Pri-Med Medical News

Digital Divide Exists With Physician EHR Adoption

Adopters found to be optimistic about IT's potential, while non-adopters remain skeptical

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Changes in Organ Allocation Helped Kids in Past Decade

From 2001 to 2010, increase seen in pediatric transplantation, decrease in wait-list deaths

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AHA: Variation in Outpatient Cardiac Risk Factor Management

Considerable variation in hypertension and hyperlipidemia control; tobacco screening

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AHA: iPhone App Transmits Heart Images Quickly

App is accurate and more reliable than standard e-mail transmission

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Depression Doubles Stroke Risk in Middle-Aged Women

Association is partially attenuated with adjustment for lifestyle, physiological factors

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ASCO: Midlife Fitness May Protect Against Cancer

High fitness linked to reductions in risk of developing and dying from lung, colorectal cancer

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ASH: Practicing Yoga May Help Lower Blood Pressure

Yoga two to three times a week on average lowers both systolic and diastolic BP by three points

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ASH: Ringing Cell Phones May Cause Rise in Blood Pressure

BP rise less dramatic in hypertensive patients who more frequently use mobile phones

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Free Fatty Acids Linked to Cardiac Risk in Late Adulthood

Associated with insulin resistance during young adulthood

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AHA: Increasing Fitness in Midlife Cuts Heart Failure Risk

Rate of heart failure hospitalization down for adults who increase their fitness levels

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ASH: People With Hypertension Prefer Higher Salt Taste

Use of other seasonings in food can curb preference for higher salt intake

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Passive Smoking Exposure Tied to Lower HDL-C Among Teen Girls

Girls, but not boys, exposed to passive smoke from birth have lower HDL-C levels at age 17

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Dual Chamber ICDs Linked to More Complications

Single- and dual-chamber devices associated with similar mortality and hospitalization rates

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Healthy Lifestyle Offsets Cardio Risks From Job Strain

With job strain, healthy lifestyle linked to 53 percent lower CAD risk versus unhealthy lifestyle

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IOM: Health Effects of Further Lowering Sodium Unclear

Higher sodium intake tied to heart disease; insufficient evidence to determine optimal intake

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Higher Acute Aortic Dissection Risk With Lower-Volume Care

Lower mortality rates seen with surgeons, institutions performing more operations

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New FDA Survey to Assess Doc Attitudes on DTC Advertising

New survey will examine attitudes among non-physicians, including nurses, physician assistants

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No Change in Sodium Content of Ready Food From '05 to '11

And, meals at sit-down restaurants have nearly a full day's worth of fat, more than a day's sodium

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User Satisfaction With Electronic Health Records Down

Twelve percent decrease in user satisfaction since 2010; increase in very dissatisfied users

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Poor Service, Bedside Manner Top Patients' Online Complaints

Review of 'rate-your-doctor' websites reveals patients' most common gripes

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Antidepressants Benefit Post-CABG Mental Health Recovery

Escitalopram doesn't affect mortality, morbidity, but improves depression, mental health

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Smartphones, Smartphone Apps Increasingly Used by Docs

Two reports show use of smartphones and apps for professional purposes is increasing

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HHS Releases Data on Inpatient Charges for Hospital Services

HHS is also providing funding to data centers to collate, analyze, publish data to assist consumers

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HRS: iPad2 Can Trigger Magnet Mode in Defibrillators

Magnets embedded in iPad2 cover and body trigger magnet mode; suspend anti-tachycardia tx

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HRS: Some Shocks in Young ICD Users Due to AC Leak in Pools

Case series shows electromagnetic interference due to alternating current leak can cause shocks

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HRS: No Need to Stop Warfarin for Pacemaker, ICD Surgery

Fewer significant pocket-device hematomas for continued warfarin versus bridging heparin

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Application for Health Coverage Has Been Simplified, Shortened

First-time consumers will be able to complete one three-page application, see all available options

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AATS: Low-Dose Warfarin Safe With Bileaflet Mechanical Valve

Lower bleeding risks with use of lower-dose warfarin, with no increase in stroke, TIA

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AATS: Single Dose of EPO Pre-Cardiac Op Cuts Need for Blood

High dose of human recombinant erythropoietin two days pre-op benefits cardiac surgery patients

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n-3 Fatty Acids No Benefit for High-Risk Cardio Patients

No drop in cardiovascular mortality or morbidity for patients without myocardial infarction

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For Men, Obesity in Youth Ups Cardiometabolic Risk by Age 55

Young obese men have increased risks, including type 2 diabetes, venous thromboembolism

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Long-Detection Interval Cuts Antitachycardia Pacing, Shocks

For patients receiving ICD, inappropriate shocks also reduced with long versus standard interval

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Patient-Reported Health Status Underused in Cardio Health

Health status is currently underutilized; has potential to inform decision making, target resources

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Diabetes, Hypertension Prevalent With Spinal Stenosis

Findings among nonelderly lumbar spinal stenosis patients, compared with controls

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AHA: Lifestyle Changes May Reduce Blood Clot Risk

Ideal levels of physical activity, body mass index most significantly linked to risk

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CDC: About One in Five U.S. Adults Meets Exercise Guidelines

In 2011, 20.6 percent of adults met guidelines for both aerobic activity and muscle strengthening

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Patients Most Annoyed by Long Waits, Unclear Test Results

Survey regarding doctor's office grievances identifies patients' top pet peeves

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Micro-, Macrovascular Changes Observed in Binge Drinkers

Significantly lower flow mediated vasodilation, nitroglycerin-mediated dilation versus abstainers

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Medicaid Coverage Doesn't Lead to Better Physical Health

After two years, no reductions noted in measured BP, cholesterol, or glycated hemoglobin levels

