Alcohol-linked deaths a problem for the Americas

By Elizabeth DeVita-Raebrun

NEW YORK Tue Feb 4, 2014 4:04pm EST

NEW YORK (Reuters Health) – Liver disease and brain disorders due to alcohol abuse are important causes of premature death in the Americas, a new study concludes.

The toll of too much drinking is especially high among men and among middle-aged people, according to the report, whose authors say it’s the first to tabulate deaths resulting solely from alcohol.

“This provides direct evidence of the impact of alcohol on the health of countries in the region,” said one of the study’s authors, Dr. Vilma Pinheiro Gawryszewski, an advisor on health information and analysis for the Pan American Health Organization(PAHO).

In the 16 North, Central, and South American countries studied, alcohol was the sole cause of 79,456 deaths a year, the researchers say. That represented 1.4 percent of deaths from all causes, and alcohol-related liver disease alone accounted for 0.6 percent of all-cause mortality.

The study was based on data collected between 2007 and 2009 for countries in the PAHO mortality database.

The researchers excluded deaths from vehicle accidents and other fatal situations where alcohol might have been involved but there could also have been other causes.

Looking just at deaths due directly to alcohol, they found 63 percent were from liver disease and 32 percent were from neurological and psychiatric conditions grouped under “degeneration of the brain and nervous system.”

Other listed causes of death included alcohol poisoning, alcohol-linked heart and gastric problems and fetal alcohol syndrome.

The death toll is the “tip of the iceberg,” meaning that there are probably many more alcohol-related deaths that the researchers were not able to identify, said another of the study’s authors, Dr. Maristela Monteiro, regional advisor on alcohol and substance abuse at PAHO.

Monteiro said that raising the price of alcohol and increasing taxes would help to prevent some of these deaths. Many countries have found these steps effective in controlling tobacco use, but such measures have not been used to control alcohol consumption, she said.

Even the U.S., which was included in the study, has not done as much as it could, said David Jernigan, director of the Center on Alcohol Marketing and Youth at Johns Hopkins Bloomberg School of Public Health.

“The single most efficient thing you can do is to raise taxes,” Jernigan told Reuters Health. “Many states haven’t raised it in decades. That means the price doesn’t go up with inflation, and alcohol gets cheaper every year.”

And while the U.S. and other countries have limited tobacco advertising, alcohol advertising “is virtually everywhere,” he said.

Mortality due to alcohol was highest in El Salvador, Guatemala and Nicaragua, with death rates of 27.4, 22.3 and 21.3 per 100,000 people, respectively. These were also the countries with the highest consumption of hard liquor, the authors noted.

Colombia, Argentina and Canada had the lowest death rates attributable to alcohol at 1.8, 4.0 and 5.7 per 100,000, respectively. The alcohol death rate in the United States was “intermediate,” at 6.7 per 100,000, Monteiro said.

Men accounted for 84 percent of the deaths overall, but that proportion was not the same in all countries. The risk of a man dying from alcohol in El Salvador was nearly 30 times higher than that of a woman, but only about three times higher in Canada and the U.S.

People in the mid-to-late 50s and 60s age range were at the highest risk. This later in life risk, Jernigan said, points to the long-term impact of heavy drinking.

“Mostly in this country, we talk about alcohol and the risk for the young,” in whom drunk driving, violence, and accidents are important causes of death, Jernigan said. “This really shows the impact over the life course.”

Despite the grim statistics, Jernigan says studies like this one are a positive sign.

“On one hand, you could say, ‘this is a huge problem, and not enough is being done.’ On the other,” he said, “you could say, ‘we’re getting better at documenting it and showing that, until we take meaningful action, it’s not going to go away.'”

In poorer countries, other factors contributing to the deaths could include infectious diseases that hasten the course of liver disease, as well as poor nutrition and limited access to health services.

“In the U.S., people wouldn’t wait until they were too sick for help to seek out services, because treatment is available,” said Monteiro. That is not always the case, she said, in other countries.

Source: bit.ly/1enwJIT Addiction, online January 14, 2014.

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Brain-dead Canadian woman kept on life support to save fetus

By Julie Gordon

VANCOUVER Tue Feb 4, 2014 2:18pm EST

VANCOUVER (Reuters) – A 32-year-old Canadian woman who has been declared brain dead is being kept on life support in a Victoria, British Columbia hospital, with doctors working to keep her alive long enough to deliver her unborn son.

