Sleep duration and glycemic control | Helicobacter pylori infection in pregnancy predicts adverse birth outcome | Digital interventions for sexual minority youths
May 18, 2017
AJM: From the publisher of The American Journal of Medicine
News for physicians working in clinical settings
Top News
Sleep duration and glycemic control
Just as nonfasting oral glucose tolerance testing can generate falsely elevated glucose levels, short sleep may similarly invalidate test results. The authors recommend adding questions about subjects' sleep habits when being tested.
The American Journal of Medicine (5/2017) 
Free CME Activity on Severe Asthma
This CME-accredited Clinical Research Updates program presented by a panel of expert faculty is intended for allergists/clinical immunologists, pulmonologists involved in the identification, evaluation, and treatment of patients with severe asthma. Upon completion of this activity, you may receive up to 1.0 AMA PRA Category 1 Credit. Click here to begin this activity!
Clinical Updates
Helicobacter pylori infection in pregnancy predicts adverse birth outcome
Helicobacter pylori is an independent risk factor for more severe vomiting in pregnancy. In women with daily vomiting, Helicobacter pylori is associated with a reduction of total maternal weight gain and small for gestational age babies.
American Journal of Obstetrics & Gynecology (5/2017) 
Digital interventions for sexual minority youths
To address health disparities experienced by sexual and gender minority youths, sexual health and other digital health interventions must respond to youths' stated needs for resources that represent diverse identities, are comprehensive, link mental health and sexual health, and are non-crisis-oriented.
Journal of Adolescent Health (5/2017) 
Nonroutine discharge may predict reintegration challenges for military service personnel
Successful reintegration into civilian life by returning military service members can be complicated by mental illness and substance use disorders. One potential early indicator for these challenges is nonroutine discharge from military service. This study examined risk for receiving a Veterans Health Administration-documented diagnosis of mental illness, substance use disorder, and suicidality as a function of discharge type. It found that nonroutine service discharge strongly predicts all of these diagnoses, with particularly elevated risk among veterans discharged for disqualification or misconduct. Targeted prevention and intervention efforts are needed to improve reintegration outcomes among this vulnerable subpopulation.
American Journal of Preventive Medicine (5/2017) 
Muscle weakness and diabetes in older Mexican-Americans
Older Mexican-Americans residing in the southwestern US were followed for 19 years (n=1903) to compare normalized grip strength and prevalence of incident diabetes. Muscle weakness was found to be associated with incident diabetes rates. While there were some limitations (self-reported diabetes), this study may highlight the potential benefit of encouraging strength building to help prevent onset of diabetes.
Journal of the American Medical Directors Association (5/2017) 
A proactive approach to penicillin allergy testing in hospitalized patients
Penicillin allergy testing is underutilized in inpatients. The authors established an inpatient service at a large academic hospital to identify and test patients with a history of penicillin allergy. Eligible inpatients were flagged daily through the electronic medical record and prioritized via a specialized algorithm. A trained clinical pharmacist performed penicillin skin tests and challenges preemptively or by provider request. The system detected 1,203 applicable charts, leading to 252 direct evaluations over 18 months. Overall, 228 subjects (90.5%) had their penicillin allergy removed. Among patients testing negative, 85 (38%) subsequently received beta-lactams, preventing 504 inpatient days and 648 outpatient days on alternative agents. Penicillin allergy testing using a physician-pharmacist team model effectively removes reported allergies in hospitalized patients.
The Journal of Allergy and Clinical Immunology: In Practice (5/2017) 
Registry provides details for improving individual chronic pain management
This article describes the results of analyses of patient-reported outcomes and patient-related electronic health record data collected while under care from a prospective cohort of chronic pain outpatients at a New York City pain management clinic. Among the findings: 77% of patients received an opioid at one or more clinic encounters, and being male was associated with greater likelihood of an opioid ordered and a higher average dosage than being female. This registry provides an opportunity to learn how to improve individualized chronic pain management.
The Journal of Pain (5/2017) 
Continuing Medical Education
New Free CME Activity: Managing Patients With Familial Hypercholesterolemia
New Free CME Activity: Managing Patients With Familial Hypercholesterolemia
This CME activity will focus on the management of patients with familial hypercholesterolemia and the role of PCSK9 inhibitors in this therapeutic area. Expert faculty will review the science of PCSK9, the updated standards of care for the diagnosis, and FH scoring and management of patients with familial hypercholesterolemia. Begin this activity!
Medical News
CVD mortality falls in US, but remains high in some areas
Cardiovascular disease mortality rates in the US fell to about 253 per 100,000 people in 2014 from 507 per 100,000 in 1980, and regional disparities are shrinking, but there is still a substantial difference between the counties with the highest and lowest death rates due to hypertension, poor blood flow to the heart and poor blood flow to the brain. The disparities uncovered by the study, published in JAMA, suggest more can be done to prevent CVD, said Dr. David Goff of the National Heart, Lung, and Blood Institute.
Reuters (5/16) 
Study examines reproductive factors linked to heart failure in women
A study in the Journal of the American College of Cardiology found women who experienced menopause earlier than the average age of 47 had an increased risk of heart failure, while the risk decreased 1% for every additional year before onset. The findings, based on data for 28,516 women enrolled in the Women's Health Initiative, also showed women who never gave birth had a 2.75 times higher risk of diastolic heart failure, compared with those who had children.
The Guardian (London) (5/15) 
WHO: Many of 1.2M teen deaths annually are preventable
The World Health Organization reported that roughly 1.2 million teens around the globe, or more than 3,000 adolescents daily, died from mostly preventable causes in 2015, more than two-thirds of whom were in low- and middle-income countries in Southeast Asia and Africa. The findings also showed that road injuries were the top cause of death among 10- to 19-year-olds, especially among boys aged 15 to 19, while lower respiratory infections and pregnancy complications were the leading causes of death among girls ages 10 to 14 and ages 15 to 19, respectively.
CBS News (5/16),  National Public Radio (5/16),  United Press International (5/16) 
Business Practice News
CMS exempts over 800K physicians from evaluation under MIPS in 2017
The CMS has informed 806,879 clinicians they will not undergo evaluation under the Merit-based Incentive Payment System this year, up from October's estimate of as many as 780,000. Physicians who are new to Medicare this year and those who see less than 100 unique Medicare patients and have less than $30,000 in Medicare charges per year will not be required to comply with MIPS.
Modern Healthcare (tiered subscription model) (5/11) 
Pilot program helps health care organizations share data across state lines
The Strategic Health Information Exchange Collaborative will use a pilot program to help health care organizations share patient data across state lines. "The infrastructure that we're building with the Patient-Centered Data Home gives patients confidence that their records can follow them across the health system while adhering to their privacy preferences," said SHIEC board member David Kendrick.
Health IT Analytics (5/15) 
Patient's Perspective
Study: Patients happy with primary care telehealth visits
In-depth interviews with 19 adult patients show satisfaction with telehealth primary care visits and interest in continued use of the technology, researchers reported in the Annals of Family Medicine. Patients cited convenience and lower costs as the main benefits of telehealth visits.
Physician's Briefing/HealthDay News (5/11) 
You can have the nine greatest individual ballplayers in the world, but if they don't play together, the club won't be worth a dime.
Babe Ruth,
baseball player
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