substantial increase in academicians engaged in education and aging research. Limited support of early-career clinician–educators is a major barrier to attaining this goal. The Geriatric Academic Career Award (GACA) was a vital resource that benefitted 222 junior faculty members. GACA availability was interrupted in 2006, followed by permanent discontinuation after the Geriatrics Workforce Education Program (GWEP) subsumed it in 2015, leaving aspiring clinician–educators with no similar alternatives. GACA recipients were surveyed in this cross-sectional, multimethod study to assess the effect of the award on career development, creation and dissemination of educational products, funding discontinuation consequences, and implications of program closure for the future of geriatric health care. Uninterrupted funding resulted in fulfillment of GACA goals (94%) and overall career success (96%). Collectively, awardees reached more than 40,700 learners. Funding interruption led to 55% working additional hours over and above an increased clinical workload to continue their GACA-related research and scholarship. Others terminated GACA projects (36%) or abandoned academic medicine altogether. Of respondents currently at GWEP sites (43%), only 13% report a GWEP budget including GACA-like support. Those with GWEP roles attributed their current standing to experience gained through GACA funding. These consequences are alarming and represent a major setback to academic geriatrics. GACA's singular contribution to the mission of geriatric medicine must prompt vigorous efforts to restore it as a distinct funding opportunity.

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Beyond Meat Issues Allergy Alert on Undeclared Peanut in Beyond Meat Feisty Crumbles - FDA Safety Alerts & Drug Recalls

Beyond Meat of El Segundo, CA is voluntarily recalling certain bags of Feisty Crumbles from three production lots because they may contain low levels of undeclared peanuts. People who have an allergy or severe sensitivity to peanuts run the risk of serious or life-threatening allergic reaction if they consume these products.

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TP Food Processing, Inc. Announces the Recall Of Shrimp and Lemongrass Satay Sauces Due to Risk for Clostridum Botulinum - FDA Safety Alerts & Drug Recalls

TP Food Processing, Inc. of Westminster, CA is recalling Lemongrass Satay; and Shrimp Satay (Lot code 2016) because the acidified sauces were not properly produced making them susceptible to contamination with Clostridium botulinum. No illnesses, customer complaints, or illnesses have been reported to date.

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Jimmy’s Cookies LLC Issues Allergy Alert on Undeclared Milk in The Bakery Peanut Butter Chocolate Chunk Cookies LOT# 047 - FDA Safety Alerts & Drug Recalls

Jimmy’s Cookies LLC of Clifton, NJ is recalling LOT #047 The Bakery Peanut Butter Chocolate Chunk Cookies from all retail stores, because it may contain undeclared milk. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they consume this product.

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The Seventh Year - American Geriatric Society

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Northern California Whole Foods Market Stores Issue Recall for Undeclared Eggs in Some Cookies - FDA Safety Alerts & Drug Recalls

Nine Whole Foods Market stores in Northern California are voluntarily recalling some decorated (iced) cookies from the self-service cookie displays because the products contained egg allergen that was not listed on the product sign. People who have an allergy or severe sensitivity to eggs run the risk of serious or life-threatening allergic reaction if they consume these products.

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Feng Mao Biotechnology Organic Food CO.,LTD. Issues Allergy Alert on Undeclared Peanuts in Almond Drinking Powder. - FDA Safety Alerts & Drug Recalls

Feng Mao Biotechnology Organic Food CO. of R.O.C is recalling Almond Drinking Powder in 600 g cans, because it may contain undeclared peanuts. People who have an allergy or severe sensitivity to peanuts run the risk of serious or life-threatening allergic reaction if they consume these products.

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Choice Farms LLC Recalls Limited Quantity of Caesar Side Salad Due to Undeclared Milk, Egg, Wheat and Fish (anchovies) Allergens - FDA Safety Alerts & Drug Recalls

Choice Farms LLC is initiating a limited voluntary recall of 7-Eleven brand Caesar Salad containers produced on April 11th, at the Denver production facility only, because they contain undeclared Milk, Egg, Wheat and Fish (anchovies) allergens. People who have an allergy or severe sensitivity to these foods run the risk of serious or life-threatening allergic reaction if they consume these products.

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Standard Homeopathic Company Issues Nationwide Recall of Hyland's Baby Teething Tablets and Hyland's Baby Nighttime Teething Tablets Due to Mislabeling - FDA Safety Alerts & Drug Recalls

Standard Homeopathic Company is recalling all lots of Hyland's Baby Teething Tablets and Hyland's Baby Nighttime Teething Tablets sold in retail stores to the consumer level. The U.S. Food & Drug Administration (FDA) has concluded that the medicines have been found to contain inconsistent amounts of belladonna alkaloids that may differ from the calculated amount on the products' labels. FDA believes that belladonna represents a serious health hazard to children and that the effects of belladonna are unpredictable.

