Sudden deaths in young athletes | Measuring success in the transition to adult care for youths with chronic illness | Chronic kidney disease risk in stone formers
Sudden deaths in young competitive athletes are tragic events, with high public visibility. The importance of race and gender with respect to sport and the diagnosis and causes of sudden death in athletes has generated substantial interest.
Measurable outcomes for success of the transition to adult care for youths with chronic illness should include clinic attendance as well as hospitalizations pre-transfer and at least three years post-transfer. Additionally, satisfaction should be measured using a standardized instrument. As outcomes differ based on diagnosis, professional organizations should develop standardized, consistent methods to measure disease-specific outcomes.
The authors in this study compared the risk of chronic kidney disease (CKD) among brushite vs calcium oxalate stone formers. They concluded that brushite stone formers are not an increased risk of CKD compared to calcium stone formers. Among stone formers, factors such as recurrent urinary tract infections, struvite stones, hypertension, and diabetes seem to be at highest risk for CKD. The primary reason that stone formers have CKD is associated with pyelonephritis, in particular from an obstructive process. Nevertheless, renal stones have been associated with CKD; an active approach to preventing stones with metabolic management and prompt referral to a urologist when stones are detected is needed.
Hospitalization for acute myocardial infarction (AMI) is an opportune time to counsel smokers to quit. Data were used from a cohort study of elderly patients with AMI between 1994 and 1996 with >17 years of follow-up to evaluate the association of smoking-cessation counseling (SCC) with short- and long-term mortality. Non-counseled smokers had higher crude mortality than counseled smokers over all 17 years of follow-up. SCC was associated with a 22.6% reduction in 30-day mortality, a 7.5% reduction in mortality over 17 years, and average gains in life years of 0.13 to 0.58 years.
Electronic health information exchange (HIE) between hospitals and long-term care facilities -- how often does it happen? Researchers from Ann Arbor, Mich., reported that over half of the 1,991 readmissions studied showed that hospitals and long-term care facilities shared some form of HIE. Payment plans now emphasize payment for value care, so there is incentive to pursue avenues of care, such as HIE, that can help prevent readmissions.
This randomized clinical trial investigated the effectiveness of exercise versus exercise plus trigger point dry needling (TrP-DN) in subacromial pain syndrome. A randomized parallel-group trial with one-year follow-up was conducted. Fifty subjects with subacromial pain syndrome were randomly allocated to receive exercise alone or exercise +TrP-DN. This study found that the inclusion of two sessions of trigger point dry needling into an exercise program was effective for improving shoulder pain-related disability at short-, medium- and long-term follow-up; however, no greater improvement in shoulder pain was observed.
Oxytocin receptor-targeted immunoliposomes inhibit human myometrial contractions, localize to the uterus of pregnant mice and can be used to reduce rates of LPS-induced preterm birth.
American Cancer Society data showed a 25% decrease in cancer death rates in the US since the early 1990s, driven mainly by declines in deaths from colorectal, lung, breast and prostate cancers. Researchers credited decreasing smoking rates and earlier detection and treatment of cancer.
"Weekend warriors" who exercised just once or twice per week had lower mortality and cancer risks compared with people who did not exercise at all, researchers reported in JAMA Internal Medicine. The study found any exercise level was beneficial, compared with inactivity.
A study in the American Journal of Clinical Nutrition found people with a diet high in cholesterol did not have a higher risk of dementia or Alzheimer's disease. Researchers said the same was true for people with a gene variant that affects cholesterol metabolism and increases the risk of memory problems.
CMS and the National Library of Medicine published an addendum to the 2016 Electronic Clinical Quality Measure specifications that updates Procedure Coding System and ICD-10 Clinical Modification eCQM value sets for the 2017 performing year. The changes will affect the Merit-Based Incentive Payment System for eligible clinicians and the Medicare EHR Incentive Programs and the Hospital Inpatient Quality Reporting Program for eligible hospitals and critical access hospitals.
A study published recently in the American Journal of Medical Quality found a clear link between clinically validated patient safety indicators and patient outcomes, but researchers noted shortfalls in identifying PSIs. A forthcoming report from the National Quality Forum will urge improvements in the quality of claims data to measure PSIs.
Patient satisfaction questionnaires that are not tailored to specialties yield biased results because patients' expectations can vary based on their medical conditions, according to an article published in Plastic and Reconstructive Surgery. Accurate survey results are increasingly important as the health care system moves toward a pay-for-performance model, and fear of poor patient satisfaction ratings could lead to inappropriate prescribing, study co-author Justin Cohen said.
Everyone can rise above their circumstances and achieve success if they are dedicated to and passionate about what they do.
Nelson Mandela, activist and political leader
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