United States

A review of what we know about ultra-processed foods and their impact on health outcomes including a link to a categorized list of food based upon the degree of processing. James W. Mold, MD, MPH

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This Medical News article discusses a new American Heart Association science advisory on ultraprocessed foods, cardiometabolic health, and policy recommendations for improving dietary patterns.

Author/s:

Samantha Anderer

Air Quality Index and Childhood Asthma: A Pilot Randomized Clinical Trial Intervention

Aubrey Delammermore — Wed, 18 Jan 2023 06:00:00 +0000

Date Added:

January 18, 2023

Journal/Publication:

American Journal of Preventative Medicine

Publisher:

Elsevier

Publication Date:

January 13, 2023

Pages:

1-5

URL:

Air Quality Index and Childhood Asthma: A Pilot Randomized Clinical Trial Intervention

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.amepre.2022.12.010

Keywords

PMID (1):

36642643

MeSH

air pollution

Surveys and Questionnaires

child

random allocation

asthma

Adding instructions regarding use of the Air Quality Index to asthma action plans improved asthma control in children. James W. Mold, MD, MPH

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Introduction: To reduce air pollution exposure, the U.S. asthma guidelines recommend that children check the Air Quality Index before outdoor activity. Whether adding the Air Quality Index and recommendations to asthma action plans reduces exacerbations and improves control and quality of life in children with asthma is unknown.

Methods: A pilot, unblinded, randomized clinical trial of 40 children with persistent asthma, stratified by age and randomized 1:1, recruited from the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh (Pittsburgh, PA) was conducted. All participants received asthma action plans and Air Quality Index education. The intervention group received printed Air Quality Index information and showed the ability to use AirNow. Asthma exacerbations were assessed through a questionnaire, asthma control was assessed with the Asthma Control Test and Childhood Asthma Control Test, and quality of life was assessed with the Pediatric Asthma Quality of Life Questionnaire. After randomization (July-October 2020), participants were followed monthly for 6 months (exit January-March 2021). Outcome differences between groups were evaluated at the exit visit and over time (analysis was in 2021).

Results: At randomization, there were no significant differences in age, sex, race, or asthma severity. At exit, more intervention participants checked the Air Quality Index (63% vs 15%) with no differences in the proportion of asthma exacerbations or mean Childhood Asthma Control Test or Pediatric Asthma Quality of Life Questionnaire scores. The mean change in Asthma Control Test score was higher in the intervention group (change in Asthma Control Test=2.00 vs 0.15 for the control), which was modified by time (β=1.85, CI=0.09, 3.61). Physical activity was decreased overall and showed modification by treatment and time.

Conclusions: Addition of the Air Quality Index to asthma action plans led to improved asthma control by Asthma Control Test scores but may decrease outdoor activity.

Author/s:

Rosser, F. J., Rothenberger, S. D., Han, Y., Forno, E., Celedón, J. C.

Antibody Response Following SARS-CoV-2 Infection and Implications for Immunity: A Rapid Living Review

Aubrey Delammermore — Sat, 12 Nov 2022 06:00:00 +0000

Date Added:

November 12, 2022

Journal/Publication:

Agency for Healthcare Research and Quality

Publisher:

US Department of Health and Human Services

Publication Date:

March 15, 2021

Issue:

21-EHC016

URL:

Antibody Response Following SARS-CoV-2 Infection and Implications for Immunity: A Rapid Living Review

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.23970/AHRQEPCCOVIDIMMUNITY

Keywords

Health Services Research

PMID (1):

33784032

MeSH

Infection with the SARS-CoV-2 virus (COVID-19) induces substantial (around 90%) protection from reinfection for at least 6 months and probably longer. James W. Mold, MD, MPH

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The aims of this rapid systematic review are to synthesize evidence on the prevalence, levels, and durability of the antibody response to SARS-CoV-2 infection among adults and how antibodies correlate with protective immunity. Given the rapidly evolving evidence within this field, the Agency for Healthcare Research and Quality’s Evidence-based Practice Center (AHRQ EPC) Program will maintain this report as a living review with planned ongoing literature surveillance and critical appraisal. We will provide regular report updates as additional evidence becomes available, modifying the scope of the review as new directions in SARS-CoV-2 immunity research emerge. This review was conducted in coordination with the American College of Physicians (ACP) as part of AHRQ’s standing work to provide health professional organizations and systems with evidence reviews to support the development of clinical guidance for their clinician members.

Author/s:

Mackey, K., Arkhipova-Jenkins, I., Armstrong, C., Gean, E., Anderson, J., Paynter, R. A., Helfand, M.