Robyn Benson was just 22 weeks pregnant when she complained of a headache and then collapsed on her bathroom floor, according to postings on a blog and fundraising site by her husband Dylan Benson. Her fetus, already named Iver Cohen Benson, has continued to grow in the womb.

“On December 28th, I lost my wife to a sudden hemorrhage of blood to her brain,” Benson wrote. “Based on my decision, they are attempting to keep her body alive for up to 7 more weeks … Incredibly, they have been successful in doing this for 5 weeks now.”

The goal is to wait until the fetus reaches 34 weeks, giving the baby a greater chance of survival, according to Benson. He wrote that doctors plan to deliver his son via cesarean section and that the baby will spend his first few weeks in hospital.

That sets up a bittersweet deadline for the family, who will welcome a new baby and then take the mother off life support.

“It is very difficult to know that our son will grow up never meeting his wonderful mother, and that we will have to say our goodbyes to Robyn within hours of seeing Iver for the first time,” Benson wrote. “She was my rock. She did so much for us, and I can’t believe I won’t get to talk to her again.”

The tragic story differs from a controversial case in Texas, where Marlise Munoz, a pregnant brain-dead woman was removed from life support at her husband’s request last month after a lengthy court battle. Her husband said Munoz had told him she did not want to be kept on life support. Unlike the Benson baby, which is healthier, Munoz’s fetus had already suffered oxygen depravation and appeared to have deformed lower extremities, according to court documents.

Texas authorities had fought to keep Munoz on life support in a case that sparked fierce debate over the rights of a fetus versus the right to die.

A spokeswoman for the Vancouver Island health authority confirmed that there is a patient named Robyn Benson in the intensive care unit at the Victoria General Hospital, but was not able to provide further details due to privacy issues.

The Benson family’s plight has gripped people across Canada and around the world, with donations on their fundraising site topping C$85,000 ($76,700) early on Tuesday.

That has far exceeded the C$36,000 goal set by Benson, who had hoped to raise funds for bills, baby supplies and to allow him to more time at home with his new son after the birth.

“I just wanted to reach out and say thank you to each and every one of you that have read our story and to those who have donated and/or shared,” he wrote on the site on Monday. “We are overwhelmed with the response from not only the community, but now the nation and beyond.”

(Editing by Jeffrey Hodgson; Editing by David Gregorio)

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Fewer U.S. children dying in car crashes: CDC

CHICAGO Tue Feb 4, 2014 1:09pm EST

Ford Motor Vice President, Sustainability, Environment and Safety Engineering Sue Cischke shows off a child crash test dummy strapped in a Servo Sled Crash Simulator wearing seat belt air bags in Dearborn, Michigan November 5, 2009. REUTERS/Rebecca Cook

Ford Motor Vice President, Sustainability, Environment and Safety Engineering Sue Cischke shows off a child crash test dummy strapped in a Servo Sled Crash Simulator wearing seat belt air bags in Dearborn, Michigan November 5, 2009.

Credit: Reuters/Rebecca Cook

CHICAGO (Reuters) – Fewer U.S. children are dying in car crashes, with death rates falling by 43 percent from 2002 to 2011, the U.S. Centers for Disease Control and Prevention said on Tuesday.

But one in three of the children who died in a car crash in 2011 was not using a seat belt or child safety seat, suggesting many more deaths could be prevented, the CDC said. The results were based on a study in the Morbidity and Mortality report, the agency’s weekly report on death and disease.

According to the report, more than 9,000 children age 12 and younger died in a car crash from 2002 to 2011.

“The good news is motor vehicle deaths decreased by 43 percent over the past decade for children age 12 and younger. The tragic news is still with that decrease, more than 9,000 kids were killed on the road in this period,” CDC Director Thomas Frieden told reporters in a telephone news conference.

“Thousands of children are at risk on the road because they are not buckled up,” he said.

The study found that of the children who died between 2009 to 2010, a much higher proportion of black and Hispanic children were not buckled, compared with white kids.

“The difference was nearly half (45 percent for blacks and 46 percent for Hispanics) versus a quarter (26 percent) for white kids,” Frieden said.

The study did not investigate why racial differences played such a big role in seat belt use, but it did suggest socio-economic factors may play a role.

