Hundreds of lives saved through new tech to spot sepsis
This news report outlines how the NHS has saved hundreds of people from sepsis thanks to better use of digital technology in hospitals. In a major nationwide push to tackle the condition new'alert and action'technology is being introduced which uses algorithms to read patients'vital signs and alert medics to worsening conditions that are a warning sign of sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Loss of'measles free' status by UK sparks widespread concerns
The UK has lost its “measles free” status with the World Health Organization – three years after the virus was eliminated in the country. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Lactated Ringer`s Versus 4% Albumin on Lactated Ringer`s in Early Sepsis Therapy in Cancer Patients: A Pilot Single-Center Randomized Trial
This study reported that addition of albumin bolus to early standard resuscitation with lactated Ringer's, versus lactated Ringer's alone, in cancer patients with sepsis did not improve 7-day survival (n=360; mortality 26% vs 22%; p=0.5). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

The efficacy and safety of inhaled antibiotics for the treatment of bronchiectasis in adults: a systematic review and meta-analysis
Review (16 RCTs; n=2597) concluded that inhaled antibiotics are well tolerated, reduce bacterial load, and achieve a small but statistically significant reduction in exacerbation frequency (rate ratio 0.81, 0.67 to 0.97; p=0.020) without significant improvements in QOL. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Long-term macrolide antibiotics for the treatment of bronchiectasis in adults: an individual participant data meta-analysis
Review (3 RCTs; n=341) concluded that macrolide antibiotics reduced frequency of exacerbations (IRR 0.49; p (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

New measles surveillance data from WHO
This new report details that, reported measles cases are the highest they have been since 2006. There were 364,808 reported cases so far this year vs 129,239 cases for the same period last year. The European region has experienced a 120% increase. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Intravenous ceftriaxone at home versus intravenous flucloxacillin in hospital for children with cellulitis: a cost-effectiveness analysis
Australian study (n=180) found that the institutional cost per patient episode was lower with home ceftriaxone vs inpatient flucloxacillin (AUS$1965 vs $3775). As the QALY improvement was also greater with cetriaxone, cost-effectiveness analysis was redundant. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Campaign materials for antimicrobial resistance (AMR) and Stoptober campaigns delivered to pharmacies
Contractors are required to participate in AMR campaign from 1st to 30th Sept 2019 and Stoptober campaign from 1st to 31st Oct 2019. The campaigns are 2 of 6 campaigns agreed between PSNC and NHS England and NHS Improvement, as part of Community Pharmacy Contractual Framework. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (19982015)
Analysis (n=2361) noted significant increase (p (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Accessing sexual health testing online
Londoners can now access sexual health testing online. This service makes it simpler and convenient for people - including those at risk of sexually transmitted infections - to get tested regularly, encouraging early identification and avoiding onward transmission. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Clostridioides difficile: diagnosis and treatments
This review summarises the recent data for clinicians to understand and stratify their choice in the diagnosis and treatment of C difficile infection. Current treatment include vancomycin and fidaxomicin; metronidazole is no longer recommended. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

The national influenza immunisation programme 2019/20: Inactivated influenza vaccine: information for healthcare practitioners
This document includes detailed information on; the background of the programme, the different types of inactivated influenza vaccine, influenza vaccine recommendations and eligibility, contraindications and precautions and vaccine administration issues. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Non-inferiority versus superiority trial design for new antibiotics in an era of high antimicrobial resistance: the case for post-marketing, adaptive randomised controlled trials
Based on the development of ceftazidime-avibactam the authors propose a strategy for developing a new framework based on adaptive, post-marketing randomised clinical trials. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Risk Factors and Outcomes Associated With Treatment of Asymptomatic Bacteriuria in Hospitalized Patients
In this retrospective cohort study (2733 patients) in US hospitals it was shown that antibiotic treatment (n=2259) did not appear to be associated with improved outcomes and may be associated with longer duration of hospitalization after urine testing (4 vs 3 days). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Drinking more water reduced the frequency of recurrent UTIs
This review of an open-label study (n=130) found that increased daily fluid intake of 1.5 L in women who were low-volume ( (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

