martes, 1 de enero de 2013

Research Activities, January 2013: Comparative Effectiveness Research: Four drugs to treat chronic heart failure found similarly effective

Research Activities, January 2013: Comparative Effectiveness Research: Four drugs to treat chronic heart failure found similarly effective

U.S. Department of Health and Human Serviceswww.hhs.gov/
Agency for Healthcare Research Quality

Four drugs to treat chronic heart failure found similarly effective

Thanks to their tolerability profiles, angiotensin receptor blockers (ARBs) are becoming the preferred medications to treat chronic heart failure (CHF). A new study that compared four ARBs to determine their ability to reduce mortality in patients with CHF found them to be similarly effective at reducing the death rate in everyday clinical practice.

The researchers identified 1,536 veterans with CHF from electronic medical records, with review of their medical charts providing additional clinical data. They categorized patients into one of four groups based on the ARB initially used: candesartan, valsartan, losartan, and irbesartan. They measured time to death during the study's 2-year period.

Of the 4 ARBs, irbesartan was the most popular, taken by 55.21 percent of patients. This was followed by losartan, candesartan, and valsartan. There was significant geographic variation in use of ARBs. For example, Midwest patients tended to use losartan and candesartan. However, no patients from the northeast were on candesartan and only two patients in the West were on valsartan. Concurrent hospitalization rates were higher for patients receiving irbesartan; valsartan had the lowest rate.

After the researchers controlled for numerous demographic and clinical factors, they found no statistically significant difference among the four ARBs in their ability to reduce mortality. The study was supported in part by the Agency for Healthcare Research and Quality (HS16901).
See "Comparative effectiveness of individual angiotensin receptor blockers on risk of mortality in patients with chronic heart failure," by Rishi J. Desai, MS, PhD, Carol M. Ashton, MD, MPH, Anita Deswal, MD, MPH, and others in Pharmacoepidemiology and Drug Safety 21, pp. 233-240, 2012.
— KB

Acute Migraine Treatment in Emergency Settings - Research Review - Final | AHRQ Effective Health Care Program

Acute Migraine Treatment in Emergency Settings - Research Review - Final | AHRQ Effective Health Care Program


Department of Health and Human Serviceswww.hhs.gov
Agency for Healthcare Research Quality

Many non-oral medications appear to effectively treat acute migraines in emergency department patients

Many non-oral agents, such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and triptans, appear to be effective for treating acute migraine headache when compared to placebo for patients seeking treatment at the emergency department. However, the strength of evidence is not sufficient to show any one treatment is better than another, according to a recent review of the evidence by the Agency for Healthcare Research and Quality (AHRQ).

The review compares the effectiveness of non-oral medications versus standard care, placebo, or other treatments for acute migraine headaches in patients who seek treatment at an emergency department. Nine different classes of drugs are reviewed: antiemetics (metoclopramide), neuroleptics, ergotamines, NSAIDs, opioids, corticosteroids, triptans, magnesium sulfate (MgSO4), and antihistamines.

Intravenous systemic corticosteroids were found to be effective for preventing headache recurrence up to 72 hours after discharge, especially in patients with prolonged headaches. The report also discussed that adverse event reporting is not consistent across trials. Therefore, there is not enough evidence to compare adverse events among different treatments. More research is required to identify the most effective non-oral treatments for adults with acute migraine in an emergency setting.

Acute migraine is a debilitating condition caused by dysfunction of the central and peripheral nervous systems and intracranial vasculature. Episodes of migraine cause severe and disabling pain that often results in visits to an emergency department as well as decreased productivity and missed time from work, school, and other activities. Migraine has a negative impact on overall quality of life, and in the United States, migraine and related medical issues result in costs of more than $13 billion per year in lost productivity.

These findings are available in the research review Acute Migraine Treatment in Emergency Settings. You can read this review and other reports from AHRQ's Effective Health Care Program at http://www.effectivehealthcare.ahrq.gov.

CDC Features - Inspiration for a Healthy New Year

CDC Features - Inspiration for a Healthy New Year

Inspiration for a Healthy New Year



Many popular New Year's resolutions focus on how to improve our health. That is good news, considering that being healthy provides us protection against disease and injury, as well as strength and energy to help us have a good quality of life.

