Getting the Whole Picture: Lymphangitic Carcinomatosis | Youth fitness levels in the U.S. | Walking speed as predictor of future disability
August 27, 2015
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Top News
Getting the Whole Picture: Lymphangitic Carcinomatosis
Pulmonologists often rely heavily on lung imaging when formulating a differential diagnosis. We present a classic example of this strategy, though the cause of the woman’s diagnosis was not at all typical. A 53-year-old woman with a 30 pack-year history of smoking was admitted with severe shortness of breath and a cough that produced frothy whitish sputum. She had been coughing for a month but had experienced progressive worsening over the previous 3-4 days. Upon questioning, she denied fevers, chills, hemoptysis, or chest pain. The American Journal of Medicine (8/2015) Share: Email
Clinical Updates
Youth fitness levels in the U.S.
Although it is known that child and adolescent overweight and obesity have been increasing in the U.S., little is known about actual fitness levels in these age groups. Of close to 200,000 children assessed using the NFL PLAY 60 FITNESSGRAM, less than 60% met the healthy fitness zone for aerobic capacity and body mass index. Middle school years, from fifth to eighth grade, were identified as the critical period when aerobic capacity declines and body mass index increases. The Journal of Pediatrics online (7/15) Share: Email
Walking speed as predictor of future disability
Slower walking speed can indicate prefrailty or frailty in older individuals, and can be a predictor of future disability. A Japanese study followed over 14,000 elderly (65+ years) for nearly 30 months. Those with prefrailty and frailty with or without slow walking speed during the baseline assessment were more likely to require long-term care. Frail older men and those with low cognitive skills were at highest risk of disability. Journal of the American Medical Directors Association (8/2015) Share: Email
Structured transition care for adolescent inflammatory bowel disease patients
This study evaluates the clinical and developmental outcomes of a structured transition service for irritable bowel syndrome patients moving from pediatric to adult care. Findings show that transition care has a positive impact on disease outcomes, paving the way to develop new models for transition care in irritable bowel disease. Journal of Adolescent Health (8/2015) Share: Email
Effectiveness of Pretreatment with Dual Oral Antiplatelet Therapy
In this article, the authors review clinical data on pretreatment with dual oral antiplatelet therapy and comment on some criticisms raised from recent trials. The American Journal of Cardiology (8/15/2015) Share: Email
Survey of American obstetricians regarding group B streptococcus
Confusion exists about some aspects of the CDC guidelines for intrapartum antibiotic prophylaxis against group B streptococcal infections. There are potential areas for improvement in implementation. American Journal of Obstetrics & Gynecology (8/2015) Share: Email
Placebo analgesia enhances descending pain-related effective connectivity
The use of placebo to reduce pain is well documented; however, knowledge of the neural mechanisms underlying placebo analgesia (PA) remains incomplete. This study used fMRI data from 30 healthy subjects and dynamic causal modeling (DCM) to investigate changes in effective connectivity associated with the placebo analgesic response. The results indicate that during the PA but not baseline condition, couplings between brain regions, including those involved in cognitive processes, were significantly enhanced. Changes in effective connectivity among pain-related brain regions may be more sensitive detectors of the neural representation of small placebo effects than changes in the magnitude of brain activation. Knowledge of these mechanisms highlights the importance of integrated neural networks in the understanding of pain modulation. The Journal of Pain (8/2015) Share: Email
Medical News
Study links cardiorespiratory fitness to risk of AF
A study found 84% of overweight or obese people with atrial fibrillation who had high levels of cardiorespiratory fitness over four years no longer experienced the potentially dangerous heartbeat, compared with 76% of those who maintained adequate fitness levels and 17% in a low fitness group. People who also lost weight reduced their risk of recurring atrial fibrillation even more, researchers wrote in the Journal of the American College of Cardiology. HealthDay News (8/24) Share: Email
Reductions in heart disease mortality wane for younger adults
A report in the journal Circulation showed the decline in heart disease death rates for patients younger than age 55 has slowed down, unlike rates for older adults. Emory University researcher Viola Vaccarino said the reason could be a lack of effective heart disease prevention strategies for young adults, especially women. HealthDay News (8/24) Share: Email
Flu shots may reduce death, hospital use among nursing home residents
Brown University researchers said giving flu shots to nursing home residents may reduce mortality and hospitalizations. The study in the Journal of the American Geriatrics Society showed that the more effective the flu vaccine was in a given year, the lower the rates of flu-related deaths and hospital visits were among nursing home patients. HealthDay News (8/25) Share: Email
Business Practice News
Study finds gender, racial disparities in physician workforce
A report published in JAMA Internal Medicine found that only 7% of the 16,835 medical school graduates in 2012 were Hispanic, 7% were black and 48% were women. In the same year, just 30% of practicing physicians were female, 5% were Hispanic and 4% were black. Women generally gravitate toward obstetrics, gynecology and family medicine while representing just 14% of trainees in orthopedics. Researchers note that a more diversified physician workforce is important to reaching underserved populations. Reuters (8/24) Share: Email
5 drivers of health IT priorities in 2016
Dr. John Halamka, chief information officer at Harvard Medical School, identifies five key issues affecting the priorities of stakeholders in 2016: demand is increasing for support of personal software and devices; clinicians need better data-capture tools; the demand for IT resources and tools is outstripping the supply; IT departments need time and space to focus on user's needs and not federal regulations; and the cloud is where people want to work. (8/23) Share: Email
Patient's Perspective
Study: Patients with better physician support lose more weight
A government-funded weight loss study that included 347 obese patients found those who gave their primary care physicians the highest ratings for helpfulness had an average weight loss of 11 pounds, compared with about 5 pounds for those who gave their physician the lowest ratings, researchers reported in Patient Education and Counseling. "This trial supports other evidence that providers are very important in their patients' weight-loss efforts," said Johns Hopkins University researcher Dr. Wendy Bennett. HealthDay News (8/21) Share: Email
The harder the conflict, the more glorious the triumph."
-- Thomas Paine,
political theorist and revolutionary Share: Email
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