MMWR. Morbidity and mortality weekly report
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MMWR Morb. Mortal. Wkly. Rep. · Jun 2012
Case ReportsSodium azide poisoning at a restaurant - Dallas County, Texas, 2010.
In April 2010, Dallas County Health and Human Services (DCHHS) staff members investigated reports of acute-onset dizziness among patrons in a local restaurant. Symptoms, which included fainting resulting from low blood pressure, occurred within minutes of consuming food from the restaurant and were consistent with chemical poisoning. Toxicologic and epidemiologic investigations were begun to determine the cause of the poisonings and identify potentially exposed persons. ⋯ For rapid-onset foodborne illnesses, chemical poisons should be considered as a potential cause, regardless of negative initial toxicologic screening tests. Although unusual chemicals can be challenging to detect, a multidisciplinary approach involving public health officials and forensic and medical toxicologists can lead to appropriate testing. In the absence of an identified agent, epidemiologic tools are valuable for active case-finding and confirming suspected contaminated food vehicles.
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MMWR Morb. Mortal. Wkly. Rep. · Jun 2012
Practice GuidelineUpdated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older - Advisory Committee on Immunization Practices (ACIP), 2012.
Since 2005, the Advisory Committee on Immunization Practices (ACIP) has recommended a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine booster dose for all adolescents aged 11 through 18 years (preferred at 11 through 12 years) and for those adults aged 19 through 64 years who have not yet received a dose. In October 2010, despite the lack of an approved Tdap vaccine for adults aged 65 years and older, ACIP recommended that unvaccinated adults aged 65 years and older be vaccinated with Tdap if in close contact with an infant, and that other adults aged 65 years and older may receive Tdap. ⋯ In February 2012, ACIP recommended Tdap for all adults aged 65 years and older. This recommendation supersedes previous Tdap recommendations regarding adults aged 65 years and older.
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MMWR Morb. Mortal. Wkly. Rep. · Jun 2012
Pneumoconiosis and advanced occupational lung disease among surface coal miners--16 states, 2010-2011.
Coal workers' pneumoconiosis (CWP) is a chronic occupational lung disease caused by long-term inhalation of dust, which triggers inflammation of the alveoli, eventually resulting in irreversible lung damage. CWP ranges in severity from simple to advanced; the most severe form is progressive massive fibrosis (PMF). Advanced CWP is debilitating and often fatal. ⋯ A high proportion of the radiographs suggested silicosis, a disease caused by inhalation of crystalline silica. Surface coal mine operators should monitor worker exposures closely to ensure that both respirable dust and silica are below recommended levels to prevent CWP. Clinicians should be aware of the risk for advanced pneumoconiosis among surface coal miners, in addition to underground coal miners, to facilitate prompt disease identification and intervention.
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MMWR Morb. Mortal. Wkly. Rep. · Jun 2012
Conclusions and future directions for periodic reporting on the use of adult clinical preventive services of public health priority--United States.
The findings described in this supplement can help improve collaboration among public health and other stakeholders who influence population health, including employers, health plans, health professionals, and voluntary associations, to increase the use of a set of clinical preventive services that, with improved use, can substantially reduce morbidity and mortality in the U. S. adult population. This supplement highlighted that the use of the clinical preventive services in the U. ⋯ Therefore, improving opportunities for coverage might be insufficient, and focused efforts by governmental health agencies and other stakeholders are likely to be needed to enroll uninsured persons in health plans. In addition, although use of the preventive services in insured populations was greater than among the uninsured, use among the insured was generally <75%, and often much less. Therefore, having health insurance coverage might not itself be sufficient to optimize use of clinical preventive services, and additional measures to improve use are likely to be necessary.
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MMWR Morb. Mortal. Wkly. Rep. · Jun 2012
Tobacco use screening and counseling during physician office visits among adults--National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005-2009.
Tobacco use continues to be the leading cause of preventable disease and death in the United States; cigarette smoking accounts for approximately 443,000 premature deaths annually. In 2009, the prevalence of smoking among U. S. adults was 20.6% (46 million smokers), with no significant change since 2005 (20.9%). ⋯ Public Health Service (PHS) Clinical Practice Guideline: Treating Tobacco Use and Dependence recommends that clinicians and health-care delivery systems consistently identify and document tobacco use status and treat every tobacco user seen in a health-care setting using the 5 A's model: 1) ask about tobacco use, 2) advise tobacco users to quit, 3) assess willingness to make a quit attempt, 4) assist in quit attempt, and 5) arrange for follow-up. The PHS guideline also recommends the following as effective methods for increasing successful cessation attempts: individual, group, and telephone counseling; any of the seven first-line medications for tobacco dependence that are approved by the Food and Drug Administration (FDA); and provision of coverage for these treatments by health-care systems, insurers, and purchasers. However, clinicians and health-care systems often do not screen for and treat tobacco use consistently and effectively.