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Stay up to date on the latest operating room and anesthesiology products as well as news and research from medical companies, government agencies, and more.
Weight-loss surgery linked to longer lifespans, study says
ASA Monitor Staff
In a recent study, lower all-cause mortality was reported for male bariatric surgery patients as well as female patients when compared with sex-matched non-surgery participants (Obesity (Silver Spring) 2023; 31: 574- 85).
Similar studies have reported lower all-cause mortality among patients who have undergone bariatric surgery when compared with BMI-matched patients who have not undergone bariatric surgery. This study extends follow up to 40 years and includes almost 22,000 surgical patients representing all four major types of bariatric procedures performed today.
This study is important because it confirms decades long durability of bariatric surgery in reducing death from all causes and those related to cardiovascular disease, cancer, and diabetes when compared with matched participants with severe obesity. These findings may not only increase interest in bariatric surgery treatment for patients with severe obesity, but further stimulate important research related to the discovery of physiologic and biomolecular mechanisms leading to nonsurgical treatment that results in weight loss and improved mortality similar to that achieved by bariatric surgery.
Massachusetts Department of Public Health announces first cases of concerning gonorrhea strain
ASA Monitor staff
The Department of Public Health (DPH) announced it has detected a novel strain of gonorrhea in a Massachusetts resident that showed reduced response to multiple antibiotics and another case with genetic markers that indicate a similar drug response (asamonitor.pub/3ZMsmkm). This is the first time that resistance or reduced response to five classes of antibiotics has been identified in gonorrhea in the United States.
Both cases in Massachusetts were successfully cured with ceftriaxone, the antibiotic currently recommended to treat gonorrhea. To date, no direct connection between the two individuals has been identified.
Gonorrhea is a bacterial sexually transmitted infection. It may present without symptoms, and if left untreated, can result in pelvic inflammatory disease, infertility, and other health problems.
This strain of gonorrhea has been previously seen in Asia-Pacific countries and in the United Kingdom, but not in the U.S. A genetic marker common to these two Massachusetts residents was also previously seen in a case in Nevada, though that strain retained sensitivity to at least one class of antibiotics. Overall, these cases are an important reminder that strains of gonorrhea in the U.S. are becoming less responsive to a limited arsenal of antibiotics.
The Massachusetts cases were detected by DPH’s State Public Health Laboratory as part of disease surveillance activities. Field epidemiologists in DPH’s Division of Sexually Transmitted Disease Prevention are conducting contact tracing to determine if other individuals have acquired this infection. Working with the US Centers for Disease Control and Prevention (CDC) and local hospitals and health centers, DPH is expanding its testing of gonorrhea specimens for evidence of this strain in other patients.
DPH has issued an alert to clinicians and laboratories to raise awareness of this new strain. The alert recommends increased use of laboratory culture testing for individuals with symptoms of gonorrhea to detect antibiotic resistance and reminds providers of the process for submission of gonorrhea specimens to the State Public Health Laboratory to support DPH’s and CDC’s surveillance of further resistance in this organism. This alert also reinforces the CDC’s recommendation to use high doses of the antibiotic ceftriaxone for the treatment of all gonorrhea cases and to perform follow-up tests to ensure all patients with gonorrhea are successfully treated.
“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting in the US,” said Public Health Commissioner Margret Cooke. “We urge all sexually active people to be regularly tested for sexually transmitted infections and to consider reducing the number of their sexual partners and increasing their use of condoms when having sex. Clinicians are advised to review the clinical alert and assist with our expanded surveillance efforts.”
Gonorrhea has been increasing in Massachusetts and nationally, adding to concerns about the potential spread of this strain which is more difficult to treat. In Massachusetts, laboratory-confirmed cases of gonorrhea have increased 312% since a low point of 1,976 cases in 2009 to 8,133 in 2021. Nationally, confirmed cases have risen by 131% between 2009 and 2021, with 696,764 cases reported in the US in 2021 according to preliminary data released by the CDC.
FDA Moves to Simplify Covid Vaccine Schedule and match strains annually
In recently published guidance, the Food and Drug Administration (FDA) plans to simplify the Covid-19 immunization schedule and periodically update the composition of Covid-19 vaccines as needed. The FDA anticipates conducting an assessment of SARS-CoV-2 strains at least annually and engaging the Vaccines and Related Biological Products Advisory Committee (VRBPAC) in about early June of each year regarding strain selection for the fall season.
FDA approves Tzield to delay onset of stage 3 type 1 diabetes
ASA Monitor staff
The U.S. Food and Drug Administration (FDA) has approved Tzield (teplizumab-mzwv) injection to delay the onset of stage 3 type 1 diabetes in adults and pediatric patients 8 years and older who currently have stage 2 type 1 diabetes. Type 1 diabetes occurs when the immune system attacks and destroys the cells that make insulin. People with a type 1 diabetes diagnosis have increased glucose that requires insulin shots to survive and must check their blood sugar levels regularly. Type 1 diabetes is usually diagnosed in children and young adults but can appear at any age. Tzield binds to certain immune system cells and delays progression to stage 3 type 1 diabetes. Tzield may deactivate the immune cells that attack insulin-producing cells, while increasing the proportion of cells that help moderate the immune response. The safety and efficacy of the drug were evaluated in a randomized, double-blind, event-driven, placebo-controlled trial with 76 patients with stage 2 type 1 diabetes. Patients randomly received Tzield or a placebo once daily via intravenous infusion for14 days. The trial results showed that over an average follow-up of 51 months, 45% of the 44 patients who received Tzield were later diagnosed with stage 3 type 1 diabetes, compared to 72% of the 32 patients who received a placebo. The mid-range time from randomization to stage 3 type 1 diabetes diagnosis was 50 months for the patients who received Tzield and 25 months for those who received a placebo.
Major digital health initiative for children and adolescents combines advanced movement tracking and AI
The World Health Organization (WHO), the Ministry of Public Health of Qatar, and FIFA are launching a digital app designed to help increase physical activity and improve the health and well-being of children and adolescents. GenMove, Season1 is a games app that uses advanced movement tracking and artificial intelligence (AI) technology to provide 8–15-year-olds with a vigorous game experience. The games call for a range of different movements that develop different physical skills and are suitable for children with all levels of fitness.
WHO recommends all children and adolescents get an average of 60 minutes of moderate-intensity aerobic physical activity per day, including activities that strengthen muscles and bones at least 3 times a week. Yet, more than 80% of adolescents do not meet these recommendations and can spend more than 8 hours of their waking day being sedentary and inactive. The app is hoped to spur activeness in children around the world. GenMove games are built around popular sports such as football and involve actions such as jumping, reaching, and kicking to build kids’ confidence and enjoyment of moving. The games can be played inside or outside and need only a mobile phone or tablet (IOS or Android) and a small space to get children active. GenMove Season 1 is available in English, Arabic, Chinese, French, Russian, and Spanish.