Modern management of irritable bowel syndrome | What type of physical activity is associated with mental well-being? | Omalizumab in the treatment of aspirin-exacerbated respiratory disease
 
August 20, 2015
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Modern management of irritable bowel syndrome
Irritable bowel syndrome is a common symptom-based diagnosis, with several etiopathophysiologic mechanisms. Implementation of an informed evaluation leads to high diagnostic accuracy. Treatment strategies that consider symptom severity and dominant symptoms, using multifaceted pharmacotherapeutic and nonpharmacologic and complementary approaches, provide for effective irritable bowel syndrome management. Coupled with education, reassurance, and support, even the most challenging patients with irritable bowel syndrome will experience improvement in symptoms and quality of life. The American Journal of Medicine (8/2015) Share: Email
 
Clinical Updates
What type of physical activity is associated with mental well-being?
Although evidence suggests physical activity (PA) may be associated with mental well-being at older ages, it is unclear whether some types of PA are more important than others. Data on 1,976 men and women, aged 60 to 64 years from the U.K. were analyzed for associations of monitored total PA under free-living conditions, self-reported leisure-time PA (LTPA), and walking for pleasure with mental well-being. Results showed participation in self-selected activities such as LTPA and walking are positively related to mental well-being, whereas total levels of free-living PA are not. (Available for CME credit.) American Journal of Preventive Medicine (8/2015) Share: Email
 
Omalizumab in the treatment of aspirin-exacerbated respiratory disease
Aspirin-exacerbated respiratory disease (AERD) is a distinct clinical entity characterized by aspirin-induced respiratory reactions, asthma, eosinophilia, and nasal polyps. Patients with AERD are often resistant to standard treatment. AERD is not considered to be IgE-mediated, but two prior case reports have indicated that omalizumab may be an effective therapy for AERD. This report describes the effect of omalizumab treatment in a 55-year-old non-atopic woman with AERD and anaphylaxis in response to aspirin who experienced more than 50 asthma exacerbations in the previous five years. Omalizumab treatment rapidly reduced asthma symptoms, improved lung function, enhanced quality of life, and restored tolerance to aspirin. Further studies of the use of omalizumab in the treatment of AERD appear warranted. The Journal of Allergy and Clinical Immunology: In Practice (6/2015) Share: Email
 
Adolescents' perceptions of e-cigarette and marijuana risks
Adolescents demonstrate poor understanding of the risks and benefits of e-cigarette and marijuana use. Clinicians, prevention campaigns, and interventions must explicitly address risks of marijuana and e-cigarette use alongside the risks of traditional cigarette use. Journal of Adolescent Health (8/2015) Share: Email
 
Ankle brachial index and cognitive function
Low ankle brachial index (ABI), indicates peripheral artery disease. But does low ABI predict cognitive decline in those of advanced age (70-89 years)? LIFE (Lifestyle Interventions and Independence for Elders) trial investigators from many U.S. universities found a greater two-year risk for cognitive decline in those older individuals who had lower baseline ABI, were sedentary, and had more functional limitations. However, changes in ABI over the two years did not necessarily mean changes in cognitive function. Journal of the American Medical Directors Association (8/2015) Share: Email
 
Preparticipation screening for cardiac disease in young athletes
Preparticipation screening is one method to prevent sudden cardiac death in young athletes. Over 500,000 preparticipation screenings occurred in almost 420,000 5- to 21-year-olds, of whom 2% also received electrocardiograms. Female gender, lower socioeconomic status, and rural setting were associated with fewer electrocardiograms. Preparticipation screenings alone had a sensitivity of 44% and a specificity of 99% for identifying cardiac disease. Electrocardiograms can be used selectively along with preparticipation screening in children with a high rate of identification of cardiac disease. The Journal of Pediatrics (8/2015) Share: Email
 
