Plainview, NY – Indoor tanning has been in the news recently with California signing a new law prohibiting teens from indoor tanning. “While tanning can help preserve your summer tan, it can also increase your risk of developing melanoma, the deadliest form of skin cancer, by as much as 75 percent,” says George Hollenberg, MD., dermatopathologist and medical director of Acupath Laboratories in Long Island, New York.

Recent studies have led the World Health Organization, National Institutes of Health and other international health experts to rank indoor tanning among the top definite, undisputable causes of cancer. “That means tanning beds are in the same category as tobacco, arsenic and mustard gas,” said Dr. Hollenberg,. “They’re deadly and at all costs need to be avoided.”

Yet according to the American Academy of Dermatology, an average of 1 million Americans each day tan at an indoor facility. Most of them are young, Caucasian women between 16 and 29 years old. Though as TV programs like “Jersey Shore” illustrate, the practice is popular with young men, too.

“Most people tan to look good-for aesthetics,” Dr. Hollenberg added. “But every time you put yourself in a tanning bed, you put yourself at risk for skin cancer-a risk that increases each time you do it. No matter what some companies purport, there are no safe tanning devices or safe number of times to tan indoors. Misinformation is a huge problem with this issue.”

Indeed, medical experts cite indoor tanning as the primary reason for the whopping 50 percent increase in melanoma cases in women under 40 over the last 20 years. If left undiagnosed and not promptly and properly treated, melanoma can spread throughout the body and be fatal. The American Cancer Society blames melanoma for more than 70,000 new cancer cases, and as many as 8,400 cancer deaths, in the U.S. each year.

Also linked to ultraviolet exposure from tanning beds-as well as from spending prolonged, unprotected periods in the sun-are basal and squamous cell cancer carcinomas, which annually affect more than 1 million Americans and lead to 2,000 cancer deaths. Skin cancer (melanoma, basal cell and squamous cell together) is the No. 1 cause of cancer in the United States, affecting more people than breast, lung, prostate, colon, uterine, ovarian and pancreatic cancer combined.

Because of the definitive connection between indoor tanning and skin cancer, 32 states now require tanning salons to receive in-person parental consent before a minor can tan. In New York, youths under 14 are prohibited from tanning at all.

Dr. Hollenberg is one of many medical experts-including members of a federal skin cancer advisory panel-lobbying the U.S. Food and Drug Administration to ban anyone under age 18 from using tanning beds. However, like the American Cancer Society, his preference is that people avoid tanning beds altogether.

“There are many cancer risk factors we can’t control, such as age and family history. But especially with skin cancer, there are many things we can control,” Dr. Hollenberg said, “including staying away from tanning beds.”

Also, to protect skin from the sun’s ultraviolet rays, which even during fall and winter can burn and cause damage, Dr. Hollenberg recommends:

• Not leaving the house without applying a sunscreen with an SPF of 30 or higher to exposed areas
• Protecting the face and head with a wide-brimmed hat
• Wearing light-colored clothes to help deflect the sun’s rays
• Limiting the time spent in direct sun, especially between 10 a.m. to 2 p.m., when its rays are strongest

People should also know the “ABCDEs” of melanoma and skin cancer, so they can point out new or unusual skin spots to their doctor.  Melanoma is most often seen on the back, chest, legs, face and ears, forming on its own or growing out of an existing mole. Its ABCDE characteristics include:

A-Asymmetry. Half of the mole or mark does not match the other.
B-Border irregularity. Edges are ragged, notched or blurred.
C-Colors are different within the same mole. Shades of brown or black may be seen,
sometimes with patches of red, white or blue.
D-Diameter greater than 6 millimeters, roughly the size of a pencil eraser.
E-Enlargement. It’s grown or changed over time.

–  The anti-clotting drug rivaroxaban reduced the risk of death, heart attack and stroke in patients hospitalized for heart attack or chest pain.
–  However, as with other anti-clotting drugs, patients taking rivaroxaban were more likely to experience major bleeding than patients not taking the medication.

ORLANDO, — Added to standard medical treatment, the anti-clotting drug rivaroxaban lowered risk of death, heart attack and stroke in acute coronary syndrome patients, according to late-breaking research presented at the American Heart Association’s Scientific Sessions 2011.

The study is simultaneously published in the New England Journal of Medicine.

