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Source: http://news.yahoo.com/deena-jersey-shore-didnt-sidewalk-175052891.html
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Public release date: 3-Jul-2012
Share ] Contact: Bob Shepard
Bshep@uab.edu
205-934-8934
JAMA and Archives Journals
CHICAGO Although some have suggested that patients receiving medication for immune-mediated diseases such as rheumatoid arthritis or psoriasis may be at increased risk of herpes zoster (HZ; shingles) shortly after receipt of the vaccine, an analysis that included nearly 20,000 vaccinated Medicare beneficiaries finds that the live zoster vaccine is not associated with an increased risk of HZ shortly after vaccination in patients currently treated with biologics, and that it is associated with a significantly reduced longer-term risk of HZ in patients with an immune-mediated disease, according to a study in the July 4 issue of JAMA.
"A live attenuated vaccine reduces HZ risk by 70 percent and 51 percent among immunocompetent individuals 50 to 59 years and 60 years and older in 2 randomized blinded trials, respectively," according to background information in the article. "The risk of HZ is elevated by 1.5 to 2 times in patients with rheumatic and immune-mediated diseases such as rheumatoid arthritis and Crohn's disease. This increase has been attributed to both the underlying disease process and treatments for these conditions." Currently, the Food and Drug Administration (FDA) and other organizations consider the live HZ vaccine to be contraindicated in patients receiving some immunosuppressive medications commonly used to treat these conditions, including all immune-modulating biologic agents and some nonbiologic immunosuppressive medications. The safety concern is that these individuals may develop varicella infection from the vaccine virus strain, the authors write.
Jie Zhang, Ph.D., of the University of Alabama at Birmingham, and colleagues, evaluated patients with immune-mediated diseases. The retrospective cohort study included 463,541 Medicare beneficiaries 60 years and older with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis (a form of chronic inflammation of the spine), or inflammatory bowel disease using Medicare claims data from January 2006 through December 2009. The researchers measured the incidence rate of herpes zoster within 42 days after vaccination (a safety concern) and beyond 42 days.
The average age of the patients at the start of follow-up was 74 years, with the median (midpoint) duration of follow-up being 2 years; 72 percent of the patients were women, and 86 percent were white. During the study, 18,683 patients (4.0 percent) received the zoster vaccine.
The researchers found that among 633 patients exposed to biologics, including 551 patients exposed to anti-tumor necrosis factor (TNF) biologics, no cases of varicella or HZ occurred within the 42 days following vaccination. Among all patients, only 1 case of primary varicella was identified within the 42-day risk window, occurring on day 10 after vaccination.
During the period of more than 42 days after vaccination, the researchers observed 138 HZ cases. After controlling for demographics, type of immune-mediated disease, health care utilization, and exposure to biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs) and oral glucocorticoids, data indicated that vaccination was associated with decreased HZ risk over a median of 2 years of follow-up.
"Despite the recognition that patients with immune-mediated conditions are at increased risk of HZ, this and previous studies have shown that only a small fraction of these patients received the vaccine, likely in part due to safety concerns. Our data call into question the current recommendations that HZ vaccine is contraindicated in patients receiving biologics and suggest a need for a randomized controlled trial to specifically address the safety and effectiveness of HZ vaccination among patients receiving biologics," the authors conclude.
###
(JAMA. 2012;308[1]:43-49. Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: This project was supported by the Agency for Healthcare Research and Quality (AHRQ). Dr. Zhang received support from the AHRQ, and Dr. Curtis received support from AHRQ and the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.
To contact corresponding author Jeffrey R. Curtis, M.D., M.S., M.P.H., call Bob Shepard at 205-934-8934 or email Bshep@uab.edu.
[ | E-mail | Share ] ?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Public release date: 3-Jul-2012 Share ] Contact: Bob Shepard
Bshep@uab.edu
205-934-8934
JAMA and Archives Journals
CHICAGO Although some have suggested that patients receiving medication for immune-mediated diseases such as rheumatoid arthritis or psoriasis may be at increased risk of herpes zoster (HZ; shingles) shortly after receipt of the vaccine, an analysis that included nearly 20,000 vaccinated Medicare beneficiaries finds that the live zoster vaccine is not associated with an increased risk of HZ shortly after vaccination in patients currently treated with biologics, and that it is associated with a significantly reduced longer-term risk of HZ in patients with an immune-mediated disease, according to a study in the July 4 issue of JAMA.
"A live attenuated vaccine reduces HZ risk by 70 percent and 51 percent among immunocompetent individuals 50 to 59 years and 60 years and older in 2 randomized blinded trials, respectively," according to background information in the article. "The risk of HZ is elevated by 1.5 to 2 times in patients with rheumatic and immune-mediated diseases such as rheumatoid arthritis and Crohn's disease. This increase has been attributed to both the underlying disease process and treatments for these conditions." Currently, the Food and Drug Administration (FDA) and other organizations consider the live HZ vaccine to be contraindicated in patients receiving some immunosuppressive medications commonly used to treat these conditions, including all immune-modulating biologic agents and some nonbiologic immunosuppressive medications. The safety concern is that these individuals may develop varicella infection from the vaccine virus strain, the authors write.
