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Benefits of flu vaccination hotly debated

first_img Looking to flu vaccine to prevent death among the elderly may be focusing on the wrong benefit, Dr. Kristin Nichol of the University of Minnesota said Tuesday. While studies of reductions in mortality may have been clouded by selection bias, she said, studies that show decreases in rates of respiratory diseases and hospitalizations look solid. A study published earlier this month in the New England Journal of Medicine (and placed online in September) found that giving the flu shot to pregnant women lowered both their risk of flu and also the risk for their newborns, who were too young to be vaccinated themselves. Reports in the American Journal of Respiratory and Critical Care Medicine in September and the Lancet in August contended that flu vaccine’s ability to protect the elderly from death and from pneumonia has been overstated, and several papers have pointed out that, while vaccination in the elderly has increased, the mortality rate has not declined. The question whether flu vaccine protects recipients both from developing flu and from serious complications of flu, as well as whether its administration protects contacts of recipients, has been an active research topic over the past year. Researchers from Emory University and the biotech companies i3 Innovus and Wyeth Research modeled the potential effect of vaccinating infants during a flu season with Prevnar, the 7-valent pneumococcal conjugate vaccine, in hopes of preventing the secondary bacterial infections that frequently cause flu-season deaths. But vaccinating children to protect others was challenged in a separate presentation, with Catherine Weil-Oliver of the Universite de Paris arguing that indirect benefit “has not been demonstrated in schoolchildren in any European study. . . . In children younger than two, no indirect benefit has been recorded at all.” They found that in a typical flu season, preventing post-flu bacterial pneumonia saves $1.4 billion in healthcare spending. In a flu pandemic such as 1918, however, vaccination’s effect would be much larger: It would prevent 1.24 million cases of pneumonia and 357,000 pneumococcal-related deaths and reduce costs by $7 billion. (Rubin JL, McGarry LJ, Klugman KP, et al. Public health and economic impact of 7-valent pneumococcal conjugate vaccination in an influenza pandemic in the US. [Abstract K-4210]) Oct 30, 2008 – WASHINGTON (CIDRAP News) – The benefits conferred by influenza vaccination—to recipients and to their close contacts—were hotly disputed at an international medical meeting this week. The concern about low immunization rates also includes pregnant women. An analysis from Bridgeport Hospital and Yale University Medical School in Connecticut found that, out of 520 women who were pregnant during flu season, 19% had been vaccinated, though 28% had discussed vaccination with their physicians during prenatal care. (Panda B, Stiller R, Bruce L, et al. Influenza vaccination in pregnancy: compliance with current CDC guidelines for prevention and control of influenza pertaining to vaccination during pregnancy. [Abstract K-4202]) The authors theorized that the very old are so frail that they are unable to get the shots by themselves, while attendants or healthcare workers deem the shot not useful for them. The result, the authors said, is that the oldest old and most at risk from flu complications are excluded from analyses of flu-shot effectiveness and age, so that results are distorted. (Baxter R, Fireman B, Lee J. “Who gets flu vaccines? A look at bias in flu vaccine effectiveness studies” [Abstract G1-1206]) That includes children, according to a team from the Centers for Disease Control and Prevention (CDC), Vanderbilt University, and the University of Rochester. They examined the medical histories of 772 children younger than 5 and 401 children aged 5 to 12 who were brought to outpatient care for flu-like symptoms and fever. Among the older children, 133 had at least one characteristic that put them at high risk for serious flu complications, but only 32 of them (24%) had gotten a flu shot. Among the younger children, 549 had at least one high-risk indication, but only half—275 or 51%—had gotten at least one dose of flu vaccine. (Shinde V, Iwane M, Prill M, et al. Influenza among outpatient children: US, 2006-07. [Abstract G1-1700]) Sep 18 CIDRAP News story “Study: Flu shots in pregnant women benefit newborns” Observational studies faulted”Observational studies have greatly exaggerated vaccination benefits in the elderly,” Lone Simonsen, PhD, of George Washington University said Tuesday afternoon (Oct 28). She wrote a controversial paper challenging flu-mortality estimates for the elderly in 2005 while serving as a National Institutes of Health senior scientist.center_img Meanwhile, however, other age-groups for whom the flu vaccine is most recommended continue to go unvaccinated. “We need to remember that the vaccine also reduces influenza illness and it reduces hospitalization, and so while we explore the controversy we need to continue to vaccinate the elderly,” she said. Aug 29 CIDRAP News story “Study: Flu vaccine doesn’t lower death rates in elderly” And healthcare workers also continue to have low vaccination rates. Researchers from the Chinese University of Hong Kong reported that among 133 acute-care nurses who responded to a questionnaire, 38% said they had received flu vaccine—but 23% of the group developed flu-like illness themselves, and most missed work as a result. (Ng K, Lee N, Hui D. A Survey on ILI among health-care workers during a peak ‘flu’ season – What are the risk factors? [Abstract K-4204]) Such studies distort reality, she said, by assigning any deaths in winter to flu—including deaths that occur before the flu season begins—and do not make sense given what is known about age-related decay of the immune system. She proposed that flu researchers tackle the problem of making separate, more immunogenic vaccine formulas for seniors, and stressed the importance of indirect protection via vaccines given to child and adult contacts of the elderly. Presenters at the 48th Interscience Conference on Antimicrobial Agents and Chemotherapy and the 46th annual meeting of the Infectious Diseases Society of America (ICAAC-IDSA) presented abundant but often contradictory evidence regarding flu vaccine’s direct and indirect protective abilities. Age and immunization ratesA poster presentation earlier in the conference explored one of the hypotheses behind the distrust of flu-mortality studies: that they are subject to a “healthy recipient” design defect. Several Kaiser Permanente researchers looked at medical records for recipients of flu vaccine older than 65 who are members of Kaiser Permanente of Northern California, a healthcare organization with about 3 million members. They found a statistical oddity: The likelihood of an elderly person’s taking the flu shot rose along with their age and risk of flu mortality, but only up to a certain age. Once women passed 80 and men passed 85, they stopped taking the shot, even though their risk of dying from flu complications continued to rise. See also: The answer to improving protection against flu and flu complications, one group of scientists said, might be an additional vaccine—and not just for ordinary seasons, but for an influenza pandemic as well. Flu vaccine came in for additional critical examination during ICAAC-IDSA, which drew 15,000 people to Washington, DC, and concluded Oct 28.last_img read more


