Here are his top three public health newsmakers:
On March 29, 2016, Allegheny County announced its first confirmed case of the Zika virus, a few months after the world started to take notice of an outbreak of the virus in Brazil that was quickly spreading in South and Central America. Zika typically causes a mild flu-like illness, but when a pregnant woman gets it, there is a strong chance that her baby will have serious neurological deficits. This outbreak highlighted the ongoing public health need for better resources to quickly respond to such outbreaks. While Congress debated for months whether to authorize the $1.9 billion proposed to fight the virus, we launched Cura Zika – an alliance with our partners at Fundação Oswaldo Cruz in Brazil – to accelerate the research needed to develop strategies to prevent and treat infections, and address the ongoing public health needs.
You can talk to almost anybody and they know a friend or a family member who has died of an opioid overdose – we haven’t seen an epidemic like this since the AIDS epidemic. Using national data stored at Pitt Public Health, our biostatisticians have found that overdose deaths have skyrocketed. It’s now the leading cause of years of lives lost in Pennsylvania and most of the U.S., far surpassing motor vehicle accident deaths. While this epidemic shares much in common with infectious disease epidemics, it also has distinct differences – forcing public health officials to forge new partnerships that include law enforcement and addiction treatment facilities in order to start to stem its spread.
The presidential election and future of the Affordable Care Act
A lightning rod of the recent U.S. presidential election, which consumed much of our nation’s news broadcasts, social media feeds, water cooler discussions and commercial breaks through 2016, was the most significant public health policy created in the past several years: the Affordable Care Act (ACA). President-elect Donald Trump has vowed to “repeal and replace” the ACA, and only time will tell how he will do that, though we do know that it is unlikely to be an easy undertaking, considering that more than 11.3 million people are covered by it. Health is a serious issue for voters – Trump swept the 16 states with the highest mortality rates, while people in 15 of the 18 states with the lowest mortality voted for Hillary Clinton, suggesting that Trump voters were expressing dissatisfaction with real problems that included shorter lives and less healthy living conditions.
Magee-Womens Hospital of UPMC celebrated babies born during the Christmas holiday by transforming the nursery into the North Pole.
Newborns were tucked into hand-knitted blankets and their tiny heads were topped with handmade Santa and reindeer caps. The blankets and caps were made by the Magee Hat Makers, a group of local women who gather each month in the Magee lobby to knit, socialize and give back to the community.
For more information about Magee-Womens Hospital of UPMC, click here.
We asked Dr. John W. Mellors, chief of the Division of Infectious Diseases at the University of Pittsburgh School of Medicine, what he believes were the most important news developments in his field in 2016.
Here are his top three infectious disease newsmakers:
While the association of maternal Zika infection with fetal microcephaly was suggested in 2015, the data from the South American outbreak and prior French Polynesian outbreak have been sufficient only in this past year to show Zika as a cause of microcephaly. In addition to reports of sexual transmission, there was a case of non-sexual transmission, likely via tears or sweat, in a patient who died with high levels of Zika in the blood. Local transmission of Zika via mosquito bite has now occurred in the US in both in Florida and Texas.
Tenofovir alafenamide, a new formulation of tenofovir (a nucleoside inhibitor of HIV reverse transcriptase and part of many HIV treatment regimens), has been integrated into the first line-treatment guidelines for HIV patients. Multiple trials were published that demonstrated similar efficacy with the older formulation (tenofovir disoproxil fumarate), which improved rates of renal and bone toxicity. Given the need for lifelong therapy in HIV patients, this new agent may improve long-term health in these patients.
Hospital-acquired and ventilator-associated pneumonia guidelines
New guidelines for Hospital-Acquired Pneumonia (HAP) and Ventilator-Associated Pneumonia (VAP) were published by the Infectious Diseases Society of America and the American Thoracic Society. An important update was the exclusion of Healthcare-Associated Pneumonia (HCAP), which has been previously been included. This change may help prevent unnecessarily broad antibiotic use in many patients. In addition, an emphasis was placed on considering local resistance patterns in choosing the most appropriate initial antibiotics in these conditions.
Women and men with mild cognitive impairment have a new resource in Pittsburgh with the recently established Brain Training and Exercise (BRiTE) mind and body wellness program.
Participants engage with others affected in wide-ranging activities, including music, art, brain games and yoga training, all of which are designed to reduce frailty, increase strength and endurance and improve balance and stability.
While many resources are available for those with advanced cognitive diseases, the BRiTE program fills a void for people with mild cognitive deficits. The program allows them to continue with their active occupational and social lifestyles, while stimulating the brain and body and in the process, improving overall health and wellness.
A collaboration between the University of Pittsburgh and Grifols International, the BRiTE program is the first of its kind in the United States. The BRiTE team has been working with colleagues at Fundació ACE Barcelona Alzheimer Treatment and Research Center for nearly 20 years. This center pioneered a model of nonpharmacological programs to help stimulate cognitive, behavioral and physical functions to improve social and occupational functions.
Experts from the UPMC Comprehensive Pulmonary Hypertension Program are now using a new procedure aimed at improving the quality of life for chronic thromboembolic pulmonary hypertension (CTEPH) patients who aren’t responding to medication or are ineligible for surgery.
The UPMC CTEPH Program is one of only a few centers across the country to offer balloon pulmonary artery angioplasty (BPA) as a treatment option for CTEPH – a type of high blood pressure caused by chronic blood clots that affects arteries in the lungs and in the heart.
“The UPMC CTEPH Program is a specialized, multidisciplinary team of experts who come together to improve a patient’s survival and quality of life,” said Dr. Belinda Rivera-Lebron, director of the program. “CTEPH is a serious condition that affects our patient population, and this new procedure adds a treatment option for those who previously had very few alternatives.”
For the majority of patients who have suffered a blood clot, blood thinners are used to restore blood flow, which in turn improves breathing and exercise ability. However, in many patients, despite appropriate anticoagulation, their acute blood clots don’t resolve and progress to CTEPH. Others may develop it from multiple small clots over a long period of time, and some develop CTEPH with no history of acute blood clots.
The symptoms of CTEPH are similar to other types of PH: shortness of breath and a limited ability to exercise, according to the Pulmonary Hypertension Association. Other symptoms include a dry cough, chest pain and heart palpitations. As the disease progresses, patients may experience light-headedness or exercise-related dizziness. Abdominal and lower extremity swelling may develop as lung pressures increase and the right ventricle, which pumps blood into the lungs, begins to weaken.
Treatment for the disease includes medication for those ineligible for surgery and pulmonary thromboendarterectomy, a surgery that removes those chronic blood clots from the pulmonary artery.
Dr. Rivera-Lebron, who is also an associate professor of medicine in the University of Pittsburgh’s Division of Pulmonary, Allergy and Critical Care Medicine, and Dr. Catalin Toma, director of interventional cardiology at the UPMC Heart and Vascular Institute and assistant professor of medicine in Pitt’s Division of Cardiology, traveled to the Osaka Cardiovascular Hospital in Japan to learn from one of the world’s leading BPA experts, Dr. Takeshi Ogo. (more…)