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Health Industry Payment Details to Be Publicly Available

New CMS website will detail financial ties between drug, device manufacturers and docs, hospitals

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AHA: Mediterranean Diet Improves Cholesterol Measures

Findings in men with metabolic syndrome, even without accompanying weight loss

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AHA: Blood Vessel Function Better With Controversial Diet

Restriction of lectin-containing foods, adding 'anti-aging' supplements reduces endothelial dysfunction

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Azithromycin Not Tied to Increased Risk of CV Death

Versus no antibiotics, penicillin; based on a general population of young, middle-aged adults

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April 2013 Briefing - Cardiology

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Renewed Efforts From AAFP to Repeal OTC Provision in ACA

Provision will increase costs to health care system; add to burden on physician offices

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FDA Approves Kcentra to Reverse Anticoagulation

Can be administered faster than plasma to stop severe bleeding in heart patients

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Mediterranean Diet Adherence Cuts Cognitive Impairment

Lower likelihood of incident cognitive impairment, especially among individuals without diabetes

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FDA Announces New Network to Focus Exclusively on Patients

Interactive tool designed to educate patients and advocates about processes of drug development

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L-Carnitine Found to Improve Heart Attack Outcomes

Significant improvements seen in all-cause mortality, ventricular arrhythmias, and angina

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EB: Sleep Restriction Affects Respiratory, Vascular Control

With sleep restriction, central chemosensitivity increases and endothelial function decreases

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EB: Displaying Exercise Needed to Burn Food Calories Effective

Displaying amount of exercise needed to burn off menu items shows benefits over just listing calories

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Medical Interns Spending Less Time With Patients

More time being spent at a computer since work hours were limited in 2011

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Saturday Marks Sixth Annual Rx Drug Take-Back Day

Collection sites will be available around the country

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Teens Targeting Strength, Cardio Fitness Battle Insulin Resistance

Findings detected among assessed youth followed into young adulthood

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Analgesics in Endurance Events Can Have Serious Adverse Effects

GI, kidney, and cardiovascular adverse events may increase with analgesic dose

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Air Pollution Linked to Marker of Atherosclerosis

Greater exposure to air pollution associated with greater increases in artery thickness

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One 12-Ounce Sweet Drink a Day Ups Risk of T2DM 22 Percent

Association for sweet drinks persists, even after adjustment for energy intake, body mass index

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Prevalence, Costs of Heart Failure Estimated for 2030

More than eight million U.S. adults expected to have heart failure by 2030; $70 billion in costs

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Physicians Less Empathetic in Talking to Heavy Patients

Patient weight plays no role in quantity of physicians' biomedical communications

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Risk of Delay in Response to Patient E-Mails Up Over Weekend

Increased risk of messages not being opened within 12 hours, not receiving response in 36 hours

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Diagnostic Errors Are the Leading Type of Malpractice Claim

Diagnosis-related payments from 1986 to 2010 totaled $38.8 billion

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AMA Reveals First Step Toward Improving Health Outcomes

First stage of initiative focuses on prevention of cardiovascular disease and diabetes

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Diabetes Target Achievement Up From 1999 to 2010, More Needed

Only 14.3 percent meet targets for glycemic control, BP, LDL cholesterol, and tobacco use

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Intestinal Microbiota Tied to Proatherosclerotic Metabolite

Raised levels of trimethylamine-N-oxide predict major adverse cardiac events

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Patient Characteristics Impact CABG-PCI Treatment Effect

Link between CABG and reduced mortality greater for those with diabetes, tobacco use, heart failure

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Behaviors Indicative of More Trips to Buffet Table Identified

Serving oneself immediately and using larger plate linked to more trips at all-you-can-eat buffet

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Pediatric HIV Antiretroviral Treatment Cardioprotective

Long-term highly active antiretroviral therapy associated with improved cardiac function

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Peri-Noncardiac Op Exposure to β-Blockers Improves Outcome

Exposure tied to lower mortality for patients with two or more Revised Cardiac Risk Index factors

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One-Year Survival Up for Critical Congenital Heart Defects

Increase in survival from 67.4 percent in 1979-1993 to 82.5 percent in 1994-2005 birth era

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TEDMED: Patients Can Become Leaders on the Health Team

Communities can raise their own leaders; may be key approach to change at community level

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TEDMED: Is the Obesity Crisis a Disguise for a Deeper Problem?

Surgeon-researcher discusses hypothesis that we may be 'blaming the victims'

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TEDMED: Get the Joy Back Into Health and Wellness

Surgeon General talks about importance of bringing joy back into movement and medicine

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TEDMED: The 'Zombie Doctor Apocalypse' Is Here

Innovative, satirical physician discusses the syndrome and antidote

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TEDMED, April 16-19, 2013

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Alternative Approaches May Be Beneficial for Lowering BP

Relatively stronger supporting evidence for exercise-based regimens, including aerobic

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ASCO: Combo Antibody Therapy Effective for Melanoma

Findings from a phase I study of concurrent ipilimumab and nivolumab for advanced melanoma

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Twitter Reveals Popular Health Beliefs About Acne

Disconnect found between Twitter word choices, perceptions and those of professional organizations

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Risk Factors ID'd for Poor Cutaneous Cell CA Outcomes

Tumor diameter, invasion beyond fat, poor differentiation, and location tied to poor outcomes

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Nonmelanoma Skin Cancer Tied to Lower Alzheimer's Risk

Same association not seen with Alzheimer's and other diagnosis or with all-cause dementia

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Majority of Surgical Residents Object to Regulated Hours

Many report noncompliance with the regulations and falsification of duty hours

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Primrose Oil, Borage Oil Not Effective Eczema Treatment