5 Healthy Tips for 2013

Whatever your situation, see your health care provider and find out how you can live a safer and healthier life. Here are a few general tips for a safe and healthy life:
Need inspiration to get started? Meet three people who changed their health habits—and their lives. They lost weight, became active, gained energy, and grew in self-confidence. Here are their stories and tips for making healthy living easier. They say if they can do it, you can too!

Bill

Photo: BillBill had stayed in shape playing football in high school, but then became inactive in college and started gaining weight. By the time he was in his mid-30s and the mid-300 pound range, he was diagnosed with type 2 diabetes and started giving himself insulin shots twice a day.
In his 50s, Bill weighed 515 pounds, had achy knees, used a cane, and rode a scooter to get around the store when he shopped. A friend's well-meaning comment about his weight and health got his attention. That night, Bill took stock of his life and developed a plan to change his habits.
At his doctor's suggestion, he took the plunge into exercise with water aerobics. To his surprise, Bill found he enjoyed the workout and could move easily in the water with little impact on his joints. He lost 35 pounds and the knee pain subsided. That encouraged him to keep going and make other changes in his life.
He dropped 140 pounds on his own before having surgery for help in taking off 145 more. He jokes that with 285 pounds gone, he lost the equivalent of an NFL linebacker. Not only that—Bill has been off diabetes medication for years.
"Obesity robbed me of a lot in life," says Bill. "I call it the O-beast." For example, when his son was 8, Bill was scared to go on a ride with him at an amusement park. However, when a slimmer Bill took the family to the same park years later, he asked his then 30-year-old son, "Will you ride with me?" They did, and as he says, "It was an emotional moment."
Strategies That Work For Me
  • Make small changes, like sometimes eating other things instead of meat.
  • Make a commitment to yourself. I don't care if it rains, sleets, or snows: I walk an hour five times a week.
  • Get the professional help that you need, whether for emotional support or physical check-ups.
  • Enjoy life! I didn't go to my high school prom, so I plan to have a prom this year, with a band and all the people I love. I will take a date and celebrate.

Becky

Photo: BeckyTo look at Becky, a triathlete, marathoner, and ultramarathoner, you would never know she used to be a couch potato who spent nights watching TV and eating junk food. Fishing was her only real activity, and as she quips, she only exercised one arm.
She weighed close to 180 pounds and smoked two packs a day, but gave up cigarettes on her own. Then in 1995, her sister, who was training for a race, challenged her to run a mile.
Becky started out walking and tried running a little bit. Once she ran a full mile, she thought maybe she could do more. Exercise gave her an unexpected physical and mental boost. It relieved stress from taking care of her ill mother.
Soon Becky had built up to running a half-marathon. The next year, she tackled her first marathon. She never looked back, and has completed 29 marathons since 1996 and at age 50 completed a full Ironman triathlon.
Strategies That Work For Me
  • Adapt to your body's needs. I now have arthritis in my knee, so have focused on finding what types of movement I can do instead of what I can't do. I do moderate running, walk, cycle, kayak, and work out with weights.
  • Eat healthily. I cut out french fries and pizza, ate less sugar, and dropped 40 pounds.
  • Get adequate sleep and rest. I teach meditation, which is all part of overall wellness. I'm working on the sleep and rest part.
  • Move more at your desk. I try to make myself get up every 30 to 60 minutes, even if it's just to walk around for a minute or move around from my desk.

Sylvia

Photo: SylviaSylvia was a stay-at-home mom whose life revolved around cooking, cleaning, watching soap operas, and eating unhealthy food. Her weight had climbed to 175. "I'd always been skinny," says the former farm girl, who ran track and played basketball in her youth. "But at that weight I was sluggish and tired."
Then she and her husband took in an ill friend who had undergone surgery. While helping the friend eat healthier and regain his strength, they began to change their eating habits too. Sylvia's energy skyrocketed. She began working out, doing an hour on the treadmill or elliptical machine. Next, she added weight training.
The mother of two toned up and slimmed down by more than 30 pounds. "I'm a witness that this change in lifestyle works. The same way I changed my life and made health a priority, you can too."
Strategies That Work For Me
  • Buy your food fresh. Love yourself by cooking your own food. I make my own vegetarian pizza and pasta.
  • Season with herbs instead of salt. I use curry, basil, cilantro, rosemary, parsley, and ginger.
  • Steam vegetables like broccoli or string beans.
  • Find the physical activity and training level that's right for you. I started with cardio workouts to raise my heart rate and build my aerobic capacity, then added weight training to become strong.
Below are more tips for creating a healthy you and healthy family in the new year.

