Recommendations for beta-blockers after myocardial infaction: Should guidelines be reassessed? | Prevalence of persistent pain in U.S. adults | The fractal nature of blood glucose fluctuations
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October 16, 2014
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Recommendations for beta-blockers after myocardial infaction: Should guidelines be reassessed?
In contemporary practice of treatment of myocardial infarction, β-blockers have no mortality benefit but reduce recurrent myocardial infarction and angina (short-term) at the expense of increase in heart failure, cardiogenic shock and drug discontinuation. The guidelines should reconsider the strength of recommendations for β-blockers post-myocardial infarction. The American Journal of Medicine (9/2014) Share: Email
Clinical Updates
Prevalence of persistent pain in U.S. adults
This article presents a secondary analysis of the 2010 Quality of Life Supplement of the National Health Interview Survey and determines that about 19% of adults in the U.S. report persistent pain – 50.5% of whom call the pain "unbearable and excruciating." The authors note that persistent pain, defined as self-reported pain "every day" or "most days" in the preceding three months, is a useful way to characterize health-related quality of life in the general population. Policymakers should consider including this core measure in ongoing health surveys like the National Health Interview Survey and the Medical Expenditure Panel Survey. The Journal of Pain (9/2014) Share: Email
The fractal nature of blood glucose fluctuations
Blood glucose fluctuations are generated by multiple factors modifying concentrations through complex feedback loops. The traditional theory suggests that physiological systems achieve homeostasis when disturbed and restore equilibrium through linear feedback loops. The authors applied nonlinear analytical methods such as detrended fluctuation analysis to data derived from continuous glucose monitoring devices for prolonged time periods and found that glucose fluctuations show fractal-like behavior and power law behavior of the system. Journal of Diabetes and Its Complications (10/2014) Share: Email
Significance of positive family history for coronary heart disease
This study concluded that asymptomatic individuals with a coronary artery calcium score of zero and a positive family history of coronary heart disease are at increased risk for cardiovascular disease and coronary heart disease events compared with those without a family history of coronary heart disease, although absolute event rates remain low. The American Journal of Cardiology (10/15/2014) Share: Email
Predictors of multiple sexual partners
Although sexual behavior changes across adolescence and early adulthood, little is known about how predictors of sex change by age. Associations between substance use and depression and recent multiple sexual partners weaken over time. Programs targeting these factors hold greater promise for the prevention of sexual risk behavior earlier in adolescence. (Full-text access is time limited.) Journal of Adolescent Health (10/2014) Share: Email
Recurrent pregnancy loss and long-term maternal atherosclerotic morbidity
Recurrent pregnancy loss is an independent risk factor for long term maternal cardiovascular complications and for hospitalizations due to a cardiovascular cause. American Journal of Obstetrics & Gynecology (10/2014) Share: Email
Risk for second hip fracture
Are patients who experience a hip fracture likely to develop a second hip fracture or to die in a seven-year period? A study from Taiwan shows that patients with a second hip fracture were significantly more likely to die than those without. Diagnosis and adequate treatment of osteoporosis were often overlooked. A treatment program and prevention strategy needs to be refined to improve care of these vulnerable elderly patients. (Free abstract only.) Journal of the American Medical Directors Association (10/2014) Share: Email
Medical News
Smoking tied to 14 million medical conditions in U.S.
An FDA study linked some 14 million cases of major medical conditions to smoking, an increase from the 12.7 million estimated by the CDC a decade ago. The study in JAMA Internal Medicine said the increase may be due to better survey methods or because people who have smoking-related illnesses are living longer. HealthDay News (10/13), Reuters (10/13) Share: Email
Living near major highways tied to sudden cardiac mortality risk
An analysis of data from the Nurses' Health Study found that women who live close to major roads were more likely to die from sudden cardiac events. Study author Jaime Hart said the risk of living near major roads was comparable to that of obesity, smoking or a poor diet. The findings, based on data from more than 107,000 U.S. women, appeared in the journal Circulation. HealthDay News (10/13) Share: Email
Few serious reactions with MMR vaccine in adults, study finds
A decade's worth of study data on more than 3,000 adults who received the measles, mumps and rubella vaccine show a low number of serious adverse reactions, according to CDC researchers. The study, presented at IDWeek, found that 134 pregnant women had been vaccinated, which is not recommended, and researchers said it indicates a need for better education about vaccine recommendations. MedPage Today (free registration) (10/13) Share: Email
Business Practice News
2nd hospital worker in Texas tests positive for Ebola
A second health care worker at Texas Health Presbyterian Hospital in Dallas has tested positive for the Ebola virus. On Tuesday, the CDC said it was actively monitoring 75 other hospital workers in Dallas, and teams of infections control experts will be sent to hospitals treating Ebola. "I wish we had put a team like this on the ground the day ... the first patient was diagnosed," CDC Director Dr. Thomas Frieden said. CNN (10/15), The New York Times (tiered subscription model) (10/15), HealthDay News (10/14) Share: Email
EHR use linked to fewer adverse events, data show
Advanced EHR use resulted in a 30% decline in adverse events tied to drug errors and a 25% reduction in complications, according to a new study. The findings, drawn from hospitals and physician practices, were presented at the Workshop on Health IT and Economics. (10/14) Share: Email
Patient's Perspective
Mediterranean diet may help reduce obesity, diabetes risks
Participants who followed a Mediterranean diet supplemented with olive oil attained significant improvements in adiposity and blood glucose levels at nearly five years, while those who followed a Mediterranean diet supplemented with nuts exhibited reductions in obesity, according to a study in CMAJ. However, researchers did not observe a difference in metabolic syndrome incidence between the Mediterranean diet groups and the controls who followed a low-fat diet. (10/14) Share: Email
Sometimes you have to step outside of the person you've been, and remember the person you were meant to be, the person you wanted to be, the person you are."
-- H.G. Wells,
British author Share: Email
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