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Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials - American Geriatric Society

Objectives

To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture.

Design

Systematic review and metaanalysis.

Setting

Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included.

Participants

Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions.

Measurements

MEDLINE, EMBASE, CINAHL and PsycINFO databases; Clinicaltrials.gov; and the Central Register of Controlled Trials were searched. Reference lists from full-text articles were reviewed. Incidence of delirium was the primary outcome. Length of stay, delirium severity, institutionalization, long-term cognition and mortality were predefined secondary outcomes. Duration of delirium was included as a post hoc outcome.

Results

There was a significant reduction in delirium overall (relative risk (RR) = 0.81, 95% confidence interval (CI) = 0.69–0.94) in the intervention group. Post hoc subgroup analysis found this effect to be preserved in the team-based intervention group (RR = 0.77, 95% CI = 0.61–0.98) but not the ward-based group. No significant effect was observed on any secondary outcome.

Conclusion

There was a reduction in the incidence of delirium after hip fracture with CGA. This is in keeping with results of non-randomized controlled trials and trials in other populations. Team-based interventions appeared superior in contrast to the Ellis CGA paper, but it is likely that heterogeneity in interventions and population studied affected this.

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Association Between Vascular Pathology and Rate of Cognitive Decline Independent of Alzheimer's Disease Pathology - American Geriatric Society

Objectives

To examine the association between vascular pathology and rate of cognitive decline in older adults independent of Alzheimer's disease (AD) pathology.

Design

Prospective cohort study.

Setting

Community sample.

Participants

Individuals from the Einstein Aging Study autopsy series (N = 62).

Measurements

The Blessed Information-Memory-Concentration (BIMC) test was used to assess global cognitive status. AD pathology was quantified according to Braak stage (<3 vs ≥ 3). Vascular pathology was quantified using a previously reported macrovascular lesion (MVL) score. The association between vascular pathology and antemortem rates of cognitive decline adjusted for level of AD pathology was assessed using linear mixed-effects models.

Results

Mean age was 81.8 at enrollment and 89.0 at death. Participants with more than two MVLs had faster cognitive decline than those with no MVLs (difference in annual rate of change in BIMC 0.74 points/yr, P = .03). Braak stage was also associated with cognitive decline (difference 0.57 points/yr, P = .03). The difference in rate of cognitive decline between those with more than two MVLs and those free of vascular lesions persisted after adjustment for AD pathology (difference in rate of change in BIMC 0.68 points/yr, P = .04). The effect of vascular pathology on cognitive decline was not significantly different according to AD pathology.

Conclusion

Vascular brain pathology is associated with rate of cognitive decline after adjusting for level of AD pathology.

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Neutrophil-To-Lymphocyte Ratio: An Emerging Marker Predicting Prognosis in Elderly Adults with Community-Acquired Pneumonia - American Geriatric Society

Objectives

To explore the performance of the neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation that predicts prognosis of several diseases, in a cohort of elderly adults with community-acquired pneumonia (CAP).

Design

Prospective clinical study from January 2014 to July 2016.

Setting

Unit of Internal Medicine, University of Catania, Catania, Italy.

Participants

Elderly adults admitted for CAP (N = 195).

Measurements

Clinical diagnosis of CAP was defined as the presence of a new infiltrate on plain chest radiography or chest computed tomography associated with one or more suggestive clinical features such as dyspnea, hypo- or hyperthermia, cough, sputum production, tachypnea (respiration rate >20 breaths per minute), altered breath sounds on physical examination, hypoxemia (partial pressure of oxygen <60 mmHg), leukocytosis (white blood cell count >10,000/μL). Clinical examination, traditional tests such as Pneumonia Severity Index (PSI); Confusion, Urea, Respiratory rate, Blood pressure, aged 65 and older (CURB-65), and NLR were evaluated at admission. The accuracy and predictive value for 30-day mortality of traditional scores and NLR were compared.

Results

NLR predicted 30-day mortality (P < .001) and performed better than PSI (P < .05), CURB-65, C-reactive protein, and white blood cell count (P < .001) to predict prognosis. No deaths occurred in participants with a NLR of less than 11.12. Thirty-day mortality was 30% in those with a NLR between 11.12% and 13.4% and 50% in those with a NLR between 13.4 and 28.3. All participants with a NLR greater than 28.3 died within 30 days.

Conclusions

These results would encourage early discharge of individuals with a NLR of less than 11.12, short-term in-hospital care for those with a NLR between 11.12 and 13.4, middle-term hospitalization for those with a NLR between 13.4 and 28.3, and admission to a respiratory intensive care unit for those with a NLR greater than 28.3.