Findings based on extensive literature review over several decades of research

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Half of Plastic Surgeons Use Social Media Professionally

Social media use highest among those who primarily perform cosmetic plastic surgery

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Most Endoscopic Brow-Lift Patients Satisfied With Result

Most patients report increase in confidence; decrease in headaches for 50 percent of patients

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Port Wine Stains, Sturge-Weber Syndrome Genetically Linked

A somatic activating mutation in GNAQ identified as cause of both conditions

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Skin Cancer Tx Mostly Surgical, Regardless of Life Expectancy

For nonmelanoma skin cancer, treatment choice unaffected by patient prognosis

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FDA Proposes to Increase User Awareness of Sunlamp Risks

Proposed order would reclassify sunlamp products to moderate risk, require labeling relating to risks

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AAP Endorses Pediatric Acne Management Guidelines

Evidence-based treatment recommendations provide guidance for childhood, adolescent acne

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Potentially Toxic Metals Present in Lip Cosmetics

Researchers estimate risk based on detected concentrations and estimated daily use

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Penicillin Prophylaxis Prevents Recurrent Leg Cellulitis

Protective effect disappears after stopping treatment

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Breast Implants May Impair Breast CA Diagnosis, Prognosis

Increased odds of diagnosis at non-localized stage of disease; worse breast cancer survival

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April 2013 Briefing - Dermatology

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April 2013 Briefing - Cosmetic Surgery

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2012 Saw Major Increase in 'Arm Lift' Cosmetic Procedures

Upper arm lifts, including liposuction or brachioplasty, up 4,473 percent since 2000

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FDA: Purveyors of Phony Botox Targeting U.S. Practices

Products advertised through fax; not FDA approved

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History of Skin Cancer Linked to Secondary Cancers

History of NMSC associated with a greater risk of secondary cancers at other sites

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Fumarate Linked to Progressive Multifocal Encephalopathy

Two letters describe cases of lymphocytopenia, which contributes to PML

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Severe Cutaneous Adverse Rxns Up in Allopurinol Initiators

SCARs are rare; usually occur within first 180 days of initiating treatment

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HPV Exposure in Family, School Linked to Wart Development

Increased risk with white skin, and for children with family members, classmates with warts

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Outcomes No Worse With Home Call for Surgical Interns

Overall unadjusted morbidity and mortality rates no worse with home call versus in-hospital call

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Body Fat Reduction Best Predicts Exercise-Induced HbA1c Change

Improved fitness also highly predictive of HbA1c changes in response to exercise

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Prednisolone Disturbs Carbohydrate Metabolism

Patients with inflammatory diseases should consider other anti-inflammatory agents

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Exercise Prevents Fructose-Induced Hypertriglyceridemia

Changes induced by high-fructose diet are normalized with moderate aerobic exercise

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Marijuana Use Tied to Lower Fasting Insulin Level, HOMA-IR

Current users have lower fasting insulin, lower insulin resistance, smaller waist circumference

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CDC: Guidelines Reduce Blood Infections at Dialysis Facilities

Interventions included chlorhexidine use, staff training, and audits

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Hospital Hypoglycemia Rates Up in Black Men With Diabetes

Home diabetes regimen partially explains the increased risk of hypoglycemia

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ECO: Distilled Water Doesn't Up Resting Energy Expenditure

Drinking 500 ml distilled water does not increase REE; modest increase seen with bottled water

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ECO: Industry-Funded Reviews Query Sweet Drink, Obesity Tie

Industry-funded reviews find weak evidence for link; other reviews show well-founded evidence

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Even Mild Iodine Deficiency Can Affect Child's Cognition

Mild deficiency during pregnancy has effect on fetal neuro-cognition that persists at age 9

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'Eating More Protein' Strategy Helps Women Lose Weight

Strategy of eating more protein linked to weight loss over two-year period for middle-aged women

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Hormones, Amino Acids Altered by Gastric Bypass Surgery

Model allowed simulation of preoperative condition and postoperative situation in the same patient

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Insurer Incentive Program for Obese Encourages Walking

Most met their step targets and appreciated the value of the program

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Title V Coverage Varies Across States for Diabetes

Children with diabetes in 32 states eligible to Title V programs; based on link to federal poverty limit

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Virtual Reality Beneficial for Weight Maintenance

Virtual reality not as good as face-to-face for weight loss; better for weight maintenance

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American Association of Clinical Endocrinologists, May 1-5, 2013

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Cases Question Diagnostic Criteria for Inherited Diabetes

Patients developed diabetes ketoacidosis even though this normally excludes genetic testing

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LAP-BAND Safe, Effective for Obese With BMI <40 kg/m²

Improvements in weight loss, quality of life, and comorbidities through two years

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Genetic Variant May Explain Weight Loss Post-RYGB Surgery

Locus identified at 15q26.1, which is linked to weight loss after Roux-en-Y gastric bypass

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PAS: Magnesium, Not Calcium, Linked to Bone Mineral Status

Among 4- to 8-year-olds, dietary magnesium, not calcium linked to bone mineral content, density

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AUA: Websites for Testosterone Replacement Mum on Risks

Risks mentioned more often on websites run by urologists or endocrinologists

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ACOG: Nutritional Components of Diet Impact Fertility

Protein intake of more than 25 percent linked to increased blastocyst development, pregnancy rate

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Injecting Insulin Through Clothes May Contribute to Infection

Emerging evidence of prolonged incubation period for cutaneous mycobacterium

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~13 Percent of Total Calories Come From Added Sugars

Most of the calories from added sugars come from food, not beverages, and are consumed at home

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ECE: Abnormal Metabolites Found in Cured Cushing's Patients

