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    <recommendedItem id="20100101_19_343"
                     title="U.S. Marshals Seize Unapproved Ozone Generators"
                     score="0.009"
                     href="http://www.medpagetoday.com/PublicHealthPolicy/EnvironmentalHealth/tb/18228?impressionId=1265780904029"
                     
      &lt;p&gt;WASHINGTON  --  U.S. Marshals have seized 77 unapproved ozone generators, valued at almost $76,000 from a California device manufacturer, the FDA announced.&lt;/p&gt;
&lt;p&gt;The devices were advertised as treatments for various conditions, including cancer, AIDS, hepatitis, herpes, and other diseases, but lacked approval or efficacy data to support the claims made on their behalf, an FDA release said.&lt;/p&gt;
&lt;p&gt;The raid came after the company, Applied Ozone Systems (AOS) of Auburn, Calif., failed to respond to a voluntary recall request last December, the agency said.&lt;/p&gt;
&lt;p&gt;The FDA raised concerns that patients using AOS-IM and AOS-IMD devices will consider it an appropriate treatment for an affliction and delay or stop FDA-approved and proven medical treatments. Patients using the devices may risk infection from contamination of the applicator or catheter, the release said.&lt;/p&gt;
&lt;p&gt;The FDA recommended that healthcare professionals and consumers cease use of the devices.&lt;/p&gt;
&lt;p&gt;The agency said it obtained an inspection warrant for the company&apos;s manufacturing facilities after the owner refused to admit FDA inspectors. It said the inspection revealed several breaches of the FDA&apos;s good manufacturing practice requirements for medical devices, which had never been approved in the first place.&lt;/p&gt;
&lt;p&gt;Ozone is an unstable allotrope of oxygen with three atoms, instead of the normal two. Ozone generators produce ozone from oxygen and have consumer and industrial applications, but ozone itself is harmful to the respiratory system, even at relatively low concentrations.&lt;/p&gt;
&lt;p&gt;Instructions with the Applied Ozone Systems devices suggest blowing ozoned air into the rectal and vaginal areas.&lt;/p&gt;
&lt;p&gt;Friday&apos;s seizure was part of a joint effort of the FDA and the California Department of Public Health to remove or prevent unapproved or unsafe medical devices from entering the market.&lt;/p&gt;
&lt;p&gt;A statement on the company&apos;s Web site said the two ozone generator models, which sold for $750 and $1,200 respectively, were no longer available by order of the FDA and California authorities.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_299"
                     title="Teen Pregnancies, Births, and Abortions Increase"
                     score="0.004"
                     href="http://www.medpagetoday.com/OBGYN/Pregnancy/tb/18162?impressionId=1265780904029"
                     
      &lt;p&gt;After a decade of decline, the rate of teenage pregnancies increased by 3% in 2006 as 750,000 women younger than 20 became pregnant, according to a report released by the Guttmacher Institute.&lt;/p&gt;
&lt;p&gt;And as pregnancies increased, so did births  --  41.9 births per 1,000 U.S. teenage girls, which was 4% higher than in 2005  --  and abortions, which increased by 1% from 2005 to 2006.&lt;/p&gt;
&lt;p&gt;In a prepared statement, Planned Parenthood blamed abstinence-only sex education programs for the uptick.&lt;/p&gt;
&lt;p&gt;&quot;It is a tragedy that after a decade of progress in reducing the rate of teenage pregnancy we are witnessing a substantial increase in the number of teens who are getting pregnant,&quot; Planned Parenthood said.&lt;/p&gt;
&lt;p&gt;In a statement released last May in conjunction with the &quot;National Day to Prevent Teen Pregnancy&quot; the American College of Obstetricians and Gynecologists (ACOG), agreed that comprehensive sex education was likely to be more effective than abstinence-only programs.&lt;/p&gt;