Acute coronary syndrome is an umbrella term for heart attacks and chest pain known as unstable angina — conditions in which the heart’s blood supply is suddenly reduced.

“Despite our best efforts at treatment following a recent heart attack or unstable angina, patients still face a 10 percent or higher risk of a repeat heart attack, stroke or death one year later,” said C. Michael Gibson, M.D., senior investigator of the TIMI Study Group, Harvard Medical School, and the Principal Investigator in the ATLAS ACS studies of rivaroxaban for this indication.

“We know that people with a heart attack or unstable angina make too much thrombin, an enzyme that forms clots. We looked at whether reducing the production of thrombin with rivaroxaban reduces the risk of death, stroke or heart attack.”

Researchers analyzed more than 15,000 people hospitalized with a recent heart attack or unstable angina in the Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome-Thrombolysis in Myocardial Infarction 51 Trial (ATLAS ACS 2-TIMI 51). Study participants were randomized to receive either standard care along with rivaroxaban or standard care with placebo.

Researchers followed these patients for an average of more than a year and found:

–  Those who took rivaroxaban had a 16 percent reduced risk of cardiovascular death, stroke or heart attack compared to patients who didn’t.
–  The risk of death, including all causes of death, was reduced more than 30 percent with the addition of rivaroxaban.
–  Stent thrombosis was reduced by 31 percent in patients taking rivaroxaban compared to patients who didn’t.
–  As with other types of anticoagulants, more internal bleeding occurred among those who took rivaroxaban than those who took placebo and the increase in TIMI major bleeding was significant. However, there was no increase in fatal bleeding.

Rivaroxaban and other new oral anticoagulants have demonstrated the ability to reduce strokes in patients with atrial fibrillation, but their use in patients with acute coronary syndrome has had mixed results. Because these patients are often on other anti-clotting medications, the bleeding risk has been very high.

“Our findings are important because blocking the production of thrombin is an important new way to improve acute coronary syndrome patients’ long-term risk of death, stroke and heart attack after being hospitalized with an acute coronary syndrome,” Gibson said.

Co-authors are Eugene Braunwald, M.D., and Jessica Mega, M.P.H., M.D.

In this study, researchers compared middle-aged and older women who drank two or more sugar-sweetened beverages a day, such as carbonated sodas or flavored waters with added sugar, to women who drank one or less daily. Women consuming two or more beverages per day were nearly four times as likely to develop high triglycerides, and were significantly more likely to increase their waist sizes and to develop impaired fasting glucose levels. The same associations were not observed in men.

“Women who drank more than two sugar-sweetened drinks a day had increasing waist sizes, but weren’t necessarily gaining weight,” said Christina Shay, Ph.D., lead author of the study and assistant professor at the University of Oklahoma Health Sciences Center in Oklahoma City. “These women also developed high triglycerides and women with normal blood glucose levels more frequently went from having a low risk to a high risk of developing diabetes over time.”

The Multi-Ethnic Study of Atherosclerosis (MESA) included food frequency surveys in 4,166 African-American, Caucasian, Chinese-Americans and Hispanic adults 45 to 84 years old. At the beginning of the study the participants didn’t have cardiovascular disease.

Researchers assessed risk factors in three follow-up exams spanning five years starting in 2002. Participants were monitored for weight gain, increases in waist circumference, low levels of high density lipoproteins (HDL “good” cholesterol), high levels of low density lipoproteins (LDL “bad” cholesterol), high triglycerides, impaired fasting glucose levels, and type 2 diabetes.

“Most people assume that individuals who consume a lot of sugar-sweetened drinks have an increase in obesity, which in turn, increases their risk for heart disease and diabetes,” said Shay,
formerly of Northwestern University’s Department of Preventive Medicine in Chicago, where the study was conducted. “Although this does occur, this study showed that risk factors for heart disease and stroke developed even when the women didn’t gain weight.”

Women may have a greater chance for developing cardiovascular disease
risk factors from sugar-sweetened drinks because they require fewer
calories than men which makes each calorie count more towards
cardiovascular risk in women, Shay said.

Researchers have yet to determine exactly how sugar-sweetened beverages influence cardiovascular risk factors such as high triglycerides in individuals who do not gain weight, Shay said, but further work is planned to try and figure that out.

Co-authors include Jennifer A. Nettleton, Ph.D.; Pamela L. Lutsey, Ph.D., M.P.H.; Tamar S. Polonsky, M.D.; Mercedes R. Carnethon, Ph.D.; Cheeling Chan, M.S.; Linda Van Horn, Ph.D., R.D.; and Gregory Burke, M.D.

