News

A daily dose of 2,000 IU of vitamin D had no impact on reducing wintertime upper respiratory tract infections in young children, compared with a 400 IU dose, based on a study of 703 children aged 1-5 years. The report was published July 18 in JAMA.

“Vitamin D increases the synthesis of the antimicrobial peptide cathelicidin in respiratory epithelium, which has been shown to reduce disease severity and replication of the influenza virus in vitro,” but studies on the effect of vitamin D on upper respiratory infections have been limited, wrote Mary Aglipay of St. Michael’s Hospital, Toronto, and her colleagues.

copyright istock/Thinkstock

The study was supported by the Canadian Institutes of Health Research, Institute of Human Development, Child and Youth Health, and Institute of Nutrition, Metabolism and Diabetes, and the Thrasher Research Fund. The vitamin D formulations were donated by Ddrops. Ms. Aglipay had no financial conflicts to disclose. One coauthor, Muhammad Mamdani, MPH, had ties to a number of pharmaceutical companies.

A daily dose of 2,000 IU of vitamin D had no impact on reducing wintertime upper respiratory tract infections in young children, compared with a 400 IU dose, based on a study of 703 children aged 1-5 years. The report was published July 18 in JAMA.

“Vitamin D increases the synthesis of the antimicrobial peptide cathelicidin in respiratory epithelium, which has been shown to reduce disease severity and replication of the influenza virus in vitro,” but studies on the effect of vitamin D on upper respiratory infections have been limited, wrote Mary Aglipay of St. Michael’s Hospital, Toronto, and her colleagues.

copyright istock/Thinkstock

The study was supported by the Canadian Institutes of Health Research, Institute of Human Development, Child and Youth Health, and Institute of Nutrition, Metabolism and Diabetes, and the Thrasher Research Fund. The vitamin D formulations were donated by Ddrops. Ms. Aglipay had no financial conflicts to disclose. One coauthor, Muhammad Mamdani, MPH, had ties to a number of pharmaceutical companies.

A daily dose of 2,000 IU of vitamin D had no impact on reducing wintertime upper respiratory tract infections in young children, compared with a 400 IU dose, based on a study of 703 children aged 1-5 years. The report was published July 18 in JAMA.

“Vitamin D increases the synthesis of the antimicrobial peptide cathelicidin in respiratory epithelium, which has been shown to reduce disease severity and replication of the influenza virus in vitro,” but studies on the effect of vitamin D on upper respiratory infections have been limited, wrote Mary Aglipay of St. Michael’s Hospital, Toronto, and her colleagues.

copyright istock/Thinkstock

The study was supported by the Canadian Institutes of Health Research, Institute of Human Development, Child and Youth Health, and Institute of Nutrition, Metabolism and Diabetes, and the Thrasher Research Fund. The vitamin D formulations were donated by Ddrops. Ms. Aglipay had no financial conflicts to disclose. One coauthor, Muhammad Mamdani, MPH, had ties to a number of pharmaceutical companies.

A new tumor immune-related gene signature may help take the guesswork out of prognostication in patients with early-stage non–small cell lung cancer (NSCLC), according to a retrospective cohort study.

“Various components of the immune system have been shown to be a determining factor during cancer initiation and progression,” note the investigators, who were led by Bailiang Li, PhD, of Stanford (Calif.) University. “Recent immunotherapies targeting specific immune checkpoints such as programmed death 1 or programmed death ligand 1 have demonstrated a remarkable, durable response in NSCLC. Certain histopathologic patterns, such as intratumoral infiltration by cytotoxic lymphocytes, have also been associated with better prognoses in several cancer types, including NSCLC.”

For the study, the investigators developed and validated an immune-related gene signature using frozen tumors from 2,414 patients with stage I or II nonsquamous NSCLC from 19 public cohorts who underwent resection with negative margins and did not receive any neoadjuvant or adjuvant therapy.

The new signature contained 25 gene pairs consisting of 40 unique immune-related genes, Dr. Li and associates report (JAMA Oncol. 2017 Jul 6. doi: 10.1001/jamaoncol.2017.1609).

Processes such as chemotaxis were enriched among the included genes.

