Insomnia increases mortality risk | Underuse of alternatives to hysterectomy | Sex differences in serum leptin and cardiometabolic risk
March 19, 2015
AJM: From the publisher of The American Journal of Medicine
News for physicians working in clinical settings

Top News
Insomnia increases mortality risk
In a population-based cohort, persistent, and not intermittent, insomnia was associated with increased risk for all-cause and cardiopulmonary mortality and was associated with a steeper increase in inflammation. The American Journal of Medicine (3/2015) Share: Email
Clinical Updates
Underuse of alternatives to hysterectomy
This study provides evidence that alternatives are underutilized before hysterectomy and that unsupportive pathology is most often found among women <40 years of age. American Journal of Obstetrics & Gynecology (3/2015) Share: Email
Sex differences in serum leptin and cardiometabolic risk
In this study, the sex-related differences in the relationship between circulating leptin and cardiometabolic risk and obesity were investigated. In men, serum leptin had significant indirect effects on total cholesterol/HDL-cholesterol ratio, triglyceride/HDL-cholesterol ratio, and fasting glucose. In women, serum leptin had positive effects on body weight and indirect effects on all cardiometabolic risk factors examined. Nutrition (3/2015) Share: Email
Accurate diagnosis of dehydration
Dehydration in the elderly means longer hospital stays and comorbidities. Accurate and early diagnosis of dehydration is key to halting the progress of serious outcomes such as acute kidney injury. The typical physical signs looked for may not provide a correct diagnosis. Researchers from the United Kingdom found that low systolic blood pressure could help in the diagnosis, but saliva osmolality was superior and, indeed, was able to detect water- and solute-loss dehydration. Journal of the American Medical Directors Association (3/2015) Share: Email
Improving mental health problem diagnosis in teens
A Web-based previsit screening tool may increase teen disclosure and doctor–patient discussion of mental health problems, potentially increasing the salience of mental health issues in primary care settings. Journal of Adolescent Health (3/2015) Share: Email
Obstructive lung disease and childhood idiopathic scoliosis
In this retrospective study, 39% of children with idiopathic scoliosis and Cobb angles ≥40 degrees had obstructive lung disease. Radiographic measures were found to be poor predictors of pulmonary function outcomes of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FVC/FEV1, and total lung capacity. The authors recommend pulmonary function testing for children with idiopathic scoliosis prior to spinal fusion surgery. The Journal of Pediatrics (2/2015) Share: Email
Utility of exercise ECG with coronary artery calcium
In subjects with coronary artery calcium, further risk stratification can be achieved by an exercise electrocardiogram, whereas in those without coronary artery calcium an exercise electrocardiogram has less additional value in predicting coronary events. The American Journal of Cardiology (3/15/2015) Share: Email
Continuing Medical Education
Moving Beyond Laxatives in Opioid-induced Constipation
This three-module activity series reviews the current and evolving approaches to managing opioid-induced constipation (OIC) through the use of patient vignettes and faculty-facilitated audio Q&As. The activity reviews current and evolving approaches for the pharmacologic and non-pharmacologic management of OIC and explores a series of OIC treatment questions and practice considerations for healthcare providers who wish to learn about OIC or who currently manage patients with OIC. Elsevier CME Share: Email
Medical News
Early habits influence heart health in adulthood
Approximately 90% of nearly 9,000 children had healthy blood pressure levels, but less than 1% were eating a healthy diet and 40% had poor cholesterol levels, according to a study based on the 2003-2010 National Health and Nutrition Examination Survey. Although children started with good BP levels, poor diet can trigger greater body mass index and cholesterol levels, lead researcher Donald Lloyd-Jones said. The findings appear in the journal Circulation: Cardiovascular Quality and Outcomes. HealthDay News (3/17), (3/17) Share: Email
Study data link fitness to diabetes risk
Data on 46,979 patients in the Henry Ford Exercise Testing Project linked fitness to a lower risk of diabetes. Treadmill tests were used to measure metabolic equivalents, and the study found patients who achieved 12 or more metabolic equivalents had a 54% lower risk of diabetes compared with those with six or fewer. The study was published in Diabetes Care. Healio (free registration) (3/17) Share: Email
Business Practice News
More physicians, hospitals turn to shared decision-making
Physicians and hospitals are using shared decision-making protocols to give patients more input into their care, according to a Kaiser Health News report. It can be challenging for physicians to adopt this model, but research shows it can improve patient satisfaction and possibly save money, says researcher Glyn Elwyn of the Dartmouth Institute for Health Policy and Clinical Practice. Kaiser Health News (3/16) Share: Email
Study: Patient hand-off tool may not be enough at night
A widely used patient hand-off tool may not fully address nighttime clinical issues for hospital staff, according to a report in the Journal of Hospital Medicine. Researchers found that in 94.4% of patient encounters at night, a nurse or patient chart was used for information, compared with 27.7% of encounters that used the hand-off tool. News (3/16) Share: Email
Patient's Perspective
Study links obesity to higher lifetime cancer risk in women
A Cancer Research UK study found a 40% greater risk of developing at least one weight-related cancer type among obese women compared with slimmer counterparts. For every 1,000 U.K. obese women, 274 are likely to get one of the cancers, compared with 194 among women of a healthy weight, the study says. HealthDay News (3/17) Share: Email
You cannot shake hands with a clenched fist."
-- Indira Gandhi,
prime minister of India Share: Email
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