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April 25, 2013 | News for physicians working in clinical settings
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  Top News 
  • Unnecessary antinuclear antibody testing
    In this retrospective study, more than 90% of patients who were referred to a tertiary rheumatology clinic for a positive ANA test result had no evidence for an ANA-associated rheumatic disease. The poor predictive value of a positive ANA in this cohort was largely attributable to unnecessary testing in patients with low pretest probabilities for ANA-associated rheumatic disease. The American Journal of Medicine (4/2013) Email this Story
  Clinical Updates 

   From AJM and other Elsevier publications

  • Comparing home care models
    What are the differences in health status between home care veterans and home care Medicaid waiver clients? Veterans were more independent in basic activities of daily living, but the rate of falls was nearly identical between the two groups. Veterans had more pain, sleep issues, coronary artery disease, COPD and cancer, but prevalence of geriatric syndromes was nearly the same as in Medicaid clients. Home care will continue to expand, and studies such as these may help plan for improved client health. (Free abstract only.) Journal of the American Medical Directors Association (4/2013) Email this Story
  • Where should paracentesis be performed?
    The decision to perform a paracentesis procedure at the bedside or in interventional radiology is largely discretionary. Paracentesis procedures performed at the bedside result in equal or better patient outcomes. Clinicians should receive the training needed to perform paracentesis procedures safely at the bedside. Large prospective studies are needed to confirm the findings of this study and inform national practice patterns. The American Journal of Medicine (4/2013) Email this Story
  • Hospice use among nursing home patients
    Indiana University researchers studied 10 years of data for hospice use among nursing home residents. The portion of noncancer patients increased over time, length of hospice stay remained high, and over 90% of patients had three or more comorbid diagnoses. Nearly 20% had hospice stays longer than six months and were more likely to discharge before death. It was not easy to predict the clinical course of hospice users, pointing to a need for supporting multiple approaches of palliative care delivery. (Free abstract only.) Journal of the American Medical Directors Association (4/2013) Email this Story
  Medical News 
  • Certain alternative treatments may reduce blood pressure levels
    The American Heart Association issued a scientific statement in the journal Hypertension that some alternative therapies, particularly aerobic exercise and resistance training, can help lower blood pressure levels. Biofeedback methods, isometric handgrip exercise and device-guided slow breathing slightly lowered blood pressure, but researchers found insufficient evidence that other alternative treatments like meditation, yoga and relaxation therapy can help treat hypertension. Family Practice News (4/22) Email this Story
  • U.S. mammogram rate didn't drop after 2009 USPSTF guidelines
    The rate of mammograms in the U.S. remained almost the same more than three years after the U.S. Preventive Services Task Force rejected annual breast cancer screenings for most women, a study found. Conflicting recommendations from several groups may have confused providers and patients, researchers said. The findings were reported online in the journal Cancer. HealthDay News (4/19) Email this Story
  Business Practice News 
  • Study: Diagnosis issues are most common medical errors
    More than a quarter of U.S. medical malpractice claims analyzed in a study were associated with missed or wrong diagnoses, making them the most common, dangerous and expensive errors in the health care system. Mistakes in diagnosis were also linked to "death or disability almost twice as often as other error categories and accounted for the plurality of these outcomes," researchers reported in BMJ Quality & Safety. Modern Healthcare (subscription required) (4/22) Email this Story
  • Report examines physician response to patient messages
    Nearly all messages that patients sent to their physicians during weekdays were opened within 12 hours, but doctors were not able to check 87.1% of messages in at least 36 hours during weekends, a report in Quality Management in Health Care showed. Researchers said evidence shows no negative effect associated with delayed communication, but studies are needed to determine the impact on patient satisfaction and health care decision making. American Medical News (free content) (4/22) Email this Story
  Patient's Perspective 
  • Study: 30% of women don't comply with osteoporosis treatment
    About 30% of women with osteoporosis did not pick up new prescriptions for bisphosphonate medications within 60 days, Kaiser Permanente researchers reported. These women also used fewer medications overall, were less likely to be diagnosed with depression and had lower health care usage, which included hospitalization, hospice, nursing home and non-hospital visits in the past year, the study in Osteoporosis International found. Medscape (free registration) (4/22) Email this Story
  • Poll: Many parents give their children ineffective cold medicines
    More than 40% of parents with children younger than age 4 reported giving their children multisymptom cough and cold medicines, according to the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health. Such medications are not effective for relieving cold symptoms in young children and could be harmful. The FDA has cautioned against their use in children under age 2. (4/22) Email this Story
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