A study in the Journal of the American Medical Association showed that 31.1% of black preterm infants given sustained vitamin D supplementation had recurrent wheezing at age 12 months, compared with 41.8% of those who received diet-limited supplementation. The findings also showed that upper and lower respiratory infections were the most common adverse events and were less prevalent among those in the sustained vitamin D supplementation group.
A study of 100 simulated NICU networks of 52 infants showed as the frequency of surveillance for methicillin-resistant Staphylococcus aureus increased from four weeks to one week, the mean number of MRSA-colonized infants decreased from 2.9 per episode to 0.6 per episode. The study in the Journal of Hospital Infection also showed a drop in the mean duration of MRSA colonization from 307 hours to 61 hours, though researchers noted reduced availability of isolation rooms.
Researchers found that children with chronic hepatitis B and immune-tolerant characteristics who received interferon therapy followed with lamivudine had significantly better rates of undetectable serum HBV DNA, HBV surface antigen loss and HBV e-antigen seroconversion, compared with those in the control group. The findings in the Journal of Hepatology showed similar median alanine aminotransferase levels between both groups, and no serious adverse events were reported.
In this cross-sectional study of 1,047 community-dwelling older adults, frailty and disability were associated with lower diurnal systolic blood pressure, blunted nocturnal decline of SBP, and higher nocturnal SBP regardless of conventional BP and a number of confounders. Ambulatory blood pressure monitoring may provide additional information over usual conventional BP measurements in the clinical evaluation of older individuals with frailty or disability, and may help explain the higher mortality risk with lower clinic BP among frail older adults observed in nonrandomized studies.
While mental stress-induced myocardial ischemia -- as opposed to ischemia brought on by conventional stress -- is a frequent phenomenon in patients with coronary artery disease, women with stable coronary artery disease report more chest pain or angina symptoms than men. These results highlight the importance of psychosocial determinants of chest pain in daily life among women with coronary artery disease; this in turn has implications for the management of women with angina.
Nursing homes (NHs) collaboration with hospices appears to improve end-of-life (EOL) care. In this retrospective cohort study, the association between the attributes of NH hospice collaborations and EOL hospitalizations among dying NH residents was examined. As expected, a higher volume of hospice use in a NH was related to lower risks of EOL hospitalizations. However, this study found that having four or more Hospice providers in a NH was actually associated with higher EOL hospitalization rate.
This study compared the effectiveness of extra-fine vs. fine-particle inhaled corticosteroids administered as ICS monotherapy or ICS-long acting beta-agonist combination therapy by conducting a meta-analysis of observational real-life studies. Seven studies with 33,453 subjects aged 5 to 80 years met eligibility criteria for inclusion. Six studies used extra-fine beclomethasone propionate (efBDP) and one study both efBDP and extra-fine ciclesonide as comparators with fine-particle ICS. The overall odds of achieving asthma control were significantly higher for extra-fine ICS compared with fine-particle ICS. Overall exacerbation rate ratios and ICS dose were significantly lower for extra-fine ICS compared to fine-particle ICS. This meta-analysis demonstrates that ef-ICS have significantly higher odds of achieving asthma control with lower exacerbation rates at significantly lower prescribed doses than fine-particle ICS.
From the electronic fetal monitoring patterns studied, deceleration area is the most predictive EFM pattern for acidemia (AUC: 0.76), and combined with tachycardia for significant risk of morbidity (AUC: 0.77).
Young adults insured as dependents on parental insurance plans and their policyholder peers have similar utilization of several reproductive health services, despite the potential for confidentiality breaches that have concerned providers and reproductive health advocates.
This study modeled associations between drug-related mortality at the county level and social determinants of health. Results revealed average mortality rates were significantly higher in counties with greater economic and family distress and economically dependent on mining. Average mortality rates were significantly lower in counties with a greater presence of religious establishments and recent in-migrants, and with economies reliant on public (government) sector employment. Health care supply factors did not contribute to between-county disparities in mortality rates.