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Nonsurgical Treatment of Periodontal Disease Does Not Improve Glycemic Control in Type 2 Diabetes

Posted on December 24, 2013

For persons with type 2 diabetes and chronic periodontitis, nonsurgical periodontal treatment did not result in improved glycemic control, according to a study appearing in the December 18 issue of JAMA.

Emerging evidence implicates inflammation in the development of type 2 diabetes. Chronic periodontitis, a destructive inflammatory disorder of the soft and hard tissues supporting the teeth, is a major cause of tooth loss in adults. Nearly half of the U.S. population older than 30 years is estimated to have chronic periodontitis, according to background information in the article. Individuals with diabetes are at greater risk for chronic periodontitis. Well-controlled diabetes is associated with less severe chronic periodontitis and a lower risk for progression of periodontitis, suggesting that level of glycemia is an important mediator of the relationship between diabetes and risk of chronic periodontitis. Limited evidence suggests that periodontal therapy may improve glycemic control.

Steven P. Engebretson, D.M.D., M.S., M.S., of New York University, New York, and colleagues examined whether nonsurgical periodontal therapy, compared with no therapy, reduces levels of glycated hemoglobin (HbAlc) levels in persons with type 2 diabetes and moderate to advanced chronic periodontitis. The trial included 514 participants who were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with 5 academic medical centers. The treatment group (n = 257) received scaling and root planing plus an oral rinse at baseline and supportive periodontal therapy at 3 and 6 months. The control group (n = 257) received no treatment for 6 months.

The researchers found that levels of HbAlc did not change between baseline and the 3-month or 6-month visits in either the treatment or the control group, and the target 6-month reduction of HbAlc level of 0.6 percent or greater was not achieved. There were no differences in HbAlc levels across centers.

Periodontal measures improved in the treatment group compared with the control group at 6 months.

"This multicenter randomized clinical trial of nonsurgical periodontal treatment for participants with type 2 diabetes and chronic periodontitis did not demonstrate a benefit for measures of glycemic control. Although periodontal treatment improved clinical measures of chronic periodontitis in patients with diabetes, the findings do not support the use of nonsurgical periodontal treatment for the purpose of lowering levels of HbAlc," the authors conclude.







Young Dental Introduces Its Latest Disposable Prophy Angle

Posted on December 19, 2013

Young Dental is excited to introduce its latest disposable prophy angle, Vera by Young™, to the dental community. Vera by Young offers a compact prophy angle head and slim neck design; these unique features improve maneuverability in the mouth during polishing. This prophy angle enhances reach and access in a variety of clinical situations.

Vera by Young’s design makes polishing the distal regions of posterior molars easy and improves reach into the mouth, while its smooth, round head can also help with patient comfort. Vera by Young provides the durable performance that Young is known for, making polishing enjoyable for both hygienists and patients. Request samples at youngdental.com/vera!







Hepatitis C Virus Dried on Inanimate Surfaces Can Remain Infectious for Up to Six Weeks

Posted on December 23, 2013

Dried spots of blood contaminated with hepatitis C virus (HCV) can remain infectious for up to six weeks at normal room temperatures, research published in the online edition of the Journal of Infectious Diseases shows. Commercially available antiseptics reduced the infectivity of the blood spots, but only when used at recommended concentrations.

To read more, click here.







Joint Policy Statement Issued on Mandatory Immunization of Health Care Personnel

Posted on December 20, 2013

The Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), and the Pediatric Infectious Diseases Society (PIDS) (“Societies”) support universal immunization of health care personnel (HCP) by health care employers (HCEs) as recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) for HCP.*

Although some voluntary HCP vaccination programs have been effective when combined with strong institutional leadership and robust educational campaigns mandatory immunization programs are the most effective way to increase HCP vaccination rates. As such, when voluntary programs fail to achieve immunization of at least 90% of HCP, the Societies support HCE policies that require HCP documentation of immunity or receipt of ACIP-recommended vaccinations as a condition of employment, unpaid service, or receipt of professional privileges.

For HCP who cannot be vaccinated due to medical contraindications or because of vaccine supply shortages, HCEs should consider, on a case-by-case basis, the need for administrative and/or infection control measures to minimize risk of disease transmission (e.g., wearing masks during influenza season or reassignment away from direct patient care).