The signature significantly stratified patients into groups that have high and low risks of death during follow-up, both across and within subsets with stage I, IA, IB, or II disease. Relative to counterparts falling into the signature-defined low-risk group, those falling into the signature-defined high-risk group had roughly twice the risk of death after adjustment for clinical and pathologic characteristics, with a hazard ratio range of 1.72 (P less than .001) to 2.36 (P less than .001).

Accuracy of the immune signature exceeded that of two commercialized gene signatures for estimating survival in similar validation cohorts (mean concordance index [C-index], 0.64 vs 0.53 and 0.61).

Moreover, the combination of the immune signature with clinical factors outperformed the signature alone (mean C-index, 0.70 vs 0.63) and another commercialized clinical-molecular combination signature (mean C-index, 0.68 vs 0.65).

“The proposed immune-related gene pair–based signature is a promising prognostic biomarker in nonsquamous NSCLC, including early-stage disease,” concluded the investigators. “Prospective studies are needed to further validate its analytical accuracy for estimating prognoses and to test its clinical utility in individualized management of nonsquamous NSCLC.”

A new tumor immune-related gene signature may help take the guesswork out of prognostication in patients with early-stage non–small cell lung cancer (NSCLC), according to a retrospective cohort study.

“Various components of the immune system have been shown to be a determining factor during cancer initiation and progression,” note the investigators, who were led by Bailiang Li, PhD, of Stanford (Calif.) University. “Recent immunotherapies targeting specific immune checkpoints such as programmed death 1 or programmed death ligand 1 have demonstrated a remarkable, durable response in NSCLC. Certain histopathologic patterns, such as intratumoral infiltration by cytotoxic lymphocytes, have also been associated with better prognoses in several cancer types, including NSCLC.”

For the study, the investigators developed and validated an immune-related gene signature using frozen tumors from 2,414 patients with stage I or II nonsquamous NSCLC from 19 public cohorts who underwent resection with negative margins and did not receive any neoadjuvant or adjuvant therapy.

The new signature contained 25 gene pairs consisting of 40 unique immune-related genes, Dr. Li and associates report (JAMA Oncol. 2017 Jul 6. doi: 10.1001/jamaoncol.2017.1609).

Processes such as chemotaxis were enriched among the included genes.

The signature significantly stratified patients into groups that have high and low risks of death during follow-up, both across and within subsets with stage I, IA, IB, or II disease. Relative to counterparts falling into the signature-defined low-risk group, those falling into the signature-defined high-risk group had roughly twice the risk of death after adjustment for clinical and pathologic characteristics, with a hazard ratio range of 1.72 (P less than .001) to 2.36 (P less than .001).

Accuracy of the immune signature exceeded that of two commercialized gene signatures for estimating survival in similar validation cohorts (mean concordance index [C-index], 0.64 vs 0.53 and 0.61).

Moreover, the combination of the immune signature with clinical factors outperformed the signature alone (mean C-index, 0.70 vs 0.63) and another commercialized clinical-molecular combination signature (mean C-index, 0.68 vs 0.65).

“The proposed immune-related gene pair–based signature is a promising prognostic biomarker in nonsquamous NSCLC, including early-stage disease,” concluded the investigators. “Prospective studies are needed to further validate its analytical accuracy for estimating prognoses and to test its clinical utility in individualized management of nonsquamous NSCLC.”

A new tumor immune-related gene signature may help take the guesswork out of prognostication in patients with early-stage non–small cell lung cancer (NSCLC), according to a retrospective cohort study.

“Various components of the immune system have been shown to be a determining factor during cancer initiation and progression,” note the investigators, who were led by Bailiang Li, PhD, of Stanford (Calif.) University. “Recent immunotherapies targeting specific immune checkpoints such as programmed death 1 or programmed death ligand 1 have demonstrated a remarkable, durable response in NSCLC. Certain histopathologic patterns, such as intratumoral infiltration by cytotoxic lymphocytes, have also been associated with better prognoses in several cancer types, including NSCLC.”

For the study, the investigators developed and validated an immune-related gene signature using frozen tumors from 2,414 patients with stage I or II nonsquamous NSCLC from 19 public cohorts who underwent resection with negative margins and did not receive any neoadjuvant or adjuvant therapy.

