Temporal trends in women with acute coronary syndromes | Assessing risk for opioid drug overdose | Clinical phenotyping in preterm birth
April 23, 2015
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Temporal trends in women with acute coronary syndromes
Despite increased frequency of comorbidities and lack of change in time to admission among women hospitalized with acute coronary syndrome, temporal change in management strategies over the last decade may have contributed to improved outcomes in this population. The American Journal of Medicine (4/2015) Share: Email
Clinical Updates
Assessing risk for opioid drug overdose
Current research on the risk of opioid analgesics with drug overdose does not account for the total morphine equivalent dose (MED) of opioids filled by a patient. In this study, time from first opioid prescription until drug overdose was examined for 206,869 privately insured patients. Opioid therapy was examined in six-month intervals including six months before an overdose. Survival analysis was used, adjusting for demographics, clinical conditions and psychoactive drugs. This analysis suggests that clinicians should consider total MED to assess risk of overdose for persons prescribed 50 mg to 99 mg daily MED. The Journal of Pain (4/2015) Share: Email
Clinical phenotyping in preterm birth
Precise spontaneous preterm birth phenotyping identifies specific differences between very early and early preterm deliveries and between African-Americans and Caucasians. American Journal of Obstetrics & Gynecology (4/2015) Share: Email
Sedative load and frailty
Does sedative load correlate with higher frailty scores among elderly? Utilizing the TILDA study from Ireland, researchers studied the association between use of sedative drugs and frailty in 1,612 men and 1,804 women aged 65 and older. Using the frailty phenotype status and the frailty index scores, it was found that sedative drug use (ie, antipsychotics and anxiolytics) was 46% for frail, 23% for prefrail, and 9% for nonfrail elderly. Advanced age showed more frailty, but there were no differences in gender. Journal of the American Medical Directors Association (4/2015) Share: Email
Serum uric acid and cardiovascular risk in adolescents
Previous studies have shown strong associations between serum uric acid and cardiovascular diseases in adults. In the current study, serum uric acid was positively associated with high cardiovascular risk class in adolescents. Journal of Adolescent Health (4/2015) Share: Email
Abnormal heart rate variability, chronic kidney disease and type 2 diabetes
A prospective, longitudinal, observational cohort study was conducted of cardiovascular autonomic neuropathy (CAN) and development of chronic kidney disease (CKD) in people with type 2 diabetes. Those who developed CKD were older, had a longer duration of diabetes and hypertension, received more insulin and ACE inhibitor/ARB treatment, and exhibited lower eGFR, HbA1C, and albuminuria levels. The development of CKD was associated with presence of CAN, which therefore is an independent prognostic factor for the future development of CKD in type 2 diabetes. Diabetes Research and Clinical Practice (4/2015) Share: Email
Integrated Scoring Model of treadmill tests
Management of chronotropic incompetence or abnormal heart rate recovery in an asymptomatic population may prevent future ischemic heart disease and thus improve the quality of life. The American Journal of Cardiology (4/15/2015) Share: Email
Medical News
Group issues guidelines for adults with congenital heart disease
The American Heart Association released guidelines for treating adults over 40 with congenital heart disease, who may develop cardiovascular problems linked to the condition or past treatments. The recommendations, reported in the journal Circulation, cover exercise, sexual activity, cardiac monitoring and use of hormone replacement therapy for menopausal women. HealthDay News (4/20) Share: Email
Study predicts breast cancer incidence will grow by 50%
A study presented at the American Association for Cancer Research meeting predicted breast cancer incidence in the U.S. will rise by 50% from 2011 to 2030. Longer life spans and increased detection of cancers, including in-situ lesions that may not need treatment, will contribute to the trend, experts say, noting it isn't always clear which tumors can go without treatment. The data suggest the percentage of treatment-responsive estrogen-receptor-positive cases will grow, highlighting opportunities to identify "smarter screening and kinder, gentler and more effective treatment," said researcher Philip Rosenberg. Time.com (4/20) Share: Email
New study refutes link between MMR vaccine, autism
A large study published in the Journal of the American Medical Association found that the measles, mumps and rubella vaccine does not increase the risk of autism spectrum disorder, even in children who are considered to be at an increased risk because of an older sibling with the disorder. The findings revealed that among the 95,727 children followed, the 2% with an older sibling with ASD had a greater risk of developing the disorder themselves, but the risk was not affected by whether or not they received the MMR vaccine. HealthDay News (4/21), Reuters (4/21) Share: Email
Business Practice News
Survey: Few people use health care quality, cost information
A Kaiser Family Foundation survey found only about 20% of people said they had seen specific quality and cost information about a hospital, physician or insurer, while two out of three found it difficult to know how much health care professionals or facilities charge for treatments or procedures. The poll found 6% of people had used quality information in making medical decisions, and fewer than 9% had used price information. Kaiser Health News (4/21) Share: Email
ONC reveals increase in acute care hospitals with basic EHR platform
An ONC brief based on American Hospital Association data showed that 76% of U.S. nonfederal acute care hospitals used at least a basic EHR with notes system last year, up by 27% from a year earlier. The data also revealed that the percentage of hospitals with comprehensive EHR platforms rose to 34.4% in 2014 from 25.7% in 2013. Health Data Management (4/21) Share: Email
Patient's Perspective
Cancer diagnosis associated with higher smoking-cessation rates
Researchers found that 31% of almost 800 smokers with cancer had quit the habit within two years after diagnosis compared with 19.5% of a cancer-free control group. The study in the Journal of Clinical Oncology also found that 43% of 900 smokers with cancer stopped smoking four years after diagnosis compared with 34% of those without cancer. HealthDay News (4/20) Share: Email
Every man must do two things alone: He must do his own believing and his own dying."
-- Martin Luther,
theologian Share: Email
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