Suggestive of neuronal dysfunction

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ECE: Gene Variants Linked to Reduced Male Fertility

Study examines variants in follicle stimulating hormone and its receptor

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April 2013 Briefing - Diabetes & Endocrinology

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Social Network Interests Can Predict Obesity Prevalence

Higher obesity prevalence for areas with more people with TV-related interests on Facebook

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Zoledronic Acid Linked to Early Increase in Sclerostin Levels

For postmenopausal women, sclerostin up within two days; returns near to baseline after 360 days

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Teen Moms More Likely to Be Subsequently Overweight

Findings based on a large, nationally representative cross-sectional survey

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Post-Fracture Targeting Boosts Osteoporosis Management

Mail-based interventions demonstrate better cost-effectiveness than usual care

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Report Updates Impact of Hypoglycemia in Diabetes

Reviews outcomes, strategies, and current gaps in knowledge

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Gene Variants Link to Insulin Resistance Based on Diet

Variants of IRS1 associated with metabolic syndrome under certain dietary conditions

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Teen Type 1 Diabetes Outcomes Up With Internet Interventions

Better outcomes with diabetes management education and behavioral interventions

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Food-Tied Parenting Practices Common in Parents of Teens

Use of food restriction and pressure-to-eat practices varies with adolescent weight

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DDW: Full-Spectrum Beats Forward-Viewing Colonoscopy

Increased polyp and adenoma detection rates with use of full-spectrum endoscopy colonoscope

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DDW: Vitamin D May Be Beneficial in Crohn's Disease

Improvements in muscle strength, fatigue, quality of life for patients with stable Crohn's

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FDA Approves Simponi for Ulcerative Colitis

Golimumab injection approved to treat adults with moderate-to-severe ulcerative colitis

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Only Half Newly Reported HCV Cases Receiving Follow-Up Test

HCV antibody positivity and HCV RNA positivity more likely among those born from 1945 to 1965

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For Living Donor, Liver Transplant Mortality Rate at 0.2 Percent

Higher experience tied to lower rates of aborted hepatectomies and near-miss events in donors

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Bacterial Contamination Rife in Retail Store Ground Turkey

Ninety percent of samples contaminated with one of five bacteria; many bacteria resistant to antibiotics

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April 2013 Briefing - Gastroenterology

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FDA: Samsca May Cause Liver Damage

Use should be time-restricted or avoided in some patients

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Female Smokers More Susceptible to Colon Cancer

Female smokers have significantly increased risk, particularly for proximal colon cancer

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Comprehensive Discussion With Docs Ups Cancer Screening

Odds of screening up with more comprehensive discussion, greater perceived benefits of screening

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Sofosbuvir Shows Promise for Chronic Hepatitis C Infection

Two studies each reporting on two trials demonstrate good sustained virologic response

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CT Radiation Risk Less Than Risk of Examination Indicator

The most common non-cancer indications for body CT are trauma and abdominal pain

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Vitamin C Deemed Ineffective As Therapy for Gout

Pilot study shows no clinically significant lowering of serum urate after eight weeks

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Whole-Cell Pertussis Vaccines More Effective Protection

Teens who received DTaP have significantly higher risk of developing pertussis during outbreak

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Boyhood ADHD Tied to Obesity in Adulthood

Higher rates of obesity, BMI found in men with remitted ADHD versus men with no ADHD history

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Increase in ICU Admissions From Emergency Departments

From 2002/2003 to 2008/2009, 48.8 percent increase in ICU admissions from ERs in U.S.

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Little Evidence for Prediction Rules for Low Back Pain

Trials are of low quality and provide insufficient support of clinical prediction rules

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Review: Exercise Indeed Beneficial for Major Depression

Exercise beneficial as monotherapy or adjunct tx; maximum effect with 10 to 12 weeks exercise

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Study Reviews Readmissions in Inpatient Psychiatric Facilities

Study finds most Medicare beneficiaries treated in IPFs exhibit characteristics linked to readmission

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DSM-4 Task Force Chairman Advises Caution With DSM-5

Diagnostic changes are likely to lead to overdiagnosis, unnecessary treatment, high costs

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CT Usage in Pediatric Trauma Cases Stable in Recent Years

For children versus adults, spine, maxillofacial, thoracic CT less likely; head CT more likely

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Discectomy Post-Op Pain Worse in Patients With Retrolisthesis

Vertebral slippage makes it difficult to manage back pain and physical function after surgery

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Study Compares Surgical Procedures for Spinal Stenosis

Fewer complications, but higher rate of revision surgery for interspinous process with spacer alone

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Cancer Diagnosis Tied to Increased Bankruptcy Risk

Findings show younger cancer patients are increasingly vulnerable to bankruptcy

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Traumatic Brain Injuries May Up Suicide Risk in U.S. Troops

Multiple traumatic brain injuries increase suicidal ideation in deployed military personnel

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Many Patients Would Switch Doc to Cut Health Care Costs

For most patients willing to switch, saving of $500 to $1,000 annually enough to justify switch

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CDC: Mental Disorders on the Rise in U.S. Youth

CDC calls for more comprehensive surveillance

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Ultrasound Findings Can Improve Classification of RA

Ultrasound findings plus 2010 ACR/EULAR criteria can help predict need for methotrexate treatment

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Surgeon Variation Affects QoL After Prostatectomy

Significant associations seen in men's urinary and sexual function based on surgeon

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Overinterpretation Common in Diagnostic Accuracy Studies

Imaging studies have similar proportions of overinterpretation, misreporting

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School-Based Smoking Prevention Programs Work

Programs' effectiveness seen one year or more after implementation

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No Benefit of Vertebral Body Stenting Over Kyphoplasty

Higher pressures during balloon inflation and more material-related complications with stenting