For the study, CDC researchers analyzed data collected by the National Highway Traffic Safety Administration to find the number of deaths among occupants in cars from 2002 to 2011 for all children aged up to the age of 12.

Overall, 9,182 children died in car crashes during the period. But deaths dropped sharply, from 2.2 deaths per 100,000 people in 2002, to 1.2 deaths per 100,000 in 2011, a 43 percent decline.

According to the report, seat belt use increased from 88 percent in 2002 to 91 percent in 2011 among all children age 7 and under. The study also confirmed earlier findings that older children are less likely to be wearing seat belts than younger children.

To prevent future deaths from car crashes, Frieden said parents should make sure their children use appropriate-sized car seats, booster seats and seat belts on every trip.

The CDC recommends that children from birth to age 2 should be in a rear-facing car seat.

Starting at age 2, children should be in a forward-facing car seat until at least age 5, or when they reach the upper weight or height limit of that seat.

Children age 5 and older should use a booster seat until the adult seat belt fits them properly, generally when the lap belt lays across the upper thighs and the shoulder belt slays across the chest, but not the neck.

More information on proper use of child safety seats can be found at www.safekids.org or other websites.

(Reporting by Julie Steenhuysen; Editing by Dan Grebler)

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Added sugars abundant In U.S. diets, linked to death

By Andrew M. Seaman

NEW YORK Mon Feb 3, 2014 4:13pm EST

NEW YORK (Reuters Health) – Most U.S. adults are eating too much sugar and that’s linked to an increased risk of dying from heart disease, according to a new government study.

Researchers from the Centers for Disease Control and Prevention (CDC) analyzed nutrition surveys of U.S. adults from the past couple of decades and found most were getting more sugar than the daily limit set by the World Health Organization (WHO).

What’s more, participants who got more than the recommended amount of calories from added sugar were more likely to die of heart disease, compared to those who typically got less added sugar.

“We know cardiovascular disease is the leading cause of death in the U.S.,” Quanhe Yang told Reuters Health. “There are a lot of risk factors for cardiovascular disease. Many of them are modifiable.”

Yang, the study’s lead author and a researcher at the CDC in Atlanta, said one factor that can be modified is the amount of added sugar a person eats.

Unlike sugars that occur naturally in fresh ingredients like fruit, added sugars are incorporated into food during processing and preparation.

Researchers and doctors have identified added sugars as a problem spot in American diets, but there are conflicting guidelines over how much adults can safely eat.

Yang and colleagues write in JAMA Internal Medicine that the Institute of Medicine recommends added sugars make up less than 25 percent of a person’s daily calories, and the WHO suggests 10 percent as the limit.

The American Heart Association, on the other hand, sets the limit for added sugars at 100 calories per day for women and 150 calories per day for men.

For the new study, the researchers used data from a series of studies that periodically asked U.S. adults about their diets between 1988 and 2010. More than 31,000 people were surveyed during that period.

The authors found adults got an average of 16 percent of their calories from added sugars between 1988 and 1994. That increased to about 17 percent between 1999 and 2004, but fell to about 15 percent between 2005 and 2010.

During the 2005 to 2010 span, about 71 percent of U.S. adults were getting 10 percent or more of their calories from added sugars. About 10 percent were getting at least 25 percent of their calories from added sugars.

The most common sources of added sugar were sugar-sweetened beverages, grain-based desserts, fruit drinks, dairy desserts and candy.

The researchers also looked at data on 11,733 people who had been asked about their diets in the early study years and were tracked through 2006. Over about 15 years, 831 died of cardiovascular disease, which includes conditions such as heart attacks, strokes and artery disease.

Compared to people who got less than 10 percent of their daily calories from added sugar, those who got between 10 and 25 percent of their calories from added sugar were 30 percent more likely to die of cardiovascular disease during that time. Those who got 25 percent or more of their calories from added sugar were more than twice as likely to die of cardiovascular disease.

That increased risk couldn’t be explained by differences in people’s age, sex, education, smoking habits, physical activity, medications, blood pressure, weight or other components of their diets.

In an accompanying editorial, Laura Schmidt of the University of California, San Francisco wrote that the new study lends more research to the theory that added sugar is not only a marker of an unhealthy lifestyle, but may itself be the cause of some health conditions.

“What’s really interesting and important for readers to understand is they linked sugar consumption – independent of all other risk factors – to cardiovascular disease,” Schmidt told Reuters Health.

