Fish consumption and coronary risk | Treatment recommendations for barbiturate poisoning | Paradoxical second-meal phenomenon after exercise
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September 4, 2014
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Fish consumption and coronary risk
Our meta-analysis demonstrated that there is an inverse association between fish consumption and the risk of acute coronary syndrome. Fish consumption appears beneficial in the primary prevention of acute coronary syndrome, and higher consumption is associated with greater protection. The American Journal of Medicine (9/2014) Share: Email
Clinical Updates
Treatment recommendations for barbiturate poisoning
Barbiturate poisoning, although often nonfatal, can have serious cardiovascular, central nervous system and pulmonary effects. Mactier et al report research conducted by the EXTRIP Work Group on the different forms of extracorporeal treatment (ECTR) used for barbiturate poisoning during 1951 to 2013. High incidence of death in the reviewed literature suggests that ECTR was reserved for the most severe cases. The work group supports use of ECTR in select cases, recommending that intermittent hemodialysis may be useful for severe intoxications with long-acting barbiturates, which are excreted more readily by the kidneys and thus dialyzable. American Journal of Kidney Diseases (9/2014) Share: Email
Paradoxical second-meal phenomenon after exercise
People with blood sugar imbalances are generally encouraged to eat breakfast. This is in part because of the well-established second-meal phenomenon, such that blood sugar status is better recorded after a second meal than it would have been had not an earlier meal containing protein been eaten. But when a person has been exercising, the effect is very different: glucose tolerance is actually worsened after the second meal. This review article examines the literature regarding this physical activity factor apparently counteracting the second-meal phenomenon. Nutrition (9/2014) Share: Email
Identifying the most effective hepatitis C virus testing strategies
Forty percent to 85% of adults infected with hepatitis C virus (HCV) are currently undiagnosed. This study compares two HCV antibody (anti-HCV) testing strategies based on elevated alanine aminotransferase levels (ALT) and a birth cohort approach for people born during 1945 to 1965. The authors found the birth cohort strategy would identify 1 million more anti-HCV+ people than the elevated ALT approach, while concurrent implementation would identify an even greater number. (Available for CME credit.) American Journal of Preventive Medicine (9/2014) Share: Email
Effect of empathy and accountability on clinical judgment
Research demonstrates bias in the evaluation of patients with chronic pain, typically reflected in observer discounting of patient reports of severity or the attribution of symptoms to psychological factors. In this study, medical students read a vignette about a hypothetical patient referred for evaluation of severe low back pain. Results showed that empathy had strong associations with symptom validity and severity judgments, demonstrating that role demands can affect symptom judgments in complex ways and that empathy may play both direct and moderating roles. Because physicians are the primary gatekeepers regarding disability determination in both consultative and treating roles, accountability may have significant mediating effects on such determinations. The Journal of Pain (9/2014) Share: Email
Sleep duration and obesity among young adults
Using a sample from the National Longitudinal Study of Adolescent Health Study, short sleep duration was associated with obesity in adolescent males, but not in females. Longitudinally, short sleep duration in adolescence was associated with obesity in young adulthood for both males and females. Increased sleep duration during adolescence may be an effective intervention to reduce excess weight gain in young adults. The Journal of Pediatrics (7/2014) Share: Email
Depression and survival rates after coronary bypass
The authors found a strong and significant association between depression and long-term survival in patients with established ischemic heart disease who underwent coronary artery bypass grafting. Depression was also associated with an increased risk for a combination of death or rehospitalization for heart failure, myocardial infarction or stroke. The American Journal of Cardiology (9/1/2014) Share: Email
Medical News
Low birth weight, premature birth may have lasting effects
Research published in the journal Pediatrics involving more than 1,200 infants born in Iceland showed that smaller birth size was associated with reduced brain volume and function late in life, although brain performance was also connected to education early in life. A second study, also reported in Pediatrics, found that babies born prematurely were more likely have cardiovascular risk factors at age 16 than those born full-term. HealthDay News (9/2) Share: Email
Review: Many diet plans work regardless of brand
A review of 11 popular diets revealed all plans resulted in weight loss among obese participants, with low-fat and low-carb diets being the most successful. The results in the Journal of the American Medical Association also showed different diet brands within each category didn't differ significantly. Reuters (9/2) Share: Email
Study: MERS virus unlikely to be passed within household
A study in the New England Journal of Medicine found that Middle East respiratory syndrome virus, which has infected around 837 individuals and killed at least 291, is unlikely to be passed among family members or to others in the household. Researchers examined data related to 26 people with MERS and found that 12 people out of 280 household contacts came down with the virus. HealthDay News (8/27) Share: Email
Business Practice News
Incentives, technical help with EHR implementation associated with better care
A study in Medical Care revealed EHR use alone may not bolster quality among small practices, but providing incentives and assistance may improve care delivery. Data on 143 practices showed a significant improvement in performance among those that received financial incentives compared with those that did not, while better performance were seen among practices given technical assistance for certain measures. Healio (free registration)/O&P Business News (8/29) Share: Email
Patient's Perspective
Study highlights need for prostate cancer patient education
Educating patients who have prostate cancer about their condition will help them make good treatment decisions, according to a study in the journal Cancer that calls for clinicians to identify those most in need of information. Data from 70 men with localized prostate cancer suggest those with little understanding of the disease have difficulty deciding on treatments and less confidence in treatment efficacy. HealthDay News (8/29) Share: Email
Patients cite problems with accessing patient portals
A survey conducted by Software Advice found that patients still have problems using online portals despite having access to the platforms. Unresponsive staff and confusing interfaces were among the top frustrations cited by 1,540 respondents. (8/28) Share: Email
The art of being wise is the art of knowing what to overlook."
-- William James,
American philosopher and psychologist Share: Email
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