Reliability of calculated low-density lipoprotein cholesterol
Based on this study, calculated low-density lipoprotein cholesterol (LDL-C) <30 mg/dL (0.8 mmol/L) should not be reported due to significant deviation from the gold standard measured LDL C results, and caution is advised when using calculated LDL-CF values <70 mg/dL (1.8 mmol/L) to make treatment decisions. The American Journal of Cardiology (8/15/2015) Share: Email
 
Continuing Medical Education
Improving the Treatment and Management of Endometriosis: An Overview of Current and Novel Approaches
Endometriosis is an estrogen-dependent disease of unknown etiology that frequently results in significant morbidity, severe pelvic pain, multiple surgeries, and impaired fertility. It affects at least 8.5 million women in North America alone and is a leading cause of gynecologic hospitalization and surgery. It is clinically defined as presence of ectopic or extrauterine endometrial or endometrial-like tissue resulting in a sustained inflammatory reaction. Although pharmacologic and surgical treatment options are available, endometriosis can be difficult to manage because many treatments have limited efficacy, while serious side effects of some agents limit long-term treatment or make them inappropriate for some patients. New hormonal agents are in late-stage development and will expand the available treatment options. Elsevier CME Share: Email
Medical News
Moderate drinking linked to higher risk for certain cancers
Light to moderate drinking of one to two alcoholic beverages per day may be linked to an increased risk of some cancers in men and women, researchers reported in The BMJ. Data showed light to moderate drinking was associated with a higher risk of breast cancer in women and several cancers in men who smoked, but not to a significant increase in risk for cancers overall. HealthDay News (8/18) Share: Email
Study explores predictors of falls among older COPD patients
A small study published in the journal Respirology found that senior patients with chronic obstructive pulmonary disease have a higher risk of falling if they have other medical problems, have fallen in the past year or have a history of heavy smoking. Balance and stability training may help build confidence and physical ability in such patients, one expert said. Reuters (8/14) Share: Email
Infection may increase children's BMI, metabolic syndrome risk later
A study in Pediatrics found an association between early childhood infection-related hospitalization and increased body mass index and risk of metabolic syndrome in adulthood, with the greatest increase in adult BMI seen among children hospitalized more than once. Researchers followed a cohort of 1,376 children, ages 3 to 9, into adulthood. PhysiciansBriefing.com/HealthDay News (8/17) Share: Email
Business Practice News
Study IDs predictors of readmission
Belgian researchers found that patients with chronic cardiovascular and pulmonary disease were most likely to be readmitted to the hospital. Predictors of readmission included at least four emergency department visits over six months, Friday discharge and longer length of hospitalization. The researchers, whose work was published in the Journal of Evaluation in Clinical Practice, suggest improving continuity of care following discharge and carefully monitoring patients who exhibit risk factors for readmission. PhysiciansBriefing.com/HealthDay News (8/18) Share: Email
Hospitals aim to reduce sleep interruptions to improve patient satisfaction
Hospitals that want better patient satisfaction ratings are trying to ensure patients get a better night's sleep by reducing the number of times they are awakened unnecessarily for vital signs checks or medication administration. Hospitals are also trying to reduce noise levels at night and are creating quiet hours to help patients sleep better. Kaiser Health News (8/17) Share: Email
Patient's Perspective
Patients find apologies don't come easily from hospitals
Few hospitals have implemented best practices for responding to questions or complaints from family members and caregivers whose loved ones have died in hospital care. However, patients and their families are less likely to pursue legal action when health care providers show accountability, respect and open communication, surveys show. Communication-and-resolution models backed by the Agency for Healthcare Research and Quality that call for apologies, investigations and prompt offers of financial compensation in cases of medical mistakes have been shown to reduce both the frequency of malpractice claims and the amount spent on patient compensation. Modern Healthcare (tiered subscription model) (8/15) Share: Email
SmartQuote
Be thankful for what you have; you'll end up having more. If you concentrate on what you don't have, you will never, ever have enough."
-- Oprah Winfrey,
businesswoman Share: Email
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