The new signature contained 25 gene pairs consisting of 40 unique immune-related genes, Dr. Li and associates report (JAMA Oncol. 2017 Jul 6. doi: 10.1001/jamaoncol.2017.1609).

Processes such as chemotaxis were enriched among the included genes.

The signature significantly stratified patients into groups that have high and low risks of death during follow-up, both across and within subsets with stage I, IA, IB, or II disease. Relative to counterparts falling into the signature-defined low-risk group, those falling into the signature-defined high-risk group had roughly twice the risk of death after adjustment for clinical and pathologic characteristics, with a hazard ratio range of 1.72 (P less than .001) to 2.36 (P less than .001).

Accuracy of the immune signature exceeded that of two commercialized gene signatures for estimating survival in similar validation cohorts (mean concordance index [C-index], 0.64 vs 0.53 and 0.61).

Moreover, the combination of the immune signature with clinical factors outperformed the signature alone (mean C-index, 0.70 vs 0.63) and another commercialized clinical-molecular combination signature (mean C-index, 0.68 vs 0.65).

“The proposed immune-related gene pair–based signature is a promising prognostic biomarker in nonsquamous NSCLC, including early-stage disease,” concluded the investigators. “Prospective studies are needed to further validate its analytical accuracy for estimating prognoses and to test its clinical utility in individualized management of nonsquamous NSCLC.”

Does your work make you sick? If it does, do you have paid sick leave? A NIOSH study found that aspects of anoccupation influences people’s health in a multitude of ways, including work conditions, how the work is organized, job-related tasks, long work hours, and work-life balance. “Work is an important determinant of health,” the researchers conclude.

NIOSH researchers analyzed data from 10,767 adults in many occupations who participated in the 2010 National Health Interview Survey. People employed in business operations jobs, such as marketing and human resources, were 85% more likely to rate their health as fair or poor. Workers with no paid sick leave were 35% more likely to report fair or poor health. Workers who were worried about becoming unemployed were 43% more likely to report fair or poor health. Those who reported difficulty combining work and family were 23% more likely. Those who reported being bullied at work were 82% more likely.

“We believe this is the first study to show an association between business operations jobs and poor health,” said Sara Luckhaupt, MD, NIOSH medical officer and lead author of the study. “Knowing which aspects of a person’s job can lead to poor health can help public health and employee wellness professionals develop—ideally with worker input—tailored workplace interventions to advance worker well-being.”

Does your work make you sick? If it does, do you have paid sick leave? A NIOSH study found that aspects of anoccupation influences people’s health in a multitude of ways, including work conditions, how the work is organized, job-related tasks, long work hours, and work-life balance. “Work is an important determinant of health,” the researchers conclude.

NIOSH researchers analyzed data from 10,767 adults in many occupations who participated in the 2010 National Health Interview Survey. People employed in business operations jobs, such as marketing and human resources, were 85% more likely to rate their health as fair or poor. Workers with no paid sick leave were 35% more likely to report fair or poor health. Workers who were worried about becoming unemployed were 43% more likely to report fair or poor health. Those who reported difficulty combining work and family were 23% more likely. Those who reported being bullied at work were 82% more likely.

“We believe this is the first study to show an association between business operations jobs and poor health,” said Sara Luckhaupt, MD, NIOSH medical officer and lead author of the study. “Knowing which aspects of a person’s job can lead to poor health can help public health and employee wellness professionals develop—ideally with worker input—tailored workplace interventions to advance worker well-being.”

Does your work make you sick? If it does, do you have paid sick leave? A NIOSH study found that aspects of anoccupation influences people’s health in a multitude of ways, including work conditions, how the work is organized, job-related tasks, long work hours, and work-life balance. “Work is an important determinant of health,” the researchers conclude.

NIOSH researchers analyzed data from 10,767 adults in many occupations who participated in the 2010 National Health Interview Survey. People employed in business operations jobs, such as marketing and human resources, were 85% more likely to rate their health as fair or poor. Workers with no paid sick leave were 35% more likely to report fair or poor health. Workers who were worried about becoming unemployed were 43% more likely to report fair or poor health. Those who reported difficulty combining work and family were 23% more likely. Those who reported being bullied at work were 82% more likely.