The Societies also support requiring comprehensive educational efforts to inform HCP about the benefits of immunization and risks of not maintaining immunization.*

ACIP-RECOMMENDED VACCINES FOR HCP: http://www.cdc.gov/vaccines/adults/rec-vac/hcw.html.

RATIONALE

1. Immunizing HCP against vaccine-preventable diseases protects both patients and HCP from illness and death associated with these diseases.

2. Immunizing HCP also prevents them from missing work during outbreaks, which would further negatively impact patient care.

3. Immunization rates for ACIP-recommended vaccines remain low among HCP

4. Mandatory immunization programs are necessary where voluntary programs fail to maintain adequate HCP vaccination rates.

5. ACIP-recommended vaccines are proven to be safe, effective, and cost-saving

6. Educational programs increase HCP compliance with vaccination programs, but standing alone do not consistently achieve adequate vaccine coverage levels.

7. The provision of immunizations at no cost in the occupational setting increases HCP immunization compliance.

8. Physicians and other health care providers are obligated “to do good or to do no harm” when treating patients (see, e.g., Hippocratic Corpus in Epidemics: Bk. I, Sect. 5, trans. Adams), and they have an ethical moral obligation to prevent transmission of infectious diseases to their patients.







Exercise Counters the Physiological Effects of Christmas Excess

Posted on December 19, 2013

Daily exercise lessens many of the harmful physiological effects of short-term overeating and inactivity, shows a new study [published 15 December] in The Journal of Physiology, which is well timed with the Christmas holiday approaching.

Earlier studies have found that even a few days of energy surplus – where you consume more calories than you burn – brings detrimental health impacts. This new study shows that a daily bout of exercise generates vast physiological benefits even when you consume thousands of calories more than you are burning. Exercise clearly does a lot more than simply reduce the energy surplus.

James Betts, one of the researchers from The University of Bath, says: "This new research shows that the picture is more sophisticated than 'energy' alone: exercise has positive effects even when we are actively storing energy and gaining weight."

After just one week of overeating, people being monitored showed poor blood sugar control and their fat cells were expressing genes that lead to unhealthy metabolic changes and disrupted nutritional balance. However, these negative effects were markedly less in those who were exercising.

Jean-Philippe Walhin, a researcher on the study, says: "Our research demonstrates that a short period of overconsumption and reduced physical activity leads to very profound negative changes in a variety of physiological systems – but that a daily bout of exercise stops most of these negative changes from taking place."

In the study, 26 healthy young men were asked to be generally inactive in their daily activities. Half of the group then exercised daily on a treadmill for 45 minutes. Everyone was asked to overeat: the non-exercising group increased their caloric intake by 50 per cent, whilst the exercising group increased by 75 per cent, so everyone's net daily energy surplus was the same.

Dr Dylan Thompson, senior author on the paper, says: "A critical feature of our experiment is that we matched the energy surplus between groups – so the exercise group consumed even more energy and were still better off at the end of the week."

After one week, the groups had blood insulin measurements and biopsies of fat tissue taken, with striking results. The non-exercising group showed a significant and unhealthy decline in their blood sugar control, and their fat cells were overexpressing genes linked to unhealthy metabolic changes and were under-expressing genes involved in well-functioning metabolism. However, the exercising group had stable blood sugar levels and their fat cells showed less 'undesirable' genetic expression.

Jean-Philippe Walhin, a researcher on the study, says, "Short-term overfeeding and reduced physical activity had a dramatic impact on the overall metabolic health of the participants and on various key genes within fat tissue – and exercise prevented these negative changes even though energy was still being stored."

Dr Dylan Thompson says: "If you are facing a period of overconsumption and inactivity, which is probably quite common around Christmas time, then our study shows that a daily bout of exercise will prevent many of the negative changes from taking place even though you are gaining weight."

The effects are obvious, but the underlying causes will need further study to be determined. The findings are likely to apply to other groups, like older adults and women, and perhaps to lesser amounts of training.