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Docs and Nurse Practitioners Have Different Role Perceptions

Research shows discrepancies in the way the role of nurse practitioners is viewed

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Combination Osteoporosis Rx Further Improves Bone Density

Teriparatide and denosumab administered together more effective than either therapy alone

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Meds for Back Pain Tied to Higher Erectile Dysfunction Risk

Dose and duration of opioid use associated with increased odds of erectile dysfunction

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Insomnia Tied to Greater Health Care Utilization

More hospitalizations, home health care, nursing home use with increasing insomnia symptoms

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Cognitive Health Info From Doctors Found to Be Lacking

Most patients get info from TV, magazines; only 7.8 percent report receiving info from physicians

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Chiropractic Therapy Helps Reduce Acute Low Back Pain

Manipulative interventions used with standard medical care boosts LBP outcomes

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Classification System Would Help Spinal Deformity Care

Review: management of adult spinal deformity, optimal fusion levels incompletely defined

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Review: In-Hospital Antibiotic Rx Behavior Can Be Improved

Meta-analyses show that restrictive and persuasive methods improve prescribing in hospital setting

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Guidelines Issued to Prevent Infection With Dental Work

Three recommendations to prevent orthopedic implant infection for patients having dental work

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No Recent Change in Youths' Use of Smokeless Tobacco

Decreases seen for children aged 14 years or younger; increase for those aged 15 to 17 years

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Pelvic Organ Prolapse Surgery Loses Effectiveness

Long-term follow-up shows increasing failure rates

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Simulator-Based Robotic Sx Curriculum Hones Skills

Significant improvements seen in effectiveness of surgery skills, instrument handling

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Glove Balloon Design Useful for Distraction of Children in ER

Inflated hospital glove is useful distraction for children with acute injury

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Experts Aim to Draw Attention to High Cancer Drug Costs

Leukemia experts call for examination of the 'right' way to price life-saving drugs

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Nearly 10 Percent of Patients Have C. Difficile at Admission

Screening patients with risk factors would have identified 74 percent of C. difficile carriers

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Social Considerations Not Accounted for in DSM-5

Other forces that drive the diagnosis of mental disorders not adequately considered, editorial says

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Even Low Blood Lead Levels May Impact Children's Cognition

Children with levels ≥5 µg/dL more likely to fail to achieve benchmark for reading readiness

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USPSTF Recommends Screening Adults for Alcohol Misuse

Brief intervention should be provided for those who engage in risky or hazardous behavior

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Excessive Soda Can Mimic Illicit Drug Use Effects on Teeth

Dental erosion due to methamphetamines, crack cocaine, excessive soda can be misdiagnosed

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Self-Image Worse for Teens With Untreated Scoliosis

Also report worse pain, but difference is not clinically significant from unaffected

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FDA Approves Breo Ellipta for Treatment of COPD

Respiratory disease is the third-leading cause of death in the United States

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Creative Arts Therapies Up Mental Health for Cancer Patients

Review shows significant reductions in anxiety, depression, pain; improved QoL during treatment

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Strong Genetic Component of Fibromyalgia Suggested

One major locus for fibromyalgia detected on the chromosome 17p11.2-q11.2 region

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Hospital Rapid Response Teams Need Training

Teams are effective but require good communication

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Specific Antibiograms Needed for Outpatients in Primary Care

Differences in susceptibility to ciprofloxacin among P. aeruginosa for inpatients, primary care

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Accidental Strangulation Is Hazard of Looped Blind Cords

In U.K., one to two children thought to die each year from blind cord strangulation

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With Suspected TB, Behavioral Support Curbs Smoking

Behavioral support with or without bupropion better than usual care for smoking abstinence

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Menopause Education Lacking in U.S. Residency Programs

Only one-fifth of residents are in program with menopause medicine learning curriculum

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Depression Overdiagnosed, Overtreated in the Community

Those more educated, with poorer overall health were more likely to meet major depression criteria

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Pediatric Academic Societies, May 4-7, 2013

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One in Eight Over Age 60 Reports Memory Loss, Confusion

Study provides baseline estimate of those who might require services, support in the future

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In Most States, Primary Care Medicaid Payments to Increase

In 2013, average increase of 73 percent in Medicaid payments for primary care services

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Study Quantifies Injuries Involving Amusement Rides

Annual injury rate requiring ER visits is 6.24 per 100,000 children, but hospitalization rare

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Hospice Use Down in Terminal Patients With Religious Support

For these patients, spiritual support from medical team ups hospice use, cuts interventions

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ACOG: Better Outcomes for IVF by Single-Embryo Transfer

Obstetric and neonatal outcomes better than double-embryo transfer

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AUA: Primary Care Treatment for UTI Could Save $2 Billion

Treatment in the emergency room more expensive

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AUA: Death Up in Weekend ER Visits for Prostate Cancer Patients

Patients with metastatic prostate cancer who visit ER over the weekend have increased odds of death

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AUA: ER Visits for Hematuria Pose Sizeable Economic Burden

Studies show increased costs for patients who undergo imaging; considerable annual ER charges

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AAFP Member Urges Investment in Primary Care

During testimony to Congress committee, emphasis on support for a strong primary care service

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Guidelines Issued for Exercise-Induced Bronchoconstriction

Evidence-based guidelines developed for diagnosis and appropriate management of EIB

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Shift in Lung Allocation Score Alters Transplant Survival

Assessing for acute changes could help inform strategies for organ wait lists

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ARVO: Additional Nutrients Do Not Reduce Progression to AMD

Adding carotenoids, omega-3s does not further lower risk of age-related macular degeneration

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AATS: MnDCT Beats Chest X-Ray for Detecting Lung Cancer