&lt;p&gt;&quot;Abstinence works for some teens, but the idea that most teens will wait to have sex indefinitely is rigid and impractical,&quot; said Richard S. Guido, MD, chair of the ACOG&apos;s Committee on Adolescent Health Care.&lt;/p&gt;
&lt;p&gt;But the Guttmacher report suggested that the reasons for increase may be more complex, including &quot;shifts in the racial and ethnic composition of the population, increases in poverty, the growth of abstinence-only sex education programs at the expense of comprehensive programs, and changes in public perception and attitudes toward both teenage and unintended pregnancy.&quot;&lt;/p&gt;
&lt;p&gt;Among black teenagers the pregnancy rate was 126.3 per 1,000 versus 44 per 1,000 non-Hispanic white teenagers.&lt;/p&gt;
&lt;p&gt;A breakdown by state revealed that New Mexico had the highest teenage pregnancy rate, followed by Nevada, Arizona, Texas, and Mississippi.&lt;/p&gt;
&lt;p&gt;Conversely, the lowest teenage pregnancy rate was in New Hampshire  --  33 pregnancies per 1,000  --  followed by Vermont, Maine, Minnesota, and North Dakota.&lt;/p&gt;
&lt;p&gt;Texas had the highest rate of births to teenage mothers  --  62 per 1,000  --  and New York had the highest rate of abortions among teenagers, 41 per 1,000.&lt;/p&gt;
&lt;p&gt;The report was based on data from the National Center for Health Statistics of the U.S. Department of Health and Human Services (number of births), the Guttmacher Institute (total number of abortions), the U.S. Centers for Disease Control and Prevention (age and race/ethnicity distribution of women obtaining abortions), and the Population Estimates Program of the U.S. Bureau of the Census in collaboration with NCHS (population estimates).&lt;/p&gt;
&lt;p&gt;Among other findings in the report: &lt;ul&gt; &lt;li&gt;The pregnancy rate was 71.5 pregnancies per 1,000 girls ages 15-19 and pregnancies occurred among 7% of females in this age group.&lt;/li&gt; &lt;li&gt;Although teenage abortions increased by 1% from 2005 to 2006, the overall teenage abortion rate declined by about a third over the two decades from 1986 to 2006.&lt;/li&gt; &lt;li&gt;The increase in teen pregnancies and births to teenage mothers was observed across all racial and ethnic groups.&lt;/li&gt; &lt;/ul&gt;&lt;/p&gt;
&lt;p&gt;The authors said that additional research was needed to determine if the disparities in rates by both race and region carry over to adult women.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The report was prepared by Kathryn Kost, Stanley Henshaw, and Liz Carlin of the Guttmacher Institute.&lt;/p&gt;&lt;p&gt;Lawrence Finer, Rebecca Wind, Susheela Singh, and Laura Lindberg provided comments on early drafts.&lt;/p&gt;&lt;p&gt;The report was funded by grants from the Brush Foundation, The California Wellness Foundation (TCWF) and the Annie E. Casey Foundation. The Guttmacher Institute also gratefully acknowledges the general support it receives from individuals and foundations, including major grants from The William and Flora Hewlett Foundation, The David and Lucile Packard Foundation, and the Ford Foundation, which undergirds all of the Institute&apos;s work.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20090101_19_2384"
                     title="Pregnancy Increases Risk of Severe H1N1 Disease"
                     score="-0.005"
                     href="http://www.medpagetoday.com/InfectiousDisease/SwineFlu/tb/15284?impressionId=1265780904029"
                     
      TORONTO, July 29 -- Pregnant women are at greater risk for severe disease and complications from H1N1 pandemic flu than the general public, researchers said. 
              &lt;br&gt;&lt;br&gt;They should be treated promptly with antiviral drugs if the pandemic flu strain is suspected, according to Denise Jamieson, MD, of the CDC, and colleagues. 
              &lt;br&gt;&lt;br&gt;The recommendation is based on an analysis of cases and deaths of pregnant women from the pandemic strain in the early weeks of the U.S. outbreak, Dr. Jamieson and colleagues reported online in &lt;em&gt;The Lancet&lt;/em&gt;. 
