Public Release: 

Advice for preventing spread of Zika; news from Annals of Internal Medicine

American College of Physicians

1. Experts offer advice for preventing spread of Zika virus in the West
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-0150
URL goes live when the embargo lifts

In an article published in Annals of Internal Medicine, experts offer advice for preventing the spread of Zika virus in the West. Zika virus, a mosquito-borne illness that causes fever and flu-like symptoms, has been rapidly emerging in the Western Hemisphere over the past few months. Since Aedes mosquitoes (a genus found on all continents except Antarctica) are carriers for Zika as well as chikungunya and dengue fever, clinicians should consider these viruses as a differential diagnosis in patients presenting with fever, rash, arthralgia, and myalgia after travel to Central and South America and the Caribbean. Patients, especially those who are pregnant or breastfeeding, are advised to protect themselves against mosquitoes. Pregnant women should practice meticulous mosquito avoidance using repellents containing DEET, picaridin, or IR3535 - all of which have been deemed safe for this population. If possible, pregnant women should avoid travel to areas that are reporting outbreaks of Zika virus, as Zika is associated with microcephaly, a birth defect causing low birth weight, small heads, and lasting developmental problems.

Note: For an embargoed PDF, please contact Cara Graeff. To interview the lead author, Dr. Lin H. Chen, please contact Michael O'Connell at moconnel@mah.harvard.edu.


2. Do patients need an annual physical?
Annals of Internal Medicine and Beth Israel Deaconess Medical Center go "Beyond the Guidelines" to discuss differing opinions on periodic health exams
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-2885
URL goes live when the embargo lifts

What are the benefits and harms of periodic health exams and who should have one? Two experts debate these questions in a multicomponent educational article being published in Annals of Internal Medicine.

Periodic health exams, known as the annual physical when they occur yearly, are routine visits with physicians to discover asymptomatic illness and provide preventive care. These visits are valued by patients and are one of the most common reasons for patients to visit a physician. While some private insurance plans cover annual exams, the American Board of Internal Medicine (ABIM) Foundation and the Society of General Internal Medicine (SGIM) have identified annual physicals as an example of low value care, or a practice that physicians and patients should question, as part of the Choosing Wisely campaign. In a new 'Beyond the Guidelines' feature, experts from Beth Israel Deaconess Medical Center and Harvard Medical School present opposing viewpoints for and against the annual physical.

All 'Beyond the Guidelines' papers are based on the Department of Medicine Grand Rounds at Beth Israel Deaconess Medical Center in Boston and include print, video, and educational components. A list of topics is available at http://www.annals.org/grandrounds.

Note: The URLs, including video link, will be live when the embargo lifts. For an embargoed PDF, please contact Cara Graeff. To interview the lead author, please contact Lizzie Williamson at erwillia@bidmc.harvard.edu or 617-632-8217.


3. ACIP Releases its Recommended Adult Immunization Schedule for 2016
Group recommends major changes to HPV, pneumococcal, and meningococcal vaccines
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-3005
URL goes live when embargo lifts

The Advisory Committee on Immunization Practices (ACIP) released its 2016 Recommended Immunization Schedule for adults with major changes to the human papillomavirus (HPV), pneumococcal, and meningococcal (MenB) vaccines. The schedule is published in Annals of Internal Medicine along with two easy-to-reference charts showing recommended vaccines by age and by medical condition.

For 2016, the nine-valent HPV vaccine (9vHPV) was added to the adult immunization schedule. The vaccine can be used for routine vaccination against HPV as one of three HPV vaccines recommended for females and one of two HPV vaccines recommended for males. The vaccine interval for 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) has changed from "6 to 12 months" to "at least 1 year" for immunocompetent adults aged 65 and older. Adults aged 19 years or older with anatomical or functional asplenia, cerebrospinal fluid leak, or cochlear implant or who are immunocompromised should receive PPSV23 at least 8 weeks after PCV13. And finally, the MenB vaccine series should be administered to all persons aged 10 and older who are at increased risk for serogroup B meningococcal disease.

The complete schedule, including footnote changes, is being simultaneously published in Annals of Internal Medicine and on the Centers for Disease Control and Prevention (CDC) web site. The CDC's ACIP is comprised of the American College of Physicians and 16 other medical societies representing various medical practice areas. Each year, the ACIP reviews the CDC's Recommended Adult Immunization Schedule to ensure the schedule reflects current clinical recommendations for licensed vaccines. The recommendations are intended to guide physicians and other clinicians about the appropriate vaccines for their adult patients.

