Health
Sepsis Increases Risk of Post-Discharge Cardiovascular Events, Death


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According to the CDC, each year about 1.7 million adults in the United States develop sepsis.
As one of the leading causes of hospitalization, researchers know that sepsis can prompt a major cardiovascular event including heart failure. But are adult patients who recovered from sepsis at a higher risk of developing a post-discharge cardiovascular event?
In a recent retrospective cohort analysis, researchers determined the answer is a resounding “yes”. Indeed, patients either hospitalized with sepsis or who developed it while hospitalized had a higher risk of rehospitalization for cardiovascular events (43%) compared with those hospitalized without sepsis. When compared with patients who did not have sepsis during hospitalization, those with sepsis were 27% more likely to die and 38% more likely to be rehospitalized for any cause.
“Compared with patients hospitalized without a sepsis diagnosis, patients hospitalized with sepsis had an elevated risk of all examined postdischarge adverse events,” the researchers wrote.
The researchers used a database containing administrative claims data to eventually identify more than 2 million commercial and Medicare Advantage enrollees throughout the United States from 2009-2021. Of these adult patients, the medical claims showed that more than 800,000 patients had sepsis during their hospital stay. They then compared that group with about 1.45 million hospitalized patients who did not develop sepsis but had at least one cardiovascular disease risk factor, including older age, hypertension, hyperlipidemia, type 2 diabetes, chronic kidney disease, obesity, or smoking.
Looking deeper into the data, the researchers also found that heart failure was the most common major cardiovascular event among those who had sepsis. Further, those hospitalized with sepsis had a 51% higher risk of developing heart failure during the 12-year follow-up period.
The authors noted several limitations to their study. For example, the authors were limited in their analysis due to the variability associated with the documentation of diagnosis codes to identify diseases of interest. Additionally, the authors did not have a gold-standard definition for sepsis, which could have impacted the association with the results.
Despite these limitations, the authors are confident that the current study will warrant further examination of the underlying associations between sepsis and the risk of post-discharge cardiovascular events.
“The increased risk for cardiovascular disease after sepsis hospitalization necessitates diligent follow‐up and optimization of guideline‐directed medical therapies in patients with preexisting cardiovascular disease,” the authors concluded. “It is imperative to determine the mechanisms underlying this association and whether standard medical therapies for cardiovascular prevention are efficacious for reducing the risk of cardiovascular events associated with sepsis survivorship in the absence of preexisting cardiovascular disease.”
Want more insight on this research? Check out this Q&A with lead author, Jacob C. Jentzer, MD.
Reference: Jentzer JC, Lawler PR, Van Houten HK, Yao X, Kashani KB, Dunlay SM. Cardiovascular events among survivors of sepsis hospitalization: a retrospective cohort analysis. J Am Heart Assoc. 2023;12(3):e027813. doi:10.1161/JAHA.122.027813.





Health
Restrict junk food marketing to kids at grocery stores, restaurants: report – Global News
A new report that looks at the prevalence of marketing to children inside grocery stores and restaurants suggests regulation is needed to help reduce unhealthy food temptations.
The report funded by Heart and Stroke audited displays at more than 2,000 restaurants and 800 stores across Canada and says children may be bombarded with messages that make junk food seem appealing.
Researchers found nearly 53 per cent of stores had “junk food power walls” at checkout aisles, which it says are prime areas to market to kids because products are placed within their reach.
The research says that placement encourages “pester power” — when children nag or pester their parents to make impulse purchases.
University of Waterloo associate professor Leia Minaker says designs and themes such as “magic, adventure and zoo animals” are also commonly seen in beverage and ice cream fridges.
The report says healthy checkout aisle policies and prohibiting toy giveaways with children’s meals could help reduce consumption of unhealthy food.

© 2023 The Canadian Press
Health
Health unit suspends 1,900 students for incomplete immunization records – Windsor Star


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More than 1,900 elementary school students in Windsor and Essex County have been suspended for out-of-date immunization records, the Windsor-Essex County Health Unit said Monday.
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Parents must provide the health unit with an up-to-date immunization record for the suspension to be lifted and the student to return to school. Immunization clinics are available at both health unit locations in Windsor and Leamington on Monday and throughout this week, while immunization records are accepted in-person between 8:30 a.m. and 4:30 p.m. Monday to Friday at both locations.
Students who were suspended but attend and receive vaccinations at the health unit clinics, or who update their records with the health unit, will receive a notice and can return to school the same day.
Proof of immunization can also be submitted online at immune.wechu.org. Primary care providers can also send immunization records to the health unit at 519-258-7288.
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The Immunization of School Pupils Act requires local health units to maintain and review vaccination records for all students and to enforce school suspensions if records are incomplete. These routine immunizations are often administered by primary care providers, but records must still be updated and on file with the health unit.
The review of student immunization records began in December 2022, when more than 12,000 students received notice their records were not up to date.
Earlier this month the health unit warned 3,200 students faced suspension for incomplete records; ultimately 1,908 were suspended on Monday, according to health officials.
Visit wechu.org/getimmunized for information and clinic times.
Health
COVID-19 hair loss: Experts weigh in on PRP therapy – CTV News