Treatment of Clostridioides difficile Infection

Aubrey Delammermore — Sat, 10 Sep 2022 05:00:00 +0000

Date Added:

September 10, 2022

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

September 6, 2022

Issue:

Volume:

328

Pages:

881-882

URL:

Treatment of Clostridioides difficile Infection

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2022.12251

Keywords

PMID (1):

35939317

MeSH

Clostridioides difficile*

Clostridium infections* / drug therapy

Cross infection

diarrhea

Clostridium Infections

An evidence-based summary of the treatment of Clostridium difficile infections. James W. Mold, MD, MPH

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Clostridioides difficile infection is a common nosocomial and community-acquired cause of diarrhea, with an estimated 453 000 cases per year in the United States.1 Treatment of CDI is based on severity and recurrence risk.

Author/s:

Sehgal, K., Cifu, A. S., Khanna, S.

Covid-19 Vaccines — Immunity, Variants, Boosters

Aubrey Delammermore — Thu, 08 Sep 2022 05:00:00 +0000

Date Added:

September 8, 2022

Journal/Publication:

The New England Journal of Medicine

Publisher:

Massachusetts Medical Society

Publication Date:

August 31, 2022

URL:

Covid-19 Vaccines — Immunity, Variants, Boosters

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1056/NEJMra2206573

Keywords

PMID (1):

36044620

MeSH

Vaccination Hesitancy

A summary of the current state of knowledge regarding COVID vaccines and emerging COVID variants. James W. Mold, MD, MPH

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The coronavirus disease 2019 (Covid-19) pandemic has claimed an estimated 15 million lives, including more than 1 million lives in the United States alone. The rapid development of multiple Covid-19 vaccines has been a triumph of biomedical research, and billions of vaccine doses have been administered worldwide. Challenges facing the Covid-19 vaccine field include inequitable vaccine distribution, vaccine hesitancy, waning immunity, and the emergence of highly transmissible viral variants that partially escape antibodies. This review summarizes the current state of knowledge about immune responses to Covid-19 vaccines and the importance of both humoral and cellular immunity for durable protection against severe disease.

Author/s:

Barouch, D. H.

Recommended Adult Immunization Schedule, United States, 2022

Saige Blanchard — Mon, 28 Feb 2022 06:00:00 +0000

Date Added:

February 28, 2022

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

February 18, 2022

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.7326/M22-0036

Keywords

MeSH

Immunization Schedule

Advisory Committees

This is a summary of the 2022 CDC adult immunization recommendations. James W. Mold, MD, MPH

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In November 2021, the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Adult Immunization Schedule for Ages 19 Years or Older, United States, 2022. The 2022 adult immunization schedule, available at www.cdc.gov/vaccines/schedules/hcp/imz/adult.html, summarizes ACIP recommendations in the cover page, tables, notes, and appendix (Figure). The appendix lists the contraindications and precautions for all routinely recommended vaccines on the adult immunization schedule (Figure). The full ACIP recommendations for each vaccine are available at www.cdc.gov/vaccines/hcp/acip-recs/index.html. The 2022 schedule has also been approved by the director of the Centers for Disease Control and Prevention (CDC) and by the American College of Physicians (www.acponline.org), the American Academy of Family Physicians (www.aafp.org), the American College of Obstetricians and Gynecologists (www.acog.org), the American College of Nurse-Midwives (www.midwife.org), the American Academy of Physician Associates (www.aapa.org), and the Society for Healthcare Epidemiology of America (www.shea-online.org).

Author/s:

N., Wodi, A. P., Bernstein, H., Ault, K. A.

A retrospective cohort study of 12,306 pediatric COVID‑19 patients in the United States

Devin Evans — Fri, 21 May 2021 05:00:00 +0000

Date Added:

May 21, 2021

Journal/Publication:

Scientific Reports

Publication Date:

May 13, 2021

Issue:

Volume:

URL:

A retrospective cohort study of 12,306 pediatric COVID‑19 patients in the United States

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1038/s41598-021-89553-1

Keywords

2019 novel coronavirus

coronavirus

PMID (1):

33986390

MeSH

child

2-toluenesulfonamide

delivery of health care

Critical Care

COVID-19

A retrospective analysis of the symptoms and clinical course of over 12,000 children with COVID-19. James W. Mold, Md, MPH

