Effect of smoking on sciatica risk | Omega-3 to ameliorate methotrexate-induce hepatotoxicity | Opioid risk reduction initiatives for chronic therapy patients
January 28, 2016
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Effect of smoking on sciatica risk
The role of smoking in sciatica is unknown. This study aimed to estimate the effect of smoking on lumbar radicular pain and clinically verified sciatica. The authors used a random-effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses with regard to study design, methodological quality of included studies, and publication bias. The American Journal of Medicine (1/2016) Share: Email
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Clinical Updates
Omega-3 to ameliorate methotrexate-induce hepatotoxicity
Cancer treatment involving methotrexate can sometimes result in hepatotoxicity. This study investigated whether omega-3 fatty acids given as an adjuvant therapy can moderate the potentially toxic affects of methotrexate in children and adolescents with acute lymphoblastic leukemia. Participants were divided into two groups, one of which received omega-3 fatty acids, the other a placebo, along with methotrexate. Patients supplemented with omega-3s had more normal liver function after six months and did not experience any adverse effects due to omega-3 supplementation. Nutrition (1/2016) Share: Email
Opioid risk reduction initiatives for chronic therapy patients
Avoiding high opioid doses may reduce chronic opioid therapy (COT) risks, but the feasibility of reducing opioid doses in community practice is unknown. Washington state and a health plan's group practice implemented initiatives to reduce high-dose COT prescribing. The group practice physicians were exposed to both initiatives, while its contracted physicians were exposed only to statewide changes. The authors assessed whether these initiatives reduced opioid doses among COT patients. The proportion receiving excess opioid days supplied declined from 24.0% to 10.4% among group practice COT patients and from 20.1% to 14.7% among COT patients of contracted physicians. The Journal of Pain (1/2016) Share: Email
Prolonged organ dysfunction in pediatric sepsis
More than 750,000 U.S. children develop severe sepsis annually, with mortality rates of 10% to 20%. In children with sepsis and organ dysfunction, lactate normalization within 4 hours was associated with decreased persistent organ dysfunction. Serial lactate level measurement may be a useful prognostic tool during the first hours of resuscitation in children with sepsis. The Journal of Pediatrics (1/2016) Share: Email
Predictors of sustained opioid use after trauma
Adolescents with pre-injury marijuana use and high baseline pain scores had increased risk of sustained prescription opioid use following admission for trauma. Screening for substance use at the time of injury could help identify patients at risk. Journal of Adolescent Health (1/2016) Share: Email
Competing risk model for preeclampsia
A competing risk model based on maternal factors and biomarkers provides the basis for effective screening for preeclampsia. American Journal of Obstetrics & Gynecology (1/2016) Share: Email
Nursing home administrators' role in physical activity policies
How can nursing home administrators be motivated to develop policies to promote physical activity for their residents? There is no doubt about the benefits of keeping the elderly moving to benefit their overall health. Indeed, administrators who completed the survey in this study reported that two key motivators were the general health and the psychological well-being of their residents. Since nursing home administrators are key in developing care policies for their home, it is important to motivate them in this area of care. Journal of the American Medical Directors Association (1/2016) Share: Email
Medical News
AHA outlines deficits in heart attack care for women
The American Heart Association published a scientific statement in Circulation that said when it comes to heart attacks, women are "understudied, underdiagnosed and undertreated," which leads to poor outcomes, hospital readmissions, repeat heart attacks and death after a heart attack. The first scientific statement from the AHA on heart attacks in women emphasizes the differences in warning signs and causes of heart attack for women compared with men. Reuters (1/25), MedPage Today (free registration) (1/25) Share: Email
USPSTF calls for all adults to be screened for depression
The US Preventive Services Task Force recommended all US adults be screened for depression, especially pregnant or postpartum women, in a final statement that updates 2009 guidance. The recommendations, published in the Journal of the American Medical Association, carry a B rating. Reuters (1/26), The New York Times (free-article access for SmartBrief readers) (1/26) Share: Email
Increased diabetes risk tied to emotional distress, study finds
Men who reported emotional distress at initial screening had an incident diabetes rate of 6.35 cases per 1,000 person-years, compared with 3.32 cases per 1,000 person-years among those who didn't report emotional distress, according to a study in the American Journal of Preventive Medicine. Israeli researchers followed 32,586 men without diabetes between 1995 and 2011 and found those who reported emotional distress at two time points had a higher likelihood of incident diabetes than those who did not report distress. Healio (free registration)/Endocrine Today (1/26) Share: Email
Business Practice News
US sees fewer geriatricians even as elderly population grows
Patient care.
(Justin Sullivan/Getty Images)
Fewer physicians are going into geriatrics than other medical specialties even as the US population is aging and increasingly in need of care. The specialty offers lower pay than others, and physicians tend to want to cure patients, which often is not possible with older patients. Some believe interest in and respect for geriatrics will increase, and there has been new emphasis on training other physicians and clinicians to provide geriatric care. The New York Times (free-article access for SmartBrief readers) (1/25) Share: Email
Survey: Physicians say face-to-face delivery of bad news is best
An Aptus Health and mHealthIntelligence.com survey found that nearly 88% of participating physicians said bad biopsy results should be delivered in person rather than through virtual consultations or phone calls. Several physicians said that telehealth services may be preferred when a patient is not otherwise available or the news is time-sensitive. mHealthIntelligence.com (1/20) Share: Email
Patient's Perspective
Poll: 88% of adults satisfied with physician visits
An online Harris poll of more than 3,000 adults showed 88% of those who had a physician visit in the past year were satisfied with it, an increase of 5% from 2012. The poll showed satisfaction increased with age, and factors affecting satisfaction included physician knowledge, training and expertise, time spent with patient and ease of making appointments. HealthDay News (1/22) Share: Email
Obstacles can't stop you. Problems can't stop you. Most important of all, other people can't stop you. Only you can stop you."
-- Jeffrey Gitomer,
business trainer and writer Share: Email
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