Study disputes use of palliative chemo in end-stage cancer care | CT scans can cause DNA damage, cell death, study finds | Lifestyle intervention benefits children with obesity
July 24, 2015
AANP SmartBrief
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Study disputes use of palliative chemo in end-stage cancer care
Patients with end-stage metastatic cancer who received palliative chemotherapy did not see improvements in quality of life or survival, compared with those who did not get the treatment, according to a study in JAMA Oncology. "If this so-called palliative chemotherapy is given to improve their symptoms, then these data should give [oncologists] pause that it's not going to help," said lead author Holly Prigerson of Weill Cornell Medical College. Medscape (free registration) (7/23)
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CT scans can cause DNA damage, cell death, study finds
A study published in the Journal of American College of Cardiology: Cardiovascular Imaging found that computed tomography scans are associated with DNA damage, although cells also initiate repair mechanisms, and sometimes cellular death. The findings come from 67 patients who had heart CT scans. The team found that scans using the lowest radiation dose did not adversely affect the cells of healthy patients, and they recommend practitioners minimize use of radiation when possible. HealthDay News (7/22)
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Lifestyle intervention benefits children with obesity
Researchers evaluated 172 overweight, obese and morbidly obese children and found that 21% and 25% of those with morbid obesity improved their weight status to the obese category after undergoing an ongoing, tailored lifestyle intervention at the outpatient clinic for 12 months and 24 months, respectively. The findings in The Journal of Clinical Endocrinology & Metabolism revealed no significant differences in the changes in body mass index z score between the groups and all groups saw a reduction in serum total cholesterol, LDL cholesterol, HbA1C and waist circumference z score. Healio (free registration)/Endocrine Today (7/23)
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Study links sleep apnea to greater likelihood of panic disorder
A study in the Annals of Family Medicine found that patients with sleep apnea are more likely to develop panic disorder, with a hazard ratio of 2.17. The study compared 8,704 sleep apnea patients with 34,792 matched controls, finding 1.34% of those with sleep apnea developed panic disorder during the follow-up period, compared with 0.42% of the control group. (7/23)
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DNP Distance Education Program at Frontier Nursing University
Create your future by earning a Post-Master's Doctor of Nursing Practice degree in FNU's full time 15-month community-based program. Two 3-day visits to campus required. Learn with a cohort of dedicated professionals, both students and faculty. Develop a unique capstone project aiming to improve health care outcomes. Learn More About FNU's Post-Master's DNP.
Pharmaceutical News
Study reveals list of unnecessary tests, treatments for newborns
Survey respondents suggest avoiding the routine use of antireflux drugs as treatment for symptomatic gastroesophageal reflux disease or apnea and desaturation treatment, as well as the routine continuation of antibiotics beyond 48 hours if asymptomatic patients don't show any signs of bacterial infection. The findings in Pediatrics also revealed that respondents prefer avoiding routine pneumograms for predischarge assessment of ongoing/prolonged apnea of prematurity, use of daily chest radiographs for intubated infants, and routine screening term-equivalent or discharge brain MRI in premature infants. (7/23)
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Type 1 diabetes patients see benefit from psoriasis drug
Patients with newly diagnosed type 1 diabetes had a lower decline in C-peptide secretion over two years of follow-up after taking alefacept, a drug for psoriasis, for two 12-week courses, compared with those on placebo, according to a study in the Journal of Clinical Investigation. Researchers also found that C-peptide production didn't decline among nine of 30 patients who were evaluated for C-peptide function and the preservation of C-peptide lasted as long as 15 months after stopping treatment. News (7/22)
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Diabetes drug may not significantly increase bladder cancer risk
A 193,099-patient cohort study in the Journal of the American Medical Association found no statistically significant link between pioglitazone and increased risk of bladder cancer. In a second cohort, an association with risk of prostate cancer and pancreatic cancer was found that "merits further investigation," according to the researchers. Family Practice News (7/21), Medscape (free registration) (7/21)
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Emerging Trends, Products and Technologies
CDC: Infant deaths declining faster than stillbirths
For the first time, there were more stillbirths than infant deaths in the U.S., according to a CDC report that found both were declining, but infant death rates were falling faster. The report also found disparities in fetal death rates. Teens, women over age 35, and women who are black, Hispanic, American Indian or of Alaska Native descent were among groups facing higher likelihood of fetal death. "The fact that blacks and other minorities have the highest rate is concerning, because research shows that these are not genetic differences but differences in access to care," said Dr. Edward McCabe, chief medical officer at the March of Dimes. HealthDay News (7/23)
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Health Policy and Legislative News
Bill calls for nutrition education for providers
The Education and Training for Health Act of 2015 under consideration in the U.S. House calls for nurse practitioners and physicians who are federal employees to get annual continuing education in nutrition to help them talk with patients about how diet affects disease risk. Registered dietitian Cameron Wells writes practitioners need help staying up-to-date on the best diets for weight loss, lowering cholesterol, reducing inflammation and controlling blood sugar. U.S. News & World Report (7/21)
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Auditors: Medicare needs better screening of health care professionals
A report from the Government Accountability Office found that Medicare did not catch thousands of questionable addresses submitted by medical professionals, and allowed enrollment for dozens who faced disciplinary action by state boards. The report to Congress said using an invalid address was "an indicator of potential fraud." The New York Times (free-article access for SmartBrief readers) (7/21), The Wall Street Journal (tiered subscription model) (7/21)
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Articles in JAANP online now include Altmetrics (AM) score
When you click on the score you get a pop-up box with information on the number of tweets as well as readers on Mendeley and CiteULike. You can also click on "see more details" to see where the articles have been tweeted, the combined numbers of followers of the Twitter accounts, a map of which countries have seen the tweets, and information on the score compared with other articles in JAANP. The score is in a small box just below the title, authors, and DOI in the HTML version of the article (see for example this research article by Dr. Susan Kelly-Weeder and colleagues).
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There is no passion to be found playing small -- in settling for a life that is less than the one you are capable of living."
-- Nelson Mandela,
political activist and president of South Africa
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