miércoles, 26 de noviembre de 2014

HIV & AIDS in the United States Update

e-HAP HIV & AIDS in the United States

Dear Colleague,
Today, the Centers for Disease Control and Prevention (CDC) released its 2014 HIV Vital Signs, which includes:
The topic of this year’s Vital Signs is the HIV Care Continuum in the United States, which reports on the percentages of people living with HIV in various stages of diagnosis, care, and antiretroviral treatment. Ensuring that all those living with HIV are successfully treated is critical to improve their overall health and reduce the risk of transmitting HIV to their partners. The National HIV/AIDS Strategy (NHAS) and the White House's Continuum of Care Initiative seek to identify people who are living with HIV, link them to care, and ultimately increase the proportion of people with a suppressed viral load.
For 2011, the data on the HIV Care Continuum showed that of the 1.2 million people living with HIV in the United States:
  • 86% had been diagnosed with HIV,
  • 40% were engaged in HIV medical care,
  • 37% were prescribed antiretroviral therapy (ART), and
  • 30% achieved viral suppression.
Viral suppression means having very low levels of HIV in the body, even though the virus is still there. The data show no differences in viral suppression by sex, race/ethnicity, or transmission category. However, there were differences by age. Only 13% of persons aged 18-24 had achieved viral suppression, compared with 37% of those aged 65 and over.
The percentage of people living with HIV who achieve viral suppression could be increased by expanding HIV testing efforts so that all people living with undiagnosed HIV know their status and are linked to and engaged in ongoing HIV medical care. Early and regular treatment with ART can protect health and extend life. People with HIV who are diagnosed early, begin ART immediately, and continue receiving ongoing care can have a life expectancy near to that of people who do not have HIV. Further, being on ART and virally suppressed can greatly reduce the risk of sexual transmission of HIV to partners. These benefits are powerful.

Health care providers can help keep patients in care by using appointment reminders, or by referring them to support services, such as nutrition, housing, or mental health services. They can also work with health departments in a Data to Care program to use HIV surveillance data to identify people with HIV who are not in care and link them to care. To encourage people living with HIV to get in care and stay in care, CDC recently released HIV Treatment Works, a new campaign under the Act Against AIDS initiative. This campaign focuses on helping people living with HIV get into care, start taking ART, remain in care, and adhere to treatment. Our clinical partners – doctors, nurses, and other health care providers, as well as health departments and professional organizations--play a pivotal role in helping get the word out about the health-preserving and HIV- prevention potential of getting on, and staying on, ART in order to achieve viral suppression.
Please share the CDC Vital Signs information broadly with your colleagues and partners. Visit the HIV Vital Signs web page to find the Vital Signs MMWR article, fact sheet, and other materials. Take advantage of CDC’s social media tools, such as the Vital Signsbuttons and email updates. You can have Vital Signs sent directly to your own website to display through our content syndication service. We also invite you to join us for the Vital Signs Town Hall Teleconference designed to provide a forum for our nation's health officials on December 2, 2014 at 2pm (EDT).
Vital Signs is not just about data, it is about action. Please join us to fight to prevent HIV infections.

/Eugene McCray/
Eugene McCray, MD
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention

/Jonathan Mermin/
Jonathan H. Mermin, MD, MPH
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Additional Resources:
Visit CDC’s HIV/AIDS Web site.
CDC HIV Facebook
CDC Twitter
Act Against AIDS 
Act Against AIDS Facebook
Act Against AIDS Twitter
Get information about personal risk, prevention, and testing.
Please contact us with questions, comments or other feedback about e-HAP

Special Edition: Raising Awareness About Antibiotic Resistance

CDC and Food Safety: Updates on outbreaks, publications, partners, and good-to-know info.

