Venous thromboembolism and cancer | How does cigarette smoking history affect mortality after the age of 70? | Infant outcomes in prenatal Zika screening program
March 23, 2017
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Venous thromboembolism and cancer
The risk of major bleeding, recurrence of thromboembolism, and mortality while undergoing anticoagulant treatment differs according to the site of cancer. Development of cancer-specific anticoagulant strategies may be warranted.
The American Journal of Medicine (3/2017) 
Register Now for Live IBS Symposium on March 31st in San Diego
A live Elsevier CME Satellite Symposium, "Irritable Bowel Syndrome: Latest Advances in Pathophysiology, Diagnosis, and Patient Management," will take place on Friday, March 31 at the Marriott Marquis San Diego Marina from 6:00-7:30 pm. Upon completion of this live activity, you may receive up to 1.00 AMA PRA Category 1 Credits. Click here to find out more and register!
Clinical Updates
How does cigarette smoking history affect mortality after the age of 70?
Tobacco use remains a leading modifiable cause of cancer incidence and premature mortality. This study found lifetime cigarette smoking history to be a key determinant of mortality after age 70 years. Among current smokers, mortality was inversely associated with age at initiation, but directly associated with the number of cigarettes smoked per day >70 years. Current smokers were more likely to die during follow-up compared to never smokers, and former smokers had lower risks than current smokers.
American Journal of Preventive Medicine (3/2017) 
Infant outcomes in prenatal Zika screening program
After screening over 14,000 pregnant women for Zika virus, the authors identified 4.3% at risk based on travel, 0.2% infected, and no infants with reduced head circumference.
American Journal of Obstetrics & Gynecology (3/2017) 
Anti-Müllerian hormone in obese adolescent girls with polycystic ovary syndrome
Anti-Müllerian hormone (AMH) concentrations in obese adolescent girls with polycystic ovary syndrome (PCOS) are almost twice as high as non-PCOS peers and correlate positively with age and testosterone. The AMH cutoff for diagnosing PCOS is 6.26 ng/mL in these obese girls, and the odds of having PCOS increases 47% for one-unit increase in AMH.
Journal of Adolescent Health (3/2017) 
Opioid abuse among high-school athletes
While the majority of sports in which adolescents participate during high school are not associated with heroin use and/or nonmedical use of prescription opioids, those who played ice hockey were at an increased risk for concurrent heroin use and nonmedical use of prescription opioid among participants.
Journal of Adolescent Health (3/2017) 
The role of inducible urticaria in patients with chronic urticaria
Chronic spontaneous urticaria affects quality of life. Some patients may note and avoid potential triggers that induce hives. This study evaluated the frequency of induced hives in patients with chronic urticaria. Patients (n=245) were questioned about triggers associated with exacerbation of urticaria, and challenge tests were performed for symptomatic dermographism, pressure, cold, water, and exercise triggers. Overall, 186 (75.9%) reported a physical trigger, but only 89 (36.3%) had a positive challenge test result. The authors concluded that suspected physical triggers should be verified by challenge tests to avoid unnecessary lifestyle restrictions.
The Journal of Allergy and Clinical Immunology: In Practice (3/2017) 
Oral care and health outcomes in Japanese nursing homes
Dental care availability is often limited in nursing homes. Researchers from Japan examined whether enhanced dental care training of facility staff members could improve health outcomes for residents. While no differences were found in incidence of critical illness, hospital transfer, mortality, or costs, there was greater likelihood for those receiving enhanced dental care to be discharged to home by improving the general condition of the resident.
Journal of the American Medical Directors Association (3/2017) 
Medical News
Study finds conflicting guidelines for statin use in black patients
A study in JAMA Cardiology found conflicting medical guidelines on prescribing statin drugs to black patients. Data showed about 25% of blacks who would be eligible for a cholesterol-lowering statin medication under American College of Cardiology/American Heart Association guidelines would not be under new recommendations from the US Preventive Services Task Force.
HealthDay News (3/18) 
Elevated teen BMI tied to later liver disease risk
Young men who were overweight and obese were nearly 50% and more than twice as likely to develop severe liver disease, respectively, later in life, compared with peers of normal weight, according to a Swedish study in the journal Gut. The findings, based on data involving 1.2 million Swedish men who underwent military training from 1969 to 1996, also showed a more than three times higher risk of liver problems later among those with both obesity and type 2 diabetes. (India)/Indo-Asian News Service (3/21),  Medical News Today (3/21) 
Study ties pre-hospitalization opioid use to elevated pneumonia risk
A study presented at the annual American Academy of Pain Medicine meeting found use of prescription opioids, such as fentanyl, codeine or morphine, in the 100 days prior to hospital admission was associated with a higher risk of hospital-acquired pneumonia, compared with no exposure to the drugs. The findings were based on 40,403 patients aged 18 to 70 years admitted to the Kaiser Permanente health system over four years.
Medscape (free registration) (3/20) 
Business Practice News
CMS issues information on upcoming eCQM changes for 2018
The CMS has updated its electronic clinical quality measure specifications for eligible professionals for the 2017 reporting period and released an advance notice about what providers can expect on the upcoming changes for the 2018 reporting period. Each of the eCQM standards were based on the six priorities of the National Quality Strategy, including patient safety, effective clinical care, and person and caregiver-centered experience and outcomes.
EHR Intelligence (3/17) 
Monthly cost scorecard may cut surgical supply costs, improve care
Surgeons who received monthly cost feedback scorecards plus a financial incentive reduced their surgical supply costs by 6.5%, compared with a 7.4% increase in costs for those who did not get scorecards. The study in JAMA Surgery found equal or better outcomes for 30-day readmissions, mortality and discharge status after the intervention.
HealthLeaders Media (3/20) 
Patient's Perspective
ACA study shows variations in access, affordability, quality
A study in Milbank Quarterly assessing the Affordable Care Act found variations in emergency department access, health care affordability and health care quality, based on income and race. The study analyzed data from the "Patients' Perspectives on Health Care in the United States" survey.
MedPage Today (free registration) (3/17) 
To different minds, the same world is a hell, and a heaven.
Ralph Waldo Emerson,
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