Quadriceps strength predicts mortality | Identifying cancer disparities in a homeless population | Prescribing exercise for hypercholesterolemic patients
November 19, 2015
AJM: From the publisher of The American Journal of Medicine
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Top News
Quadriceps strength predicts mortality
A high level of quadriceps strength was strongly associated with a lower risk of both all-cause and cardiovascular mortality in patients with coronary artery disease. Evaluation of quadriceps isometric strength offered incremental prognostic information beyond pre-existing risk factors. The American Journal of Medicine (11/2015) Share: Email
Free Pain Management CME Webcast!
The purpose of this activity is to review treatments for opioid overdose and explain how healthcare providers can use screening and diagnostic tools to effectively identify high-risk patients.
Upon completion you may receive up to 1.0 AMA PRA Category 1 Credit(s).
Click here to begin this activity!
Clinical Updates
Identifying cancer disparities in a homeless population
Homeless people have a high burden of cancer risk factors and suboptimal cancer screening rates. Cancer incidence, stage and mortality were assessed in 28,033 homeless adults from 2003 to 2008 relative to general population standards. Bronchus and lung cancer cases and cancer death exceeded Massachusetts estimates more than twofold. Excessive rates of cancer cases and cancer deaths were found in oropharyngeal and liver cancers for men and cervical cancer for women. Cancers diagnosed at more advanced stages included colorectal, female breast and oropharyngeal cancers. To reduce cancer disparities in homeless people, tobacco use should be addressed, as should the need for evidence-based screening. (Available for CME credit.) American Journal of Preventive Medicine (11/2015) Share: Email
Prescribing exercise for hypercholesterolemic patients
This study concluded that running and walking for exercise lowers diabetes, hypertension and cardiovascular disease risk in hypercholesterolemic patients and should more than compensate for the purported 9% increase in diabetes risk from statin use. By preventing morbidity and mortality for a specific existing medical condition, some exercise expenses in hypercholesterolemic patients, when prescribed by a physician, may qualify for flexible spending account expenditures. The American Journal of Cardiology (11/15/2015) Share: Email
Symptom-based clustering in chronic rhinosinusitis
This study retrospectively reviewed 97 surgical chronic rhinosinusitis (CRS) patients. Symptom-based clusters were derived based on presurgical SNOT-22 scores using unsupervised analysis and network graphs. Clusters were compared for clinical and demographic parameters, post-surgical symptom scores, and presence or absence of a history of aspirin sensitivity. CRS patients were stratified into severe overall, severe sinonasal, moderate sinonasal, moderate non-sinonasal and mild sinonasal clusters. The last two clusters were associated with lack of history of aspirin sensitivity. The first cluster had a rapid post-operative relapse in symptoms, and the last cluster demonstrated minimal symptomatic improvement after surgery. Symptom-based clusters in chronic rhinosinusitis reveal a distinct grouping of symptom burden, which may relate to aspirin sensitivity and treatment outcomes. The Journal of Allergy and Clinical Immunology: In Practice (11/2015) Share: Email
Maternal-fetal stress transfer
In addition to placental cortisol transfer, maternal stress is transferred to the fetus via a catecholamine-mediated decrease in uterine blood flow. American Journal of Obstetrics & Gynecology (11/2015) Share: Email
Social support for young adults with fibromyalgia
For young adults previously diagnosed with fibromyalgia in adolescence, perceived social support was lower than that of healthy control peers. Social support variables had significant associations with physical functioning and mood and appeared to affect physical and emotional functioning uniquely. Journal of Adolescent Health (11/2015) Share: Email
Neurodevelopmental problems and feeding issues
Preterm infants often experience neurophysiological immaturity and decreased tone, which decreases the skills needed for successful and enjoyable oral feeding. In this study of 80 preterm children, 26% were at risk for feeding difficulties, and an additional 18% had definite feeding problems at 2 years of age. Those with feeding difficulties were more likely to have neurodevelopmental problems. Focusing on improving feeding skills, in conjunction with supporting positive parent-child interactions, may be beneficial for improving outcomes. The Journal of Pediatrics (11/2015) Share: Email
