Weight Training in the Elderly

The New York Times  (3/20, Reynolds) reports, “Weight training by older people may build not only strength and muscle mass but also motivation and confidence, potentially spurring them to continue exercising,” researchers concluded. The study revealed that individuals “who discovered that they enjoyed and felt capable of completing a weight-training session subsequently joined a new gym and showed up for workouts.” The findings were published in the Scandinavian Journal of Medicine & Science in Sports.

A study published in the Journal of the American Medical Association indicates that nearly 40 percent of American adults were obese with body mass index (BMI) of over 30 in 2015 and 2016. During the same period data indicate that 7.7 percent of American adults were severely obese with BMI over 40.

The authors analyzed data from 27 449 adults and 16875 youths. Age-standardized prevalence of obesity among adults increased from 33.7% in 2007-2008 to 39.6%. Prevalence of obesity increased in adult men and women aged 20 to 59 years. There was no significant linear trend among adults 60 years and older. Age-standardized prevalence of severe obesity in adults increased from 5.7% in 2007-2008 to 7.7%.  Among youth, obesity prevalence was 16.8% in 2007-2008 and 18.5% in 2015-2016.

In conclusion over the periods between 2007-2008 and 2015-2016, there was a sharp increasein obesity among American adultsfrom a decade earlier.  Severe obesity prevalence persisted among American adults, whereas there were no overall significant trends among youth. 

Syphilis Cases Increased Among Pregnant Women in the U.S.

A study published in Obstetrics and Gynecology found the rate of primary and secondary syphilis among women increased, and the rate of congenital syphilis increased too.

During 2012–2016, the number of syphilis cases among pregnant women increased 61%, from 1,561 to 2,508 among all women aged 15–45 years, and in all U.S. regions.  The most commonly reported risk behaviors were a history of a sexually transmitted disease (43%) and more than one sex partner in the past year (30%).  Over the same period the rate of congenital syphilis increased 87 percent.  Approximately 40 percent of newborns with syphilis are stillborn and those infected if left untreated develop serious complications such as jaundice, blindness and deafness.  Treatment of pregnant women with penicillin is 98% effective in preventing congenital syphilis.

The authors concluded that efforts to reduce syphilis among pregnant women should involve screening all pregnant women for syphilis at the first prenatal visit and rescreening high-risk women during the third trimester and at delivery. 

Percutaneous Occlusion of Patent Ductus Arteriosus

The Food and Drug Administration (FDA) approved Amplatzer Piccolo Occluder, a self-expanding wire mesh device to be used in the closure of patent ductus arteriosus (PDA) an abnormal communication between aorta and pulmonary artery in premature infants.

Each year about 60,000 infants are born prematurely in the United States -- including nearly 12,000 with a PDA large enough that may cause symptoms.  These patients may not respond to medical management, and due to their small size, may be at high-risk for corrective surgery.

The device is threaded into the PDA using a catheter that is advanced through the femoral vein or artery in the groin, with a minimally invasive procedure thus demanding surgery for these premature babies that weight as little as two pounds is avoided.

The FDA approved the occluder based on the ADO II trial that evaluated the occluder on 50 patients with a PDA who were older than three days. The safety and efficacy of the device was further supported by additional experience involving 150 more patients. The device builds on more than 20 years of clinical experience with the Amplatzer™ Duct Occluder II a product, already approved for use in the U.S., Europe and countries around the world to treat PDA in larger size pediatric patients and also validated in 6,896 very preterm infants, less than 31 weeks of gestation, in the EPICE cohort study.

Cigarette smoking in all-time low among U.S. adults

According to a report from the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration and the National Cancer Institute cigarette smoking has reached the lowest level ever recorded among U.S. adults. 

Only 14 percent of adults – around 34 million people – smoked within the past 30 days. That is down from 15.5 percent in 2016.  It is remarkable that adult smoking rates have declined by 67 percent since 1965.  

The report also showed about 10 percent of young adults aged 18 to 24 years smoked cigarettes in 2017, down from 13 percent in 2016.

 This new all-time low in cigarette smoking among U.S. adults is a tremendous public health accomplishment.

Caesarean section births nearly doubled since 2000

A study published in The Lancet by Boerma et al found that the rates of caesarean section (CS) births nearly doubled between 2000 and 2015 – from 12 to 21 percent worldwide.

The paper was based on data from 169 countries that includes 98% of the world's births.  The authors estimated that 29·7 million or 21% births occurred with CS in 2015, which was almost double the number of births by CS in 2000 16 million or 12·% births. C-section use in 2015 was up to ten times more frequent in the Latin America and Caribbean region, where it was used in 44% of births, than in the west and central Africa region, where it was used in 4% of births. 

C-section births varied from 0·6% in South Sudan to 58% in the Dominican Republic. Markedly high CS use was used even among low obstetric risk births, especially among more educated women in Brazil and China; and CS use was 1·6 times more frequent in private than in public facilities.

The researchers report that CS is unavailable to women in poor countries while often over-used in richer ones. The authors found that in 15 countries in North America, Western Europe and Latin America and the Caribbean more than 40 percent of all babies born are delivered by C-section. 

C-section use in excess of the 10-15% which is considered optimal is concerning because the procedure is associated with sort-term and long-term effects without offering any significant maternal benefits.

Rates of unvaccinated children have quadrupled since 2001

The Centers for Disease Control and Prevention (CDC) reports that a small but increasing number of children in the United States are not getting some or all of their recommended vaccinations with 1.3 percent of children born in 2015 having not received any vaccinations, up from 0.3 percent in 2001. 

Though the number remains small it is something that CDC is concerned about.  CDC data show children in rural areas and those without insurance had significantly higher rates of not being vaccinated.  The CDC estimates that 100,000 young children have not had a vaccination against any of the 14 diseases for which vaccines are recommended. 

Although 70 percent of the children have been vaccinated the new estimate of 1.3 percent of the children born in 2015 were completely unvaccinated is very concerning because young children are especially vulnerable to complications from vaccine-preventable diseases, some of which can be fatal.