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Children and adolescents account for ~ 13% of total COVID-19 cases in the United States. However, little is known about the nature of the illness in children. The reopening of schools underlines the importance of understanding the epidemiology of pediatric COVID-19 infections. We sought to assess the clinical characteristics and outcomes in pediatric COVID-19 patients. We conducted a retrospective cross-sectional analysis of pediatric patients diagnosed with COVID-19 from healthcare organizations in the United States. The study outcomes (hospitalization, mechanical ventilation, critical care) were assessed using logistic regression. The subgroups of sex and race were compared after propensity score matching. Among 12,306 children with lab-confirmed COVID-19, 16.5% presented with respiratory symptoms (cough, dyspnea), 13.9% had gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain), 8.1% had dermatological symptoms (rash), 4.8% had neurological (headache), and 18.8% had other non-specific symptoms (fever, malaise, myalgia, arthralgia and disturbances of smell or taste). In the study cohort, the hospitalization frequency was 5.3%, with 17.6% needing critical care services and 4.1% requiring mechanical ventilation. Following propensity score matching, the risk of all outcomes was similar between males and females. Following propensity score matching, the risk of hospitalization was greater in non-Hispanic Black (RR 1.97 [95% CI 1.49-2.61]) and Hispanic children (RR 1.31 [95% CI 1.03-1.78]) compared with non-Hispanic Whites. In the pediatric population infected with COVID-19, a substantial proportion were hospitalized due to the illness and developed adverse clinical outcomes.

Author/s:

Parcha, V., Booker, K.S., Kalra, R., Kuranz, S., Berra, L., Arora, G., Arora, P.

Unhealthy Drug Use: Screening

Brian Desmarais — Wed, 10 Jun 2020 17:22:42 +0000

Date Added:

June 10, 2020

Publisher:

U.S. Preventive Services Task Force

Publication Date:

June 9, 2020

URL:

Unhealthy Drug Use: Screening

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Web Page

Keywords

recommendations

United States

MeSH

Mass Screening

substance-related disorders

research

We now have an official recommendation from USPSTF on screening for unhealthy drug use (do it). James W. Mold, MD, MPH

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Not available.

Author/s:

U. S. Preventive Services Task Force

Coronavirus Disease 2019 and Influenza

John Bayhi — Fri, 28 Feb 2020 14:05:34 +0000

Date Added:

February 28, 2020

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

February 26, 2020

Type:

Clinical Decision Aids

Format:

Web Page

DOI (1):

10.1001/jama.2020.2633

Keywords

2019 novel coronavirus

A comparison between COVID19 and influenza in 2020 in the U.S. so far. James W. Mold, MD, MPH

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No abstract available.

Author/s:

Livingston, E, Bucher, K, Rekito, A

Preexposure Prophylaxis for the Prevention of HIV Infection: US Preventive Services Task Force Recommendation Statement

Brian Desmarais — Wed, 12 Jun 2019 19:42:06 +0000

Date Added:

June 12, 2019

Journal/Publication:

Journal of the American Medical Association

Publication Date:

June 11, 2019

Issue:

Volume:

321

URL:

Preexposure Prophylaxis for the Prevention of HIV Infection: US Preventive Services Task Force Recommendation Statement.

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.6390

Keywords

MeSH

acquired immunodeficiency syndrome

Pre-Exposure Prophylaxis

risk factors

risk assessment

primary health care

The USPSTF recommends offering antiretroviral prophylaxis to patients at high risk for HIV infection. James W. Mold, MD, MPH

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Abstract

IMPORTANCE:

An estimated 1.1 million individuals in the United States are currently living with HIV, and more than 700 000 persons have died of AIDS since the first cases were reported in 1981. In 2017, there were 38 281 new diagnoses of HIV infection reported in the United States; 81% of these new diagnoses were among males and 19% were among females. Although treatable, HIV infection has no cure and has significant health consequences.

OBJECTIVE:

To issue a new US Preventive Services Task Force (USPSTF) recommendation on preexposure prophylaxis (PrEP) for the prevention of HIV infection.

EVIDENCE REVIEW:

The USPSTF reviewed the evidence on the benefits of PrEP for the prevention of HIV infection with oral tenofovir disoproxil fumarate monotherapy or combined tenofovir disoproxil fumarate and emtricitabine and whether the benefits vary by risk group, population subgroup, or regimen or dosing strategy; the diagnostic accuracy of risk assessment tools to identify persons at high risk of HIVacquisition; the rates of adherence to PrEP in primary care settings; the association between adherence and effectiveness of PrEP; and the harms of PrEP when used for HIV prevention.

FINDINGS:

The USPSTF found convincing evidence that PrEP is of substantial benefit in decreasing the risk of HIV infection in persons at high risk of HIV acquisition. The USPSTF also found convincing evidence that adherence to PrEP is highly associated with its efficacy in preventing the acquisition of HIV infection; thus, adherence to PrEP is central to realizing its benefit. The USPSTF found adequate evidence that PrEP is associated with small harms, including kidney and gastrointestinal adverse effects. The USPSTF concludes with high certainty that the magnitude of benefit of PrEP with oral tenofovir disoproxil fumarate-based therapy to reduce the risk of acquisition of HIV infection in persons at high risk is substantial.

CONCLUSIONS AND RECOMMENDATION:

The USPSTF recommends offering PrEP with effective antiretroviral therapy to persons at high risk of HIV acquisition. (A recommendation).

Author/s:

US Preventive Services Task Force