November 2014   |  Special Edition: Raising Awareness About Antibiotic Resistance

Get Smart Week


November 17-23 was Get Smart About Antibiotics Week, an international observance to raise awareness about the threat of antibiotic resistance and the importance of appropriate prescribing and use. Get Smart Week is a key activity in CDC’s efforts to improve antibiotic stewardship in communities, health care facilities, and on farms in collaboration with other partners.
Earlier this year, the White House announced the National Strategy to Combat Antibiotic-Resistant Bacteria. To support this, CDC will focus on:
  • Strengthening national surveillance efforts to track resistant bacteria,
  • Advancing development of rapid diagnostic tests to identify and characterize resistant  bacteria, and
  • Improving international collaboration for antibiotic resistance prevention, surveillance, control, and antibiotic research and development.
To accomplish these goals, CDC has submitted a FY 2015 budget request for:
Did You Know?
  • Each year, an estimated two million persons in the United States are infected with antibiotic-resistant bacteria, and approximately 23,000 die as a result.
  • The rise of antibiotic resistance represents a serious threat to human and animal health, national security, and economies worldwide.
  • The use of antibiotics is the single most important factor leading to antibiotic resistance around the world.


CDC partners with National Institute for Animal Agriculture:

The National Institute for Animal Agriculture (NIAA) hosted a three-day symposium (November 12-14) on antibiotic use and resistance, and moving forward through shared stewardship.
The NIAA Antibiotics Symposium brought together academia, government researchers, public health experts, the scientific community and stakeholders within animal agriculture, human medicine and the environment.  
CDC's Tom Chiller, Steve Solomon, and Rob Tauxe presented on the human-animal interface of antimicrobial resistance, and Chris Braden provided opening remarks on CDC’s efforts in antibiotic resistance and shared stewardship.

CDC and Partners "Get Smart" on Twitter

On November 18, CDC hosted an antibiotic-themed Twitter chat that coincided with Get Smart Week. The Twitter chat featured CDC experts Drs. Tom Chiller, Lauri Hicks, and Loria Pollack, who lent expertise on antibiotic resistance in animals and humans.  
Several European countries, as well as Australia and Canada, also participated in a 24-hour global antibiotic resistance-themed Twitter chat. 
Partners participating in the Twitter chat included American Academy of Pediatrics, NIAA, Perdue, and a host of others.
Twitter chat messages made more than 52.4 million impressions. 

Good-to-Know Info


Pharmacokinetic/Pharmacodynamic Measures for Guiding Antibiotic Treatment for Hospital-Acquired Pneumonia - Research Review - Final | AHRQ Effective Health Care Program

Pharmacokinetic/Pharmacodynamic Measures for Guiding Antibiotic Treatment for Hospital-Acquired Pneumonia - Research Review - Final | AHRQ Effective Health Care Program

Agency for Healthcare Research Quality

Research Review - Final – Nov. 24, 2014

Pharmacokinetic/Pharmacodynamic Measures for Guiding Antibiotic Treatment for Hospital-Acquired Pneumonia


This report is available in PDF (1.2 MB) only. People using assistive technology may not be able to fully access information in this file. For additional assistance, please contact us.

Browse NCSACW From Your Phone or Tablet

Browse NCSACW From Your Phone or Tablet
The National Center on Substance Abuse and Child Welfare (NCSACW) has updated its website to a responsive web design approach, giving users an optimal viewing experience. The website is now equipped to navigate using mobile phones and tablets. Substance abuse treatment professionals can now easily access resources, tools, and online tutorials on the go!

Access Webinar Materials
"Opioid Use in Pregnancy: A Community's Approach, the Children and Recovering Mothers (CHARM) Collaborative"
The webinar features the CHARM Collaborative based in Burlington, Vermont. CHARM is a multidisciplinary group of agencies serving pregnant women with opioid dependence, and their infants and families. Discussion centers on services provided and collaborative practice elements across systems at multiple points of intervention—prenatal, birth, and postpartum.

See Outcomes of the CAM Program
CAM Program Brief
The Children Affected by Methamphetamine (CAM) Brief presents the experiences, lessons learned, and outcomes of the collaborative efforts of the CAM Grant Program (October 2010–September 2014).
Download the CAM Brief [PDF – 936KB]

Learn About the Matrix Model
This webinar discusses practical issues around the implementation of the Matrix Model, an intensive outpatient treatment approach for stimulant abuse and dependence. You will find information on the certification process and fidelity instruments to help in the use of this evidence-based practice.

