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Cdc grand rounds

Jean Y Ko, Sara Wolicki, Wanda D Barfield, Stephen W Patrick, Cheryl S Broussard, Kimberly A Yonkers, Rebecca Naimon, John Iskander
Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that most commonly occurs in infants after in utero exposure to opioids, although other substances have also been associated with the syndrome (1). NAS usually appears within 48-72 hours of birth with a constellation of clinical signs, including central nervous system irritability (e.g., tremors), gastrointestinal dysfunction (e.g., feeding difficulties), and temperature instability (1) (Box 1). Opioid exposure during pregnancy might result from clinician-approved use of prescription opioids for pain relief; misuse or abuse of prescription opioids; illicit use (e...
March 10, 2017: MMWR. Morbidity and Mortality Weekly Report
Howard Libman, Diane M Brockmeyer, Howard S Gold
The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) recently published advice for high-value care on the appropriate use of antibiotics for acute respiratory tract infections. They conducted a narrative literature review of evidence for antibiotic use in this setting that included recent clinical guidelines from professional societies supplemented by randomized, controlled trials; meta-analyses; and systematic reviews. They concluded that clinicians should reserve antibiotic treatment for acute rhinosinusitis in patients with persistent symptoms for more than 10 days, high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or worsening symptoms after a typical viral illness that lasted 5 days and had initially improved ("double-sickening")...
February 7, 2017: Annals of Internal Medicine
Elizabeth R Unger, Jin-Mann Sally Lin, Dana J Brimmer, Charles W Lapp, Anthony L Komaroff, Avindra Nath, Susan Laird, John Iskander
Chronic fatigue syndrome (CFS) is a complex and serious illness that is often misunderstood. Experts have noted that the terminology "chronic fatigue syndrome" can trivialize this illness and stigmatize persons who experience its symptoms (1). The name was coined by a group of clinicians convened by CDC in the late 1980s to develop a research case definition for the illness, which, at the time, was called chronic Epstein-Barr virus syndrome. The name CFS was suggested because of the characteristic persistent fatigue experienced by all those affected and the evidence that acute or reactivated Epstein-Barr virus infection was not associated with many cases (2)...
December 30, 2016: MMWR. Morbidity and Mortality Weekly Report
Leah S Fischer, Scott Santibanez, Richard J Hatchett, Daniel B Jernigan, Lauren Ancel Meyers, Phoebe G Thorpe, Martin I Meltzer
Mathematical models incorporate various data sources and advanced computational techniques to portray real-world disease transmission and translate the basic science of infectious diseases into decision-support tools for public health. Unlike standard epidemiologic methods that rely on complete data, modeling is needed when there are gaps in data. By combining diverse data sources, models can fill gaps when critical decisions must be made using incomplete or limited information. They can be used to assess the effect and feasibility of different scenarios and provide insight into the emergence, spread, and control of disease...
December 9, 2016: MMWR. Morbidity and Mortality Weekly Report
Juan L Rodriguez, Cheryll C Thomas, Greta M Massetti, Debra Duquette, Lindsay Avner, John Iskander, Muin J Khoury, Lisa C Richardson
Although many efforts in cancer prevention and control have routinely focused on behavioral risk factors, such as tobacco use, or on the early detection of cancer, such as colorectal cancer screening, advances in genetic testing have created new opportunities for cancer prevention through evaluation of family history and identification of cancer-causing inherited mutations. Through the collection and evaluation of a family cancer history by a trained health care provider, patients and families at increased risk for a hereditary cancer syndrome can be identified, referred for genetic counseling and testing, and make informed decisions about options for cancer risk reduction (1)...
November 25, 2016: MMWR. Morbidity and Mortality Weekly Report
Rikita Merai, Claudia Siegel, Michael Rakotz, Peter Basch, Janet Wright, Betty Wong, Phoebe Thorpe
Hypertension is generally defined as systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg. A person who currently uses blood pressure-lowering medication is also defined as having hypertension. Hypertension is a leading risk factor for cardiovascular disease and stroke (1,2). Hypertension affects nearly one third of U.S. residents aged ≥18 years (approximately 75 million persons), and in approximately one half of adults with hypertension (nearly 35 million persons), it is uncontrolled (2)...
