Dr. Buttery's Public Health BLOG

Today, from Howard Hughes Medical Institute comes an description of interesting research
One more example,of why genetics is becoming more important to epidemiologists & public health practitioners. Maybe this can explain why a few people get bacterial meningitis while many of us harbor the bacterium whithout any consequences.
Emmanuelle Jouanguy of the Necker Medical School in Paris, along with other colleagues, have identified a single gene that predisposes individuals to herpes simplex encephalitis, an infectious disease that tends to be extremely choosy about its victims. In a paper published in the September 29, 2006, issue of the journal Science, they describe two young patients who carry mutations in this gene who are susceptible to the disease while being otherwise immunologically normal. The paper was published in advance online.

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Genetics is becoming increasingly important to public health practice.
Researchers from the Johns Hopkins University and other institutions have developed a new prediction model for genetic defects known as Lynch syndrome, which predisposes families to developing colorectal cancer.
It can assess a person’s probability of carrying a particular defect within so-called mismatch repair genes. The study is published in the September 27, 2006, issue of the Journal of the American Medical Association (JAMA).
One of the lead researchers states that Genetic defects can be passed from parents to their children; as a result, colon cancer runs in families. This new model will help identify individuals likely to have particular genetic defects. The results will give them useful information about their colon cancer risk before they decide whether to undergo invasive screenings or expensive genetic testing

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The new study by Paul Muntner, associate professor of epidemiology and medicine at Tulane University School of Public Health and Tropical Medicine, questions current thinking about what lead levels are safe in the general adult population. Earlier studies on U.S. adults indicated that blood lead levels above 40 micrograms per deciliter are associated with increased risks of cardiovascular, cancer and mortality for several adult groups having occupational exposure to lead. For the general population, studies have shown that blood lead levels above 10 micrograms per deciliter are associated with these same mortality risks.
Isn't it time for better control of housing to prevent any blood lead in children and thus adults? We need changes to the BOCA codes.

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A scorecard from the Commonwealth Fund's Commission on a High Performance Health System finds that, in addition to trailing other nations on key performance measures, the U.S. health care system achieves inconsistent outcomes across states, hospitals and health systems, Reuters reports. The scorecard, which was published Sept. 20 on the Health Affairs Web site, aims to provide a roadmap for U.S. improvement by pitting nationwide performance against quality, access, equity and efficiency benchmarks. Researchers set the measures based on levels achieved by high-performing countries, states, hospitals and health plans.

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The U.S. Food and Drug Administration (FDA) today expanded the availability of the first simple and portable lead test system to more than 115,000 certified point-of-care locations nationwide, including healthcare clinics, mobile health units and schools. This will allow children and adults to be tested and treated for lead poisoning much easier and faster.
According to the Centers for Disease Control and Prevention (CDC), more than 300,000 children under age six each year have blood levels that exceed 10 milligrams per deciliter, the threshold used to indicate lead poisoning. The U.S. Department of Housing and Urban Development estimates that 24 million homes in the United States have significant lead-based paint hazards. The American Academy of Pediatrics (AAP) estimates one out of four homes with children under age six has lead contamination. The CDC and AAP have issued recommendations for screening children at ages one and two who live in high-risk homes.
True prevention requires amendment of City/County Codes to ensure that no cihldren are ever moved into residences which expose them to lead paint.

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PBS will broadcast a series of four programs on Remaking American Medicine in October which focus not only on hospital errors. but on nosocomial infections and chronic diseases. The first pressentation will be on October 5 at 10 pm.

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A ban on public smoking is now the 'law of the land' in Philadelphia. Mayor Street signed the ban Today, though further tweaking of the plan is expected before enforcement begins in January 2007

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If you do not get the NEJM go to your nearest hospital or university library and read two wonderful pieces in today's NEJM; one, a perspective of the recently concluded AIDS meeting in Toronto, and one on the results and expectations from the Bill & Melinda Gates Foundation, stimulated by the additional resources from Warren Buffett.

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A new report from the Institute of Medicine, Progress in Preventing Childhood Obesity: How Do We Measure Up?, finds that, while our country is beginning to grasp the severity of the childhood obesity epidemic, we are not applying enough resources to the problem. Additionally, there is a pressing need for evaluation of existing programs and better tools to monitor progress moving forward. The report says we currently lack a reliable evidence base that would allow us to inform future childhood obesity programs across the United States, and it urges that evaluation be an essential component of all efforts undertaken.

The progress report, funded by the Robert Wood Johnson Foundation (RWJF), builds on IOM's 2005 report, Preventing Childhood Obesity: Health in the Balance, which recommended ways that families, schools, industry, the media, communities, and government could work together to address rising rates of obesity in children and youth.

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From Cornell University today. Detecting bacteria, viruses and other dangerous substances in hospitals, airplanes and other commonly contaminated places could soon be as easy as wiping a napkin or paper towel across a surface. "It's very inexpensive, it wouldn't require that someone be highly trained to use it, and it could be activated for whatever you want to find," said Margaret Frey, the Lois and Mel Tukman Assistant Professor of Fiber Science and Apparel Design at Cornell University. "So if you're working in a meat-packing plant, for instance, you could swipe it across some hamburger and quickly and easily detect E. coli bacteria." She reported on the research Sept. 11 at the American Chemical Society's national meeting.

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From the University of Florida research shows that babies who received a new shot that mixes five vaccines into one at the same time they were given two other standard shots visited the emergency room, underwent blood tests and were treated with antibiotics more often than other babies, the researchers write in the current issue of The Pediatric Infectious Disease Journal. “Reducing the number of shots is wonderful, but it just happens that when you combine it with two other shots also routinely given, there is an increased risk of fever,� said Dr. Lindsay A. Thompson, a UF assistant professor of pediatrics and the study’s lead author. “This study shows that beyond the important safety and efficacy studies the FDA requires there are often unintended consequences when you apply any new technology to the real-life Petri dish.�

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Today's Telegraph covers a study from the Bristol Community Family Trust, which carries out research into parenting and relationships. The BFCT states in its research notes that official government policy to abolish "marital status" and disregard marriage in government-sponsored research is incompatible with the claim that every child matters, according to a new study by BCFT's Harry Benson. "Marital status� is in fact the single most important factor predicting whether couples with young children stay together or not. Based on up-to-date Millenium Cohort Study data on 15,000 mothers with three year old children, this is the largest scale study of family breakdown yet conducted in the UK.

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A study from the University of Rochester Medical Center published in the Sept 1 issue of the international Journal of Cancer finds that "people who are routinely exposed to lead on the job are 50 percent more likely to die from brain cancer than people who are not exposed, according". The death rate among people with jobs that potentially exposed them to lead was 50 percent higher than unexposed people, and the number of deaths was larger than in many previous studies.

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