Jie Zhang, Ph.D., of the University of Alabama at Birmingham, and colleagues, evaluated patients with immune-mediated diseases. The retrospective cohort study included 463,541 Medicare beneficiaries 60 years and older with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis (a form of chronic inflammation of the spine), or inflammatory bowel disease using Medicare claims data from January 2006 through December 2009. The researchers measured the incidence rate of herpes zoster within 42 days after vaccination (a safety concern) and beyond 42 days.
The average age of the patients at the start of follow-up was 74 years, with the median (midpoint) duration of follow-up being 2 years; 72 percent of the patients were women, and 86 percent were white. During the study, 18,683 patients (4.0 percent) received the zoster vaccine.
The researchers found that among 633 patients exposed to biologics, including 551 patients exposed to anti-tumor necrosis factor (TNF) biologics, no cases of varicella or HZ occurred within the 42 days following vaccination. Among all patients, only 1 case of primary varicella was identified within the 42-day risk window, occurring on day 10 after vaccination.
During the period of more than 42 days after vaccination, the researchers observed 138 HZ cases. After controlling for demographics, type of immune-mediated disease, health care utilization, and exposure to biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs) and oral glucocorticoids, data indicated that vaccination was associated with decreased HZ risk over a median of 2 years of follow-up.
"Despite the recognition that patients with immune-mediated conditions are at increased risk of HZ, this and previous studies have shown that only a small fraction of these patients received the vaccine, likely in part due to safety concerns. Our data call into question the current recommendations that HZ vaccine is contraindicated in patients receiving biologics and suggest a need for a randomized controlled trial to specifically address the safety and effectiveness of HZ vaccination among patients receiving biologics," the authors conclude.
###
(JAMA. 2012;308[1]:43-49. Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: This project was supported by the Agency for Healthcare Research and Quality (AHRQ). Dr. Zhang received support from the AHRQ, and Dr. Curtis received support from AHRQ and the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.
To contact corresponding author Jeffrey R. Curtis, M.D., M.S., M.P.H., call Bob Shepard at 205-934-8934 or email Bshep@uab.edu.
[ | E-mail | Share ] ?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Source: http://www.eurekalert.org/pub_releases/2012-07/jaaj-sva062812.php
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During Queen Elizabeth's Diamond Jubilee celebration in June, Kate Middleton appeared to be fully embraced as a member of the royal family ... only to receive the equivalent of a DIRECT SLAP IN THE FACE from the BITTER QUEEN herself!
Yes, Life & Style claims that one of the longest-reigning monarchs in European history is jealous of Kate Middleton. How, you ask, was Kate supposedly dissed and dismissed?
In an official revision to the Royal Household's Order of Precedence, Kate is required to curtsy to Prince Andrew and Sarah Ferguson's two daughters, Beatrice and Eugenie, as they're both considered blood princesses.
Whereas Kate merely married into the royal family, obviously.
"It's a total humiliation for Kate," a source in Kate and William's social circle says. "It's like a demotion for her, and the queen is the one who ordered this."
When William's with her, no curtsy is necessary, but if she encounters them without her husband, she has to bow down, in public or private. Degrading.
"These queen's moves are designed to remind Kate that just because she's popular, she isn't as important as any other royal-born family member," the friend says.
The horror? What's next, calling Kate Middleton a gold digger?
Source: http://www.thehollywoodgossip.com/2012/07/kate-middleton-humiliated-by-queen-elizabeth-ii/
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And why is it that writers write, but fingers don't fing, grocers don't groce, and hammers don't ham? If the plural of tooth is teeth, why isn't the plural of booth beeth? One goose, 2 geese. So, one moose, 2 meese? One index, two indices? Is cheese the plural of choose?
If teachers taught, why didn't preachers praught? If a vegetarian eats vegetables, what does a humanitarian eat?
In what language do people recite at a play, and play at a recital?
Ship by truck, and send cargo by ship? Have noses that run and feet that smell? Park on driveways and drive on parkways? How can a slim chance and a fat chance be the same, while a wise man and a wise guy are opposites? How can the weather be hot as hell one day and cold as hell another?
When a house burns up, it burns down. You fill in a form by filling it out, and an alarm clock goes off by going on.
When the stars are out, they are visible, but when the lights are out, they are invisible. And why, when I wind up my watch, I start it, but when I wind up this essay, I end it.
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Jumptap -- one of the last big, independent and privately-held mobile ad networks around reaching 263 million people worldwide -- has today announced that it has picked up another $27.5 million in funding to keep up the pace with other players while it prepares for an IPO itself. This round was led by two new backers, Keating Capital and "a large institutional investor" that Jumptap tells me it cannot name. The round also saw participation from?existing investors?General Catalyst Partners, Redpoint Ventures, Summerhill Ventures, Valhalla Partners, and WPP (the last one of these perhaps one to watch the closest). In total, Jumptap has now raised $121.5 million.Source: http://feedproxy.google.com/~r/Techcrunch/~3/EROekMBq2BY/
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Source: http://news.yahoo.com/u-rapper-am-shoots-top-uk-charts-180225046.html
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Source: http://news.yahoo.com/blogs/ticket/jim-demint-launch-super-pac-201127256.html
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