Pre-discharge hyponatremia correction in heart failure patients | Comprehensive evaluation of perioperative hypersensitivity reactions | HPV trends by gender
August 18, 2016
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Pre-discharge hyponatremia correction in heart failure patients
The study objective was to compare the 30-day readmission rate and mortality between patients with heart failure who have persistent hyponatremia during hospitalization and patients who have their admission hyponatremia corrected before discharge.
The American Journal of Medicine (8/2016) 
New Complimentary Multiple Myeloma CME
This CME program will cover data on new therapeutic strategies for the management of patients with relapsed-refractory multiple myeloma that were presented at the EHA 2016 in Copenhagen, Denmark on June 9 - 12, 2016. Once complete, you may receive up to 1.00 AMA PRA Category 1 Credit(s). Click here to begin this activity!
Clinical Updates
Comprehensive evaluation of perioperative hypersensitivity reactions
Hypersensitivity reactions (HSRs) during the perioperative period are unpredictable and can be life-threatening. This study prospectively determined the success of a comprehensive allergy evaluation plan for patients with HSR during anesthesia. Over 17 months, 25 patients completed the comprehensive allergy evaluation. The most frequently observed HSR systems were cutaneous (68%), cardiovascular (64%), and pulmonary (24%). A culprit drug, defined as a positive ST, was identified in 36% (9/25) of patients. The most common agent identified was cefazolin (6/9). Following a comprehensive evaluation and management plan, seven (7/8, 88%) patients tolerated subsequent anesthesia. Tolerance of subsequent anesthesia can generally be achieved in patients undergoing a comprehensive allergy evaluation.
The Journal of Allergy and Clinical Immunology: In Practice (8/2016) 
HPV trends by gender
This study analyzed HPV immunization data for New York City adolescents in order to understand gender-specific recommendations and coverage patterns. More female than male adolescents initiated vaccination. In 2009–2012, the proportion of eligible adolescents who initiated vaccination increased from 0.1% to 17.0% for males and from 15.4% to 17.3% for females. Vaccination initiation within 1 year of gender-specific recommendations was similar. For both genders, the uninsured were less likely to have early adoption and timely completion. Being publicly insured was associated with early adoption in both genders but with timely completion in male adolescents only.
American Journal of Preventive Medicine (8/2016) 
Parents and adolescents want help discussing health topics
This study shows that adolescents and parents want health care professionals to help them to learn and talk about a wide range of adolescent health topics. Feasible primary care interventions that effectively improve parent-teen health communication and specific adolescent health outcomes are needed.
Journal of Adolescent Health (8/2016) 
Cell-free DNA fetal fraction and preterm birth
Elevated cell-free DNA fetal fraction at 14.1-20 weeks' gestation is associated with an increased incidence of preterm birth.
American Journal of Obstetrics & Gynecology (8/2016) 
Fear avoidance affects chronic low back pain
The fear-avoidance model postulates that in an initial acute phase, chronic low back pain (CLBP) patients acquire a fear of movement that results in avoidance of physical activity and contributes to the pain becoming chronic. In this report, a functional magnetic resonance imaging study investigated the neural correlates of imagining back-straining and neutral movements in CLBP patients with high and low fear avoidance and in healthy pain-free participants. Results show that low fear-avoidant back pain patients appear to utilize a strategy or mechanism that enables them to react with less fear in the face of pain. This warrants further investigation, as countering fear and avoidance provide an important advantage.
The Journal of Pain (8/2016) 
Factors contributing to readmission to inpatient rehabilitation facilities
For medically complex patients, nine patient and facility characteristics point to risk of readmission to an inpatient rehabilitation facility (IRF). Researchers from Boston found higher risk in those who were older age, male, unemployed or retired, lower motor functional independence measure (FIM) score, longer onset days, higher Elixhauser comorbidity index, larger facility size (more than 60 beds in the IRF), lower mean facility admission motor FIM score, and eastern or western US geographic location.
Journal of the American Medical Directors Association (8/2016) 
Continuing Medical Education
Free Multiple Sclerosis Meeting Reporter from Elsevier
This CME program provides meeting highlights from the 68th Annual American Academy of Neurology Meeting held on April 15-21, 2016, in Vancouver, Canada. The latest advances in treatment options and methods of slowing Multiple Sclerosis disease progression will be discussed by three expert faculty. This activity has been designed to meet the educational needs of neurologists and other healthcare professionals responsible for the treatment of patients with MS. Upon completion, you may receive up to 1.00 AMA PRA Category 1 Credit(s)™. Begin this activity!
Medical News
Study shows increase in gestational diabetes prevalence in US
A study in BJOG: An International Journal of Obstetrics & Gynaecology revealed that the prevalence of gestational diabetes mellitus among US women increased from 0.3% in 1979 to 1980 to 5.8% in 2008 to 2010. Researchers also found that the increasing GDM prevalence was associated with a 184% decrease in large for gestational age/macrosomia and a 0.75% increase in stillbirth rate. News (8/16) 
Study links duration of excess weight to increased cancer risk in women
Study links duration of excess weight to increased cancer risk in women
(AFP/Getty Images)
A longitudinal study in the journal PLOS Medicine found women had a 10% increased risk of developing breast, endometrial, kidney or colon cancer for every 10 years of being obese and a 7% greater risk for every decade of being overweight. The findings, based on 73,913 women in the US who were enrolled in the Women's Health Initiative, also showed that the risk of obesity-related cancers depended on the degree of overweight.
CNN (8/16),  HealthDay News (8/16) 
Study: Youth suicide risk linked to prescription drug abuse
Chinese researchers found that teens who took prescription drugs for non-medical use at baseline were nearly three times as likely to attempt suicide in the following year, and those who abused opiates had more than triple the risk, compared with those who didn't abuse prescription drugs. The findings in JAMA Pediatrics were based on survey data involving nearly 3,300 Chinese adolescents at ages 14 and 15.
Reuters (8/15) 
Business Practice News
Study shows effects of penalty-based readmission initiative
A survey of hospital leaders found about two-thirds said the penalty-based Hospital Readmissions Reduction Program had a significant or great impact on increasing readmission reduction efforts, compared with 36.1% who said public reporting of readmission rates and 23.7% who said public reporting of discharge planning had an impact. The report in the American Journal of Managed Care showed 42.5% of respondents said the Hospital Readmissions Reduction Program was likely to increase quality of care, while 54.8% said it was most likely to reduce costs, compared with other payment models.
RevCycle Intelligence (8/15) 
Study: EHR use may reduce health care gaps
A study in Health Affairs showed that using EHR data may help reduce gaps in health care delivery driven by geographic, racial and socioeconomic disparities. Researchers found that practices have used EHR data to develop a new patient dashboard to accommodate various race populations, improve blood pressure control among black patients, boost cardiovascular care for minority patient populations and improve care coordination.
EHR Intelligence (8/11) 
Patient's Perspective
Heart group says sedentary time increases mortality, health risks
An American Heart Association scientific statement recommends people "sit less, move more" because sedentary behavior is linked to a higher risk of mortality, cardiovascular disease, diabetes and impaired insulin sensitivity. The statement, published in the journal Circulation, called for people to get at least 30 minutes of moderate to vigorous physical activity each day but noted that exercise does not cancel out the effects of sedentary time.
Healio (free registration)/Cardiology Today (8/15) 
A lot of people are afraid to say what they want. That's why they don't get what they want.
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