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For patients undergoing right heart catheterization (RHC), borderline pulmonary hypertension (PH) is associated with increased risk of mortality, according to a study published online Oct. 25 in JAMA Cardiology. Tufik R. Assad, M.D., from Vanderbilt University School of Medicine in Nashville, Tennessee, and colleagues conducted a retrospective cohort study involving patients undergoing routine RHC for clinical indication. Patients were classified according to mean pulmonary arterial pressure (mPAP) values as reference, borderline PH, and PH (mPAP values of ≤18, 19 to 24, and ≥25 mmHg, respectively). The researchers found that the prevalence of PH and borderline PH was 62 and 18 percent, respectively, among 4,343 patients. Independent associations were seen for advanced age, features of the metabolic syndrome, and chronic heart and lung disease with increased likelihood of borderline PH versus reference patients. Borderline PH was correlated with increased mortality compared with reference patients after adjustment for 34 variables (hazard ratio, 1.31). With higher mPAP there was an incremental increase in the risk of death, without an observed threshold. Sixty-one percent of the 70 patients with borderline PH who underwent repeated RHC had developed overt PH, with a 5 mmHg median increase in mPAP (interquartile range, -1 to 11 mmHg; P < 0.001).

A novel bioinformatics approach can predict vaccine effectiveness for the influenza season, and indicates that the current vaccines are likely to be effective against H3N2 flu viruses in the U.S. 2017/2018 flu season, according to research published online Nov. 29 in F1000 Research. Slobodan Paessler, D.V.M., Ph.D., from the University of Texas Medical Branch, and Veljko Veljkovic, Ph.D., from Biomed Protection, both in Galveston, Texas, used a bioinformatics platform to predict vaccine effectiveness for the 2017/2018 influenza season in the United States. The hemagglutinin HA1 region of 251 and 113 human H3N2 viruses collected in Australia and the United States from July to September 2017 were analyzed. The informational spectrum method-based phylogenetic analysis of H3N2 viruses was performed to serve as a base for predicting vaccine effectiveness. The researchers found that analyses of Australian viruses generated two clusters; the vaccine virus was placed in the smaller group. As a result, the vaccine was predicted not to be efficient against most Australian H3N2 viruses in the 2017 flu season; low vaccine effectiveness was reported in Australia in the 2017 flu season in accordance with this prediction. The U.S. H3N2 viruses were also grouped into two clusters, but the vaccine virus was placed in the largest cluster encompassing 71 percent of analyzed viruses. Consequently, the vaccine effectiveness is expected not to be suboptimal in the United States.

Higher dietary total fiber and fruit fiber is protective against bone loss at the femoral neck in men, according to a study published online Oct. 12 in the Journal of Bone and Mineral Research. Zhaoli Dai, Ph.D., from the Boston University School of Medicine, and colleagues examined the correlation between dietary fiber, assessed using the Willett food frequency questionnaire, and bone loss at the femoral neck, trochanter, and lumbar spine in older men and women. Bone mineral density was measured using dual-energy X-ray absorptiometry at baseline (1996 to 2011) and in 2001 to 2005 and 2005 to 2008 among 792 men and 1,065 women. The researchers found that in men, but not women, higher dietary total fiber and fruit fiber was protective against bone loss at the femoral neck (P = 0.003 and 0.008, respectively). Compared with men in quartile 1 of fiber intake, those in quartiles 2 to 4 had significantly less bone loss at the femoral neck (all P < 0.04). There were no associations with hip bone loss in women; fiber from vegetables seemed protective against spine bone loss in women but not men. No correlations were seen for cereal fiber or nut and legume fiber with bone loss in men or women.

Conjugated linoleic acid (CLA) supplementation is associated with an increase in serum C-reactive protein (CRP) concentration, according to a review and meta-analysis published online May 29 in Cardiovascular Therapeutics. Mohsen Mazidi, Ph.D., from the Chinese Academy of Sciences in Beijing, and colleagues conducted a systematic review and meta-analysis to examine the impact of CLA supplementation on serum CRP. Data were included from 14 studies. The researchers found that following supplementation with CLAs there was a significant increase in serum CRP concentrations (weighted mean difference, 0.63 mg/dL; 95 percent confidence interval, 0.13 to 1.13; heterogeneity P = 0.026); these findings were robust in sensitivity analyses. The changes in serum CRP levels were found to be independent of CLA supplementation dosage (slope, −0.02; 95 percent confidence interval, −0.10 to 0.12; P = 0.889) or follow-up duration (slope, 0.271; 95 percent confidence interval, −0.05 to 0.59; P = 0.098). "This meta-analysis suggests that CLA supplementation is associated with an increase in plasma CRP concentrations and a reduction in serum adiponectin concentrations, which indicates that CLA supplements have a pro-inflammatory effect," the authors write.

More than 78 percent of health care personnel (HCP) and 53.6 percent of pregnant women received influenza vaccination during the 2016-2017 influenza season, according to two studies published in the Sept. 29 issue of Morbidity and Mortality Weekly Report. Carla L. Black, Ph.D., from the U.S. Centers for Disease Control and Prevention (CDC), and colleagues surveyed 2,438 HCP to estimate influenza vaccination coverage. The researchers found that during the 2016-2017 season, 78.6 percent of survey respondents reported receiving vaccination, similar to reported coverage in the previous three seasons. Coverage was highest for those working in hospitals compared with those working in ambulatory or long-term-care settings (92.3 versus 76.1 and 68 percent) and for those who were required by their employer to be vaccinated (96.7 percent), as in previous seasons. Helen Ding, M.D., from the CDC, and colleagues surveyed 1,893 women pregnant at any time during October 2016 to January 2017. The researchers found that 53.6 percent of respondents reported having received influenza vaccination before or during pregnancy (16.2 and 37.4 percent, respectively); this was similar to coverage during the previous four influenza seasons. Overall, 67.3, 11.9, and 20.7 percent of women reported receiving a provider offer for influenza vaccination, receiving a recommendation but no offer, and receiving no recommendation, respectively, similar to the previous influenza season; influenza vaccination coverage was 70.5, 43.7, and 14.8 percent, respectively, among these women.