Study Shows Diabetes on the Rise Among Privately Insured Americans

Posted on December 18, 2013

Washington, DC—About 8.8% of the privately insured population in 2012 had diabetes or was diagnosed as being at high risk for diabetes, up from 8.3% in 2011, but the rates of disease varied depending on age, gender and region of the country, says a new report from HCCI. In 2012, over one quarter of men between the ages of 55-64 and nearly one in 10 Southerners had diabetes or were at risk for diabetes.

HCCI analyzed the health care claims of over 40 million Americans with employer-sponsored health insurance (ESI) from 2008 to 2012, and examine subpopulations by age, gender, and region. HCCI identified individuals with "diabetes" as those diagnosed with diabetes and those at high risk for developing diabetes (diagnosed with gestational diabetes or pre-diabetes).

"This is the first time we've used our repository of claims data to track the prevalence of chronic disease among the privately insured," said David Newman, Executive Director of HCCI. "While using claims data for public health surveillance purposes has some limitations, it provides a timely way to track emerging trends and can inform policymakers, providers, and patients alike."

Here are key findings from the report:

-Population Prevalence: HCCI identified 6.4% of the privately insured as having diabetes or at high risk for diabetes in 2008. By 2012, the prevalence of diagnosed diabetes, pre-diabetes, and gestational diabetes reached 8.8%.

-Age: Diabetes was most prevalent in older adults. In 2012, the prevalence of diagnosed diabetes, pre-diabetes, and gestational diabetes was 14.3% among privately insured adults ages 45 to 54, and 26.3 percent among adults ages 55 to 64.

-Gender: In 2012, 9.1% of men and 8.4% of women were identified as having diagnosed diabetes, pre-diabetes, and gestational diabetes. Compared to men of the same age, women between the ages of 19 and 44 had higher prevalence. However, after age 45, the prevalence rates for men rapidly outpaced that of women.

-Region: Prevalence was highest in the Mid-Atlantic, South Atlantic, and East South Central census divisions, where nearly 10% of people with employer-sponsored insurance were diagnosed with diabetes, pre-diabetes, and gestational diabetes in 2012. Prevalence was lowest in the Mountain, Pacific, and New England census divisions.

Please see the report at: http://www.healthcostinstitute.org/issue-brief-diabetes







US Ranks Near Bottom Among Industrialized Nations in Efficiency of Health Care Spending

Posted on December 18, 2013

A new study by researchers at the UCLA Fielding School of Public Health and McGill University in Montreal reveals that the United States health care system ranks 22nd out of 27 high-income nations when analyzed for its efficiency of turning dollars spent into extending lives.

The study, which appears online Dec. 12 in the "First Look" section of the American Journal of Public Health, illuminates stark differences in countries' efficiency of spending on health care, and the U.S.'s inferior ranking reflects a high price paid and a low return on investment.

For example, every additional hundred dollars spent on health care by the United States translated into a gain of less than half a month of life expectancy. In Germany, every additional hundred dollars spent translated into more than four months of increased life expectancy.

The researchers also discovered significant gender disparities within countries.

"Out of the 27 high-income nations we studied, the United States ranks 25th when it comes to reducing women's deaths," said Dr. Jody Heymann, senior author of the study and dean of the UCLA Fielding School of Public Health. "The country's efficiency of investments in reducing men's deaths is only slightl better, ranking 18th."

The study, which utilized data from 27 member countries of the Organization for Economic Cooperation and Development collected over 17 years (1991–2007), is the first-known research to estimate health-spending efficiency by gender across industrialized nations.

"While there are large differences in the efficiency of health spending across countries, men have experienced greater life expectancy gains than women per health dollar spent within nearly every country," said Douglas Barthold, the study's first author and a doctoral candidate in the department of economics at McGill University.

The report's findings bring to light several questions. How is it possible for the United States to have one of the most advanced economies yet one of the most inefficient health care systems? And while the U.S. health care system is performing so poorly for men, why is it performing even worse for women?

The exact causes of the gender gap are unknown, the researchers said, thus highlighting the need for additional research on the topic, but the nation's lack of investment in prevention for both men and women warrants attention.

"The most effective way to stop people from dying prematurely is to prevent them from getting sick in the first place," Heymann said.