Read the Key Lessons of the RPG Program
Key Lessons from RPG Program
The Regional Partnership Grant (RPG) Program represents the broadest federal program ever launched to assist states, tribes, and communities across the Nation to improve the well-being, permanency, and safety outcomes of children who are in, or at-risk of, out-of-home placement as a result of a parent's or caregiver's methamphetamine or substance abuse. The Final Synthesis and Summary Report: Grantee Interviews highlights their voices and captures lessons learned from individuals working within the RPG program.
Download the RPG Report [PDF – 806KB]

About the NCSACW
The National Center on Substance Abuse and Child Welfare (NCSACW) is an initiative of the U.S. Department of Health and Human Services and jointly funded by SAMHSA's Center for Substance Abuse Treatment and the Administration on Children, Youth, and Families, Children's Bureau's Office on Child Abuse and Neglect.

Psoriatic Arthritis

Psoriatic Arthritis

National Insititute of Arthritis and Musculoskeletal and Skin Diseases

11/24/2014 03:48 PM EST

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases - NIH
Related MedlinePlus Page: Psoriatic Arthritis

Psoriatic Arthritis Overview

October 2014

What Is Psoriatic Arthritis?

Psoriatic arthritis is a form of arthritis (joint inflammation) that can occur in people who have the skin disease psoriasis. Psoriasis is a common condition characterized by scaly red and white skin patches. Psoriatic arthritis can affect any joint in the body, including the spine.

Who Is Affected?

Anyone can be affected by psoriatic arthritis, but it is more common in Caucasians than African Americans or Asian Americans. It most commonly appears between the ages of 30 and 50, but it can also begin in childhood. According to the Centers for Disease Control and Prevention (CDC), 10 to 20 percent of people with psoriasis eventually develop psoriatic arthritis. Typically, skin disease precedes the arthritis, sometimes by several years. However, in some cases, arthritic symptoms appear first.

What Is the Cause?

The cause of psoriatic arthritis is not known; however, doctors believe a combination of genetic and environmental factors is involved. Research shows that people with psoriatic arthritis often have a family member with psoriasis or arthritis. In people who are susceptible, an infection may activate the immune system, triggering the development of psoriatic arthritis.

What Are the Symptoms?

Psoriatic arthritis affects both the skin and the musculoskeletal system. The joints most commonly affected are the distal joints (those closest to the nail) of the fingers or toes, as well as the wrists, knees, ankles, and lower back.
Symptoms of Psoriatic Arthritis
Musculoskeletal symptoms may include:
  • Joint pain and swelling that may come and go and may be accompanied by redness and warmth.
  • Tenderness where muscles or ligaments attach to the bones, particularly the heel and bottom of the foot.
  • Inflammation of the spinal column, called spondylitis, which can cause pain and stiffness in the neck and lower back.
  • Morning stiffness.
  • Reduced range of motion of the joints.
  • Painful, sausage-like swelling of the fingers and/or toes.
Skin symptoms may include:
  • Thickness and reddening of the skin with flaky, silverwhite patches, called scales.
  • Pitting of the nails or separation from the nail bed.
Other symptoms may include:
  • General fatigue and malaise.
  • Conjunctivitis (also known as pink eye), inflammation, or infection of the membrane lining the eyelid and part of the eyeball.

How Is Psoriatic Arthritis Diagnosed?

The diagnosis of psoriatic arthritis is made based on the findings of a medical and family history and physical exam as well as x rays or magnetic resonance imaging (MRI) of the affected joints. Although there is no lab test to diagnose psoriatic arthritis, your doctor may order tests on blood or joint fluid to rule out other forms of arthritis with similar symptoms. If you have psoriasis and start to develop joint pain, it’s important to see your doctor. Early diagnosis and treatment of psoriatic arthritis can help prevent irreparable joint damage.

How Is Psoriatic Arthritis Treated?