November 18, 2016: MMWR. Morbidity and Mortality Weekly Report
Corinne David-Ferdon, Alex E Crosby, Eric D Caine, Jarrod Hindman, Jerry Reed, John Iskander
Suicide in the United States is a major public health problem with approximately 42,000 reported suicides in 2014 among persons aged >10 years (1). The overall suicide rate is increasing, with a 27% increase from 2000 (12.1 per 100,000 population) to 2014 (15.4 per 100,000) (Figure 1). Males, youths and young adults, and certain racial/ethnic groups have historically had higher rates of suicide. In 2014, suicide rates were approximately four times higher among males (24.3 per 100,000) than females (6.8 per 100,000), and suicide was the second leading cause of death among youths and young adults aged 10-34 years (1)...
September 2, 2016: MMWR. Morbidity and Mortality Weekly Report
Carrie K Shapiro-Mendoza, Wanda D Barfield, Zsakeba Henderson, Arthur James, Jennifer L Howse, John Iskander, Phoebe G Thorpe
Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth (1). Infants born at earlier gestational ages, especially <32 0/7 weeks, have the highest mortality (Figure) and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance...
August 19, 2016: MMWR. Morbidity and Mortality Weekly Report
Stephen Banspach, Stephanie Zaza, Patricia Dittus, Shannon Michael, Claire D Brindis, Phoebe Thorpe
Approximately 42 million adolescents aged 10-19 years, representing 13% of the population, resided in the United States in 2014 (1). Adolescence is characterized by rapid and profound physical, intellectual, emotional, and psychological changes (2), as well as development of healthy or risky behaviors that can last a lifetime. Parents have strong influence on their adolescent children's lives, and family-based programs can help parents support healthy adolescent development. Because schools are natural learning environments, implementing and improving school-based policies and programs are strategic ways to reinforce healthy behaviors and educate adolescents about reducing risky behaviors...
August 5, 2016: MMWR. Morbidity and Mortality Weekly Report
M Watson, C C Thomas, G M Massetti, S McKenna, J E Gershenwald, S Laird, J Iskander, B Lushniak
No abstract text is available yet for this article.
February 2016: American Journal of Transplantation
Meg Watson, Cheryll C Thomas, Greta M Massetti, Sharon McKenna, Jeffrey E Gershenwald, Susan Laird, John Iskander, Boris Lushniak
Skin cancer is the most common cancer in the United States, and most cases are preventable. Persons with certain genetic risk factors, including having a lighter natural skin color; blue or green eyes; red or blonde hair; dysplastic nevi or a large number of common moles; and skin that burns, freckles, or reddens easily or becomes painful after time in the sun, have increased risk for skin cancer. Persons with a family or personal history of skin cancer, especially melanoma, are also at increased risk. Although these genetic factors contribute to individual risk, most skin cancers are also strongly associated with ultraviolet (UV) radiation exposure...
December 4, 2015: MMWR. Morbidity and Mortality Weekly Report
Regina M Simeone, Marcia L Feldkamp, Jennita Reefhuis, Allen A Mitchell, Suzanne M Gilboa, Margaret A Honein, John Iskander
Major birth defects (birth defects) are defined as structural abnormalities, present at birth, with surgical, medical, or cosmetic importance. Each year in the United States, 3% of live births (approximately 120,000 infants) have an identifiable structural birth defect. Examples of birth defects include neural tube defects, such as spina bifida; orofacial clefts; abdominal wall defects, such as gastroschisis; and congenital heart defects, such as hypoplastic left heart syndrome. Collectively, congenital heart defects are the most common birth defects (27%), followed by musculoskeletal defects (18%), genitourinary defects (15%), orofacial defects (5%), and neural tube defects (2%)...
October 9, 2015: MMWR. Morbidity and Mortality Weekly Report
Cynthia F Hinton, Stephanie E Griese, Michael R Anderson, Esther Chernak, Georgina Peacock, Phoebe G Thorpe, Nicole Lurie
Recent public health emergencies including Hurricane Katrina (2005), the influenza H1N1 pandemic (2009), and the Ebola virus disease outbreak in West Africa (2014–2015) have demonstrated the importance of multiple-level emergency planning and response. An effective response requires integrating coordinated contributions from community-based health care providers, regional health care coalitions, state and local health departments, and federal agency initiatives. This is especially important when planning for the needs of children, who make up 23% of the U...