MnDCT has similar radiation to X-ray, greater sensitivity for detecting new and recurrent cancer

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Palivizumab Cuts Number of Days of Wheezing in Preemies

Monoclonal antibody given to prevent RSV tied to reduction in days of wheeze during first year

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Higher Incidence of Multiple Sclerosis Seen for Blacks

Black women have increased risk versus white women; risk similar for black and white men

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PAS: Neurodevelopment Marred With Prenatal PBDE Exposure

Increased exposure to brominated diphenyl ethers tied to cognitive deficits, hyperactivity in children

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PAS: Most High School Athletes Won't Report Concussion

Despite being knowledgeable about symptoms, most feel it's acceptable to play with a concussion

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PAS: Racial Variation in Age-Appropriate Restraint Use

Second study shows most drivers of children are distracted; phone calls most common distraction

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Ambrisentan Not Effective in Idiopathic Pulmonary Fibrosis

Increased risk of disease progression, respiratory hospitalizations with ambrisentan treatment

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In-Utero Exposure to Migraine Drugs May Lower Offspring IQ

FDA recommends pregnant women avoid certain migraine medicines completely

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Belief in God Tied to Greater Psychiatric Treatment Response

Belief in God linked to reduced depression, self-harm even after controlling for age and gender

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AUA: Incidence of Testicular Cancer Up Through 2009

Largest increase seen for Hispanic men, at 5.6 percent annually from 2002 to 2009

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AUA: Low-Dose Pill Linked to Chronic Pelvic Pain Symptoms

Low-dose OCP users also have increased incidence of pain or discomfort during or after climax

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ACOG: Most Hospitals Have Implemented Induction Policies

Second study shows decrease in time to delivery for elective inductions post-policy implementation

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PAS: Children With Strep Don't Need to Toss Toothbrushes

Toothbrushes from children with GAS did not show GAS bacterial growth

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PAS: Prenatal Vitamin C Cuts Wheeze in Infants of Smokers

Vitamin C seems to have greatest effect on infants born to pregnant smokers with rs16969968 allele

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PAS: Nearly Half of Teens Report Texting While Driving

Texting while driving more likely among males and older adolescents

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PAS: Childhood Disability Rates Up 16 Percent in Past Decade

Lower rates of physical disability but higher rates of mental disability

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PAS: Cyberbullying Common Among High School Students

Prevalence found to be highest among females

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2000 to 2009 Saw Drop in Pediatric Hydrocarbon Injuries

Injuries mainly among males, children aged 1 to 2; ingestion is most common mechanism of injury

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Parental Saliva on Infant's Pacifier Protects From Allergies

Children whose parents 'clean' their pacifiers have significantly reduced odds of asthma, eczema

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American Association of Neurological Surgeons, April 27 - May 1, 2013

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AUA: Many Men With Erectile Dysfunction Untreated

Under-treatment persists despite heavy promotion in the media

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PAS: Target Oxygen Saturation Levels for Preemies Explored

Different results seen in two studies comparing 85 to 89 percent versus 91 to 95 percent saturation

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Video Games Improve Cognition in Older Adults

Games improve visual speed of processing

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Ethical, Legal Aspects of Docs' Discrimination Discussed

Inclusion of weight as a protected category under civil rights laws is one way of protecting obese

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1997 to 2011 Saw Increase in Allergies Among U.S. Children

Prevalence of all allergies lower among Hispanic children; prevalence varies with income level

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In-Hospital Mortality No Different at Critical Access Hospitals

Mortality similar at CAHs, non-CAHs for eight common procedures; costs higher at CAHs

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Self-Medicating With Alcohol Linked to Later Dependence

Self-medicating for mood disorders linked to subsequent incident and persistent dependence

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Nearly One-Third Don't Pick Up New Osteoporosis Rx

Women receiving Rx from rheumatology, internist practicing 10 or more years more likely to get meds

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Prevalence of Prolonged Fatigue 3 Percent in U.S. Teens

More than half of teens with prolonged fatigue have comorbid depressive or anxiety disorder

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IMFAR: Sex Difference in Visual Scanning Patterns in ASD

Second study shows females with ASD have increased risk-linked de novo variants than males

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IMFAR: Robot Co-Therapist May Be Beneficial in ASD

And child communication can be improved with augmentative alternative communication devices

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Low Birth Weight Accounts for Part of Intellectual Disability

Low birth weight correlates with about 10 to 15 percent of the total prevalence of ID

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ASBS: Value of <12-Month Interval Imaging Examined

Imaging performed less than 12 months post benign biopsy has low yield for breast cancer detection

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CDC: Big Increase in Middle-Aged Suicides Seen 1999-2010

Suicide rate increased nationally, particularly among whites, American Indian/Alaska Natives

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Teriparatide Injections Improve Pedicle Bone Quality

Findings compared to either oral administration of bisphosphonate or no medication for osteoporosis

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Young Vets With PTSD Receive More CT Scans

Daily probability of receiving a scan significantly higher prior to PTSD diagnosis

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Coordinated Approach Needed to Protect From Arsenic Exposure

Physicians, FDA, and legislators have roles to play in monitoring and regulating arsenic in foods

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AANS: Brain Machine Interface Can Control Prosthetic Arm

After six months, robust 10 degree-of-freedom movements routinely performed

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Breath Test Can Detect Illicit Drug Use Up to 24 Hours Later

Simple, commercially available breath sampler can detect 12 analytes

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Neuraxial Bests General Anesthesia in Arthroplasty

Significantly better 30-day mortality, length of stay, and in-hospital complications with neuraxial

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Foreign-Born U.S. Children Have Lower Odds of Atopic Disorders

After 10 years of residence in U.S., odds increase for allergic disorders, not asthma, food allergies