European Region loses ground in effort to eliminate measles
Following several years of steady progress toward measles elimination (EL) in WHO European Region, number of countries who achieved/sustained EL has declined. For first time since verification process began in Region in 2012, 4 countries, including UK, have lost measles EL status (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Risk of antibiotic resistant meningococcal infections in Hajj pilgrims
Editorial discusses PHE report of resistant meningococcal conjunctivitis in people returning from Mecca, highlighting urgent need to review currently recommended prophylactic measures for Hajj pilgrims, and how best to prevent spread of N meningitidis amongst mass gatherings. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Smartphones can improve adherence rates for TB treatment
Synopsis/commentary is provided of RCT which found video observation (VO) offers possibilities for achieving better outcomes in TB treatment compliance at lower cost, and appears more acceptable to patients. Following this study, smartphone VO was implemented in London services. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Influenza Vaccine Effectiveness Among Patients With Cancer: A Population-Based Study Using Health Administrative and Laboratory Testing Data From Ontario, Canada
Study (n=26,463) reports active chemotherapy usage did not significantly affect vaccine effectiveness (VE), especially among patients with solid tumor cancer. Authors support recommendations for influenza vaccination for patients with cancer. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence
In analysis based on>100,000 postmenopausal women, all types of HRT, except vaginal oestrogens (ONs), were linked to increased risks of developing breast cancer, particularly for ON+progestogen (PN) than for ON only preparations, and if PN given daily rather than intermittently. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Vancomycin is commonly underdosed in critically ill children and neonates
Study (n=115) reports target concentration (10 –20 mg/L) at initial steady state trough sample in only 38/126 (30%) courses administered; and dose adjustments in only 49 (56%) of the 88 courses with initial trough concentrations outside target range. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Review of Informed Choice for Cancer Registration: NCRAS response
This progress update examines how the National Cancer Registration and Analysis Service is improving awareness of the national cancer registery in line with the findings from the 2016 Review of Informed Choice for Cancer Registration. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Prime Minister orders urgent action to improve vaccination uptake
This Press Reease outlines how due to a small but steady decline in coverage in recent years, the UK has lost its'measles-free'status with the World Health Organisation three years after the virus was eliminated in the country. As a result, the Prime Minister has ordered urgent action to improve measles vaccination uptake and sets out a series of actions to improve uptake. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Measles and rubella elimination UK indicators
This information about the UK's progress towards measles and rubella elimination was updated in August 2019. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Health matters: preventing STIs
This edition of Health Matters focuses on the prevention of five common sexually transmitted infections (STIs): gonorrhoea, chlamydia, syphilis, genital herpes and genital warts. It also covers the public health challenge of antimicrobial-resistant STIs, and the commissioning and improvement of sexual health services. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Antimicrobial resistance local data in sepsis
Antimicrobial resistance (AMR) is one of the life-threatening world problems which should be noticed and controlled seriously. One of the major causes of the increasing AMR is the inappropriate use of antimicrobial where antimicrobial choices should be based on local data pattern to select the proper antibiotic. Sepsis causes high mortality and needs appropriate antibiotic while antimicrobial treatment should be started as soon as sepsis is suspected to prevent the development of further complications and progression. The aim of the study is to find the AMR prevalence, the causal bacteria in sepsis adult can be used as ant...
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Sepsis in 2018: a review
This article provides a summary of the most recent clinical evidence and professional guidelines for the diagnosis and treatment of the sepsis in the critical care setting. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Point of care technologies for sepsis diagnosis and treatment
Sepsis is a rapidly progressing, life threatening immune response triggered by infection that affects millions worldwide each year. Current clinical diagnosis relies on broad physiological parameters and time consuming lab-based cell culture. If proper treatment is not provided, cases of sepsis can drastically increase in severity over the course of a few hours. Development of new point of care tools for sepsis has the potential to improve diagnostic speed and accuracy, leading to prompt administration of appropriate therapeutics, thereby reducing healthcare costs and improving patient outcomes. In this review we examine d...
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Neutrophil activation in septic acute kidney injury: A post-hoc analysis of the FINNAKI study
Inflammation, reflected by high plasma interleukin-6 concentration, is associated with acute kidney injury (AKI) in septic patients. Neutrophil activation has pathophysiological significance in experimental septic AKI. We hypothesized that neutrophil activation is associated with AKI in critically ill sepsis patients. Interleukin-8 in plasma and urine was associated with septic AKI. Elevated plasma activin A indicates intravascular neutrophil activation in septic AKI. Concomitant plasma and urine myeloperoxidase measurements suggest neutrophil accumulation into injured kidneys. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Clinical trial design for unmet clinical needs: a spotlight on sepsis
Despite considerable advances in our understanding of how sepsis develops and multiple clinical trials of potential therapies, no new pharmacologic agent has been consistently shown to improve survival. We reviewed relevant publications identified through PubMed and from the authors'knowledge of this field. We discuss the main reasons why clinical trials on new therapeutic interventions have failed in the past, including heterogeneity of study populations and choice of outcome measures. We discuss how changes in study design and in patient selection could help improve identification of effective agents in the future. The s...
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Sepsis-related Organ Failure Assessment Score is a strong predictor of survival in acute-on-chronic liver failure
The objective of this study was to identify variables associated with mortality. The mortality was high in these severely ill patients, even when they received optimum supportive therapy in the ICU. The finding that the SOFA score and age best predicted mortality shows that the increased mortality was caused mainly by insufficiency of organs other than the liver. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Non-utility of sepsis scores for identifying infection in surgical intensive care unit patients
In this study, neither daily SOFA, qSOFA, nor SIRS criteria correlated with new infection in a population of critically ill surgical patients. Scores were globally elevated in non-infected patients, potentially related to high levels of existing inflammation in this population. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Does Early Follow-Up Improve the Outcomes of Sepsis Survivors Discharged to Home Health Care?
We examined whether early home health nursing (first visit within 2 days of hospital discharge and at least 1 additional visit in the first posthospital week) and early physician follow-up (an outpatient visit in the first posthospital week) reduce 30-day readmissions among Medicare sepsis survivors. Our findings suggest that, together, early postdischarge care by home health and medical providers can reduce hospital readmissions for sepsis survivors. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Epidemiology and Changes in Mortality of Sepsis After the Implementation of Surviving Sepsis Campaign Guidelines
We set out to determine the epidemiology and outcome of severe sepsis and septic shock after 9 years of the implementation of the Surviving Sepsis Campaign (SSC) and to build a mortality prediction model. Although the incidence of sepsis/septic shock remained unchanged during a 10-year period, the implementation of the SSC guidelines resulted in a marked decrease in the overall mortality. The lower severity of patients on ICU admission and the reduced early mortality suggest an improvement in early diagnosis, better initial management, and earlier antibiotic treatment. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