Continuing Medical Education
2015 AAN Medical Meeting Reporter: Advances in B-Cell and Other Novel Therapeutics in Multiple Sclerosis
This Medical Meeting Reporter will review and analyze data presented at the 67th Annual American Academy of Neurology Meeting. This activity has been designed to meet the educational needs of Neurologists and other healthcare professionals responsible for the diagnosis, treatment or management of patients with multiple sclerosis. Upon completion of this activity, participants will be able to: 1) Describe the pathophysiology of multiple sclerosis and the role of the B-cell, 2) Analyze mechanisms of action and clinical trial data for novel therapeutics in multiple sclerosis, and 3) Integrate B-cell targeted therapies into the discussion of therapy selection to help apply the most appropriate treatment plan. Upon successful completion of this activity you may receive up to 1.0 AMA PRA Category 1 Credit™. Faculty presenters include: Fred Lublin, MD, Clyde E. Markowitz, MD, Suhayl S. Dhib-Jalbut, MD. Begin the free CME activity. Share: Email
Medical News
CDC: 47% of people with hypertension don't have it controlled
A CDC report said about 47% of people with high blood pressure did not have it under control through use of medication or lifestyle changes, raising their risk of heart attack and heart disease. Data showed almost 56% of whites had their hypertension under control, compared with 48% of blacks, 43% of Asians and 47% of Hispanics. HealthDay News (11/12) Share: Email
Study links moderate coffee consumption to lower risk of death
Researchers found people who drank one to five cups of coffee daily, whether caffeinated, decaffeinated or both, were less likely to die from type 2 diabetes, heart disease, neurological diseases or suicide, but not cancer, compared with those who didn't drink coffee. The findings in Circulation were based on data from more than 200,000 participants. Reuters (11/16) Share: Email
Study: Lower ovarian cancer risk seen for black women with healthy diets
Black women with the healthiest diets had a 34% lower risk of developing ovarian cancer compared with those with the least healthy diets, according to a study presented at the American Association for Cancer Research conference. Researchers found the risk was even lower for postmenopausal women who had the healthiest diets. HealthDay News (11/13) Share: Email
Business Practice News
Patients may benefit when surgical residents scrub in
There is no danger and it might even be beneficial to have surgical residents join senior physicians in the operating room, data show. Rates of complications were similar in cases that included residents, compared with those involving only senior physicians, and 30-day mortality risk was 7% lower, according to a study published in the Journal of the American College of Surgeons. Surgical residents may help attending surgeons to improve proper preoperative decision-making and act as an additional safety checkpoint, said senior study author Faek Jamali. Reuters (11/13) Share: Email
Doctor-patient discussions may cut antibiotic overprescribing
Shared decision-making between primary care physicians and patients helps reduce prescriptions for antibiotics to treat respiratory infections, according to a Cochrane Library report. When patients and doctors discuss the issue, 29% are prescribed antibiotics, compared with nearly 50% of clinical encounters that did not involve shared decision-making. The findings were based on over 1,000 doctors and hundreds of thousands of patients who participated in 10 randomized controlled trials in the UK and Europe. Reuters (11/16) Share: Email
Other News
Patient's Perspective
Rates for 3 STDs increased in 2014, CDC says
CDC data showed there were more cases of chlamydia, syphilis and gonorrhea in the US in 2014, compared with the previous year, marking the first time rates of the three sexually transmitted diseases increased since 2006. Researcher Dr. Gail Bolan said the STDs disproportionately affect young people, and in 2014 those ages 15 to 24 made up almost two-thirds of reported cases of chlamydia and gonorrhea. HealthDay News (11/17) Share: Email
Editor's Note
AJMPlus will not publish Nov. 26
In observance of the Thanksgiving holiday in the US, AJMPlus will not publish Thursday, Nov. 26. Publication will resume Dec. 3. Share: Email
You cannot swim for new horizons until you have courage to lose sight of the shore."
-- William Faulkner,
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