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Reduced Healthcare Use and Apparent Savings with Passive Home Monitoring Technology: A Pilot Study - American Geriatric Society

Objectives

To conduct a cost analysis of ambient assisted living technology, which is promising for improving the ability of individuals and care providers to monitor daily activities and gain better awareness through proactive management of health and safety.

Design

Three-arm cohort study.

Setting

Homes of enrollees of a state-based healthcare plan for older adults.

Participants

Enrollees dually eligible for Medicare and Medicaid (N = 268).

Intervention

Health and safety passive remote patient monitoring (PRPM) systems were installed in enrollees’ homes (the intervention group) with monitoring and proactive intervention of a case manager when deviation from baseline subject behavior was detected.

Measurements

Claims data were collected over 12 months to assess healthcare use and costs in the intervention group and to compare use and costs with those of two control groups: a concurrent group of enrollees who declined the technology and a historical cohort matched on age to the participation group.

Results

Although the small sample size precluded cost differences that were statistically significant, the participant group used substantially less custodial care, emergency department (ED) services, inpatient stays, and ED costs than the two control groups.

Conclusion

In this pilot study, the PRPM system was associated with apparent healthcare cost savings. Although more cost analyses are warranted, ambient assisted living technologies are a potentially valuable investment for older adult care.

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Vitamin D for Healthy Aging - American Geriatric Society

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The Smokehouse of NY Recalls Smoked Fish Products Listed Because of Possible Health Risk - FDA Safety Alerts & Drug Recalls

The Smokehouse of NY, Mamaroneck, NY 10543 is recalling all of the Smoked fish listed below, because they have 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 weaken 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 still births among pregnant women.

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FDA allows marketing of first whole slide imaging system for digital pathology - FDA Press Releases

The U.S. Food and Drug Administration today permitted marketing of the Philips IntelliSite Pathology Solution (PIPS), the first whole slide imaging (WSI) system that allows for review and interpretation of digital surgical pathology slides prepared from biopsied tissue. This is the first time the FDA has permitted the marketing of a WSI system for these purposes.

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Impact of Transitional Care Services for Chronically Ill Older Patients: A Systematic Evidence Review - American Geriatric Society

Transitions in care from hospital to primary care for older patients with chronic diseases (CD) are complex and lead to increased mortality and service use. In response to these challenges, transitional care (TC) interventions are being widely implemented. They encompass education on self-management, discharge planning, structured follow-up and coordination among the different healthcare professionals. We conducted a systematic review to determine the effectiveness of interventions targeting transitions from hospital to the primary care setting for chronically ill older patients.. Randomized controlled trials were identified through Medline, CINHAL, PsycInfo, EMBASE (1995–2015). Two independent reviewers performed the study selection, data extraction and assessment of study quality (Cochrane “Risk of Bias”). Risk differences (RD) and number needed to treat (NNT) or mean differences (MD) were calculated using a random-effects model. From 10,234 references, 92 studies were included. Compared to usual care, significantly better outcomes were observed: a lower mortality at 3 (RD: −0.02 [−0.05, 0.00]; NNT: 50), 6, 12 and 18 months post-discharge, a lower rate of ED visits at 3 months (RD: −0.08 [−0.15, −0.01]; NNT: 13), a lower rate of readmissions at 3 (RD: −0.08 [−0.14, −0.03]; NNT: 7), 6, 12 and 18 months and a lower mean of readmission days at 3 (MD: −1.33; [−2.15, −0.52]), 6, 12 and 18 months. No significant differences were observed in quality of life. In conclusion, TC improves transitions for older patients and should be included in the reorganization of healthcare services.

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Histo-blood group antigens as receptors for rotavirus, new understanding on rotavirus epidemiology and vaccine strategy

Histo-blood group antigens as receptors for rotavirus, new understanding on rotavirus epidemiology and vaccine strategy

Emerging Microbes & Infections 6, e22 (April 2017). doi:10.1038/emi.2017.30

Authors: Xi Jiang, Yang Liu & Ming Tan

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Diversity and role of cave-dwelling hematophagous insects in pathogen transmission in the Afrotropical region

Diversity and role of cave-dwelling hematophagous insects in pathogen transmission in the Afrotropical region

Emerging Microbes & Infections 6, e20 (April 2017). doi:10.1038/emi.2017.6

Authors: Judicaël Obame-Nkoghe, Eric-Maurice Leroy & Christophe Paupy

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Recent emergence of a novel porcine pestivirus: interference with classical swine fever diagnosis?

Recent emergence of a novel porcine pestivirus: interference with classical swine fever diagnosis?

Emerging Microbes & Infections 6, e19 (April 2017). doi:10.1038/emi.2017.5

Authors: Alexander Postel, Denise Meyer, Anja Petrov & Paul Becher

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