The Comparative Epidemiology of Pediatric Severe Sepsis
To determine whether the coding strategies used to identify severe sepsis in administrative data sets could identify cases with comparable case mix, hospitalization characteristics, and outcomes as a cohort of children diagnosed with severe sepsis using strict clinical criteria. The ICD-9-CM codes for " severe sepsis " and " septic shock " identify smaller but higher acuity cohorts of patients that more closely resemble the children enrolled in the largest clinical trial of pediatric severe sepsis to date. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Strategies for preventing early-onset sepsis and for managing neonates at-risk: wide variability across six Western countries
Group B streptococcus (GBS) early-onset sepsis (EOS) has declined after widespread intrapartum antibiotic prophylaxis. However, strategies for preventing EOS may differ across countries. The analysis of their strategies allows to compare the effectiveness of prevention in different countries and suggests opportunities for improvement. Wide variations exists in preventing EOS. They depend on national epidemiology of GBS infections, compliance, cost, and feasibility of the strategy. The extreme variability of approaches for managing neonates at risk for EOS reflects the even greater uncertainty regarding this issue, and may ...
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Strategic Trials to Define the Best Available Treatment for Neonatal and Pediatric Sepsis Caused by Carbapenem-resistant Organisms
The optimal standard of care for carbapenem-resistant bloodstream infections in children is currently unknown. This systematic review, aiming to define the best available treatments to be compared with new antibiotics in clinical trials, clearly points out the paucity of available data. The simplification and a wider harmonization of study design are a global priority to inform the best strategies to treat these life-threatening infections in children. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Efficacy and safety of applying a neonatal early-onset sepsis risk calculator in China
Aim was to evaluate and compare the performance of the early-onset sepsis (EOS) risk calculator with procalcitonin (PCT), complete blood count (CBC) and C-reactive protein (CRP) for predicting neonatal EOS. In this pilot study, applying the EOS calculator in China, the EOS risk calculator and PCT showed good predictive value compared to CBC and CRP. Risk scores from the EOS risk calculator strongly correlated with EOS, and the EOS risk calculator offered increased predictive value when used in combination with blood biomarkers. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Accuracy of presepsin in neonatal sepsis: systematic review and meta-analysis
This study aimed to evaluate the diagnostic accuracy of presepsin (P-SEP) for neonatal sepsis. Diagnostic accuracy of P-SEP resulted high in detecting neonatal sepsis. Even though it cannot be recommended as a single diagnostic test, P-SEP could be a helpful and valuable biomarker in neonates with suspected sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Unusual presentation of late-onset disseminated staphylococcal sepsis in a preterm infant
An ex-30-week gestation, preterm male baby was admitted to a tertiary neonatal unit and noted to have increased ventilator requirements and diagnosed with sepsis. The baby also developed an abscess over the left elbow and over the xiphisternum along with a decrease in movement of the left hand and the right leg. Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus (SA) was isolated from the blood culture. A whole body MRI showed disseminated abscess with multiple foci in the lung, left elbow and over the xiphisternum. Disseminated sepsis with multiple septic foci has not been previously reported in neonates. W...
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Antimicrobial Stewardship in the Neonatal Intensive Care Unit: An Update
Neonates represent a vulnerable population for infections and neonatal sepsis is a major cause of mortality and morbidity worldwide. Therefore, antimicrobials are the most commonly prescribed drugs in the Neonatal Intensive Care Unit Setting but unfortunately are quite often used inappropriately with various short and long-term effects. The rational use of antimicrobials is of paramount importance in this population and structured antimicrobial stewardship interventions should be in place. These interventions are slightly different from those used in adults and older children due to the particularities of the neonatal medi...
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