              &lt;br&gt;&lt;br&gt;The findings underscore the CDC recommendation that pregnant women with the flu should get swift antiviral treatment and may also have implications for the use of a vaccine against the pandemic. 
              &lt;p&gt;
              &lt;p&gt;&quot;If a pregnant woman feels like she may have influenza, she needs to call her healthcare provider right away,&quot; Dr. Jamieson said in a statement. 
              &lt;p&gt;
              &lt;p&gt;In addition, she said, doctors treating pregnant women need a triage system to screen for influenza-like symptoms &quot;and they should not delay in initiating appropriate antiviral therapy.&quot; 
              &lt;p&gt;
              &lt;p&gt;Dr. Jamieson said some doctors hesitate to use antiviral drugs in pregnant women &quot;because of concerns for the developing fetus, but this is the wrong approach. It is critical that pregnant women, in particular, be treated promptly.&quot; 
              &lt;p&gt;
              &lt;p&gt;During the first month of the outbreak -- from April 15 to May 18 -- 34 confirmed or probable cases of pandemic H1N1 in pregnant women were reported to the CDC from 13 states, the researchers found. 
              &lt;p&gt;
              &lt;p&gt;Confirmed cases were those with laboratory evidence of H1N1; probable cases were those in which the victim had an acute febrile respiratory illness and was positive for influenza A, but negative for H1 and H3, Dr. Jamieson and colleagues said. 
              &lt;p&gt;
              &lt;p&gt;Of the 34 cases, 11 -- or 32% -- required inpatient care, for an estimated hospital admission rate of 0.32 per 100,000 pregnant women, compared with 0.076 per 100,000 in the general population at risk, they said. 
              &lt;p&gt;
              &lt;p&gt;By June 16, six H1N1-related deaths in pregnant women had been reported to the CDC, all in women who had developed pneumonia and subsequent acute respiratory distress syndrome requiring mechanical ventilation.
              &lt;p&gt; 
              &lt;p&gt;That was 13% of the 45 deaths reported during that period, the researchers said. 
              &lt;p&gt;
              &lt;p&gt;Of the six who died, one was in the first trimester, one in the second trimester, and four were in the third trimester and all were &quot;fairly healthy&quot; before their illness, the researchers said. 
              &lt;p&gt;
              &lt;p&gt;All the women were treated with oseltamivir (Tamiflu) and the time from symptom onset to treatment ranged from six to 15 days, they said. 
              &lt;p&gt;
              &lt;p&gt;The five patients with viable pregnancies had cesarean sections and none of the infants were born with flu. Four have been discharged home in good health, while the fifth -- born at 27 weeks gestation -- remains in the hospital and is doing well, Dr. Jamieson and colleagues said. 
              &lt;p&gt;
              &lt;p&gt;Meanwhile, the issue seems likely to kindle debate over who should get the H1N1 vaccine when it becomes available. 
              &lt;p&gt;
              &lt;p&gt;&quot;There are two broad goals in using a vaccine,&quot; said Marc Lipsitch, DPhil, of Harvard University, &quot;to protect people who are likely to get severely ill if they are infected, and to slow down transmission by vaccinating the people who are most likely to get infected and pass the virus on.&quot; 
              &lt;p&gt;
              &lt;p&gt;But the second goal is going to be difficult to reach since current estimates show the vaccine arriving on the scene well after the second wave of the pandemic starts this fall, he said. 
              &lt;p&gt;
              &lt;p&gt;&quot;Therefore,&quot; Dr. Lipsitch said, &quot;it is very wise to plan to use vaccines mainly to protect those most vulnerable.&quot; 
              &lt;p&gt;
              &lt;p&gt;But he cautioned that it will be vital to monitor vaccine safety, since pregnant women -- and some other potentially high-risk groups -- are also at higher risk for other adverse events. 