During cardiopulmonary resuscitation (CPR) performed by males, self-adjusted and nearest kneeling postures are more effective for chest compression, with lower perceived exertion, according to a study published online Oct. 5 in the Journal of Clinical Nursing. S.H. Ho, from The Hong Kong Polytechnic University and Daniel H.K. Chow, Ph.D., from The Education University of Hong Kong, applied a self-controlled repeated-measures design to examine the impact of kneeling posture on chest compression during CPR in males. The authors recruited 18 participants with a qualified first-aid certificate. Each participant performed three sessions of CPR on a mannequin using one of three kneeling postures (farthest, self-adjusted, and nearest) in each. Each session comprised five CPR cycles (30 strokes of chest compression within 18 seconds) in each kneeling posture and lasted two minutes. The researchers found that the efficacy of chest compression was significantly better in the self-adjusted and nearest kneeling postures than in the farthest posture. Similar effect was seen for the self-adjusted and nearest postures, while because of the lower rate of perceived exertion, most participants preferred self-adjusted kneeling posture.

Internal medicine patients are frequently prescribed potentially inappropriate medications (PIMs), but screening tools can detect clinically relevant PIMs, according to a study published online Oct. 8 in the Journal of Clinical Pharmacy and Therapeutics. Anne-Laure Blanc, Pharm.D., Ph.D., from Geneva University Hospitals in Switzerland, and colleagues compared two PIM-screening tools -- STOPP/START and PIM-Check -- in a general internal medicine ward. They also analyzed a random sample of 50 patients hospitalized in 2013, whose readmission within 30 days of discharge had been potentially preventable, and 50 sex-and age-matched patients who were not readmitted. The researchers found that across the whole ward population, PIM-Check and STOPP/START detected 1,348 and 537 PIMs, respectively, which was the equivalent of 13.5 and 5.4 PIMs per patient. PIM-Check had a substantially shorter screening time versus STOPP/START (four versus 10 minutes). Of the PIMs detected using PIM-Check and STOPP/START, the clinical pharmacist found 45 percent and 42 percent, respectively, to be clinically relevant to individual patients' cases. There were no significant differences in the rates of detected and clinically relevant PIMs between readmitted and nonreadmitted patients.

Aspirin therapy is associated with a reduced risk of hepatitis B virus-related hepatocellular carcinoma (HCC), according to a study scheduled for presentation at The Liver Meeting, held by the American Association for the Study of Liver Diseases from Oct. 20 to 24 in Washington, D.C. Teng-Yu Lee, M.D., Ph.D., from Taichung Veterans General Hospital in Taiwan, and colleagues used data from Taiwan's National Health Insurance Research Database from 1998 to 2012. Patients with non-hepatitis B infections were excluded, as were those with HCC before the follow-up index dates. A total of 1,553 patients who continuously received daily aspirin ≥90 days were randomly matched (1-to-4 ratio) with 6,212 patients who never received anti-platelet therapy based on baseline characteristics, the index date, and nucelos(t)ide analogue (NA) use during follow-up. The researchers found that the cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group in five years (2.86 percent versus 5.59 percent). Aspirin therapy was independently associated with a reduced HCC risk (hazard ratio [HR], 0.63) in a multivariable regression analysis. An increased HCC risk was independently associated with older age (HR, 1.03 per year), male gender (HR, 2.65), cirrhosis (HR, 1.89), and diabetes mellitus (HR, 1.51). NA (HR, 0.57) and statin (HR, 0.57) use were associated with a decreased HCC risk.

Too many carbs, not fats, may be the culprit in raising risk of premature death, according to a study published online Aug. 29 in the The Lancet to coincide with the European Society of Cardiology Congress 2017, held from Aug. 26 to 30 in Barcelona, Spain. Mahshid Dehghan, Ph.D., an investigator with the Population Health Research Institute at McMaster University in Hamilton, Canada, and colleagues tracked the diet and health of 135,335 people, aged 35 to 70, from 18 countries around the world, to gain a global perspective on the health effects of diet. Participants provided detailed information on their social and economic status, lifestyle, medical history, and current health. They also completed a questionnaire on their regular diet, which researchers used to calculate their average daily calories from fats, carbohydrates, and proteins. The research team then tracked the participants' health for about seven years on average, with follow-up visits at least every three years. The investigators found that high-carbohydrate diets are common, with more than half of the people deriving 70 percent of their daily calories from carbs. People with a high fat intake -- about 35 percent of their daily diet -- had a 23 percent lower risk of early death and 18 percent lower risk of stroke compared to people who ate less fat. The researchers also noted that a very low intake of saturated fats (below 3 percent of daily diet) was associated with a higher risk of death in the study, compared to diets containing up to 13 percent daily. At the same time, high-carb diets -- containing an average 77 percent carbohydrates -- were associated with a 28 percent increased risk of death versus low-carb diets. "The study showed that contrary to popular belief, increased consumption of dietary fats is associated with a lower risk of death," Dehghan told HealthDay. "We found no evidence that below 10 percent of energy by saturated fat is beneficial, and going below 7 percent may even be har

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