Statin use and erectile dysfunction onset | Cost-effectiveness of population-based BRCA1 founder mutation testing in Sephardi Jewish women | E-cigarettes do not assist in smoking cessation in Europe
April 12, 2018
AJM: From the publisher of The American Journal of Medicine
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Statin use and erectile dysfunction onset
Erectile dysfunction, an independent risk factor for cardiovascular disease and stroke, has been reported as an adverse effect of statin therapy. This research finds that among men with established cardiovascular disease or cardiovascular disease risk factors, statin use does not seem to be associated with a new onset of erectile dysfunction. No difference in treatment effect according to age or diabetes mellitus was seen.
The American Journal of Medicine (4/2018) 
Live CME Webcast on Non-Hodgkins Lymphoma
Join us April 17 as experts from Australia, UK and the US discuss important statistical concepts and evaluate the strengths, weaknesses, reproducibility, and applicability of established and emerging endpoints to individual NHL patients. 1.5 AMA PRA Category 1 Credit, 1.5 Nursing Contact Hours. Click here to begin this activity!
Clinical Updates
Cost-effectiveness of population-based BRCA1 founder mutation testing in Sephardi Jewish women
Population testing for BRCA mutations is cost-effective in Sephardi Jewish women aged over 30 in UK and US populations.
American Journal of Obstetrics & Gynecology (4/2018) 
E-cigarettes do not assist in smoking cessation in Europe
Study authors assessed the relationship between e-cigarette use and smoking cessation among current and former smokers in the European Union and Great Britain. Among all ever-smokers, experimentation with e-cigarettes was associated with lower rates of smoking cessation compared with smokers who had never used e-cigarettes. The results indicate e-cigarettes are associated with inhibiting rather than assisting in smoking cessation.
American Journal of Preventive Medicine (4/2018) 
Maternal asthma and early pregnancy vitamin D associated with risk of preeclampsia
This study of 816 subjects was undertaken to investigate the association of physician-diagnosed asthma and uncontrolled asthma status during pregnancy with risk of preeclampsia and the effects of early pregnancy vitamin D concentrations on this relationship. The incidence of preeclampsia was not related to the presence of asthma diagnosis, but the adjusted odds of preeclampsia controlled for maternal serum 25OHD concentrations was higher for more uncontrolled asthma (adjusted Odds Ratio (aOR): 3.55). Adjusting for asthma control status, an additional decrease of the associated preeclampsia risk by 7% was observed for a 10 unit (ng/mL) increase of early pregnancy 25OHD levels, as compared to the prior risk estimate of preeclampsia associated with low maternal 25OHD unadjusted for asthma control status.
The Journal of Allergy and Clinical Immunology: In Practice (4/2018) 
Recurrence of chronic urticaria: Incidence and associated factors
Chronic urticaria (CU) is urticaria that has been present continuously or intermittently for at least 6 weeks. This retrospective chart review of adults (n=345) sought to establish a definition, determine the frequency, and evaluate risk factors for recurrence (RCU). RCU was defined as CU recurring at least 6 months after cessation of controller therapy. Thirteen percent had RCU; those with RCU had a higher frequency of alternative agent use (57.8%) compared to the non-recurrence group (34.8%, p <0.01). Exposure to anti-inflammatory agents, immunosuppressants, and omalizumab had a significantly higher relative risk of recurrence compared to those who only used first-line agents (relative risk [RR] 2.32, p<0.01; RR 2.69, p<0.01; and RR 2.18, p=0.05, respectively).
The Journal of Allergy and Clinical Immunology: In Practice (4/2018) 
Fecal calprotectin as a potential biomarker for necrotizing enterocolitis
Fecal calprotectin levels are used to detect mucosa-level inflammation in monitoring indolent disease activity in patients with inflammatory bowel diseases. The aim of this prospective study was to determine baseline calprotectin levels in preterm infants at risk for necrotizing enterocolitis (NEC) and to assess the utility of calprotectin as an early detection biomarker for NEC. The fecal calprotectin levels were highly variable, and maternal causes for preterm birth were associated with higher baseline levels. More data are needed to confirm whether an acute rise in these levels prior to the clinical diagnosis of NEC can serve as a biomarker.
The Journal of Pediatrics (4/2018) 
Frailty -- still a complex concept in geriatric care
Frailty is a geriatric syndrome characterized by impaired performance and reduced functional reserve across multiple physiologic systems, and associated with increased vulnerability to adverse health outcomes from stressor events. In this editorial, frailty is introduced as both a physical and cognitive concept that may be evaluated and may be prevented. The articles in the April edition of JAMDA will lend support to these ideas while making it obvious that the field of frailty is under evolution and expansion.
Journal of the American Medical Directors Association (4/2018) 
Medical News
Study finds PPI use doesn't increase risk of first stroke
Regular use of proton pump inhibitors does not significantly increase the risk of a first stroke, according to a study in the journal Gastroenterology. The study counters earlier evidence suggesting a higher risk of stroke with PPI use, which the researchers said may have been due to confounding factors related to chronic conditions that are associated with PPI use.
MedPage Today (free registration) (4/10) 
Study finds lower heart disease risks for adults who exercise
A study that included almost 500,000 adults ages 40 to 69 linked higher fitness levels to a lower likelihood of heart disease over six years, even for people with genetic variants that increased their cardiovascular risks, researchers reported in the journal Circulation. People who had the highest fitness level but also the greatest genetic risks had a 49% reduced risk of coronary heart disease and a 60% lower risk of atrial fibrillation, compared with individuals who were least fit.
HealthDay News (4/9) 
PET study: Lack of sleep tied to increase in marker for Alzheimer's
NIH researchers who used PET found that 19 of 20 healthy individuals who experienced one night of sleep deprivation had significantly increased levels of beta-amyloid protein, which is associated with Alzheimer's disease, in their brains, compared with when they had a good night's sleep, but the increases were not clinically significant for Alzheimer's. The findings in the Proceedings of the National Academy of Sciences should prompt more studies to determine whether there is a direct association between inadequate sleep and higher Alzheimer's risk, researchers said.
Quartz (4/9),  HealthDay News (4/9) 
Business Practice News
Report: Hospital M&As may raise patient safety risks
Hospital mergers and acquisitions could lead to significant, unintended patient harm unless steps are taken to mitigate safety risks, researchers wrote in the Journal of the American Medical Association. The researchers created a toolkit to help hospitals identify patient safety risk factors and address potential harms.
Becker's Hospital Review (4/6) 
Study evaluates physicians' online, institutional reviews
Physicians who receive negative online reviews may not receive negative reviews on formal institutional patient surveys, according to a study in the Mayo Clinic Proceedings. These physicians still often get lower scores on factors outside of their control, compared with doctors who do not get negative online reviews.
Medscape (free registration) (4/6) 
Patient's Perspective
Addictive substance exposures increasing among young children
Calls to US poison control centers for youths ages 5 and younger who were exposed to addictive substances totaled 30,520 in 2016, with e-cigarette exposures rising by more than 1,400% over three years and marijuana exposures increasing by 148% over eight years, according to a report from the National Center on Addiction and Substance Abuse. The findings also showed a 93% annual increase in prescription opioid exposures over a nine-year period, as well as an annual increase in alcohol exposures since 2012.
HealthDay News (4/10) 
There is nothing stronger than those two: patience and time. They will do it all.
Leo Tolstoy,
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