              &lt;p&gt;
              &lt;p&gt;&quot;This means that even with a perfectly safe vaccine, there will be (by chance) people who receive the vaccine and then very shortly after experience adverse health events,&quot; he said. 
              &lt;p&gt;
              &lt;p&gt;To avoid a possible backlash, Dr. Lipsitch said, &quot;it is critical for the public and the health community to understand in advance that adverse events in vaccinated people are expected to happen, and their occurrence is not in itself an indication that the vaccine is unsafe.&quot; 
              &lt;p&gt;
              &lt;p&gt;Carlos del Rio, MD, of Emory University in Atlanta, concurred that safety is an important issue. &quot;The vaccine (as far as I can tell) has not yet been tested for safety in pregnancy,&quot; he said. 
              &lt;p&gt;
              &lt;p&gt;Dr. del Rio said it&apos;s not surprising that pregnancy appears to be a risk factor for severe H1N1 disease. &quot;Pregnancy is also a risk factor for other infectious diseases to be more severe,&quot; he said. &quot;Thus, it makes sense that (pregnant women) should be immunized.&quot; 
              &lt;p&gt;
              &lt;p&gt;On the other hand, he said, obesity also appears to be a risk factor for more severe disease, so the obese might also be considered as a priority group. 
              &lt;p&gt;
              &lt;p&gt;The principle that should guide vaccine use is that &quot;limited vaccine needs to go where it will do most good and prevent the most serious cases or deaths,&quot; according to Howard Markel, MD, PhD, of the University of Michigan in Ann Arbor. 
              &lt;p&gt;
              &lt;p&gt;Pregnant women, the obese, and those with asthma and diabetes appear to be such groups, he said, &quot;but we also need to think of first responders,&quot; including doctors, nurses, police, and fire personnel. 
              &lt;p&gt;
              &lt;p&gt;&quot;Even the people who keep our power lines, coal, water, electricity, and energy lines going -- we don&apos;t want any of these people out in time of a national crisis,&quot; Dr. Markel said. 
              &lt;p&gt;
              &lt;p&gt;The CDC&apos;s former director, Julie Gerberding, MD, said vaccinating pregnant women would have a double benefit. It &quot;protects mom and also likely protects newborns until they are old enough to be vaccinated or take antivirals, she said. 
              &lt;p&gt;
              &lt;p&gt;The authors noted several limitations of the study including the fact that &quot;ascertainment of women infected with pandemic H1N1 influenza virus was dependent on surveillance and laboratory testing methods used by state public health authorities during the outbreak. These methods varied by state and by the timing during the outbreak.&quot;
              &lt;p&gt; 
              &lt;p&gt;Other limitations include the fact that that pregnant women might be less likely to be tested than were those who were not pregnant and that &quot;healthcare providers might be more likely to admit a pregnant woman than a nonpregnant person with similar findings, which could lead to an exaggerated admission rate in pregnant women.&quot; 
              &lt;p&gt;
              &lt;p&gt;&lt;table cellspacing=&quot;0&quot; hspace=&quot;1&quot; style=&quot;border-style:solid; border-width:1px; border-color:#8dabbc; font-family:arial; font-size:12px; background-color:#DBE9F2; padding:5px 5px 5px 5px;&quot;&gt;
&lt;tr&gt;&lt;td&gt;The study was supported by the CDC. Dr. Jamieson and several other authors are employees of the agency. No other potential conflicts were reported.&lt;/td&gt;&lt;/tr&gt;&lt;/table&gt;
              &lt;p&gt;
              &lt;p&gt;&lt;em&gt;This article was developed in collaboration with ABC News.   &lt;/em&gt;&lt;img src=&quot;http://www.medpagetoday.com/upload/2009/5/14/14212.jpg&quot;&gt;


        
    </recommendedItem>
    <recommendedItem id="20090101_1_544"
                     title="Strep or No, Half of Kids Get Antibiotics for Sore Throat"
                     score="-0.005"
                     href="