Last year, the U.S. spent a tiny fraction of its $2.65 trillion annual health care budget on prevention. Health care spending is a large — and ever-increasing — portion of government budgets, particularly in the U.S. Therefore, allocating the necessary resources for prevention and improving overall efficiency are both critically important to preventing premature deaths and wiser spending, the researchers stressed.







CDC Gives Public a Look at How Local Hospitals Are Preventing Common Infections

Posted on December 18, 2013

New data posted this week and gathered through the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) gives patients a first look at how their local hospitals are doing at preventing Clostridium difficile infections (deadly diarrhea) and methicillin-resistantStaphylococcus aureus (MRSA) bloodstream infections. This information, as well as other hospital performance measures, is collected as part of the Centers for Medicare & Medicaid Services' (CMS) Hospital Inpatient Quality Reporting (IQR) Program and is publicly available on the Hospital Compare website.

The numbers represent only the first quarter of 2013; measurements of how hospitals are doing will be more precise and provide a more complete picture as more information is collected over time.

The next update, which will represent six months of data, is scheduled for April 2014.

"Sunlight is a great disinfectant, and public reporting of hospital infections is the sunlight the public has asked for and deserves when it comes to their health and safety," said CDC Director Tom Frieden, M.D., M.P.H. "Hospitals understand the importance of reporting, and their leaders are using this information to prevent infections and keep their patients safer."

The Hospital IQR Program uses a variety of tools to help stimulate and support improvements in patient care, including the Hospital Compare website, which helps distribute objective, easy-to-understand data on hospital performance.

"The Hospital Compare website enables consumers to make informed choices and gives hospital leaders and their staff comparative information to help drive improvement," said Patrick Conway, M.D., CMS chief medical officer and director of the Center for Clinical Standards and Quality. "Central line bloodstream infections have decreased more than 40 percent through transparency and improvement efforts, which has saved thousands of lives, and we hope to see the same positive results for these two common infections."

C. difficile causes at least 250,000 hospitalizations and 14,000 deaths every year, and was recently categorized by CDC as an urgent threat to patient safety. On the other hand, although still a common and severe threat to patients, invasive MRSA infections in healthcare settings appear to be declining. Between 2005 and 2011 overall rates of invasive MRSA dropped 31 percent. Success began with preventing central-line-associated bloodstream infections caused by MRSA, for which rates fell nearly 50 percent from 1997 to 2007.

Some facilities that do not currently have a sufficient amount of data to collect may not have their infection ratios included in the Hospital IQR Program and subsequently, on the Hospital Compare website. For example, the number of C. difficile and MRSA bloodstream infections in some smaller facilities might not provide enough information to calculate infection ratios until they report additional calendar quarters of data.

In accordance with the clinical quality measure used by CMS and CDC for laboratory-identified C. difficile and MRSA bloodstream infections, the Hospital Compare website only reflects hospital-onset infections, which are defined as those detected after patients are hospitalized for a minimum of three days. Patients whose infections arose outside of the hospital are not included in the infection counts for the quality measure.

Major teaching hospitals, hospitals with more than 400 beds and those with high community-onset rates continue to have the highest risk for C. difficile and MRSA bloodstream infections, all of which is taken into account by risk adjustment when the clinical quality measure is calculated.

CDC and CMS continue to provide hospitals with the training and tools to look deeper into their healthcare-associated infection data to target prevention efforts. Hospitals are encouraged to participate in a variety of federal healthcare-associated infection prevention efforts, including those made available through state health departments, CMS Quality Improvement Organizations, andPartnership for Patients Hospital Engagement Networks.

Additionally, CDC is working with hospitals and healthcare information technology vendors to build capacity for electronic reporting of antibiotic use and resistance data to NHSN. This work includes combining data from hospital admission, discharge, and patient transfer information (ADT) systems with data from medication administration and laboratory information systems. More systematic reporting of antibiotic use and resistance data will help hospitals assure that powerful medications are used appropriately. Additional data from ADT systems, including transfer destinations also will provide a comprehensive view of patient movement between facilities and readmissions associated with MRSA and C. difficile infections. Given that these infections can arise in non-hospital settings, tracking patient movements and the onset of infections is critical to protecting patients and saving lives.







