Diabetes drug gets boxed warning about amputation risks | Statin use for CVD prevention may not benefit older patients, study finds | Study: Older blacks have higher colorectal cancer risk
May 23, 2017
Family Medicine SmartBrief
Top Story
Diabetes drug gets boxed warning about amputation risks
The FDA is putting a new boxed warning on package labels of the diabetes drug canagliflozin, alerting prescribers and patients that the drug is associated with an increased risk of leg and foot amputations. Two large clinical trials found leg and foot amputations occurred about twice as often in patients on canagliflozin as in patients who were taking a placebo.
AAFP News (5/22) 
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FREE CME Webinar on Peripheral Artery Disease
Join AHA June 6th at 12:00 PM CST for a free webinar, The Treatment of Symptomatic PAD: Revascularization for Claudication and Critical Limb Ischemia. Dr. Matthew A. Corriere will review highlights of the 2016 AHA/ACC PAD guidelines. Register now!
Clinical News
Statin use for CVD prevention may not benefit older patients, study finds
A study in JAMA Internal Medicine found no benefit from statin use for primary prevention of cardiovascular disease in patients aged 65 and older. The findings, based on 2,867 patients who had high blood pressure but no evidence of arterial plaque buildup, showed no significant differences between usual care and statin use regarding all-cause mortality, deaths from specific causes and coronary heart disease events.
Medical News Today (5/22) 
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Study: Older blacks have higher colorectal cancer risk
A study in the Annals of Internal Medicine found that older black patients had a 31% higher risk of colorectal cancer than older white patients. Researchers noted greater racial and ethnic disparities for distal colon and rectal cancer than for proximal colon cancer.
Healio (free registration) (5/22) 
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Fluoxetine use in 1st trimester tied to birth defect risk
A significant increased risk of major malformations and cardiovascular malformations was found for infants whose mothers took fluoxetine during their first trimester of pregnancy, researchers reported in the British Journal of Clinical Pharmacology. Researchers said fluoxetine has a longer half-life than other selective serotonin reuptake inhibitors and has been shown to cross the placenta.
MedPage Today (free registration) (5/17) 
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Childhood adiposity may increase depression risk in adulthood
Overweight or obese youths had threefold increased odds of developing depression in adulthood, compared with normal-weight children who became overweight as adults, Dutch researchers reported at the European Congress on Obesity. The findings, based on data involving about 900 Icelanders born from 1907 to 1935 followed until age 75, on average, also showed a more than fourfold higher depression risk among those who were overweight or obese as children and adults.
CBS News/HealthDay News (5/22) 
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Report: One drink per day can increase breast cancer risk
Report: 1 drink per day can increase breast cancer risk
(Carl Court/Getty Images)
A report that included data from 119 studies and 12 million women found drinking one small glass of an alcoholic beverage per day increased the risk of breast cancer for premenopausal and postmenopausal women. The analysis from the American Institute for Cancer Research and the World Cancer Research Fund said there was strong evidence that vigorous exercise may reduce the risk of breast cancer.
The Washington Post (tiered subscription model) (5/23) 
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Practice Management
Limiting unnecessary medical tests lowers costs, improves care
A study at Cedars-Sinai Medical Center in Los Angeles found EHR alerts to prompt adherence to the Choosing Wisely campaign recommendations, a nationwide initiative aimed at reducing unnecessary medical test ordering, have reduced instances of patient harm and cut costs. The research showed that patient cases with low adherence to the guidelines had a higher risk of complications and higher readmission rate.
California Healthline (5/19) 
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Study: Postdischarge phone calls fail to affect readmissions
Data on 2,000 patients showed telephone follow-up for older adults following discharge from the emergency department did not affect readmission rates, researchers reported at the American Geriatrics Society's annual meeting. The study found the nurse-led intervention also did not make it more likely that patients would follow up with their physician.
Medscape (free registration) (5/22) 
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Health Policy & Legislation
ONC, CDC to create national system for electronic sharing of Zika info
The Office of the National Coordinator for Health IT and the CDC are developing a system to facilitate electronic sharing of Zika virus testing data between laboratories and health care professionals. The project will use a web portal for clinicians and Health Level Seven's Fast Healthcare Interoperability Resources standard, said Michelle Meigs of the Association of Public Health Laboratories, which is also a partner on the project.
Health Data Management (5/19) 
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Professional Issues & Trends
Global study ranks countries on state of health care
The US scored 81 out of 100 points in a study of health care access and quality that was published in The Lancet, well below countries such as Australia and Norway. "America's ranking is an embarrassment, especially considering the US spends more than $9,000 per person on health care annually, more than any other country," said Christopher Murray, a senior author of the study.
BenefitsPro (5/23) 
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AAFP CareerLink - Connecting Family Physicians and Employers
Faculty Family Medicine Clinical/Academic
Primary Care Physician
LIFELINK MEDICAL GROUP - Erwin, North Carolina
Family Practitioner Opportunities, MI
Family Practice Physician with Government Contractor
POSTERITY GROUP, LLC - Fort Campbell, Kentucky
Family Medicine Physician
Family Medicine in College town Maine
Outpatient Primary Care - Great Location Near Nashville, TN
CEJKA SEARCH - Nashville, Tennessee
Life is what we make it -- always has been, always will be.
Grandma Moses,
folk artist
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About AAFP
This news roundup is provided as a timely update to AAFP members and other health care professionals about family medicine topics in the news media. Links to articles are provided for the convenience of family physicians who may find them of use in discussions with patients or colleagues. Opinions expressed in Family Medicine SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American Academy of Family Physicians. On occasion, media articles may include or imply incorrect information about the AAFP and its policies, positions or relationships. For clarification on AAFP positions and policies, we refer you to http://aafp.org.
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