The combination of procalcitonin and C-reactive protein or presepsin alone improves the accuracy of diagnosis of neonatal sepsis: a meta-analysis and systematic review
Sepsis is an important cause of neonatal morbidity and mortality; therefore, the early diagnosis of neonatal sepsis is essential. ur aim was to compare the diagnostic accuracy of procalcitonin (PCT), C-reactive protein (CRP), procalcitonin combined with C-reactive protein (PCT + CRP) and presepsin in the diagnosis of neonatal sepsis. The combination of PCT and CRP or presepsin alone improves the accuracy of diagnosis of neonatal sepsis. However, further studies are required to confirm these findings. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

Challenges and opportunities for antibiotic stewardship among preterm infants
Antibiotic stewardship programmes aim to optimise antimicrobial use to prevent the emergence of resistance species and protect patients from the side effects of unnecessary medication. The high incidence of systemic infection and associated mortality from these infections leads neonatal providers to frequently initiate antibiotic therapy and make empiric antibiotic courses one of the main contributors of antibiotic use in the neonatal units. Yet, premature infants are also at risk for acute life-threatening complications associated with antibiotic use such as necrotising enterocolitis and for long-term morbidities such as ...
Source: Current Awareness Service for Health (CASH) - September 4, 2019 Category: Consumer Health News Source Type: news

What should be done to fix the crisis in social care?
Report discusses five priorities for government for social reform including stabilising& sustaining the current system, improving access to care, providing social protection against care costs, using the capped cost model& options for raising revenue. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 3, 2019 Category: Consumer Health News Source Type: news

More harm than good: why more isn't always better with older people's medicines
Report calls for more considered approach to prescribing medicines for older population. It says too many older people are on too many prescribed medicines, putting them at risk of side effects that in a worrying number of cases can lead to falls and range of other serious harms. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 3, 2019 Category: Consumer Health News Source Type: news

NIHR Signal: Packages of care interventions'not effective' to reduce repeat admissions for COPD
An expert commentary on this study suggests that care bundles are only likely to work if they are actually implemented, though this is likely to require additional resources and additional prioritisation of care for this group of patients. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 3, 2019 Category: Consumer Health News Source Type: news

NIHR Signal: closer links between police and health services can improve experiences for people in mental health crisis
An expert commentary is provided of this rapid evidence synthesis; which found tighter working partnerships between health professionals& police services are likely to improve the care of people who come into contact with police during mental health crises. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 3, 2019 Category: Consumer Health News Source Type: news

More harm than good: why more isn't always better with older people's medicines
This report calls for a more considered approach to prescribing medicines for our older population. It says too many older people in our society are on too many prescribed medicines, putting them at risk of side effects that in a worrying number of cases can lead to falls and a range of other serious harms. The report also provides evidence showing that prescribing more drugs isn't always the best option, particularly when it comes to older people. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 2, 2019 Category: Consumer Health News Source Type: news

CCG 360 ° Stakeholder Survey National Report 2018/19
A central part of the CCG assessment process is the CCG 360 ° Stakeholder Survey, the findings of which are presented in this report. A key aim of the survey is to enable NHS England to assess whether CCGs are operating effectively in partnership with key organisations in the local health system to commission safe, high-quality and sustainable services. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 2, 2019 Category: Consumer Health News Source Type: news

Bleak houses: tackling the crisis of family homelessness in England
This report shines a light on this homelessness crisis and shares the experiences of some of those children. The Children's Commission visited children and families living in temporary accommodation, and spoke with them and some of the frontline professionals who work with them. They also carried out new data analysis to identify the scale of the problems. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - September 2, 2019 Category: Consumer Health News Source Type: news