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April 2013 Briefing - Family Practice

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April 2013 Briefing - Nursing

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April 2013 Briefing - Surgery

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April 2013 Briefing - Internal Medicine

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April 2013 Briefing - Critical Care

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April 2013 Briefing - Emergency Medicine

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Plan B Approved for Women 15 Years and Older Without Rx

FDA says company submitted data showing that women 15 years and older understood proper use

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SAMHSA: Sharp Rise in ER Visits Due to Zolpidem

Emergency department visits up over 200 percent from 2005 to 2010

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Manufacturers Donating Limbs to Boston Victims

Group vows to assist those whose insurance fails to cover costs for prosthetic legs

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Risk Factors ID'd for Scoliosis Surgery Complications

Curve, kyphosis, and number of rod-lengthening procedures independently linked to complications

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Novel System Proposed for Accountable Cancer Care

Cancer Care Groups proposed, which would be compensated under bundled payment system

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Comprehensive Analysis Supports SERMs for Cutting Breast Cancer

Meta-analysis shows reduced incidence of breast cancer, especially in first five years of follow-up

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Optimal Vitamin D Dosage for Infants Remains Uncertain

Study offers comparison of effect of different vitamin D supplementation dosages in breastfed infants

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Outcomes Often Good for Extremely Premature Infants

About 75 percent of infants have mild or no neurodevelopmental disability at 2.5 years of age

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Virological Failure Up With Nevirapine in HIV-Infected Youth

Combined end point of virological failure higher for children receiving nevirapine versus efavirenz

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Non-Inferior Response With Two-Dose HPV Vaccine

Non-inferior antibody response one month after last dose for girls receiving two or three doses

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No Evidence of Lyme Disease in Children With Autism

Two-tier testing shows no serological evidence among children with autism or unaffected controls

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Multicenter Study Links Peri-Op SSRI Use to Adverse Outcomes

Increased odds of in-hospital mortality, bleeding, 30-day readmission, after adjustment

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FDA Concerned Caffeinated Foods Could Harm Children

Such products becoming abundant in U.S. markets

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High Doses of Saw Palmetto Appear Safe Over 18 Months

No evidence of toxicity for patients given doses of up to 960 mg daily for up to 18 months

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Rx for High-Risk Meds Varies Widely in Medicare Advantage

Women, whites, low-income patients, and those in the South more likely to receive high-risk meds

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Explicit Sex Materials Modestly Influence Sexual Behaviors

After accounting for variables, SEM use accounts for 0.3 to 4 percent of variance

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AAP Issues Guidelines for Care of Infants Born at Home

Requirements for assessment, resuscitation, and care of newborn infants born at home summarized

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Med Errors Common Among Pediatric Cancer Outpatients

Rate of 3.6 medication errors with injury per 100 patients; errors more common with non-chemo meds

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Child Fruit Consumption Up With Pre-Slicing in Schools

Study also finds that schools serving pre-sliced fruit saw decreases in food waste

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USPSTF Recommends Universal HIV Screening From Age 15 to 65

Grade A recommendations include screening older and younger at-risk individuals, pregnant women

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Hawaii Is Least Stressed State With Highest Enjoyment Levels

Based on Gallup-Healthways poll, Hawaii, Louisiana, Mississippi, Iowa, Wyoming are least stressed

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Standardized Debriefing Ups Outcomes on CPR Simulation

Improvement in knowledge and team leader behavioral performance with scripted debriefing

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Standard Criteria Needed for Spinal Stenosis Diagnosis

MRI is the most promising imaging test; superior to electrodiagnostic testing

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One-Third of Female Marathon Runners Report Breast Pain

Breast cup size significantly related to reported symptoms of pain

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Mindfulness-Based Cognitive Therapy Improves PTSD

Results based on an eight-week pilot program involving veterans seeking outpatient treatment

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Smoking Water Pipes Is Not a Safe Cigarette Alternative

Different patterns of exposure to tobacco toxins seen with cigarettes, water pipes

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Collagenase Clostridium Histolyticum OK in Peyronie's

Improvements in penile curvature deformity, Peyronie's disease bother score

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Insurance Prior Authorization Doesn't Up Psych ER Stay

Average of 38 minutes needed to receive insurance authorization for admission

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Natural Ventilation Effective in 'Nightingale' Wards

Small extractor fans added to naturally-ventilated hospital wards can improve ventilation year round

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Review: All Approved Drugs Similarly Prevent Migraines

Off-label angiotensin-inhibiting drugs and beta-blockers have favorable benefit-to-harm ratios

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Even Light Smoking Increases Risk of RA Among Women

Smoking cessation reduces, but does not eliminate, risk of rheumatoid arthritis

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Device Detects Blood Fungal Infections Rapidly

Portable device detects Candida bloodstream infections accurately

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Most With Confirmed H7N9 Avian Flu Are Critically Ill

Possible human-to-human transmission in two family clusters; no transmission in close contacts

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American Lung Association Stresses Clean Air Act Benefits

Despite uptick in short-term unhealthy air days, across the nation, year-round pollution declines

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Obesity Tied to Risk of Prostate Cancer After Negative Biopsy

Also associated with the presence of precancerous lesions in initial benign biopsy

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Teen Residence in Stroke Belt Linked to Risk of Stroke

After adjustment for risk factors, residence in stroke belt during adolescence increases risk of stroke

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Impact of Childhood Bacterial Meningitis Lasts Into Adulthood

Bacterial meningitis in childhood linked to lower education attainment, economic self-sufficiency

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Review Looks at Best Modality for Diagnosing Ectopic Pregnancy

Sonogram found to be best diagnostic method for women with abdominal pain, vaginal bleeding