The list of ways a COVID-19 infection disrupts the body’s natural functions is long and diverse, and, as Viktorya Skrypnyk’s clients have come to learn, includes hair loss.
Skrypnyk is a registered nurse who owns and operates VBeauty Spa, a medical aesthetic clinic in Toronto. The last two years have sent a parade of people through the doors of her clinic struggling with hair loss they say began after a COVID-19 infection.
“Lately, I do see that there’s people that are coming in that have no history of hair loss in the family, no history of alopecia that are developing these symptoms of alopecia within last few years,” she told CTVNews.ca on Friday. “Most of them are saying that they generally noticed an increase in the year loss specifically after acquiring COVID.”
Multiple published studies have shown COVID infections can trigger a type of hair shedding called telogen effluvium (TE). With TE, thinning typically occurs around the top of the head.
When clients suffering from TE come to Skrypnyk, it’s usually for a treatment she offers known as platelet-rich plasma (PRP) therapy. Before the pandemic, Skrypnyk estimates 70 per cent of her PRP therapy clients were men. Now?
“Lately I’ve noticed, after COVID especially, it’s been more popular among women,” she said.
WHAT IS PRP THERAPY?
Platelet-rich plasma therapy is a form of regenerative medicine that uses a patient’s own blood cells – specifically platelets – to accelerate healing in a specific area of the body.
Plasma is the liquid portion of blood; the medium that carries red and white blood cells and platelets through the body. It’s made mostly of water and proteins. Platelets are blood cells that aid in blood clotting and contain a naturally-occurring substance called growth factor, which stimulates cell growth and wound healing.
In PRP therapy, a patient’s blood is collected and spun in a centrifuge to concentrate the platelet component of the blood. The patient’s own platelet-rich plasma is then injected into an area of the body that needs help with growth or healing, like an injured muscle or, in some cases, a scalp losing hair.
“We usually withdraw the platelets and re-inject them back into the hairline, specifically where there’s a lot of hair loss,” Skrypnyk said.
PRP meets the definition of a drug under Canada’s Food and Drugs Act, but isn’t covered by provincial health insurance plans. At VBeauty Spa, a treatment typically costs $600, though other clinics may charge more or less.
According to an entry by doctors Neera Nathan and Maryanne Makredes Senna in the Harvard Health Blog, most of the research on PRP for hair loss has looked at its use to treat androgenetic alopecia, also known as hormone-related baldness. Androgenetic alopecia affects both men and women, resulting in balding at the crown and front of the head in men, and balding that begins with a widening of the part in women.
“There is not enough evidence to make conclusions about the effectiveness of PRP for other types of hair loss, like telogen effluvium, alopecia areata or forms of scarring hair loss,” Nathan and Senna wrote.
YOUR MILEAGE MAY VARY
A person can elect to receive PRP therapy for any type of hair loss, but Dr. Jeff Donovan cautions it should only be considered as a second- or third-line treatment for most patients and most types of hair loss.
“PRP is very popular, but the overwhelming message that I would have is that there is no hair loss condition for which PRP is the first-line option,” Donovan told CTVNews.ca in a phone interview on Friday.
Donovan is a dermatologist and member of the Canadian Dermatology Association who specializes in hair loss. Like Skrypnyk, he sometimes treats patients using PRP therapy. However, he rarely uses it to treat the type of hair loss most commonly linked to COVID-19 infections – telogen effluvium – and he never prescribes it as a first-line treatment.
For one thing, he explained, TE normally resolves on its own after four to eight months, as long as the condition that triggered it has resolved. It often doesn’t respond to the typical hair loss treatments.
“Telogen effluvium is a hair loss condition that happens due to a trigger,” Donovan told CTVNews.ca on Friday. “The treatment for telogen effluvium involves treating the trigger, not a bandaid with some other treatment plan.”
If a patient’s TE was triggered by low iron, treatment would involve restoring their iron levels, he said. Likewise, TE triggered by a thyroid condition, or a condition like anorexia nervosa, should resolve after the underlying condition has been treated.
In rare cases, Donovan will recommend PRP therapy for a patient suffering from TE for which an underlying cause can’t be pinpointed. More often, he’ll recommend it for patients suffering from other types of hair loss, but even then, only after exhausting other treatment options.
“When we speak about treatment for hair loss, we must speak about what is the first line treatment, what is the second line treatment and what is the third line treatment,” he said. “These are treatment ladders according to evidence-based medicine.”
For a client with alopecia areata, a type of hair loss that results in circular bald patches, Donovan said the first-line treatments are topical steroid injections and topical minoxidil, which is the active ingredient in Rogaine. For genetic hair loss or androgenetic hair loss, Donovan would first recommend oral and topical minoxidil as well as topical and oral anti-androgens.
Among clients who do end up using PRP therapy, Donovan said between 20 and 40 per cent will see mild benefits, such as a slower rate of hair loss or some modest growth. In order for PRP therapy to provide long-term benefits, however, Donovan said clients typically need to return for treatments three times per year, indefinitely.
Like Skrypnyk, Donovan has noticed more people seeking out PRP therapy for TE in the past year or two. However, he cautions against shelling out for the treatment before speaking to a doctor.
“Due to the popular nature of PRP and the marketing that goes into PRP, there has been an increase in the number of patients demanding that therapy,” he said. “However, that is not necessarily reflective of the benefit of the treatment. Nor is it reflective of how these conditions should be managed based on current scientific evidence.”
Instead, Dovovan said anyone who has hair loss concerns should start by seeking a diagnosis from their usual health-care provider, who can screen for underlying triggers and suggest treatments.
“In my practice, I really prefer when patients come after having tried several therapies,” he said, “because then I get a sense of how well the hair is responding to certain types of treatments.”
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