Predictors of intraoperative hypotension and bradycardia | There are no nonresponders to resistance training | Mental health status of young people
 
 
May 21, 2015
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Predictors of intraoperative hypotension and bradycardia
The 5-point HEART score was predictive of intraoperative hypotension or bradycardia. These findings suggest a role for using the HEART score to risk-stratify patients better preoperatively and may help guide decisions on perioperative management of blood pressure and heart rate-lowering medications and anesthetic agents. The American Journal of Medicine (5/2015) Share: Email
 
Clinical Updates
There are no nonresponders to resistance training
Healthy, pre-frail and frail elderly all benefit from resistance exercise. Even those who showed a nonresponse in lean body mass, for example, showed a response in another area such as strength or physical function, leading researchers from the Netherlands to conclude there are no nonresponders to resistance-type exercise training in older men and women. Journal of the American Medical Directors Association (5/2015) Share: Email
 
Mental health status of young people
The prevalence of emotional problems among girls appears to be increasing, though boys showed a small decrease. Recent economic and social trends may be contributing to changes in the mental health status of young people. Journal of Adolescent Health (5/2015) Share: Email
 
Decreasing trends in childhood melanoma
Melanoma, an aggressive form of skin cancer, has been increasing in adults over the past 40 years. Although pediatric melanoma is rare (5 to 6 children per million), a study assessed more than 1,100 new cases of pediatric melanoma from 2000 to 2010. Overall, the number of new cases each year decreased by 12% per year from 2004 to 2010. Public health programs should continue to teach sun protective behavior (e.g., regular use of sunscreen) to reduce the incidence of melanoma. The Journal of Pediatrics (5/2015) Share: Email
 
Maternal circulating angiogenic factors in twin and singleton pregnancies
This longitudinal study found higher maternal anti-angiogenic proteins in twin than in singleton pregnancies, with implications for diseases associated with multiple gestations. American Journal of Obstetrics & Gynecology (5/2015) Share: Email
 
What factors lead to regular aspirin use in adults with and without cardiovascular disease?
The use of aspirin in patients without cardiovascular disease (CVD) remains controversial. A survey of U.S. adults aged 45–75 years was performed to ascertain aspirin use and associated factors. Among 2,509 respondents, 52% reported current aspirin use, including 47% of respondents without a history of CVD. Among those with a primary prevention indication, having discussed aspirin with a provider was the strongest predictor of regular use. Other factors in regular aspirin use included presence of major CVD risk factors and high self-assessed knowledge of aspirin. (Available for CME credit.) American Journal of Preventive Medicine (5/2015) Share: Email
 
Results of intravenous ultrasound-guided percutaneous coronary intervention
In one of the largest studies on intravenous ultrasound (IVUS)-guided percutaneous coronary interventions (PCIs) in the drug-eluting stent era, the authors demonstrate that IVUS guidance is associated with reduced in-hospital mortality, similar length of hospital stay, and increased cost of care and vascular complications when compared to conventional angiography guided PCIs. The American Journal of Cardiology (5/15/2015) Share: Email
 
Continuing Medical Education
Utilizing GLP-1 Receptor Agonists and Insulins: High-Efficiency Therapies in the Optimal Management of Patients with Type 2 Diabetes
In this MediTalk series, leading experts in type 2 diabetes mellitus (T2DM) management will review the long-recognized patient-, system-, and clinician-related barriers to insulin initiation and intensification and will provide strategies that have been shown to be effective in addressing these barriers. Concerns regarding the risk of hypoglycemia as well as insulins currently available and under development will also be discussed. Based on these discussions, the participants will be able to use appropriate communication strategies during their interactions with patients. It will also allow them to become partners with their patients with T2DM in the overall management of T2DM. Special focus will be made on the role of impaired incretin response in the pathogenesis of T2DM and how the existing and emerging glucagon-like peptide-1 receptor agonists (GLP-1 RAs) help address this impairment. Additionally, T2DM management strategies allowing for the selection of appropriate therapies that can be applied directly to clinical practice will be shared. Elsevier CME The American Journal of Cardiology (5/15/2015) Share: Email
Medical News
Researchers look at prevalence of metabolic syndrome in U.S. adults
The rates of metabolic syndrome among U.S. adults went from about 33% in 2003 to about 35% in 2012, but remained mostly stable between 2008 and 2012, according to a study in the Journal of the American Medical Association. The syndrome was seen in more than 35% of women, compared with 30% of men, and was most common among Hispanics and older adults, researchers said. Reuters (5/19) Share: Email
Study examines obesity trends, disparities in U.S. children
A study in JAMA Pediatrics found that obesity rates among U.S. kindergartners increased by 20% from 1998, when nearly 12% were obese, to 2010, when about 14% were obese. No difference in the rates of obesity between boys and girls was observed, but researchers found a bigger increase in the prevalence of obesity among poorer children, while children of higher-income families possibly had a decrease in the prevalence of obesity. Reuters (5/18) Share: Email
Business Practice News
Physicians look for better ways to deliver bad news to patients
Training programs try to help physicians do a better job of breaking bad medical news to patients and families, but so far research shows the results have been mixed. Oncology physicians often are faced with delivering a poor prognosis, and oncologist Andrew Epstein at Memorial Sloan Kettering Cancer Center said if doctors fail to balance the physiological and treatment aspects of disease with the psychosocial side, they may alienate patients and families. The Wall Street Journal (tiered subscription model) (5/18) Share: Email
Physicians moving to private practice should prepare carefully
An article in Medical Economics advises physicians who want to start a private practice to research and consult other physicians who have already moved to an independent practice. Physicians should consider finances, legal issues and insurance, assemble their teams carefully, and form a partnership with other physicians to ensure that their private practice thrives. PhysiciansBriefing.com/HealthDay News (5/18) Share: Email
Patient's Perspective
Health problems prevalent among shift workers
Researchers looked at 1,600 employees in Wisconsin and found that shift workers were more likely to become overweight, have sleep problems, be excessively sleepy and get too little sleep than those who worked on a 9 to 5 schedule. The findings were published in the journal Sleep Health. HealthDay News (5/18) Share: Email
SmartQuote
All truths are easy to understand once they are discovered; the point is to discover them."
-- Galileo Galilei,
astronomer Share: Email
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