Chronic coinfections with Lyme disease | A new opioid compliance checklist | Selenium level association with low muscle mass
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November 13, 2014
AJM: From the publisher of The American Journal of Medicine
News for physicians working in clinical settings

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Chronic coinfections with Lyme disease
The medical literature does not support the diagnosis of chronic, atypical tick-borne coinfections in patients with chronic, nonspecific illnesses. The American Journal of Medicine (11/2014) Share: Email
Clinical Updates
A new opioid compliance checklist
There has been a need for a brief assessment tool to determine compliance with use of prescribed opioids for pain. The purpose of this study was to develop and begin the validation of a brief and simple compliance checklist (the Opioid Compliance Checklist) for chronic pain patients who are prescribed long-term opioid therapy. This measure asks patients about aberrant drug-related behavior over the past month, and any positive response indicates problems with adherence with opioids. Further cross-validation testing is needed. The Journal of Pain (8/2014) Share: Email
Selenium level association with low muscle mass
Do low selenium levels put elderly at risk of sarcopenia? Gradual loss of muscle mass and strength results in sarcopenia. A study from Taiwan found low serum selenium levels are independently associated with low muscle mass in people aged 65 and older. Although a causal relationship could not be confirmed in this study, results suggest a relationship between levels of the antioxidant, selenium, and skeletal muscle mass and thus could be an indicator of sarcopenia risk. (Free abstract only.) Journal of the American Medical Directors Association (11/2014) Share: Email
Gatekeeper training for mental health care
A large-scale multisite study of gatekeeper training programs to increase utilization of mental health services among college students showed mixed results. Trainees experienced improved outcomes, but utilization of mental health services in student communities did not increase. Journal of Adolescent Health (11/2014) Share: Email
Acute decompensated heart failure after hospital admission
In this study, post-admission onset of acute decompensated heart failure (ADHF) was characterized by differences in comorbidities and worse short-term prognosis. Opportunities for reducing post-admission ADHF occurrence and associated risks need to be studied. The American Journal of Cardiology (11/15/2014) Share: Email
Stem cell epigenetics and future health
The epigenetic profile, including genes known to be relevant for future health, in stem cells from umbilical cord blood differ in relation to mode and duration of delivery. American Journal of Obstetrics & Gynecology (11/2014) Share: Email
Normative values for children's steps per day
An analysis sample of 2,610 children (1,329 girls) was taken from the 2005-2006 National Health and Nutrition Examination Survey. Step per day was inversely associated with age; it was apparent in only small decrements for boys, but the girls' reduction was much steeper. Boys maintained or increased their peak 60-minute cadence between 8 and 15 years of age, with a reduction between 16- to 19-year-olds. The peak 60-minute cadence was more variable for girls; a sharp reduction in 60-minute cadence and steps/day was seen in girls 10 to 13 years of age. (Free access is time limited.) The Journal of Pediatrics (10/2014) Share: Email
Medical News
Hypertensive young adults may not get advice on lifestyle changes
A study of 500 young adults with hypertension found only 55% received counseling on making lifestyle changes to control their blood pressure within a year of diagnosis, University of Wisconsin researchers reported in the Journal of General Internal Medicine. The research showed women, patients who regularly saw a physician, those with a family history of hypertension and patients diagnosed with high cholesterol were more likely to get lifestyle counseling. HealthDay News (11/10) Share: Email
Anxiety may boost dementia risk for patients with cognitive decline
Anxiety may raise the risk of dementia in patients with mild cognitive impairment, University of Toronto researchers reported in the American Journal of Geriatric Psychiatry. Researcher Dr. Linda Mah said clinicians should screen patients who have memory problems for anxiety. Science World Report (11/11) Share: Email
Business Practice News
Survey: Almost 20M clinical referrals annually are inappropriate
Data from the 2014 Kyruus Physician Referral Survey revealed about 19.7 million patients experience clinically inappropriate referrals annually. Researchers also found about 8% of all clinical referrals were considered inappropriate, while 75% of specialists said they had received at least one inappropriate referral during the previous year. (11/10) Share: Email
Report examines providers' support for telehealth services
A Foley & Lardner report found that 9 in 10 providers are working on telehealth initiatives despite challenges recruiting physicians and securing coverage by insurers. The study also found that 64% of participants provide remote monitoring services, and 52% have real-time interaction capabilities. Healthcare Informatics online (11/11) Share: Email
Other News
Patient's Perspective
Some people exercise but fail to lose weight, studies show
Study data show some people who exercise do not lose much weight, if any, and some even gain pounds, usually from increased fat rather than increased muscle. Arizona State University researchers found overweight and sedentary women who did treadmill workouts for 12 weeks were more aerobically fit but most also had gained some fat. Those who lost weight after four weeks were more likely to continue to shed pounds, researchers reported in The Journal of Strength and Conditioning Research. The New York Times (tiered subscription model)/Well blog (11/12) Share: Email
Study: Cancer survivors report lower health-related quality of life
Older cancer survivors, especially those who had pancreatic cancer and multiple myeloma, reported lower health-related quality of life compared with patients who had not had cancer, researchers reported in the journal Cancer. National Cancer Institute researchers said mental health scores were similar between the groups, but most cancer survivors had lower scores on the Role-Emotion and Social Functioning scales. News (11/11) Share: Email
Progress lies not in enhancing what is, but in advancing toward what will be."
-- Kahlil Gibran,
Lebanese artist, poet and writer Share: Email
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