Racial abuse on Mikel and family: Trabzonspor take legal action

first_img “We inform the public that we have filed a criminal complaint against the culprits.” It has also been reported, but not confirmed, that the former Chelsea man will file his own case to authorities. Obi Mikel, 32, played the entirety of the match at Trabzon’s Senol Gunes Stadium. This is his first season in Turkey after leaving Middlesbrough in the summer, making 22 appearances so far. read also:Racial abuse: How teammates prevented Mikel from beating up Emre In an Instagram post following the win, he chose to pay tribute to his team and fans, writing: “Great victory tonight, amazing team spirit, thank you to our amazing fans.” FacebookTwitterWhatsAppEmail分享 Trabzonspor have confirmed an official criminal complaint over racist abuse allegedly suffered by John Obi Mikel. Loading…center_img A group of Fenerbahce fans were said to have targeted the Nigerian midfielder after their Super Lig meeting on Saturday. Local media claim that thousands of abusive messages were sent to Obi Mikel’s social media accounts, as well as to his family, as his side won the encounter 2-1. On Monday afternoon, Trabzonspor released a statement announcing their criminal complaint over the matter. It read: “Racism is a refuge for helpless and ignorant people. “Our player, Obi Mikel, condemns the racist attacks after the Fenerbahce match.Advertisementlast_img read more


Ethiopia’s Desisa, Kenya’s Keitany win at NYC Marathon

first_imgMary Keitany and Lelisa Desisa showed impressive finishing pace to win the New York City MarathonNew York, United States | AFP | Ethiopia’s Lelisa Desisa edged compatriot Shura Kitata to win the men’s title and Kenya’s Mary Keitany captured her fourth women’s crown Sunday at the 48th New York City Marathon, on Sunday.It was a historic day in perfect running conditions for 50,000 entrants in the 26.2-mile showdown over the streets of New York.Two-time Boston Marathon champion Desisa, second in New York in 2014 and third in 2015 and 2017, finally claimed the crown in 2 hours, 5 minutes and 59 seconds with Kitata only two seconds back and defending champion Geoffrey Kamworor of Kenya third in 2:06:26.“I (was) thinking this year to be a champion,” Desisa said. “I’m very thirsty to be the champion. I’ve been second. I’ve been third. This year I decided to be champion because I had the training, everything in my power I controled.“Today is my day. I’m very, very happy.” he added.The only faster time in the history of the New York Marathon was the 2:05:05 men’s record set by in 2011 by Kenya’s Geoffrey Mutai.Keitany took her fourth women’s title in five attempts after finishing second to American Shalane Flanagan last year, crossing the finish line in 2:22:48.Kenya’s Vivian Cheruiyot was second in 2:26:02 with Flanagan third, another 20 seconds adrift.“I felt great today. I’m really happy for winning,” Keitany said. “I did not give up (after last year). I went back home and said I will try my best and that’s why I came back and that’s what I did. I worked very hard for the victory.” she added.Keitany, also a three-time London Marathon winner, was only 17 seconds off the New York women’s record time set by Kenya’s Margaret Okayo in 2003.Only Norway’s Grete Waitz, a nine-time champion from 1978 to 1988, has won more New York titles than Keitany.In the men’s race, Ethiopia’s Kitata, also runner-up this year at London, and compatriot Tamirat Tola pushed the pace early, taking Desisa and Kamworor with them from the ninth mile. Kitata, six years younger than Desisa at age 22, fell back to leave Kamworor and Desisa to fight for the lead. The Kenyan faded but Kitata surged and Desisa looked back with 1,500 meters remaining to see his work was far from over.Desisa held off Kitata around the final curve and surged across the finish line to emerge the winner in the fastest 1-2 finish in New York history.Keitany, 36, stayed among the women’s leaders from the start, taking on the challenging pace of Ethiopians Netsunet Gudeta and Rahma Tusa in a midway breakout.World half-marathon champion Gudeta cracked in the 16th mile and Tusa faded in the 18th, leaving Keitany to run alone to the finish line.Flanagan and Cheruiyot, the 2016 Olympic 5,000m champion who won in London in April, charged over the final miles to claim podium places. Mary Keitany leads compatriot Vivian Cheruiyot to a 1-2 Kenyan finish at the New York City Marathon to win her fourth title. Geoffrey Kamworor earns a third-place finish in the men’s race. Brilliant performance. #NYCMarathon— William Samoei Ruto (@WilliamsRuto) November 4, 2018Share on: WhatsApplast_img read more