geoffrey modest medical blogs

  the CDC just published a report on food insecurity in children aged 0-17 in the US, covering the period 2019-2020, finding about 15 million American kid s fit in this category!!! (see  https://www.cdc.gov/nchs/data/databriefs/db432.pdf  )   Details : --food insecurity is defined as limited or uncertain availability of safe and nutritionally adequate foods, or the limited or uncertain ability to acquire acceptable foods in socially acceptable ways ; it is determined by the answer to 10 questions, mostly about both accessible food quantity and quality -- the data are based on the prior 30 days using the 2019-2020 National Interview Survey data, with stratified information based on age, sex, race/ethnicity and other demographics   Results : -- overall the percentage of children aged 0-17 who lived in households that experienced food insecurity was 10.8%, and did not vary by sex of the children or age (categorized as 0-5yo, 6-11yo and 12-17yo) ...

  there were a couple of articles of note on treatment of mild hypertension in pregnant women.   The first assessed the outcomes of women with BP <160/100 to see if they wou ld  benefit from a target BP <140/90 ( see  htn pregnancy treat mild NEJM2022  in dropbox, or DOI: 10.1056/NEJMoa2201295 ), the Chronic Hypertension and Pregnancy (CHAP) project   Details: -- 2408 pregnant women in an open-label, randomized trial done at 70 recruiting sites in the US, from 2015-2021 -- mean age 32, 28% non-Hispanic white/48% non-Hispanic Black/20% Hispanic, previous pregnancy 83%, BMI 38, gestational age <14wks in 41% -- diabetes 16%, current smoker 7%, aspirin use 45% -- blood pressure 134/84 , 22% newly diagnosed hypertension/56% prior diagnosis and receiving medication/22%  prior diagnosis  and not receiving medication -- all with singleton fetus at gestational ages <23 weeks, randomized to BP meds typically used in pregnancy (first-li...

  There is considerable controversy regarding the utility of a second booster shot in those over 50 years old, as recommended by the CDC. Will review the recent Israeli study on the second booster. (see  covid booster 4th dose israel NEJM2022 in dropbox, or  https://www.nejm.org/doi/full/10.1056/NEJMoa2201570  ).   Details: --On January 2, 2022, Israel began administering the fourth dose of the Pfizer vaccine to people at least 60 years old     --This was the time when the omicron variant was predominant in Israel (January 10 through March 2, 2022) -- 1,252,331 people in the Israeli Ministry of Health database were accessed -- 4-dose group (boostered, at least 4 months after 3 rd  shot): 23,935,905 person-days; age 60-69 33%/70-79 43%/ >79yo 25% -- 3-dose group (no second booster): 31,000,299 person-days; age 60-69 52%/70-79 32%/ >79yo 16% -- internal control group (boostered, but within 3-7 days and booster shot not likely ...