Westport, CT – Costs continue to rise for those requiring long-term care in the U.S.  According to the newly released 2011 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs, conducted by the MetLife Mature Market Institute, national average rates for a private nursing home room increased 4.4% to $239 daily or $87,235 annually, in 2011. Assisted living base rates rose by 5.6% to $3,477 monthly or $41,724 annually. Adult day services went up by 4.5% to $70 per day. Home health aides and homemaker/companion service rates were unchanged at $21 and $19 per hour, respectively.

The highest average daily rates for nursing homes continue to be in Alaska, where rates decreased slightly to $655 for a private room compared to $687 in 2010. Costs were lowest in Louisiana, outside the Baton Rouge and Shreveport Metropolitan Statistical Areas (MSA), at an average of $141 per day for a private room.

For assisted living, the Washington, D.C. area had the highest average monthly base rate at $5,757, a 10% increase from last year. Arkansas, outside of the Little Rock MSA, had the lowest average monthly rate of $2,156, also an increase.

“This year’s increases are greater than previous years. The state of the economy, combined with rising health care and energy costs, are having a significant impact on long-term care rates. In fact, long-term care rates continue to outpace the medical inflation rate,” said Sandra Timmermann, Ed.D., director of the MetLife Mature Market Institute. “The result is dramatic protracted inflation that will impact consumers. As the cost of care continues to rise, Americans need to discuss long-term care planning with their families now, to ensure they receive the kind of care they want in the future. This is especially critical at a time when retirement savings rates are low.”

The MetLife Market Survey and accompanying report provide a good deal of additional information regarding various types of long-term care available in the U.S. and a detailed breakdown of costs by region.

Nursing Homes:

• According to the U.S. Census Bureau, in 2010, 66% of nursing home residents were women. The median age of residents was 82.7 years.
• Fifteen percent of nursing homes surveyed have an associated assisted living unit or wing; 11% are part of a continuing care retirement community (CCRC).
• A small percentage (10%) of nursing homes surveyed provide adult day services.
• The majority (87%) of nursing homes surveyed provide Alzheimer’s or dementia care; of those, 80% charge the same rate for care.

Assisted Living:

• Current estimates from the American Seniors Housing Association indicate that the average age of an assisted living resident is 86.9 years old, and the median length of stay in assisted living is 25.6 months.
• Oversight of assisted living communities rests primarily with state governments rather than federal regulation. In 2007, several states strengthened existing standards or implemented new standards for communities with residents with Alzheimer’s disease or other forms of dementia.
• Almost three-quarters (72%) of assisted living communities surveyed provide Alzheimer’s and dementia care, 50% of which charge an additional fee for the service.

Home Health Care:

• The majority (79%) of the home health care agencies surveyed provide Alzheimer’s training to their employees, and almost all (99%) agencies surveyed do not charge an additional fee for patients with Alzheimer’s.
• While most home care agencies surveyed provide an hourly rate, 81% of the agencies require a minimum number of hours per day ranging from 30 minutes to eight hours with three hours being the average. Small percentages (3%) provide a daily rate. About 32% of those surveyed have a 24-hour or live-in rate. The average daily live-in rate for a home health aide is $258 and $255 for a homemaker/companion.

Adult Day Services Centers:

• More than three-quarters of adult day services centers surveyed are open Monday through Friday; 6% are also open Saturdays and 13% are open seven days per week. For those open 24 hours, 67% provide full adult day services for all 24 hours. Seven in ten centers provide transportation services to and from the center. Of these, 47% do not charge a fee for these services. Of those that charge for transportation, the average one-way fee is about $8.
• Almost all (98%) of the centers surveyed provide services for those with Alzheimer’s disease, with 2% of these charging an additional fee.

Contact Us on the MetLife Mature Market Institute Web site, by writing to: MetLife Mature Market Institute, 57 Greens Farms Road, Westport, CT 06880 or by e-mailing MatureMarketInstitute@metlife.com.

Methodology

The MetLife survey of 2,003 nursing homes, 1,492 assisted living communities, 1,644 home care agencies and 1,341 adult day services, in all 50 states and the District of Columbia, was conducted by telephone between April and August 2011, by LifePlans, Inc., for the MetLife Mature Market Institute.