“We believe this is the first study to show an association between business operations jobs and poor health,” said Sara Luckhaupt, MD, NIOSH medical officer and lead author of the study. “Knowing which aspects of a person’s job can lead to poor health can help public health and employee wellness professionals develop—ideally with worker input—tailored workplace interventions to advance worker well-being.”

Carfilzomib, a selective second-generation proteasome inhibitor, has performed well in clinical trials. So because other “triplets”—combinations of alkylator, proteasome inhibitor, and steroid—had shown “encouraging” response rates, researchers from the Center for Cancer and Blood Disorders in Bethesda, Maryland, and others, conducted a multicenter study to evaluate the safety and tolerability of twice-weekly carfilzomib combined with cyclophosphamide and dexamethasone (KCyd) for patients newly diagnosed with multiple myeloma (MM).

The researchers tested 3 doses of carfilzomib: 36 mg/m², 45 mg/m², and 56 mg/m². Of the 22 enrolled patients, 16 were treated with the maximum dose.

Fourteen patients completed all 8 cycles of treatment; 10 in the maximum-dose group completed all 8. At 56 mg/m², the overall response rate was 87.5%. Among the 14 patients whose disease responded to therapy, the median time to response was 1 month.

Five patients discontinued treatment because of adverse effects (AEs), but the researchers found no dose-limiting toxicities at any of the dose levels. The most common AEs were nausea, diarrhea, and anemia.

The researchers concluded that based on previous research, KCyd with 36 mg/m² is safe and effective in patients aged ≥ 65 years with newly diagnosed MM. However, their findings suggest that twice-weekly carfilzomib 56 mg/m² in combination with cyclophosphamide and dexamethasone also is effective with “manageable toxicity.”

Source:
Boccia RV, Bessudo A, Agajanian R, et al. Clin Lymphoma Myeloma Leuk. In press.
doi: 10.1016/j.clml.2017.05.009.

Carfilzomib, a selective second-generation proteasome inhibitor, has performed well in clinical trials. So because other “triplets”—combinations of alkylator, proteasome inhibitor, and steroid—had shown “encouraging” response rates, researchers from the Center for Cancer and Blood Disorders in Bethesda, Maryland, and others, conducted a multicenter study to evaluate the safety and tolerability of twice-weekly carfilzomib combined with cyclophosphamide and dexamethasone (KCyd) for patients newly diagnosed with multiple myeloma (MM).

The researchers tested 3 doses of carfilzomib: 36 mg/m², 45 mg/m², and 56 mg/m². Of the 22 enrolled patients, 16 were treated with the maximum dose.

Fourteen patients completed all 8 cycles of treatment; 10 in the maximum-dose group completed all 8. At 56 mg/m², the overall response rate was 87.5%. Among the 14 patients whose disease responded to therapy, the median time to response was 1 month.

Five patients discontinued treatment because of adverse effects (AEs), but the researchers found no dose-limiting toxicities at any of the dose levels. The most common AEs were nausea, diarrhea, and anemia.

The researchers concluded that based on previous research, KCyd with 36 mg/m² is safe and effective in patients aged ≥ 65 years with newly diagnosed MM. However, their findings suggest that twice-weekly carfilzomib 56 mg/m² in combination with cyclophosphamide and dexamethasone also is effective with “manageable toxicity.”

Source:
Boccia RV, Bessudo A, Agajanian R, et al. Clin Lymphoma Myeloma Leuk. In press.
doi: 10.1016/j.clml.2017.05.009.

Carfilzomib, a selective second-generation proteasome inhibitor, has performed well in clinical trials. So because other “triplets”—combinations of alkylator, proteasome inhibitor, and steroid—had shown “encouraging” response rates, researchers from the Center for Cancer and Blood Disorders in Bethesda, Maryland, and others, conducted a multicenter study to evaluate the safety and tolerability of twice-weekly carfilzomib combined with cyclophosphamide and dexamethasone (KCyd) for patients newly diagnosed with multiple myeloma (MM).

The researchers tested 3 doses of carfilzomib: 36 mg/m², 45 mg/m², and 56 mg/m². Of the 22 enrolled patients, 16 were treated with the maximum dose.