Healthy You

Learn more about Healthy Living.

Healthy Family

Learn more about Family Health and Kids' Health, and visit the Parent Portal.

Lifestyle Changes Key to Weight Loss in New Year: MedlinePlus

 
http://www.nlm.nih.gov/medlineplus/news/fullstory_132660.html
MedlinePlus Logo

Lifestyle Changes Key to Weight Loss in New Year

Small steps can help people finally achieve that elusive resolution, expert says
URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_132660.html  (*this news item will not be available after 03/30/2013)
By Robert Preidt
Sunday, December 30, 2012HealthDay Logo
HealthDay news image
Related MedlinePlus Page
SUNDAY, Dec. 30 (HealthDay News) -- Many people will resolve to lose weight in 2013 but few of them will take the right steps to achieve that goal, an expert says.
"January is the time of year when gyms get flooded with new and returning members ready to try Zumba or spin classes, and dieters start filling their grocery carts with fruits and vegetables instead of chips and cookies," Alenka Ravnik-List, diabetes program coordinator at the Mount Sinai Medical Center in New York City, said in a center news release. "But unfortunately, too often people with good intentions will fail."
But following a few rules can help people change their lifestyle and lose weight.
Ravnik-List offered the following advice:
  • Don't skip breakfast. Research shows that eating breakfast every day can help you lose weight and keep it off.
  • Keep a journal of everything you eat. People who keep food diaries eat about 15 percent less food than those who don't.
  • Get walking. Sedentary people take only about 3,000 steps a day. Adding another 3,000 steps will help you maintain your current weight and getting more than 10,000 steps a day will help you lose weight.
  • Watch your serving sizes. Eat meals on a medium-sized plate (about eight to nine inches wide). A bigger plate encourages you to eat more because you can fit more food on it. Load half of your plate with colorful vegetables and the other half with lean protein and whole grain starches.
  • Weigh yourself at least once a week. Doing so will help you detect small weight gains before they get out of control.
  • Don't be too strict with yourself. Everyone has a craving they can't avoid, so don't. Plan a night out with friends and satisfy your craving. Moderation is the key to success.
"If you follow these tips, maybe next year you can pick a different New Year's resolution because you will feel both physically and mentally better about yourself," Ravnik-List said.
SOURCE: Mount Sinai Medical Center, news release, Nov. 26, 2012
HealthDay
More Health News on:
Weight Control

Press Announcements > FDA approves first anti-diarrheal drug for HIV/AIDS patients

Press Announcements > FDA approves first anti-diarrheal drug for HIV/AIDS patients

FDA, U.S. Food and Drug Administration

FDA NEWS RELEASE


For Immediate Release: Dec. 31, 2012
Media Inquiries: Morgan Liscinsky, 301-796-0397, morgan.liscinsky@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA approves first anti-diarrheal drug for HIV/AIDS patientsFulyzaq is the second botanical drug approved by the agency

The U.S. Food and Drug Administration today approved Fulyzaq (crofelemer) to relieve symptoms of diarrhea in HIV/AIDS patients taking antiretroviral therapy, a combination of medicines used to treat HIV infection.

Diarrhea is experienced by many HIV/AIDS patients and is a common reason why patients discontinue or switch their antiretroviral therapies. Fulyzaq is intended to be used in HIV/AIDS patients whose diarrhea is not caused by an infection from a virus, bacteria, or parasite. Patients take Fulyzaq two times a day to manage watery diarrhea due to the secretion of electrolytes and water in the gastrointestinal tract.

Derived from the red sap of the Croton lechleri plant, Fulyzaq is the second botanical prescription drug approved by FDA. A botanical drug product is often a complex mixture derived from one or more plant materials with varying degrees of purification. In 2006, the FDA approved the first botanical prescription drug, Veregen (sinecatechins), a treatment for external genital and perianal warts.

