30-day readmissions after an acute kidney injury hospitalization | A nutrition intervention in the waiting room | A new hope for obesity management
February 9, 2017
AJM: From the publisher of The American Journal of Medicine
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Top News
30-day readmissions after an acute kidney injury hospitalization
The risk of hospital readmission in acute kidney injury survivors is not well understood. The authors estimated the proportion of acute kidney injury patients who were rehospitalized within 30 days and identified characteristics associated with hospital readmission.
The American Journal of Medicine (2/2017) 
Complimentary Elsevier Clinical Perspectives and Analysis CME Activity
This CME activity provides meeting highlights from the 9th annual meeting of Clinical Trials on Alzheimer's Disease (CTAD) held in December in San Diego, California. Upon completion of this activity, you may receive up to 0.75 AMA PRA Category 1 Credit. Click here to begin this activity!
Clinical Updates
A nutrition intervention in the waiting room
Double Up Food Bucks (DUFB) is a healthy food incentive program that matches Supplemental Nutrition Assistance Program (SNAP) funds spent at Michigan farmers markets. This study examined the impact of a waiting room DUFB intervention on program utilization and produce consumption. By the end of the DUFB season, 69% of participants reported use of DUFB at least once and 34% reported use of DUFB three or more times. Adjusted fruit and vegetable consumption increased by 0.65 servings/day at 3 months and remained 0.62 servings/day higher 2 months post-DUFB season compared to baseline.
American Journal of Preventive Medicine (2/2017) 
A new hope for obesity management
The authors demonstrate the inhibitory activities of boron on adipogenesis using common cellular models. Boron treatment repressed the expression of adipogenesis-related genes and proteins, including CCAAT-enhancer-binding protein α and peroxisome proliferator-activated receptor γ, by regulating critical growth factors and the β-catenin, AKT, and extracellular signal-regulated kinase signaling pathways. Although boron treatment did not induce apoptosis in pre-adipocytes, it depressed clonal expansion by regulation of cell cycle genes. These data offer promising insights into the prevention and treatment of obesity and associated diseases.
Metabolism -- Clinical and Experimental (2/2017) 
Advance in uroprotective agents for hemorrhagic cystitis
Cyclophosphamide- and ifosfamide-induced hemorrhagic cystitis is prevalent in the treatment of oncologic and rheumatologic conditions. Hemorrhagic cystitis is a sterile, noninfectious cystitis primarily induced by ifosfamide and cyclophosphamide. In general, mild hemorrhagic cystitis can be managed on an outpatient basis with hydration and is transient in nature. Moderate hemorrhagic cystitis can require clot extraction via cystoscopy, continuous bladder irrigation, and instillation of agents into the bladder such as alum or formalin. Severe hemorrhagic cystitis can require inpatient management with transfusions and major procedures, including cystectomy. Mesna and hyper hydration (in combination with diuresis) as uroprotective agents should be used routinely prior to the administration of cyclophosphamide and ifosfamide.
Urology (2/2017) 
Coffee consumption hastens gut recovery after surgery
Coffee consumption after complete staging surgery of gynecologic cancer decreases the time to bowel motility and hastens the ability to tolerate food.
American Journal of Obstetrics & Gynecology (2/2017) 
Poor sleep predicts substance use
Poor sleep health may be a prospective predictor of alcohol and marijuana use in adolescents, independent of internalizing and externalizing behaviors. The independent effect of sleep on substance use demonstrates the need for interventions targeting the types of sleep problems that are common in adolescence.
Journal of Adolescent Health (2/2017) 
Poor understanding of MRSA prevention measures in nursing homes
Could poor understanding of MRSA be preventing nursing home staff from using gowns and gloves to stop the spread of infection? A study from Maryland found that staff who took direct care of residents in three community-based nursing homes reported they were more likely to use gowns and gloves as self-protection when dealing with bodily fluid, but not to prevent the spread of MRSA. Administrators were surprised that MRSA transmission occurred during those times that the staff perceived no threat.
Journal of the American Medical Directors Association (2/2017) 
Medical News
E-cigarette use tied to higher tobacco smoking risk in US youths
Teens who used e-cigarettes had more than four times higher odds of smoking traditional cigarettes and more than four times higher odds of perceiving smoking as less risky within the next year, compared with those who never vaped, according to a study in Tobacco Control. The findings, based on Monitoring the Future study data involving 347 12th-grade students, also showed a two times higher likelihood of reporting recent cigarette smoking among those who recently used e-cigarettes.
MedPage Today (free registration) (2/7),  LiveScience.com (2/7) 
CDC: Black Americans with HIV/AIDS undertreated
Despite overall progress in HIV prevention in the US, a study conducted by the CDC found that HIV diagnosis and treatment is happening too late for black Americans. Research showed almost 22% of 12,200 black males and females who had HIV in 2014 were found to have developed AIDS by the time of diagnosis, and that many African-American males who acquired HIV were unaware they were infected with the virus.
HealthDay News (2/3) 
Business Practice News
Physicians may need to ramp up health IT for MACRA, experts say
Physician practices may need to increase adoption of health care IT to successfully transition to working within the Medicare Access and CHIP Reauthorization Act, IT experts say. Lawrence Kocot at KPMG said practices that have transitioned to or are moving toward certified electronic health record technologies will be better able to perform in MACRA's Merit-based Incentive Payment System.
Health Data Management (2/6) 
ONC paper explores future of patient-generated health data
The HHS' Office of the National Coordinator for Health IT recently issued a draft white paper on the potential opportunities and challenges associated with using patient-generated health data in clinical decisions. The paper's authors predict a more streamlined flow of health information between patients and their health care providers, a more collaborative relationship between patients and clinicians, and more use of PGHD in research; but some barriers must be overcome, including interoperability, security and data analysis problems.
MedPage Today (free registration) (2/3) 
Patient's Perspective
Study tracks elderly deaths after ED discharge
Researchers said some 10,000 Medicare patients who are generally healthy die within a week of being discharged from a hospital emergency department, most commonly from heart disease, chronic obstructive pulmonary disease or pain drug overdoses. The study in The BMJ found patients with confusion, shortness of breath or general weakness were at higher risk of death following ED discharge.
HealthDay News (2/2) 
Never give in except to convictions of honor and good sense.
Winston Churchill,
statesman and prime minister
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