Fourteen patients completed all 8 cycles of treatment; 10 in the maximum-dose group completed all 8. At 56 mg/m², the overall response rate was 87.5%. Among the 14 patients whose disease responded to therapy, the median time to response was 1 month.

Five patients discontinued treatment because of adverse effects (AEs), but the researchers found no dose-limiting toxicities at any of the dose levels. The most common AEs were nausea, diarrhea, and anemia.

The researchers concluded that based on previous research, KCyd with 36 mg/m² is safe and effective in patients aged ≥ 65 years with newly diagnosed MM. However, their findings suggest that twice-weekly carfilzomib 56 mg/m² in combination with cyclophosphamide and dexamethasone also is effective with “manageable toxicity.”

Source:
Boccia RV, Bessudo A, Agajanian R, et al. Clin Lymphoma Myeloma Leuk. In press.
doi: 10.1016/j.clml.2017.05.009.

Military service comes with many health care costs, both immediate and long term. These costs are incurred by active-duty and veteran patients, as well as the VA and DoD systems that have struggled to adequately meet their health care needs. The VA and DoD health care systems face a myriad of challenges in treating their diverse populations.

Identifying and responding to health care challenges requires reliable and detailed data. The 2017 Federal Health Care Data Trends was developed not only to report important data on the most significant health care challenges in federal medicine, but also to simplify and identify emergent trends.

The men and women who serve in the U.S. military are more likely to be diagnosed with posttraumatic stress disorder, diabetes mellitus, and chronic obstructive pulmonary disease. Agent Orange, burn pits, and other toxic exposures also increase their risk of developing multiple types of cancer, multiple sclerosis, asthma, and many other conditions. Veterans are likely to be older than nonveterans (the median age of male veterans is 64 years, compared with 41 years for nonveterans), and therefore at risk for age-related conditions.

Of the nearly 22 million veterans in the U.S., 8.9 million are enrolled in the VA, and just short of 6 million access health care services annually. Active-duty service members make up just 15% of the military health system, while the family members of active-duty service members, National Guard members, reservists, and retirees constitute more than half of the TRICARE population.

Click here to continue reading.

Military service comes with many health care costs, both immediate and long term. These costs are incurred by active-duty and veteran patients, as well as the VA and DoD systems that have struggled to adequately meet their health care needs. The VA and DoD health care systems face a myriad of challenges in treating their diverse populations.

Identifying and responding to health care challenges requires reliable and detailed data. The 2017 Federal Health Care Data Trends was developed not only to report important data on the most significant health care challenges in federal medicine, but also to simplify and identify emergent trends.

The men and women who serve in the U.S. military are more likely to be diagnosed with posttraumatic stress disorder, diabetes mellitus, and chronic obstructive pulmonary disease. Agent Orange, burn pits, and other toxic exposures also increase their risk of developing multiple types of cancer, multiple sclerosis, asthma, and many other conditions. Veterans are likely to be older than nonveterans (the median age of male veterans is 64 years, compared with 41 years for nonveterans), and therefore at risk for age-related conditions.

Of the nearly 22 million veterans in the U.S., 8.9 million are enrolled in the VA, and just short of 6 million access health care services annually. Active-duty service members make up just 15% of the military health system, while the family members of active-duty service members, National Guard members, reservists, and retirees constitute more than half of the TRICARE population.

Click here to continue reading.

Military service comes with many health care costs, both immediate and long term. These costs are incurred by active-duty and veteran patients, as well as the VA and DoD systems that have struggled to adequately meet their health care needs. The VA and DoD health care systems face a myriad of challenges in treating their diverse populations.

Identifying and responding to health care challenges requires reliable and detailed data. The 2017 Federal Health Care Data Trends was developed not only to report important data on the most significant health care challenges in federal medicine, but also to simplify and identify emergent trends.

The men and women who serve in the U.S. military are more likely to be diagnosed with posttraumatic stress disorder, diabetes mellitus, and chronic obstructive pulmonary disease. Agent Orange, burn pits, and other toxic exposures also increase their risk of developing multiple types of cancer, multiple sclerosis, asthma, and many other conditions. Veterans are likely to be older than nonveterans (the median age of male veterans is 64 years, compared with 41 years for nonveterans), and therefore at risk for age-related conditions.