“Currently, there are no FDA-approved therapies for HIV-associated diarrhea,” said Julie Beitz, M.D., director of the Office of Drug Evaluation III in FDA’s Center for Drug Evaluation and Research. “Fulyzaq may be helpful to HIV/AIDS patients with this troublesome condition.”

Just as for other types of drugs, the safety and efficacy of a botanical drug product are established through clinical trials. In addition, manufacturers of a botanical drug product must ensure rigorous control of raw materials, and good agricultural and collection practices, together with analytical testing of the complex mixture.

The safety and efficacy of Fulyzaq were established in a clinical trial of 374 HIV-positive patients on stable antiretroviral therapy with a history of diarrhea lasting one month or longer. The median number of daily watery bowel movements was 2.5 per day. Patients who had diarrhea caused by an infection or a gastrointestinal disease were excluded from participating in the trials. Patients were randomly assigned to take Fulyzaq or a placebo twice daily.

The trial was designed to measure clinical response, defined as the number of patients who had two or fewer watery bowel movements weekly. Results showed that 17.6 percent of patients taking Fulyzaq experienced clinical response compared with 8 percent taking placebo. In some patients, a persistent anti-diarrheal effect was seen for 20 weeks.
Before treating patients with Fulyzaq, health care professionals should conduct proper testing to confirm the diarrhea is not caused by an infection or a gastrointestinal disease. Common side effects reported in patients taking Fulyzaq in the clinical trial were upper respiratory tract infection, bronchitis, cough, flatulence, and increased levels of the liver enzyme bilirubin.

Fulyzaq is distributed by Salix Pharmaceuticals, based in Raleigh, N.C. under license from Napo Pharmaceuticals, Inc.

Veregen is marketed by Florham Park, N.J.-based PharmaDerm.

For more information:

Centers for Disease Control and Prevention (CDC) Health Matters for Women[TM] E-Newsletter Update

Centers for Disease Control and Prevention (CDC) Health Matters for Women[TM] E-Newsletter Update