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Asthma Health Care Access Worse for Young Adults

Compared with teens, young adults have worse access to health care and use care less optimally

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Doc Describes Medical Tent Experience of Boston Marathon

A doctor describes the transition from providing care to runners to feelings of helplessness

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Breast CA Tx Delays Still More Common for Poor, Uninsured

And, women with early-stage breast cancer with Medicaid are more likely to receive mastectomy

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Brain Stimulation Reduces Smoking Cravings

Reduction in craving temporary, but greater in those with greater nicotine dependence

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Firearms Account for About 2 Percent of Child Injuries

Firearm injuries more severe, more often require intensive care, and have higher death rate

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Maternal Use of Valproate Ups Risk of Autism in Offspring

Significantly increased risk of autism spectrum disorder, childhood autism with prenatal exposure

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Drop in Genital Warts in Young Women Since HPV Vaccination

Five years into vaccination program, proportion of young women ≤30 years with genital warts down

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U.S. Shortfall in Neurologists Expected to Get Worse

Current national shortfall of 11 percent projected to increase to 19 percent by 2025

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Breast Density Linked to Breast Cancer-Specific Survival

For women treated with tamoxifen, decrease in mammographic density tied to improved survival

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Interdisciplinary Model Ups Care of Hospitalized Elderly

Admission to MACE services linked to lower rates of adverse events, shorter length of stay

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Parental Permissiveness Linked to Rx Drug Abuse, Misuse

About one-quarter of teens report abuse, misuse of prescription meds; about half use pot, alcohol

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>40 Percent of Parents Give Cough Meds to Young Children

Despite warning label that products should not be used for young children, many parents give meds

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USPSTF: Primary Care Screening Can Help ID Suicide Risk

Based on limited evidence, tools could probably identify adults at risk; limited ability for teens

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Dangers of the 'Cinnamon Challenge' Need Emphasis

Attempt to swallow dry cinnamon carries risk of aspiration; inhalation can cause lung inflammation

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Mammogram Rates Unchanged Since USPSTF Recommendations

No decrease in mammography screening noted for women aged 40 to 49, 50 to 74 years

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Docs' Role in Gauging Fitness for Concealed Weapons Queried

Standards, guidelines needed for ethical, legal, policy issues related to assessment of competency

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American Urological Association, May 4-8, 2013

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American College of Obstetricians and Gynecologists, May 4-8, 2013

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April 2013 Briefing - OBGYN & Women's Health

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April 2013 Briefing - Urology

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April 2013 Briefing - Geriatrics

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Integrated 2D, 3D Mammogram Improves Cancer Detection

Depending on the recall strategy, integrated strategy can reduce false-positive recall

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Challenges Remain for Global Eradication of Polio

Challenges of vaccination discussed for endemic polio in Afghanistan, Nigeria, and Pakistan

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April 2013 Briefing - HIV & AIDS

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April 2013 Briefing - Infectious Disease

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Avian to Human Transmission of H7N9 Flu Virus Identified

Study confirms four cases of human H7N9 infection in Zhejiang, China, following poultry contact

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Post-Mortem MRI Accurate for Fetuses, Newborns, Infants

Similar accuracy to conventional autopsy for fetuses, newborns, infants; less accurate for older children

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Mutations in CSF3R Common in CNL, Atypical CML

Mutations segregate within two regions of gene; lead to differential downstream kinase signaling

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April 2013 Briefing - Pathology

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Average of 13 Mutations ID'd in Adult AML Genomes

At least one nonsynonymous mutation in a gene relevant for pathogenesis seen in nearly all cases

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Study Describes Outcomes, Tx for HER2-Mutated Lung Cancers

In largest to date study dedicated to HER2-mutated non-small-cell lung cancer cases

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Implanted Device Accurately Predicts Seizure Onset

Used in patients whose epilepsy is resistant to drugs

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April 2013 Briefing - Neurology

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April 2013 Briefing - Anesthesiology

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MRI Atrophy Measures May ID Patients Progressing to MS

Development of thalamic, central atrophy tied to conversion to CDMS over two years

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Pill Form of Marijuana Found to Alleviate Pain for Longer Period

Pill form produces longer-lasting pain relief and lower abuse-related effects

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FDA: Test Approved to Detect Faulty Gene in Some Lung CA

Gene present in 10 percent of NSCLC cases

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FDA Approves Xofigo for Advanced Prostate Cancer

When disease has spread to the bones but not to other organs

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SPACE, RF Ablation Combo Safe and Effective for Lung Cancer

Combination treatment is technically feasible, safe, and effective for unresectable lung tumors

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April 2013 Briefing - Hematology & Oncology

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Lifestyle Activities Impact Development of Spinal Stenosis

Those with degenerative lumbar spinal stenosis more frequently lift loads, have higher BMI

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April 2013 Briefing - Orthopedics

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Majority Use Cell Phones With Same Ear As Dominant Hand

Most right-handed and left-handed people use cell phone in their right or left ear, respectively

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Association for Research in Vision and Ophthalmology, May 5-9, 2013

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April 2013 Briefing - Ophthalmology

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April 2013 Briefing - Otolaryngology

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April 2013 Briefing - Pain Management

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April 2013 Briefing - Pediatrics

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FDA Approves Procysbi for Nephropathic Cystinosis

Study finds drug effective at controlling cystine levels

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April 2013 Briefing - Pharmacy

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April 2013 Briefing - Psychiatry

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April 2013 Briefing - Radiology

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Society of Interventional Radiology, April 13-18, 2013

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April 2013 Briefing - Nephrology

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April 2013 Briefing - Allergy

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April 2013 Briefing - Pulmonology

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April 2013 Briefing - Rheumatology

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