Public Health

Children with Certain Disabilities at Greater Risk of Abuse

A new study shows that children with intellectual disabilities and mental/behavioral problems are at greater risk of maltreatment than those with autism, Down syndrome or birth defects, but support for all are needed

Tool Tells When to Stop Phototherapy for Neonatal Hyperbilirubinemia

Key opinion leaders discuss the American Academy of Pediatrics guidelines on when to use phototherapy, as well as a newly developed prediction tool that quantifies a baby’s risk of rebound hyperbilirubinemia.

Every Year, More Athletes Are Injured By Hyponatremia than By Dehydration

The Myths of Dehydration and Heat Illnesses

  • The primary cause of hyponatremia in athletes is drinking too much water.
  • The incidence of hyponatremia appears to be between 13% and 15% among endurance athletes.
  • Gender and the duration of athletic activity appear to be predictors of the incidence of hyponatremia.
  • Sodium supplementation has no effect on the occurrence of hyponatremia.
  • There seems to not be a single case of death resulting from sports-related dehydration in the medical literature.

This Postop Outcome is the 3rd Leading Cause of Death in the U.S.

  • Postoperative myocardial infarction (MI) is the 3rd leading cause of death in the U.S.
  • Intraoperative hypotension, arterial occlusion and other phenomena appear to be part of the multifactorial causes.
  • Intraoperative clonidine is not protective against this phenomenon.
  • Perioperative aspirin use was not related to intraoperative or postoperative MI.

Surgery for Torn Meniscus in the Knee is Often Unnecessary, Ineffective, Misdirected

  • Surgical meniscus repair was not superior to sham surgery in a randomized, controlled trial.
  • Non-surgical care of meniscus-injury related pain, such as exercise, was equally or more effective than surgical interventions.
  • Approximately 700,000 arthroscopic partial meniscectomies are performed annually in the U.S.
  • Annual direct medical costs are estimated at $4 billion.
  • Physicians and patients should consider all non-surgical options before undertaking surgical intervention for knee pain related to meniscus injury.

Four Traits in Adolescents May Predict Future Substance Abuse

  • The Preventure program has been shown to reduce substance abuse among adolescents.
  • Identification of 4 personality traits along with intervention related to those traits reduces rates of substance abuse.
  • Program has been studied in randomized controlled trials in schools in the U.K.

Cost Burden Diminishes Care Quality in Minority Cancer Patients

  • Patients with lung and colorectal cancer and limited financial reserves are more likely to have a higher symptom burden and a decreased quality of life.
  • Patients with lung and colorectal cancer and limited financial reserves are more likely to have a higher symptom burden and a decreased quality of life.
  • Results Among patients with lung and colorectal cancer, 40% and 33%, respectively, reported limited financial reserves.

Data from Two Studies Show Routing Pill Mills in Florida Saved Lives

  • State crackdown on high prescribers is associated with more than 1000 fewer deaths.
  • CDC reports that prescription drug-related deaths have continued to rise.
  • Johns Hopkins researchers find the Florida program to be effective.
  • Physicians are being urged to prescribe opioids in fewer cases, to fewer patients, in lower dosages.
  • The epidemic of prescription and non-prescription opioid deaths makes clear the need for drug treatment programs and for the widespread use of naloxone kits.

New Study Links Alcohol Consumption to Seven Types of Cancer

  • There is increasing evidence linking alcohol consumption to cancer.
  • Mechanisms by which drinking alcohol increase the risk of cancer are not yet understood.
  • New meta-analysis concludes that alcohol causes cancer of the oropharynx, larynx, esophagus, liver, colon, rectum, and breast.
  • “Current estimates suggest that alcohol-attributable cancers at these sites make up 5.8% of all cancer deaths world-wide,” the authors note.

Falls Increasingly Lead to Death in Older Americans

  • In 2012, there were 24,190 fatal and 3.2 million medically treated non-fatal fall related injuries.
  • Direct medical costs totaled $616.5 million for fatal and $30.3 billion for non-fatal injuries in 2012 and rose to $637.5 million and $31.3 billion, respectively, in 2015
  • During 2014, approximately 27,000 older adults died because of falls; 2.8 million were treated in emergency departments for fall-related injuries, and approximately 800,000 of these patients were subsequently hospitalized
  • The projected 2030 population would result in an estimated 48.8 million falls and 11.9 million fall injuries.

Benefits of Fish Nutrition During Pregnancy Outweigh Mercury Risks

  • Nutritional benefits of maternal fish consumption outweighed the risk of neurologic deficits associated with mercury.
  • The better neurobehavioral performance observed in infants with higher mercury biomarkers should not be interpreted as a beneficial effect of mercury exposure, which is clearly neurotoxic.
  • Better neurobehavioral performance in mercury-exposed infants likely reflects the benefits of polyunsaturated fatty acid intake associated with fish consumption.
  • Polyunsaturated fatty acid intake has been shown to benefit attention, memory, and other areas of development in children.

Drug-Eluting Stents Do Not Reduce Death Rates but Reduce Rates of Repeat Revascularization

  • Results of largest study to date were published in The New England Journal of Medicine.
  • Randomized trial involved more than 9000 patients who had stable or unstable coronary artery disease.
  • The primary outcome was a composite of death from any cause and nonfatal spontaneous myocardial infarction at 5 years of follow-up.
  • Secondary outcomes included repeat revascularization, stent thrombosis, and quality of life.

Chicken Pox Cases Have Dropped 85% Since Implementation of 2-Dose Vaccine

  • New data from the Centers for Disease Control and Prevention show urgency of vaccination adherence.
  • Between the period 2005–2006—before the 2-dose vaccine recommendation—and 2013–2014, the overall incidence of varicella infection declined by 84.6%.
  • The largest declines were reported among children aged 5 to 9 years (89.3%) and 10 to 14 years (84.8%).

Traffic Deaths Reach 50-Year High: Opioids and Cannabis Are Adding to the Risk

  • Deaths due to traffic collisions rose in 2015 by 7.7%—the largest increase in 1966.
  • Opioid-related overdose deaths are at epidemic levels.
  • Cannabis use is legal in 25 states.
  • The cost of these collisions and deaths is estimated at nearly $38 billion.
  • Are these phenomena related?

People in These Occupations Have Dramatically Higher Suicide Rates

  • Higher suicide rates ranged from >90/100,00 to >50/100,000 vs.13 to 16/100,000 among the general population.
  • People who work as farmers, fishers, foresters, and in the construction and extraction industries are at greatest risk of suicide.
  • Among women, the highest rate was seen in those working in protective services, such as policing and firefighting.
  • Early physician intervention would be of greatest benefit with these patient groups.