Note: For an embargoed PDF, please contact Cara Graeff. To interview ACP's representative to ACIP, please contact Dr. Sandra Fryhofer directly at sandra@drsandrafryhofer.com.


4. HIV vaccines produce significant immune response in randomized trial
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-0880
URLs go live when embargo lifts

According to a randomized trial published in Annals of Internal Medicine, two novel vaccines for the prevention of HIV-1 produced significant immune response in healthy adults without HIV infection.

The development of a vaccine to prevent HIV infection is a global health priority. To date, four vaccine strategies have been assessed for possible efficacy and only one has shown modest and short-lived efficacy. A significant challenge is how to elicit robust and durable anti-HIV-1 immune response.

To assess a novel HIV vaccine platform, researchers randomly assigned healthy adults without HIV infection to one of two interventions: a vaccine consisting of adenovirus serotype 26 with an HIV-1 envelope A insert (Ad26) or adenovirus serotype 35 with an HIV-1 envelope A insert (Ad35). Both were administered at a dose of 5 x 1010 viral particles in homologous and heterologous combinations.

The researchers found that all vaccine regimens were well-tolerated and elicited both humoral and cellular immune responses. Both heterologous and homologous regimens significantly increased humoral Env responses, suggesting that a vaccine that inserts an HIV-1 envelope protein into a common adenovirus is a promising vaccine strategy for HIV-1 prevention.

Note: For an embargoed PDF, please contact Cara Graeff. To interview the lead author, Dr. Lindsey Baden, please contact Haley Bridger at hbridger@partners.org or 617-525-6383.


5. Essay suggests 21st century docs can learn something about patient care from veterinarians
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-1975
URLs go live when embargo lifts

A first-person "On Being a Patient" essay published in Annals of Internal Medicine follows a patient through a perfect doctor visit, from the waiting room through the call the morning after. Could physicians learn something from how veterinarians treat their insured and uninsured patients alike? Lois Snyder Sulmasy, JD of the American College of Physicians pens an amusing and thought-provoking essay.

Note: For an embargoed PDF or an interview with the author, please contact Cara Graeff.

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Also in this issue:

Drowning in a Sea of Paperwork: Toward a More Patient-Centered Billing System in the United States
Hannah Semigran, BA; Ateev Mehrotra, MD, MPH, MS; and Ann Hwang, MD, MPhil
Ideas and Opinions
http://www.annals.org/article.aspx?doi=10.7326/M15-2283

Comparative Effect of Contrast Media Type on the Incidence of Contrast-Induced Nephropathy: A Systematic Review and Meta-analysis
John Eng, MD; Renee F. Wilson, MS; Rathan M. Subramaniam, MD, PhD, MPH; Allen Zhang, BS; Catalina Suarez-
Cuervo, MD; Sharon Turban, MD, MHS; Michael J. Choi, MD; Cheryl Sherrod, MD, MPH; Susan Hutfless, PhD;
Emmanuel E. Iyoha, MBChB, MPH; Eric B. Bass, MD, MPH
Review
http://www.annals.org/article.aspx?doi=10.7326/M15-1402

Effectiveness of Prevention Strategies for Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis
Rathan M. Subramaniam, MD, PhD, MPH; Catalina Suarez-Cuervo, MD; Renee F. Wilson, MS; Sharon Turban, MD, MHS; Allen Zhang, BS; Cheryl Sherrod, MD, MPH; Jonathan Aboagye, MD, MPH; John Eng, MD; Michael J. Choi, MD; Susan Hutfless, PhD; and Eric B. Bass, MD, MPH
Review
http://www.annals.org/article.aspx?doi=10.7326/M15-1456

Medical Assistant-Based Care Management for High-Risk Patients in Small Primary Care Practices: A Cluster
Randomized Clinical Trial
Tobias Freund, MD; Frank Peters-Klimm, MD; Cynthia M. Boyd, MD; Cornelia Mahler, MA; Jochen Gensichen, MD; Antje Erler, MD; Martin Beyer, MA; Matthias Gondan, PhD; Justine Rochon, MSc; Ferdinand M. Gerlach, MD; and Joachim Szecsenyi, MD
http://www.annals.org/article.aspx?doi=10.7326/M14-2403

Stop Predatory Publishers Now: Act Collaboratively
David Moher, PhD, and Ester Moher, PhD
Ideas and Opinions
http://www.annals.org/article.aspx?doi=10.7326/M15-3015

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