Whistleblowers Can Now File Complaints Online with OSHA

Posted on December 17, 2013

WASHINGTON – Whistleblowers covered by one of 22 statutes administered by the U.S. Department of Labor's Occupational Safety and Health Administration will now be able to file complaints online. The online form will provide workers who have been retaliated against an additional way to reach out for OSHA assistance online.

"The ability of workers to speak out and exercise their rights without fear of retaliation provides the backbone for some of American workers' most essential protections," said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. "Whistleblower laws protect not only workers, but also the public at large and now workers will have an additional avenue available to file a complaint with OSHA."

Currently, workers can make complaints to OSHA by filing a written complaint or by calling the agency's 1-800-321-OSHA (6742) number or an OSHA regional or area office. Workers will now be able to electronically submit a whistleblower complaint to OSHA by visiting www.osha.gov/whistleblower/WBComplaint.html.

The new online form prompts the worker to include basic whistleblower complaint information so they can be easily contacted for follow-up. Complaints are automatically routed to the appropriate regional whistleblower investigators. In addition, the complaint form can also be downloaded and submitted to the agency in hard-copy format by fax, mail or hand-delivery. The paper version is identical to the electronic version and requests the same information necessary to initiate a whistleblower investigation.

OSHA enforces the whistleblower provisions of 22 statutes protecting employees who report violations of various securities laws, trucking, airline, nuclear power, pipeline, environmental, rail, public transportation, workplace safety and health, and consumer protection laws. Detailed information on employee whistleblower rights, including fact sheets and instructions on how to submit the form in hard-copy format, is available online at www.whistleblowers.gov.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA's role is to ensure these conditions for America's working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit www.osha.gov.







Team Schein Helps Make Holiday Wishes Come True for More Than 1,000 Children and Their Families

Posted on December 17, 2013

MELVILLE, N.Y./PRNewswire/ -- Holiday Cheer for Children, an annual initiative dedicated to brightening the holidays for children and families, will make holiday wishes come true this year for more than 1,000 children at multiple locations around the country.  Now in its 15th year, Holiday Cheer for Children is a flagship program of Henry Schein Cares, the corporate social responsibility program of Henry Schein, Inc. (NASDAQ: HSIC), the world's largest provider of health care products and services to office-based dental, animal health and medical practitioners.  The program is supported by the Henry Schein Cares Foundation, a 501(c)(3) organization that works to foster, support, and promote dental, medical, and animal health by helping to increase access to care for communities around the world. 

Team Schein Members contribute their own time and money to sponsor individual children through the Holiday Cheer for Children program to ensure that each child's holiday wishes come true. Clothing, toys, games, and other gifts are presented to participating children and their families at special holiday celebrations held at multiple Henry Schein locations, including Melville, NY; West Allis, Wisconsin and Indianapolis, Indiana.  Food baskets are also given to families in need through the program. 

"Words fail to express how much this program means to our families, many of whom face some of the toughest challenges during the holidays," said Linda Buczynski, co-coordinator, parent partner of the Family Support Services Program, Pederson-Krag, based on Long Island. "The success of Henry Schein's Holiday Cheer for Children program is shown on the children's faces as they open the gifts that they wished for."

Each year, Henry Schein partners with local social service organizations to help identify children and families who would benefit from participation in the Holiday Cheer for Children program.  Henry Schein's largest annual event takes place at the Company's worldwide headquarters in Melville, N.Y., where Team Schein Members sponsored 605 area children this year.  The celebration on December 5 included a special dinner, chocolate fountain, cotton candy machine, Santa and Mrs. Claus, music and other games and festivities.

"Henry Schein's commitment to giving back to our communities is embedded in our belief of doing well by doing good, and this value is shared by every Team Schein Member, companywide," said Gerry Benjamin, Henry Schein's Executive Vice President and Chief Administrative Officer.  "The Holiday Cheer for Children program is a wonderful opportunity to help make the holiday season special for children and their families. We look forward to this event all year."  

Human services organizations on Long Island receiving donations this year include: Bethany House; Madonna Heights; Nassau County Department of Social Services; McCoy Center; Family Service League (FSL); YES Community Counseling Center; Mpowering Kids; Family and Children Association (FCA); Hispanic Counseling Center (HCC); The Raymar Children's Fund; and Pederson-Krag. 







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