Treatment for psoriatic arthritis will depend largely on its severity. If the disease is mild and affects only a couple of joints, treatment with nonsteroidal antiinflammatory drugs (NSAIDs)1 may be sufficient for treating pain and inflammation. For acutely inflamed joints, corticosteroid injections may be helpful. For more persistent disease affecting multiple joints, stronger disease-modifying antirheumatic drugs (DMARDs) and/or antitumor necrosis factor (TNF) agents may be needed to control the disease.2

1 Warning: NSAIDs can cause stomach irritation or, less often, they can affect kidney function. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a patient is being treated with NSAIDs because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. Also, NSAIDs sometimes are associated with serious gastrointestinal problems, including ulcers, bleeding, and perforation of the stomach or intestine. People age 65 and older, as well as those with any history of ulcers or gastrointestinal bleeding, should use NSAIDs with caution.
2 All medicines can have side effects. Some medicines and side effects are mentioned in this publication. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.

What Research Is Being Done?

Researchers throughout the United States and the world are conducting research that will eventually improve the understanding and outcomes of psoriatic arthritis.
Some promising areas of research include:
Genetics. Scientists supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) are working to uncover genes associated with psoriasis, as well as modifier genes that can indicate which people with psoriasis are also at risk for psoriatic arthritis. Identification of genes that increase the risk of psoriatic arthritis will help scientists unlock the secrets of this troubling disease, and identify targets for more specific and effective therapy.
Biologic therapies. Biologic therapies that block the inflammatory cytokine TNF have proven to be among the most effective therapies for psoriatic arthritis. A number of other biologic agents are currently in clinical trials for psoriatic arthritis, and researchers continue to look for targets of biologic therapy for the disease.
Role of vitamin D. A recent study showed that vitamin D insufficiency is common in people with psoriatic arthritis. A new study supported by the NIAMS is designed to investigate the effects of vitamin D supplementation, along with marine omega-3 fatty acid and docosahexaenoic acid (DHA), on incidence, inflammation, and chronic pain in autoimmune diseases including psoriatic arthritis.
Risk factors. To better understand what causes psoriatic arthritis, with the eventual goal of stopping its development, scientists are looking into factors that predict risk of arthritis among people with psoriasis. One recent study found that people with psoriasis who reported being obese at age 18 were more likely to develop arthritis and develop it at an earlier age than people with a normal body mass index (BMI). Other research has shown that more severe skin disease is predictive of an increased risk of joint disease.
Diagnostics. The similarity between psoriatic arthritis and other inflammatory forms of arthritis can delay an accurate diagnosis, particularly when the arthritis precedes the skin disease. One group of researchers looking for better ways to diagnose the disease has found that a technique called contrast-enhanced MRI may help doctors differentiate between rheumatoid arthritis and psoriatic arthritis in the hand and wrist, which would enable them to target therapies to each condition.


American College of Rheumatology
Website: www.rheumatology.org
Arthritis Foundation
Website: www.arthritis.org
National Psoriasis Foundation
Website: www.psoriasis.org
# # #
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. The NIAMS information clearinghouse is a public service sponsored by the NIAMS that provides health information and information sources. Additional information can be found on the NIAMS website atwww.niams.nih.gov.
The National Institutes of Health (NIH)—The Nation’s Medical Research Agency—includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

For Your Information

This publication contains information about medications used to treat the health condition discussed here. When this publication was developed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.
For updates and for any questions about any medications you are taking, please contact
U.S. Food and Drug Administration
Toll Free: 888–INFO–FDA (888–463–6332)
Website: http://www.fda.gov
For additional information on specific medications, visit Drugs@FDA atwww.accessdata.fda.gov/scripts/cder/drugsatfda. Drugs@FDA is a searchable catalog of FDA-approved drug products.
For updates and questions about statistics, please contact
Centers for Disease Control and Prevention, National Center for Health Statistics
This publication is not copyrighted. Readers are encouraged to duplicate and distribute as many copies as needed.
Additional copies of this publication are available from:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll Free: 877-22-NIAMS (877-226-4267)
TTY: 301-565-2966
Fax: 301-718-6366
Email: NIAMSinfo@mail.nih.gov
Website: http://www.niams.nih.gov
NIH Publication No. 14–AR-8001

ADHD Medicines

ADHD Medicines

ADHD Medicines

11/24/2014 09:41 AM EST

Source: Nemours Foundation
Related MedlinePlus Page: Medicines and Children