“We’re hearing a lot about sugar these days,” she said. “The reason is because we’re seeing an impact on health above and beyond its role in obesity.”

SOURCE: bit.ly/1bW7SpA JAMA Internal Medicine, online February 3, 2014.

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U.S. says HealthCare.gov enrollment appeal hearings to begin soon

WASHINGTON Mon Feb 3, 2014 3:51pm EST

A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this October 2, 2013 photo illustration. REUTERS/Mike Segar

A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this October 2, 2013 photo illustration.

Credit: Reuters/Mike Segar

WASHINGTON (Reuters) – The Obama administration on Monday said it will soon begin hearings to resolve problems for people who enrolled in health insurance through the Obamacare website HealthCare.gov, only to encounter errors including unnecessarily high costs.

The U.S. Centers for Medicare and Medicaid Services (CMS), the lead agency responsible for implementing the healthcare reform law, issued a statement saying it was reaching out to consumers with error-ridden enrollments to help them complete applications for coverage without a formal appeal.

The statement came in response to a Washington Post report that said about 22,000 Americans have appealed to CMS for help fixing enrollment mistakes that have led to excessive charges, enrolled them in the wrong health plan, or denied them coverage altogether.

The appeals have hit a technological dead end, the newspaper reported, because the administration has yet to complete the technology infrastructure necessary to manage the appeals process.

Obamacare’s rocky implementation has already weathered paralyzing glitches and a public outcry over insurance policy cancellations for millions of people in the health plan market for individuals.

“CMS is working to fully implement an automated appeals system. Until we have that functionality, we are putting in place a manual review process wherever possible and expect hearings to begin soon,” said the agency.

“In the meantime, CMS is reaching out to these consumers to provide assistance so they can successfully complete their application without the need to complete the appeals process.”

CMS did not confirm the number of appeals reported by the Post but said those filed are “largely related to earlier technology problems that have since been fixed.”

A CMS spokesman declined to say how soon hearings might start. But analysts said a system would have to be in place before March 31, the end of the Obamacare open enrollment period for obtaining health coverage this year.

The Patient Protection and Affordable Care Act, President Barack Obama’s signature domestic policy achievement, is intended to extend private health coverage to the uninsured by selling private plans at subsidized rates through new marketplaces. The law also calls on states to expand Medicaid coverage for the poor.

HealthCare.gov, the Web portal for a federal marketplace that spans 36 states, crashed soon after its October launch, blocking access to some while saddling others with inaccurate enrollment files. Four months later, CMS is still scrambling to complete back-end systems that would allow the federal marketplace to pay government subsidies to insurers on behalf of low-income beneficiaries.

Republicans in Congress pounced on news of the appeals problem as fresh evidence that the healthcare law’s individual mandate should be delayed. The mandate requires most Americans to be enrolled in health coverage by March 31 or pay a penalty.

“Over four months after launch, the administration still does not have its act together. They appear to be incapable of addressing Obamacare’s failures, unfairly leaving Americans on the hook,” said Joe Pitts, chairman of the House Energy and Commerce health subcommittee.

(Reporting by David Morgan and Susan Cornwell; Editing by Karey Van Hall and David Gregorio)

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Gay and bisexual boys are more likely to abuse steroids

By Will Boggs MD

NEW YORK Mon Feb 3, 2014 11:51am EST

NEW YORK (Reuters Health) – Gay and bisexual boys are almost six times as likely as their heterosexual peers to misuse steroids, according to a new study.

“What was most surprising to us was the magnitude of the disparities that emerged between sexual minority and heterosexual boys,” Aaron J. Blashill from Massachusetts General Hospital in Boston told Reuters Health in an email.

Upwards of 5 percent of adolescent boys use anabolic-androgenic steroids to enhance strength, athletic performance, and muscle size, but nobody had studied the association between sexual orientation and steroid abuse before, Blashill and his colleague Steven A. Safren noted.

Long-term misuse of steroids can lead to heart problems, hormone-related changes and psychiatric disorders.

The researchers were concerned that gay and bisexual boys might be more likely to misuse steroids because of other factors that have been tied to steroid and other substance abuse. Those include depression, victimization, suicidal thoughts and intent and poor body image.

To see if that was the case, Blashill and Safren used data from the 2005 and 2007 U.S. Youth Risk Behavior Surveys of 17,250 teenage boys, including 635 who were gay or bisexual.