The states were divided into three groups, according to the population-under three million, three to 10 million and over 10 million. These groupings were determined using data from the 2000 U.S. Census and updates. The cities/areas surveyed were chosen on the basis of population and the ability to obtain a representative sampling of facilities and providers. For the “rest of state” areas, a sample of service providers or facilities were randomly selected from all providers or facilities identified in the state not already identified in the Metropolitan Statistical Area (MSA) sample. Costs for this survey were calculated for each service provider in an area and were aggregated across all providers to compute a statewide average cost. All costs are rounded to the nearest whole dollar amount.

Carrie Scheiner is not ashamed of being a bit of a math nerd.

But don’t let her degree in Math education from Rutgers University fool you – she is also a big fan of physical fitness, and her passion for both has led to her to think of exercise for kids in a completely new way.

“As adults, we don’t think about it, but much of our exercise regimens revolve around counting,” said Scheiner, creator of Exploracise, an exercise DVD for kids and parents www.exploracise.com. “So I began thinking about how much more fun, and healthy, math could be for kids if we combined it with exercise. That was the genesis of my combination of the two disciplines.”

Scheiner believes her approach actually addresses two of the most pressing problems in the United States today.

“Research shows that exercise improves learning and multi-sensory learning techniques improve the recognition and recall of information,” Scheiner added. “One-third of U.S. children are overweight or obese and 61 percent of fourth graders are not proficient in math. That being said, it just makes sense that we start approaching these problems head-on, and we can create an economy of scale in time and resources by doing it at the same time.”

Scheiner believes that parents should encourage kids to get off the couch and exercise, too, which is why she has also devised a list of tips for parents who want to see their kids exercise as they learn. They include:

• Count Along – It’s not just about counting to ten when you touch your toes. There is so much more you can do when your kids are having fun. It can be as simple as having them do the same thing you do – sets of 10 repetitions of any exercise – and then have them add up all those 10s when they are done. It will help them get comfortable tabulating simple equations in their heads.
• Shapes Can Be Healthy – When I was a kid in gym class, they made us do arm circles, but there are so many other shapes that can be explored. Triangles, rectangles and even more complex geometric shapes can be combined with exercise in a variety of ways. Be creative and don’t be content with your kids using their arms like windmills. Make it fun for them and it will help to create healthy exercise habits that will last a lifetime.
• Scavenger Hunts – Hide and Seek is a time-honored game, and with a little twist, you can use it to make math and healthy eating fun. Hide some healthy foods around the house, and set your kids to the task of finding them, but write down the calories and fat for each healthy food. When they find them, have them match up the foods with the numbers.

“It’s all about getting kids to put down the video game controllers and to get off the couch,” she said. “We owe it to our kids to start them off in life with healthy habits that we never learned as kids. As adults, we had to teach ourselves to work out and eat healthy. It wasn’t something that most of us learned when we were young. With this approach, you can help your kids develop intellectually and physically, as well as help them establish healthy habits that they will carry with them for the rest of their lives.”

About Carrie Scheiner

Carrie Scheiner has a lifelong love of helping others, and is passionate about helping children learn math and healthy lifestyle concepts. She won the award for best student teacher for secondary math while receiving her Bachelors of Arts in Math and Secondary Education at New Jersey’s Rutgers University, where she also earned a Masters of Science in Statistics. She has combined her love of math and her passion for healthy eating and exercise to help the next generation overcome its current educational and health crises. www.exploracise.com

“NCPA believes that the U.S. pharmaceutical supply chain is safe and secure,” said NCPA Executive Vice President and CEO B. Douglas Hoey, RPh, MBA. “However, there are a number of different tactics or approaches that could provide further assurances of integrity including efforts to combat pharmaceutical cargo theft and the implementation of national, uniform federal license standards for drug wholesalers.”

Hoey added, “Another approach that has been discussed is the implementation of a track and trace system for prescription drugs. Although NCPA continues to feel that track and trace technologies remain largely unproven and such a system may prove to be prohibitively expensive for independent community pharmacies, we have identified a number of essential elements that should be considered as any proposed track and trace system is developed.”

