The US Preventive Services Task Force's final recommendation on the use of folic acid to prevent neural tube defects calls for all women planning a pregnancy and those who are capable of pregnancy to take a daily supplement. The "A" recommendation reaffirmed earlier USPSTF guidance and paralleled the AAFP final recommendation statement.
A joint practice guideline from the AAFP and the American College of Physicians on systolic blood pressure for hypertensive adults ages 60 and older calls for treating patients with persistent readings at or above 150 mm Hg until levels reach less than 150 mm Hg. The full report was published in the Annals of Internal Medicine, and a summary will be published in the Annals of Family Medicine.
Only 11% of women with gestational diabetes needed insulin after receiving a combination of metformin and glyburide, compared with 32% of those who received either drug alone, according to a study published in Diabetes Care. The findings, based on 104 women with gestational diabetes, showed comparable results in mean daily blood glucose and other neonatal and obstetric outcomes, including neonatal hypoglycemia, electrolyte imbalance and macrosomia, between patients in the combination therapy and monotherapy groups.
A study found hospitalized patients with alcohol problems had more than a 10-fold higher risk of developing alcoholic liver cirrhosis over 15 years, compared with the general population. "Together with other evidence, our study indicates a need for the presence of alcohol care teams in the hospital setting," said researcher Gro Askgaard, M.D., of Copenhagen University Hospital.
The rates of hospitalization and death associated with asthma are up to three times higher in black people than in white people, and the difference might be explained in part by differences in airway inflammation, researchers reported in the Journal of Allergy and Clinical Immunology. Black people were more likely to have eosinophilic airway inflammation and may not respond as well to corticosteroids, suggesting that asthma needs to be treated differently in black people, study co-author and physician Sharmilee Nyenhuis said.
Swedish researchers looked at 147 babies with colic and found that those who received either of two types of minimal acupuncture for two weeks had 40% lower crying duration between their first and last visits, compared with a 20% reduction among those who received standard care. The findings in the journal Acupuncture in Medicine also showed that 38% of those who received acupuncture met the criteria for colic during the second week of treatment, compared with 65% in the control group.
A study in the Annals of Family Medicine found a video intervention changed patient intentions regarding US Preventive Services Task Force recommendations for prostate cancer and mammography screening. The video included illustrative slides and scenes in which patients and physicians talked about screenings.
Quality reporting requirements under the Medicare Access and Chip Reauthorization Act's Merit Based Incentive Program may be too burdensome to be of value, according to the Medicare Payment Advisory Commission's technical staff, who asked MedPAC experts whether and how to adjust the program. Suggestions included reducing or eliminating clinician reporting and eliminating the "exceptional performance" fund.
Incoming leadership can improve value and experience in the US health care system by investing in validated, cost-efficient wellness practices; expanding telehealth use across care and payment models; and ensuring a fully interoperable system by the end of 2018, according to policy recommendations from the Healthcare Leadership Council. Other priorities include expanding interstate licensure of health care professionals, fostering collaboration to fight fraud and abuse, and allowing health insurers increased flexibility in designing affordable plans.
A study published in Proceedings of the National Academy of Sciences found a variety of carbapenem-resistant Enterobacteriaceae species in three Boston hospitals and one California hospital, findings that suggest the potentially deadly superbug is more prevalent in US hospitals than previously believed. CRE species cause 9,300 infections in the US each year and 600 deaths, with incidence rising, and researchers say greater surveillance is needed.
The history of progress is written in the blood of men and women who have dared to espouse an unpopular cause, as, for instance, the black man's right to his body, or woman's right to her soul.
Emma Goldman, activist and writer
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