|
|
|
Department of Population Medicine - News
|
 |
|
|
|
|
Near real-time surveillance for influenza vaccine safety
|
|
| The emergence of pandemic H1N1 influenza in 2009 has prompted public health responses, including production and licensure of new influenza A (H1N1) 2009 monovalent vaccines. Safety monitoring is a critical component of vaccination programs. As proof-of-concept, we mimicked near real-time prospective surveillance for prespecified neurologic and allergic adverse events among enrollees in 8 medical care organizations (the Vaccine Safety Datalink Project) who received seasonal trivalent inactivated influenza vaccine during the 2005/06-2007/08 influenza seasons. In self-controlled case series analysis, the risk of adverse events in a prespecified exposure period following vaccination was compared with the risk in 1 control period for the same individual either before or after vaccination. In di... Read more
|
|
|
|
|
|
Controlling off-label medication use
|
|
| Off-label prescribing may lead to innovative new uses of old medications, is essential in such fields as pediatrics, and avoids the lengthy and expensive process of modifying U.S. Food and Drug Administration (FDA) drug labeling. Using medications for unapproved indications, however, raises concerns about patient safety when the drugs have a high potential for toxicity and generates economic concerns when their cost is high. A possible means of controlling the use of off-label drugs is to focus on medications used off-label that are both expensive and potentially risky. These are principally biotechnology drugs, such as recombinant enzymes, cytokines, and monoclonal antibodies. This article, authored by DPM Clinical Professor Muriel Gillick, suggests a 2-step process for controlling use of... Read more
|
|
|
|
|
|
Associations of Gestational Weight Gain With Short- and Longer-term Maternal and Child Health Outcomes.
|
|
| In this study led by DPM Assistant Professor Emily Oken, the authors investigated the rate of gestational weight gain associated with the lowest combined risk of 5 short- and longer-term maternal and child health outcomes for 2,012 mother-child pairs recruited in 1999-2002 into Project Viva, a prebirth cohort study in Massachusetts. Within each maternal prepregnancy body mass index (BMI, kg/m(2)) stratum, they performed a logistic regression analysis predicting all 5 outcomes, from which they determined the rate of gain at which average predicted prevalence of the adverse outcomes was the lowest. The mean rate of total gestational weight gain was 0.39 kg/week (standard deviation, 0.14). The prevalence of small for gestational age was 6%, large for gestational age was 14%, preterm delivery ... Read more
|
|
|
|
|
|
An assessment of the safety of adolescent and adult tetanus-diphtheria-acellular pertussis (Tdap) vaccine, using active surveillance for adverse events in the Vaccine Safety Datalink.
|
|
Using a new sequential analytic method, the safety of tetanus-diphtheria-acellular pertussis (Tdap) vaccine was monitored weekly among subjects aged 10-64 years during 2005-2008. Encephalopathy-encephalitis-meningitis, paralytic syndromes, seizures, cranial nerve disorders, and Guillain-Barré syndrome were selected as outcomes based on previous reports and biologic plausibility. The risk following Tdap was not significantly higher than the risk after Td. Statistical power was sufficient to detect a relative risk of 4-5 for Guillain-Barré syndrome and 1.5-2 for the other outcomes. This study provides reassurance that Tdap is similar in safety to Td regarding the outcomes studied and supports the viability of sequential analysis for post-licensure vaccine safety monitoring.
The study,... Read more
|
|
|
|
|
|
Many states lack adequate regulations for menus in child care centers
|
|
| Child care facilities in many states do not conform to federal standards relating to menu planning, content, and posting, according to a DPM study in the Journal of the American Dietetic Association led by Fellow Sara Benjamin. The guidelines contained in “Caring for our Children – National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs,” state 1) menus must be posted or made available to parents; 2) menus must be dated; 3) menus must reflect food served; 4) menus must be planned in advance; and 5) menus must be kept on file. The investigators added an additional standard to this review – that menus must be reviewed by a nutrition professional. For child care centers, seven states included regulations on all five standards, and thirteen states ha... Read more
|
|
|
|
|
|
Overweight or obese moms who underestimate their weight gain more weight during pregnancy
|
|
Women who have inaccurate estimates of their own body weight tend to gain more weight during pregnancy than women with more realistic body images. The study, led by former fellow Sharon Herring and DPM Professor Matthew Gillman, was published online in BioMed Central. Excessive weight gain during pregnancy increases the risk of overweight for both mother and child in the future and can cause other health complications.
Drs. Herring and Gillman and the study team looked at over 1500 women who were of normal weight, overweight, or obese and enrolled in project Viva, a long-term study of the effect of nutrition and other lifestyle/health factors on child and maternal health. Fourteen percent of overweight or obese women thought they weighed less than they actually did. These women ... Read more
|
|
|
|
|
|
Flu vaccination rates lag for adolescents with high-risk conditions
|
|
Influenza vaccination rates for adolescents who suffer from asthma and other illnesses are still far too low according to a recent study. Annual influenza vaccinations are recommended for all adolescents who suffer from conditions that place them at increased risk for influenza complications.
"Influenza vaccination has been recommended for adolescents with high-risk conditions for well over a decade," notes Dr. Mari Nakamura, the lead author. "We wanted to examine how effective this risk-based policy has been in achieving vaccination coverage."
The study charted vaccination rates from 1992-2002 for 18,703 adolescents with asthma, cardiac disease, immune system disorders and other high-risk conditions who received care at Harvard Vanguard Medical Associates and H... Read more
|
|
|
|
|