NCPA’s comments had the following recommendations for the federal government:

• Any track and trace system should have a risk-based approach to determine the scope of which products will be targeted at the outset of the program, such as controlled substances and frequently counterfeited products;
• Federal grants designed to incentivize adapting of any track and trace program should include smaller participants in the supply chain such as independent community pharmacies that otherwise would be unduly financially burdened;
• There should be interoperability between the various systems for any track and trace program to pave the way for easier communications between various manufacturers and distributors
• An authentication consensus should emerge about the definition and timing of when products will be verified, along with what will happen should the verification standard not be meet at any step in the process; and
• Independent community pharmacists should be allowed to use inference—a process that would allow them to scan or verify prescription drugs in larger batches instead of bottle by bottle
• Pilot projects should be pursued to ensure the best track and trace system is implemented after initial round of test cases are explored.

Study Highlights:

• Depression is associated with a moderately increased risk of stroke.
• Depressed women taking anti-depressant drugs — particularly selective serotonin reuptake inhibitors — had an increased stroke risk, which
• Researchers said may not be a cause but rather an indicator of depression severity.
• Researchers said patients should continue taking their anti-depressantmedication.

DALLAS, TX — Depressed women may face an increased risk of stroke, according to new research reported in Stroke: Journal of the American Heart Association.

In six years of follow-up of women in the Nurses’ Health Study, researchers found that a history of depression was associated with a 29 percent increased risk of total stroke — even after considering other stroke risk factors. Women who used anti-depressant medication — particularly selective serotonin reuptake inhibitors — had a 39 percent increased risk of stroke. Examples of these drugs are Prozac, Zoloft, and Celexa.

Anti-depressant medication use may be an indicator of depression severity, said Kathryn Rexrode, M.D., the study’s senior author and Associate Physician at Brigham and Women’s Hospital in Boston, Mass. “I don’t think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke.”

Researchers followed 80,574 women 54 to 79 years old in the Nurses’
Health Study from 2000-06 without a prior history of stroke. They assessed depressive symptoms multiple times with a Mental Health Index. Anti-depressant use was reported every two years beginning in 1996, and physicians diagnosed depression beginning in 2000. Depression was defined as currently reporting or having a history of depression.

The reported prevalence of depression at baseline in the women was 22 percent, and 1,033 stroke cases were documented during six years of follow-up.

Compared to women without a history of depression, depressed women were more likely to be single, smokers and less physically active. They were also slightly younger, had a higher body mass index and more coexisting conditions such as high blood pressure, heart disease and diabetes.

“Depression can prevent individuals from controlling other medical problems such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise,” said Rexrode, who is also Assistant Professor of Medicine at Harvard Medical School. “All these factors could contribute to increased risk.”

Depression may be associated with an increased risk of stroke through a variety of mechanisms. It may be linked to inflammation, which increases the risk of stroke as well as other conditions or underlying vascular disease in the brain, said An Pan, Ph.D., lead author of the study and a research scientist at the Harvard School of Public Health. “Regardless of the mechanism, recognizing that depressed individuals may be at a higher risk of stroke may help the physician focus on not only treating the depression, but treating stroke risk factors such as hypertension, diabetes and elevated cholesterol as well as addressing lifestyle behaviors such as smoking and exercise.”

Among limitations of the study, the participants were predominantly white registered nurses, it excluded women without detailed information on depression measures and the participants with onset of stroke at a young age.

“We cannot infer cause or fully exclude the possibility that the results could be explained by other unmeasured unknown factors,” Pan said. “Although the underlying mechanisms remain unclear, recognizing that depressed women may be at a higher risk of stroke merits additional research into preventive strategies in this group.”

Other co-authors are Olivia I. Okereke, M.D.; Qi Sun, M.D., Sc.D.;
Giancarlo Logroscino, M.D., Ph.D.; JoAnn E. Manson, M.D.; Walter
C.Willett, M.D.; Alberto Ascherio, M.D.; and Frank B. Hu, M.D., Ph.D.
Author disclosures are on the manuscript.

The National Institutes of Health/National Heart, Blood, Lung Institute funded the study.

Statements and conclusions of study authors published in American Heart
Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at :  www.americanheart.org/corporatefunding.

“We dodged a bullet in March when the U.S. poison control system narrowly escaped losing almost all of its federal funding, but we are already under threat for the 2012 federal budget,” said Richard Dart, MD, PhD, FACEP, president of the American Association of Poison Control Centers.  “Poison control centers save $7 for every dollar spent in state and federal funding.  In states where poison control funding has been eliminated, visits to ERs have skyrocketed.”