Of the nearly 22 million veterans in the U.S., 8.9 million are enrolled in the VA, and just short of 6 million access health care services annually. Active-duty service members make up just 15% of the military health system, while the family members of active-duty service members, National Guard members, reservists, and retirees constitute more than half of the TRICARE population.

Click here to continue reading.

Last year’s influenza vaccination reduced the overall risk for flu-related medical visits by 42%, according to the Centers for Disease Control and Prevention.

In an article summarizing influenza activity in the United States during October 2016–May 2017, investigators said that most of the viral strains antigenically characterized at the CDC “were similar to the reference viruses representing the recommended components for the 2016-2017 vaccine.”

Last year’s influenza vaccination reduced the overall risk for flu-related medical visits by 42%, according to the Centers for Disease Control and Prevention.

In an article summarizing influenza activity in the United States during October 2016–May 2017, investigators said that most of the viral strains antigenically characterized at the CDC “were similar to the reference viruses representing the recommended components for the 2016-2017 vaccine.”

Last year’s influenza vaccination reduced the overall risk for flu-related medical visits by 42%, according to the Centers for Disease Control and Prevention.

In an article summarizing influenza activity in the United States during October 2016–May 2017, investigators said that most of the viral strains antigenically characterized at the CDC “were similar to the reference viruses representing the recommended components for the 2016-2017 vaccine.”

Patients on immunotherapy treatments for lung cancer have experienced repigmentation of their formerly gray hair, according to a new report. Moreover, researchers say, all but one of the patients experiencing this effect also responded well to the therapy, suggesting that hair repigmentation could potentially serve as a marker of treatment response.

In a case series published online July 12 in JAMA Dermatology (2017. doi: 10.1001/jamadermatol.2017.2106), Noelia Rivera, MD, of the Universitat Autònoma de Barcelona and her colleagues report findings from 14 patients (13 male, mean age 65) receiving anti–programmed cell death 1 (anti–PD-1) and anti–programmed cell death ligand 1 (anti–PD-L1) therapies to treat squamous cell lung cancer or lung adenocarcinoma, with most (11) receiving nivolumab (Opdivo). All but one patient experienced a diffuse darkening of the hair to resemble its previous color, while the remaining patient’s repigmentation occurred in patches.

XiXinXing/Thinkstock

Patients on immunotherapy treatments for lung cancer have experienced repigmentation of their formerly gray hair, according to a new report. Moreover, researchers say, all but one of the patients experiencing this effect also responded well to the therapy, suggesting that hair repigmentation could potentially serve as a marker of treatment response.

In a case series published online July 12 in JAMA Dermatology (2017. doi: 10.1001/jamadermatol.2017.2106), Noelia Rivera, MD, of the Universitat Autònoma de Barcelona and her colleagues report findings from 14 patients (13 male, mean age 65) receiving anti–programmed cell death 1 (anti–PD-1) and anti–programmed cell death ligand 1 (anti–PD-L1) therapies to treat squamous cell lung cancer or lung adenocarcinoma, with most (11) receiving nivolumab (Opdivo). All but one patient experienced a diffuse darkening of the hair to resemble its previous color, while the remaining patient’s repigmentation occurred in patches.

XiXinXing/Thinkstock

Patients on immunotherapy treatments for lung cancer have experienced repigmentation of their formerly gray hair, according to a new report. Moreover, researchers say, all but one of the patients experiencing this effect also responded well to the therapy, suggesting that hair repigmentation could potentially serve as a marker of treatment response.

In a case series published online July 12 in JAMA Dermatology (2017. doi: 10.1001/jamadermatol.2017.2106), Noelia Rivera, MD, of the Universitat Autònoma de Barcelona and her colleagues report findings from 14 patients (13 male, mean age 65) receiving anti–programmed cell death 1 (anti–PD-1) and anti–programmed cell death ligand 1 (anti–PD-L1) therapies to treat squamous cell lung cancer or lung adenocarcinoma, with most (11) receiving nivolumab (Opdivo). All but one patient experienced a diffuse darkening of the hair to resemble its previous color, while the remaining patient’s repigmentation occurred in patches.

