Improving survival in heart failure and kidney disease | Daily energy intake and obesity in children | Obstetric complications of asthma
February 14, 2013
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Improving survival in heart failure and kidney disease
A discharge prescription for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was associated with a significant reduction in all-cause mortality in older patients with diastolic heart failure and chronic kidney disease, including those with more advanced chronic kidney disease. The American Journal of Medicine (2/2013) Share: Email
Clinical Updates
Daily energy intake and obesity in children
Using a nationally representative sample from 1977-2010, authors examined the relative contribution of changes in daily total energy. They conclude that there was an increase in total energy intake (+108kcal/day) and the number of daily eating/drinking occasions. The average energy density per eating/drinking occasion reached its highest level in 2005?2010. (Available for CME credit.) American Journal of Preventive Medicine (2/2013) Share: Email
Obstetric complications of asthma
In a large contemporary U.S. cohort, asthma increased risk for pregnancy, labor and delivery complications including preeclampsia, preterm birth, cesarean delivery, hemorrhage and pulmonary embolism. American Journal of Obstetrics & Gynecology (2/2013) Share: Email
Aortic valve substitutes and pregnancy outcome
This study found that pregnancy-associated complications after aortic valve replacement were common and human tissue valves should be considered in the discussion for the optimal aortic valve substitute in a young female; however, careful obstetric monitoring is mandatory. The American Journal of Cardiology (2/1/2013) Share: Email
Mentors for students with chronic illness
A group mentoring program for high school students with chronic illness helped the students successfully make the transition to adulthood by finishing high school, finding jobs and transitioning from pediatric to adult health care providers. (Full-text access is time limited.) Journal of Adolescent Health (2/2013) Share: Email
Statin therapy in the elderly
Statin therapy in elderly patients with hypertension reduces the risk of new-onset atrial fibrillation. Statins are more beneficial in patients with CHADS2  (Congestive heart failure, Hypertension, Age ?75 years, Diabetes mellitus, prior Stroke or transient ischemic attack) score ?2 than in those with score of 1. The American Journal of Medicine (2/2013) Share: Email
Factors affecting nursing home dispute resolution
Does it matter who owns a nursing home when appealing a deficiency rating? In this study, type of facility ownership did not make a significant difference, nor did the regulation stringency of a particular state. What did seem to matter was the severity of the deficiency. Less severe deficiencies and lesser number of deficiencies seemed to result in better chance of succeeding in appeal. Complaints, rather than surveys, leading to deficiency ratings seemed to carry more negative impact. (Free abstract only.) Journal of the American Medical Directors Association (2/2013) Share: Email
Medical News
Data analysis shows vitamin C may reduce duration of colds
Analysis of data from 72 trials found that regular use of vitamin C supplements may reduce the duration of colds but does not prevent them for most people, according to a report on the website of the Cochrane Database of Systemic Reviews. Researchers from the University of Helsinki said the supplements led to about an 8% reduction in the duration of cold symptoms for adults and a 14% reduction for children. Medscape (free registration) (2/8) Share: Email
Analysis: Stress at work not tied to increased cancer risk
A meta-analysis of 12 studies involving 116,000 17- to 70-year-olds found that job stress was not significantly associated with higher odds of developing breast, colorectal, lung or prostate cancers. Finnish scientists said that research that has shown a link between work stress and cancer could have done so by chance or because of factors not involving work stress. The findings appear in the journal BMJ. HealthDay News (2/7) Share: Email
Endovascular therapy doesn't improve outcomes for stroke survivors
Endovascular therapy plus intravenous tissue plasminogen activator treatment showed little advantage over IV tPA alone in terms of promoting independent living 90 days after a stroke, a study found. However, endovascular therapy was more effective than tPA alone in removing clots and re-establishing blood flow. The findings appear in the New England Journal of Medicine. (2/10) Share: Email
Business Practice News
Group releases recommendation for better post-discharge care
The American Medical Association has released five patient safety principles for transitioning patients from inpatient to outpatient care. "Patients leaving the hospital too often return to ambulatory care settings that are not well connected to the hospital team and this can result in inefficient, confusing and sometimes unsafe conditions," the report's authors wrote. Evaluating patient heath, supporting self-management and medication management, as well as goal-setting were among the responsibilities outlined in the report. HealthLeaders Media (2/11) Share: Email
U.S. readmission rates show little improvement, report finds
A Robert Wood Johnson Foundation report found hospital readmission rates in the U.S. did not show significant progress between 2008 and 2010. Researchers also noted regional variation in 30-day readmissions, with readmission rates following postsurgical discharge as low as 7.6% in Bend, Ore., and as high as 18.3% in Bronx, N.Y. (2/11) Share: Email
Patient's Perspective
Young adults have highest stress levels in U.S.
Adults between the ages of 18 and 33 reported more stress than any other generation, with an average stress level of 5.4 on a scale of 10, according to the American Psychological Association. For 18- to 47-year-olds, the main sources of stress were work, money and job stability. For older adults, said health issues were the main source of stress. (2/11) Share: Email
Several excuses are always less convincing than one."
-- Aldous Huxley,
British author Share: Email
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