Poison control centers are funded by a mix of federal and state money.  Cuts to state funding for poison control centers have already resulted in average budget cuts of 40 percent, leaving many of them understaffed.

Without access to toxicology experts at poison control centers, people usually go to the emergency department for help.  One poison control expert quoted in the article estimates that 80 percent of children who have a potential poisoning are kept out of the emergency department by poison control centers.

Poison control centers also provide phone help in public health crises, such as the H1N1 influenza epidemic that hit New York City in 2009.

“The breadth of expertise and service that poison control centers provide is well-known in the house of medicine, but cost-conscious policymakers don’t seem to get it,” said Dr. Dart.  “Poisoning is the second most common cause of injury death in the United States. Spending a relatively small amount of money to prevent some of those deaths just seems like the right thing to do.”

Lisa Hsieh, APRN; Susan Anderson, M.Ed., CAGS, LMFT; Steven Mullaney, MD; Sarah Litsch, DO; Gabor Pernyeszi, MD, MPH.

The Center for Life Management (CLM) is now providing behavioral health services as part of the integrated treatment team at Core Physicians’ Plaistow Health and Core Pediatrics of Plaistow in Plaistow, New Hampshire. According to Steve Arnault, CLM Vice President of Quality, Compliance and Integrated Care, “CLM and Core Physicians share the philosophy that treating the whole person through an integrated approach in the primary care setting provides the best outcomes for medical as well as behavioral health conditions. We are very pleased to join Core Physicians in helping patients address the behavioral and lifestyle issues that go hand-in-hand with their medical and physical well-being.”

According to Gabor Pernyeszi, MD, Core Physicians’ Plaistow Health, “having CLM located in our office provides a much needed community service and allows for improved communication between medical professionals to optimize medical care for each individual patient. CLM is another pillar in our foundation of comprehensive services that include family practice, pediatrics, specialty services, on-site laboratory and X-ray imaging.”

CLM clinician Susan Anderson, LMFT, will be on-site at Core Physicians. An experienced therapist, Susan will be available to provide comprehensive behavioral health counseling for children, adults and families. CLM services at Core will focus on helping patients manage behavioral health concerns such as stress and anxiety, depression, smoking cessation, weight management, alcohol and substance use and other lifestyle issues that have a correlating impact on many medical conditions.

Brenna Anderson, MD, MSc

A pair of research papers published in the recent issue of the American Journal of Obstetrics and Gynecology show that women who contracted H1N1 were more likely to give birth to lower birth weight babies as compared with women who had “influenza-like illness.” The papers were compiled through the work of a team of researchers, including Brenna Anderson, MD, MSc, and Dwight Rouse, MD, of the Division of Maternal-Fetal Medicine at Women & Infants Hospital of Rhode Island.

“The 2009 H1N1 influenza virus contained a unique combination of gene segments that had never been reported in human influenza cases in the United States. The first reports were that pregnancy would be a significant risk factor for mortality from H1N1,” explains Dr. Anderson, who is director of the Reproductive Infectious Diseases Consultative Service at Women & Infants and assistant professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University.

“We wanted to determine the clinical characteristics of pregnant women with influenza-like illness with those who did not have the infection. We also wanted to track how the virus affected pregnancy by studying the outcomes.”

The latter study – “Neonatal characteristics and outcomes of pregnancies complicated by influenza infection during the 2009 pandemic” – uncovered that women who had H1N1 during pregnancy were more likely to have a lower birth weight baby.

“The average gestational age at delivery was less than 39 weeks and the babies born to women with H1N1 weighed an average of 285 grams less than other babies,” Dr. Anderson notes. “Three of these babies were admitted to the neonatal intensive care unit after birth.”

The goal of the second study – entitled “Clinical characteristics of pregnant women with influenza-like illness during the 2009 H1N1 pandemic and use of a standardized management algorithm” – was to create a method for tracking of pregnancy and birth during flu season in the future. It would logically separate women with actual H1N1 and those with influenza-like illness, and track the results of their pregnancies.

“We wanted to describe the clinical characteristics of pregnant women with influenza-like illness,” Dr. Rouse says. “We then compared their clinical symptoms with those of women with confirmed H1N1.

“We knew that H1N1 mortality rates increase during pregnancy, and, during this study, we were able to determine that the time that elapses from when a pregnant woman presents to a health care provider with clinical symptoms to when she is given antiviral therapy is an important determinant of the outcome,” he adds.