XiXinXing/Thinkstock

Older HIV-infected children who have not yet receive any pneumococcal conjugate vaccine (PCV) may benefit from two doses of PCV13, while children with kidney or lung disease may need only one dose, reported Sabelle Jallow, PhD, of the University of the Witwatersrand, Johannesburg, South Africa, and associates.

An open-label study was conducted at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto, South Africa, to determine the immunogenicity of one and two doses of PCV13 in vaccine-naive children with HIV infection, kidney disease, or lung disease. Of the 112 children in the study, there were 50 HIV-infected children, 8 children with kidney disease, 9 with lung disease, and 45 HIV-uninfected control children with no chronic illness. The average age at enrollment was 62 months, 53% of participants were female, and 96% were of black African descent. At-risk children were given two doses of PCV13, 2 months apart, while control children received only one PCV13 dose (Vaccine. 2017. doi: 10.1016/j.vaccine.2017.06.081).

copyright DesignPics/Thinkstock

mkalaycio@frontlinemedcom.com

Older HIV-infected children who have not yet receive any pneumococcal conjugate vaccine (PCV) may benefit from two doses of PCV13, while children with kidney or lung disease may need only one dose, reported Sabelle Jallow, PhD, of the University of the Witwatersrand, Johannesburg, South Africa, and associates.

An open-label study was conducted at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto, South Africa, to determine the immunogenicity of one and two doses of PCV13 in vaccine-naive children with HIV infection, kidney disease, or lung disease. Of the 112 children in the study, there were 50 HIV-infected children, 8 children with kidney disease, 9 with lung disease, and 45 HIV-uninfected control children with no chronic illness. The average age at enrollment was 62 months, 53% of participants were female, and 96% were of black African descent. At-risk children were given two doses of PCV13, 2 months apart, while control children received only one PCV13 dose (Vaccine. 2017. doi: 10.1016/j.vaccine.2017.06.081).

copyright DesignPics/Thinkstock

mkalaycio@frontlinemedcom.com

Older HIV-infected children who have not yet receive any pneumococcal conjugate vaccine (PCV) may benefit from two doses of PCV13, while children with kidney or lung disease may need only one dose, reported Sabelle Jallow, PhD, of the University of the Witwatersrand, Johannesburg, South Africa, and associates.

An open-label study was conducted at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto, South Africa, to determine the immunogenicity of one and two doses of PCV13 in vaccine-naive children with HIV infection, kidney disease, or lung disease. Of the 112 children in the study, there were 50 HIV-infected children, 8 children with kidney disease, 9 with lung disease, and 45 HIV-uninfected control children with no chronic illness. The average age at enrollment was 62 months, 53% of participants were female, and 96% were of black African descent. At-risk children were given two doses of PCV13, 2 months apart, while control children received only one PCV13 dose (Vaccine. 2017. doi: 10.1016/j.vaccine.2017.06.081).

copyright DesignPics/Thinkstock

mkalaycio@frontlinemedcom.com

A combination of ambrisentan (Letairis) and tadalafil (Cialis) improves regional and global right ventricular contractility in patients with scleroderma-associated pulmonary arterial hypertension, according to an open-label investigation of 23 patients.

The project was a follow-up to a previous report showing that the upfront combination – tadalafil 40 mg and ambrisentan 10 mg oral once daily – improved hemodynamics, right ventricular (RV) structure and function, and functional status in treatment-naive patients after 36 weeks and “may represent a very effective therapy for this patient population” (Am J Respir Crit Care Med. 2015 Nov 1;192(9):1102-10).

aotto@frontlinemedcom.com

A combination of ambrisentan (Letairis) and tadalafil (Cialis) improves regional and global right ventricular contractility in patients with scleroderma-associated pulmonary arterial hypertension, according to an open-label investigation of 23 patients.

The project was a follow-up to a previous report showing that the upfront combination – tadalafil 40 mg and ambrisentan 10 mg oral once daily – improved hemodynamics, right ventricular (RV) structure and function, and functional status in treatment-naive patients after 36 weeks and “may represent a very effective therapy for this patient population” (Am J Respir Crit Care Med. 2015 Nov 1;192(9):1102-10).

aotto@frontlinemedcom.com

A combination of ambrisentan (Letairis) and tadalafil (Cialis) improves regional and global right ventricular contractility in patients with scleroderma-associated pulmonary arterial hypertension, according to an open-label investigation of 23 patients.