2015: MMWR. Morbidity and Mortality Weekly Report
Alicia Demirjian, Guillermo V Sanchez, Jonathan A Finkelstein, Shari M Ling, Arjun Srinivasan, Lori A Pollack, Lauri A Hicks, John K Iskander
Each year in the United States, approximately two million persons become infected with antibiotic-resistant bacteria, at least 23,000 persons die as a direct result of these infections, and many more die from conditions complicated by a resistant infection. Antibiotic-resistant infections contribute to poor health outcomes, higher health care costs, and use of more toxic treatments. Although emerging resistance mechanisms are being identified and resistant infections are on the rise, new antibiotic development has slowed considerably...
August 21, 2015: MMWR. Morbidity and Mortality Weekly Report
Cheryll C Thomas, Thomas B Richards, Marcus Plescia, Faye L Wong, Rachel Ballard, Theodore R Levin, Bruce N Calonge, Otis W Brawley, John Iskander
Cancer is the second leading cause of death in the United States, with 52% of deaths caused by cancers of the lung and bronchus, female breast, uterine cervix, colon and rectum, oral cavity and pharynx, prostate, and skin (melanoma). In the 1930s, uterine cancer, including cancer of the uterine cervix, was the leading cause of cancer deaths among women in the United States. With the advent of the Papanicolaou (Pap) test in the 1950s to detect cellular level changes in the cervix, cervical cancer death rates declined significantly...
April 3, 2015: MMWR. Morbidity and Mortality Weekly Report
Corinne David-Ferdon, Thomas R Simon, Howard Spivak, Deborah Gorman-Smith, Sheila B Savannah, Robert L Listenbee, John Iskander
Youth violence occurs when persons aged 10-24 years, as victims, offenders, or witnesses, are involved in the intentional use of physical force or power to threaten or harm others. Youth violence typically involves young persons hurting other young persons and can take different forms. Examples include fights, bullying, threats with weapons, and gang-related violence. Different forms of youth violence can also vary in the harm that results and can include physical harm, such as injuries or death, as well as psychological harm...
February 27, 2015: MMWR. Morbidity and Mortality Weekly Report
Samira Asma, Yang Song, Joanna Cohen, Michael Eriksen, Terry Pechacek, Nicole Cohen, John Iskander
During the 20th century, use of tobacco products contributed to the deaths of 100 million persons worldwide. In 2011, approximately 6 million additional deaths were linked to tobacco use, the world's leading underlying cause of death, responsible for more deaths each year than human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis, and malaria combined. One third to one half of lifetime users die from tobacco products, and smokers die an average of 14 years earlier than nonsmokers...
April 4, 2014: MMWR. Morbidity and Mortality Weekly Report
Michael B Streiff, Jeffrey P Brady, Althea M Grant, Scott D Grosse, Betty Wong, Tanja Popovic
Deep venous thrombosis (DVT) is a blood clot in a large vein, usually in the leg or pelvis. Sometimes a DVT detaches from the site of formation and becomes mobile in the blood stream. If the circulating clot moves through the heart to the lungs it can block an artery supplying blood to the lungs. This condition is called pulmonary embolism. The disease process that includes DVT and/or pulmonary embolism is called venous thromboembolism (VTE). Each year in the United States, an estimated 350,000-900,000 persons develop incident VTE, of whom approximately 100,000 die, mostly as sudden deaths, the cause of which often goes unrecognized...
March 7, 2014: MMWR. Morbidity and Mortality Weekly Report
Sherif Zaki, Dianna M Blau, James M Hughes, Kurt B Nolte, Ruth Lynfield, Wendy Carr, Tanja Popovic
Despite advances in public health, medicine, and technology, infectious diseases remain a major source of illness and death worldwide. In the United States alone, unexplained deaths resulting from infectious disease agents have an estimated annual incidence of 0.5 per 100,000 persons aged 1-49 years. Emerging and newly recognized infections, such as hantavirus pulmonary syndrome and West Nile encephalitis, often are associated with life-threatening illnesses and death. Other infectious diseases once thought to be on the decline, such as pertussis, again are becoming major public health threats...
February 14, 2014: MMWR. Morbidity and Mortality Weekly Report
Eileen F Dunne, Lauri E Markowitz, Mona Saraiya, Shannon Stokley, Amy Middleman, Elizabeth R Unger, Alcia Williams, John Iskander
Human papillomavirus (HPV) infection is the most common sexually transmitted infection in men and women in the United States. Most sexually active persons will acquire HPV in their lifetime. Recent data indicate that approximately 79 million persons are currently infected with HPV, and 14 million persons are newly infected each year in the United States.
January 31, 2014: MMWR. Morbidity and Mortality Weekly Report
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