About 21 percent of gay and bisexual boys said they had abused steroids at some time in their lives, compared with only 4 percent of heterosexual boys.

Gay and bisexual boys were also nearly six times as likely as heterosexual boys to report moderate use of steroids (at least 10 times) or severe use (at least 40 times), according to the report in the journal Pediatrics.

In an effort to understand why, the researchers looked at other factors thought to be important contributors to steroid use. They found drug and alcohol use, depression or suicidal tendencies and feelings of victimization played a role in steroid misuse.

Even after taking those factors into account, though, being gay or bisexual was still linked to an increased risk of steroid abuse.

“Gay and bisexual boys are often targets of bullying, and some boys (particularly if they also possess poor body image) may turn to anabolic-androgen steroids (AAS) use as a means to obtain a more muscular build, in hopes it would deter others from bullying them,” Blashill said.

“Parents should be mindful of their son’s school climate regarding bullying, in general, and specifically, attitudes toward sexual minorities.”

Steroids are often used covertly, he noted, so it may be hard for parents to observe their use directly. But they may be able to monitor related behaviors, like excessive exercise and weightlifting.

“On a broader point, sexual minority boys report high levels of body dissatisfaction (more similar to levels of heterosexual girls than heterosexual boys), so parents should also be mindful that body image concerns may well be a factor in their sons’ lives,” Blashill said.

“Often, I’ll hear from patients telling me how they are frequently told they’re ‘too skinny’ or that they need to ‘put some meat on those bones’ from family/friends, who are often well-intentioned,” or who even meant to compliment them, he added.

“These boys, quite eloquently, state how such a double-standard exists, that calling a boy ‘so skinny’ is akin to calling a girl ‘fat,’ but it appears that society, by and large, feels the former is more socially acceptable. But, these comments, coming from peers, family (and) coaches, can have real impacts on boys’ body image,” Blashill said.

SOURCE: bit.ly/1fSlTrf Pediatrics, online February 3, 2014.

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Pfizer breast cancer drug succeeds in mid-stage trial

Mon Feb 3, 2014 7:27am EST

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The Pfizer logo is seen outside their world headquarters in New York November 5, 2013. REUTERS/Adam Hunger

The Pfizer logo is seen outside their world headquarters in New York November 5, 2013.

Credit: Reuters/Adam Hunger

(Reuters) – Pfizer Inc said its experimental breast cancer drug, in a mid-stage trial, showed a statistically significant improvement in patients’ survival rates without their disease worsening.

The drug palbociclib was tested in post-menopausal patients in combination with the hormonal therapy letrozole, and results were compared with patients receiving only letrozole.

(Reporting by Esha Dey in Bangalore; Editing by Ted Kerr)

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California sees high rate of flu deaths in unusually severe season

By Sharon Bernstein

SACRAMENTO, California Fri Jan 31, 2014 9:10pm EST

SACRAMENTO, California (Reuters) – An unusually severe flu season has claimed the lives of at least 147 young and middle-aged people in California – 10 times the number killed by influenza viruses by the same time last year, public health officials said on Friday.

The California deaths were caused by a strain of the influenza virus that is sending sufferers across the nation to the doctor for flu-like symptoms at rates that are 50 percent higher than normal, said Lyn Finelli, head of the influenza surveillance and outbreak response team at the Centers for Disease Control and Prevention.

“That’s way above the norm for flu,” Finelli said. “It tells us we’re still in the middle of flu season, and in the Northeast and California it’s going up, up, up.”

The flu strain responsible for the California deaths, H1N1, also predominates nationwide this year. It hits people hardest between the ages of 25 and 64, partly because some older people are believed to have more immunity due to similar outbreaks many decades ago.

In California, 52 people died last week alone, including one child, the state’s chief of communicable disease control told reporters on a conference call Friday.

“This influenza season continues to be a severe one as the increasing number of influenza-related deaths indicates,” Ron Chapman, director of the California Department of Public Health, said in a statement, urging Californians to get vaccinated.

In addition to the 147 confirmed California flu-related fatalities this season among people under age 65, another 44 suspected flu deaths remain under investigation, said Dr. James Watt, chief of the state’s Division of Communicable Disease Control. Most of those felled by the disease had other health conditions, but not all, he said.

Last year at the same time, the state had recorded just 14 flu deaths among Californians under age 65.