The project was a follow-up to a previous report showing that the upfront combination – tadalafil 40 mg and ambrisentan 10 mg oral once daily – improved hemodynamics, right ventricular (RV) structure and function, and functional status in treatment-naive patients after 36 weeks and “may represent a very effective therapy for this patient population” (Am J Respir Crit Care Med. 2015 Nov 1;192(9):1102-10).

aotto@frontlinemedcom.com

American Indians/Alaska Natives have the highest rate of new hepatitis C virus (HCV) infections of all ethnic groups, according to recent surveillance data from CDC.

The IHS has distributed updated guidelines on HCV prevention, testing, and treatment to IHS facilities. The guidelines are based on those of the National Viral Hepatitis Action Plan for 2017-2020, the U.S. Preventive Services Task Force, the CDC, and the American Association for the Study of Liver Diseases.

Tribal programs are an important element of the outreach. In 2015, for instance, the Cherokee Nation became the first tribe in the U.S. to launch an HCV Elimination Project, with the goal of screening 80,000 patients over the next 3 years. Last year, 23,000 patients were screened.

Other programs provide telehealth and teleconsultation services to treat patients on-site, rather than referring them to facilities far from their communities. A pharmacist-led treatment program, for example, in conjunction with a local physician and Project ECHO (Extension for Community Health Outcomes) and telehealth programs, has successfully cured > 10 patients on the Fort Peck reservation.

An estimated 20,000 to 40,000 IHS patients need HCV treatment. The IHS encourages anyone with HCV—even those who had unsuccessful treatment in the past—to seek care as soon as possible.

American Indians/Alaska Natives have the highest rate of new hepatitis C virus (HCV) infections of all ethnic groups, according to recent surveillance data from CDC.

The IHS has distributed updated guidelines on HCV prevention, testing, and treatment to IHS facilities. The guidelines are based on those of the National Viral Hepatitis Action Plan for 2017-2020, the U.S. Preventive Services Task Force, the CDC, and the American Association for the Study of Liver Diseases.

Tribal programs are an important element of the outreach. In 2015, for instance, the Cherokee Nation became the first tribe in the U.S. to launch an HCV Elimination Project, with the goal of screening 80,000 patients over the next 3 years. Last year, 23,000 patients were screened.

Other programs provide telehealth and teleconsultation services to treat patients on-site, rather than referring them to facilities far from their communities. A pharmacist-led treatment program, for example, in conjunction with a local physician and Project ECHO (Extension for Community Health Outcomes) and telehealth programs, has successfully cured > 10 patients on the Fort Peck reservation.

An estimated 20,000 to 40,000 IHS patients need HCV treatment. The IHS encourages anyone with HCV—even those who had unsuccessful treatment in the past—to seek care as soon as possible.

American Indians/Alaska Natives have the highest rate of new hepatitis C virus (HCV) infections of all ethnic groups, according to recent surveillance data from CDC.

The IHS has distributed updated guidelines on HCV prevention, testing, and treatment to IHS facilities. The guidelines are based on those of the National Viral Hepatitis Action Plan for 2017-2020, the U.S. Preventive Services Task Force, the CDC, and the American Association for the Study of Liver Diseases.

Tribal programs are an important element of the outreach. In 2015, for instance, the Cherokee Nation became the first tribe in the U.S. to launch an HCV Elimination Project, with the goal of screening 80,000 patients over the next 3 years. Last year, 23,000 patients were screened.

Other programs provide telehealth and teleconsultation services to treat patients on-site, rather than referring them to facilities far from their communities. A pharmacist-led treatment program, for example, in conjunction with a local physician and Project ECHO (Extension for Community Health Outcomes) and telehealth programs, has successfully cured > 10 patients on the Fort Peck reservation.

An estimated 20,000 to 40,000 IHS patients need HCV treatment. The IHS encourages anyone with HCV—even those who had unsuccessful treatment in the past—to seek care as soon as possible.