Should chronic disease patients be told to gain weight?
The obesity paradox may be partly explained by selection on a baseline variable (e.g., diabetes) affected by prior exposure (body weight before baseline). Because results from observational studies in which the start of follow-up and exposure do not coincide should be interpreted with care, the obesity paradox provides little evidence that chronic disease patients should gain weight. The American Journal of Medicine
(4/2015) Share: 
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Braking bad: Kidney failure from brake fluid exposure
In this month's AJKD, Devoti et al. describe poisoning from transcutaneous exposure to diethylene glycol, a widely used solvent found in products like brake fluid. A previously healthy 29-year-old man presented with gastrointestinal symptoms, weakness, hypertension, anuria, and serum creatinine of 15.5 mg/dL. A family member noted that he had been treating a "dermatitis" with topical application of brake fluid. Hemodialysis was started immediately, and kidney biopsy was consistent with a toxic proximal tubular injury. After a prolonged hospitalization, including continuous venovenous hemofiltration, kidney and neurologic function improved. This report is notable for the severe toxicity following transdermal exposure to diethylene glycol. American Journal of Kidney Diseases
(8/2014) Share:
Estimating medical costs attributable to obesity and physical disability
Little is known about the combined medical costs attributable to obesity among individuals with physical disabilities (PDs). The annual health care utilization and expenditure associated with overweight and obesity was estimated among 215,107 adults with and without PDs. Adults with PDs incurred more than 1.96 times the total costs than adults without PDs, and obese individuals with PDs spent 1.13 times more than normal-weight individuals with PDs. PDs plus obesity represents $23.9 billion/year in the U.S., intensifying the need for behavioral interventions that address both healthy weight and functional independence. American Journal of Preventive Medicine
(4/2015) Share:
Automated prediction of problem opioid use
Chronic opioid therapy guidelines recommend identification of patients at increased risk for problem opioid use, but clinical assessment of risks often does not occur on a timely basis. Accurate identification of those most likely to be in danger for problem use is important when creating recommended approaches designed to mitigate these risks. Multiple patient- and clinician-based screeners exist to assess potential problems. However, there are deficiencies in evaluation of the accuracy of these screeners. This report focuses on an automated surveillance method, utilizing baseline risk indicators from structured electronic health care data. Results show this approach was moderately accurate in identifying patients who had experienced subsequent problem opioid use. The Journal of Pain
(4/2015) Share:
Prenatal exocrine pancreatic damage in cystic fibrosis
Newborn screened immunoreactive trypsinogen is a biomarker of prenatal exocrine pancreatic disease in children with cystic fibrosis. A single nucleotide polymorphism in SLC26A9 accounts for significant IRT variability, suggesting that it may be a therapeutic target to ameliorate exocrine pancreatic disease. The Journal of Pediatrics
(3/2015) Share:
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Updated guidelines set flexible blood pressure goals
Updated guidelines tailor blood pressure targets based on patient heart health history. Experts suggest a target of 130/80 mm Hg for patients who have experienced events such as heart attack, stroke or abdominal aortic aneurysm, while patients who are at risk should maintain a blood pressure lower than 140/90 mm Hg. Experts noted the guidelines should be interpreted in the context of a given patient, who may require a different target. The guidelines appeared in the journal Hypertension and were developed by the American Heart Association, the American College of Cardiology and the American Society of Hypertension. HealthDay News
(3/31) Share:
Report finds mortality rates decreasing for cancer
Deaths related to cancer have decreased over the last several years for men, women and children, according to a new report from the North American Association of Central Cancer Registries. The overall cancer diagnosis rate in men declined annually by 1.8% from 2007 to 2011, while women's diagnoses have remained steady. New cancer cases in children have increased by almost 0.8% annually over the past decade. Reuters
(3/30) Share:
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Doctors reveal concerns about stage 3 proposed rule
A poll conducted by QuantiaMD found that 71% of surveyed doctors could meet the measures in the proposed rule for stage 3 of meaningful use, but only 38% of respondents are happy with the proposed rule. The survey found that 53.33% of participants said patient engagement would be the hardest measure to meet, followed by care coordination at 42.67%. Healthcare Informatics online
(3/27) Share:
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Study: Majority of calories in U.S. groceries from processed foods
Foods that are highly processed, such as prepared meals, cookies and soda, accounted for 61% to 62.5% of the calories from products bought at U.S. grocery stores from 2000 to 2012, researchers say. The findings were presented at the meeting of the Federation of American Societies for Experimental Biology. HealthDay News
(3/29) Share:
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Attach yourself to those who advise you rather than praise you."
-- Nicolas Boileau-Despreaux, poet and literary critic Share:
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