FIRST VACCINATION

The death of a 47-year-old television advertising executive in the state’s capital city prompted a renewed call for residents to become vaccinated against flu. Sacramento County, with 21 deaths so far, leads the state in fatalities.

“After reading the heartbreaking story of Nancy Pinnella, went to CVS and got my first flu shot ever,” California’s first lady, Anne Gust Brown, posted on Twitter.

It is not fully clear whether California is an outlier in the severity of its cases, because states are not required to report flu deaths to the CDC, and data is collected differently from state to state and county to county, said CDC spokesman Jason McDonald.

The fatality data that the public health agency does collect, on pediatric deaths, is not useful in studying H1N1, because the virus is more likely to attack adults, Finelli said.

The public health agency does, however collect information on why people go to the doctor, and whether they are hospitalized for flu. Those signs, she said, show that this year’s flu is likely to continue to hit hard.

Although the number of cases nationwide appears to have plateaued, she said, that does not take into account that California and the Northeast are lagging other areas with a late flu season.

Meanwhile, CDC data does show that far more people under the age of 65 are being hospitalized with flu-like symptoms than last year. As of last week, for example, 76 percent of those hospitalized for flu were under age 65, compared to less than 50 percent last year.

Nationwide, the data shows that somewhat fewer people have contracted flu so far this year than last year, Finelli said. This year’s strain, however, appears to be causing severe illness in a population that is more typically robust, she said.

(Reporting by Sharon Bernstein; Editing by Cynthia Johnston and Lisa Shumaker)

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California college to offer non-approved meningitis vaccine

By Sharon Bernstein

SACRAMENTO, California Fri Jan 31, 2014 8:44pm EST

SACRAMENTO, California (Reuters) – Students at a California public university where meningococcal disease broke out in the fall will be offered a vaccine not approved for use in the United States, public health officials said on Friday.

Officials in the most populous U.S. state had sought permission from the federal government to use the European vaccine, which inoculates against a strain of the disease that has struck four students at the University of California, Santa Barbara.

The outbreak, which resulted in a student having his feet amputated, is similar to the one that struck eight students at Princeton University in New Jersey, where students won approval to use the same foreign vaccine in the fall.

Bexsero, made by the Swiss pharmaceutical company Novartis AG, is the only vaccine to protect against serotype B of the meningococcal bacteria, which can attack the nervous system as meningitis or cause a deadly blood condition.

California health officials sought access to the vaccine for the Santa Barbara students in December amid renewed concern about meningococcal disease, which is highly contagious among people who live in close quarters, such as college students.

Most strains of the bacteria can be controlled with a vaccine that is widely available in the United States.

But Bexsero has not been submitted for approval for use in the United States, according to the U.S. Centers for Disease Control and Prevention.

Students at Princeton began receiving that vaccine after the CDC intervened on their behalf. But when the California outbreak was announced, the CDC said it wanted to wait, in part to see if the disease spread to more students.

In a statement released to students, parents and employees on Friday, officials at UC Santa Barbara said they would make the vaccine available to students free of charge next month.

No additional cases have been reported at the university, health director Dr. Mary Ferris said in the statement.

Novartis said in a statement that it would coordinate with the CDC, the university and the California Department of Health to make Bexsero available to the students.

The company said it had submitted to U.S. officials documentation from its European studies to show that the vaccine was effective and safe, and was working on a version for eventual use in the United States

(Reporting by Sharon Bernstein; Editing by Cynthia Johnston and Mohammad Zargham)

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This Week in Oncology: Single-Payer System, GuCS

A controversial call for a single-payer healthcare system topped this week’s oncology news, along with coverage of the Genitourinary Cancers Symposium and a look at burnout among oncologists.

Working from Houston, home to one of the world’s largest medical complexes, Charles Bankhead has more than 20 years of experience as a medical writer and editor. His career began as a science and medical writer at an academic medical center. He later spent almost a decade as a writer and editor for Medical World News, one of the leading medical trade magazines of its era. His byline has appeared in medical publications that have included Cardio, Cosmetic Surgery Times, Dermatology Times, Diagnostic Imaging, Family Practice, Journal of the National Cancer Institute, Medscape, Oncology News International, Oncology Times, Ophthalmology Times, Patient Care, Renal and Urology News, The Medical Post, Urology Times, and the International Medical News Group newspapers. He has a BA in journalism and MA in mass communications, both from Texas Tech University.

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