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December

New from CDC

Women’s Health 2012: A Year in Review
In 2012, CDC made numerous contributions to better understand, address, improve, and promote the health, safety, and quality of life of women, at all stages of life.
2013 Women’s Health Calendar
Be inspired by the 2013 one-page women’s health calendar. One page calendars are also available for healthy men and healthy communities.
Recent Trends in Births and Fertility Rates Through June 2012
The provisional count of births in the United States for the 12-month period ending June 2012 was 3,942,000, which was 1% lower than the 3,981,000 births (provisional count) for the 12-month period ending June 2011. The number of births has steadily declined from the historic high of 4,316,233 in 2007, but the rate of decline has slowed from 2010 through June 2012.
Let’s Talk About Sexual Health (video)
Talking about sex may not be a regular part of your doctor-patient relationship, but it should be. This can be especially true for adolescents and young adults who are disproportionately impacted by sexually transmitted diseases (STDs). Nearly half of all new STD cases are in young people between the ages of 15 and 24. This video discusses the importance of a healthy dialogue between youth and providers concerning their sexual health
Health Care Reform and Women’s Insurance Coverage for Breast and Cervical Cancer Screening
Implementation of the ACA would increase insurance coverage and access to cancer screening for millions of women, but the NBCCEDP will remain essential for the millions who will remain uninsured.
Estimated HIV Incidence in the United States, 2007-2010
CDC released the latest estimates of new HIV infections (HIV incidence) in the United States. The estimates indicate that HIV remains a serious health problem, with an estimated 47,500 people becoming newly infected with the virus in the US in 2010. The report also finds early signs of an encouraging decrease in new HIV infections among black women when comparing 2008 and 2010.
U.S. Teen Pregnancy Rates by Outcome, Race, and Hispanic Ethnicity 2000-2011- Slide Set (pdf)
This slide set includes nine slides on teen pregnancy, induced abortion, and birth rates, by outcome, age, race, and Hispanic ethnicity. Intendedness of births at conception data is also provided.
Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact - United States, 2009-2010
Of the 1,038 outbreak reports of any etiology with complete information on distribution of cases by sex, 69% of cases occurred in females. Of the 627 outbreaks with a suspected or confirmed etiology of norovirus, 71% of cases occurred among females. Cases reported in outbreaks suspected or confirmed to be caused by Shigella were as likely to occur among males as females. In outbreaks with another etiology or unknown etiology, 66% of cases were in females, following a similar pattern to those associated with norovirus outbreaks.
Chronic Obstructive Pulmonary Disease Among Adults - United States, 2011
To assess the state-level prevalence of COPD among adults, the impact of COPD on their quality of life, and the use of health-care resources by those with COPD, CDC analyzed data from the 2011 Behavioral Risk Factor Surveillance System. Women were more likely to report COPD than men (6.7% compared with 5.2%). Among COPD module respondents, women were more likely to take daily COPD medications and to have had a physician visit related to COPD than men.
Current Cigarette Smoking Among Adults - United States, 2011
In 2011, an estimated 19.0% (43.8 million) of U.S. adults were current cigarette smokers. Of these, 77.8% (34.1 million) smoked every day, and 22.2% (9.7 million) smoked some days. Smoking prevalence in 2011 was 21.6% among males and 16.5% among females.
New HIV Infections in the United States (pdf)
Heterosexuals accounted for 25 percent of estimated new HIV infections in 2010 (12,100). About two-thirds (66 percent) of those infected through heterosexual sex were women. The number of new HIV infections among females attributed to heterosexual contact decreased by 18 percent, from 9,800 in 2008 to 8,000 in 2010, largely because of a drop in infections among black heterosexual women (see “Black Women” on page 3.)
Inspiration for a Healthy New Year
Make being healthy your resolution and find ways to get and stay healthy this year. Meet three people who changed their health habits-and their lives. Here are their stories and tips for making healthy living easier.
Sexually Transmitted Disease Surveillance 2011
The report presents statistics and trends for sexually transmitted diseases (STDs) in the United States through 2011. This annual publication is intended as a reference document for policy makers, program managers, health planners, researchers, and others who are concerned with the public health implications of these diseases.
Diabetes Interactive Atlases
The interactive atlases allow the user to view data and trends for diagnosed diabetes (new and existing cases), obesity, and leisure-time physical inactivity at national, state, and county levels.
CDC Fact Sheet: STD Trends in the United States, 2011 National Data for Chlamydia, Gonorrhea, and Syphilis (pdf)
Both young men and young women are heavily affected by STDs - but young women face the most serious long-term health consequences. Left untreated, these diseases can silently steal a woman’s chance to have children later in life; it is estimated that undiagnosed STDs cause 24,000 women to become infertile each year.
Antibiotics Aren't Always the Answer
Antibiotics do not fight infections caused by viruses like colds, most sore throats and bronchitis, and some ear infections. Unneeded antibiotics may lead to future antibiotic-resistant infections. Symptom relief might be the best treatment option.
Commit to Quit Smoking in 2013
Make 2013 the year you quit smoking! This could be the most important resolution you ever make. Help is available to help you stop smoking for good.
Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2011
This report provides national estimates for a broad range of health measures for the U.S. civilian noninstitutionalized population of adults. Selected data from the report: Thirty-five percent of non-Hispanic black women had hypertension compared with 22% of non-Hispanic white women and 24% of Hispanic women. Women were more likely to have been told they had asthma, hay fever, sinusitis, or chronic bronchitis than men. When considering single-race sex and ethnicity groups, non-Hispanic white women and men had the highest overall percentages of ever having been told by a doctor or other health professional that they had cancer. Women were more likely to be diagnosed with arthritis or to have chronic joint symptoms than men.

Snapshots

Thumbnail imageQuickStats: Birth Rates Among Women Aged 15-44 Years, by Maternal Age Group - National Vital Statistics System, United States, 1961, 2007, and 2011

Thumbnail imageQuickStats: Use of Selected Contraception Methods Among Women Aged 15-44 Years Currently Using Contraception - National Survey of Family Growth, United States, 1995 and 2006-2010

Thumbnail imageFigure 1.2. Percentage of persons under age 65 without health insurance coverage at the time of interview, by age group and sex: United States, January-June 2012

CDC - Malaria

CDC - Malaria

Malaria

Malaria is a mosquito-borne disease caused by a parasite. People with malaria often experience fever, chills, and flu-like illness. Left untreated, they may develop severe complications and die. In 2010 an estimated 216 million cases of malaria occurred worldwide and 655,000 people died, most (91%) in the African Region.