In-hospital all-cause case fatality rate and case fatality rate attributable to pulmonary embolism in unstable patients was lower in those who received thrombolytic therapy. Thrombolytic therapy resulted in a lower case fatality rate than using vena cava filters alone, and the combination resulted in an even lower case fatality rate. Thrombolytic therapy in combination with a vena cava filter in unstable patients with acute pulmonary embolism seems indicated.
Other than cervical cancer, it has become apparent that HPV causes vulvar and vaginal cancers in women, penile cancer in men, and anal cancer in both sexes. Furthermore, these viruses have been implicated in head and neck cancers in both men and women as well. American Journal of Medicine CME Program
Focal therapy of individual prostate cancer lesions, whether multifocal or unifocal, leads to a low rate of genitourinary side-effects and an encouraging rate of early absence of clinically significant prostate cancer. (Free registration required.)
This study concluded that elevated level of uric acid is an independent predictor of one-year mortality across the whole spectrum of patients with acute coronary syndrome treated with percutaneous coronary intervention.
The magnetically controlled growing rod (MCGR) procedure can be safely and effectively used in outpatient settings, and minimizes surgical scarring and psychological distress, improves quality of life, and is more cost-effective than is the traditional growing rod procedure. The technique could be used for noninvasive correction of abnormalities in other disorders. (Free registration required.)
Exercise is associated with a reduced incidence of mild and moderate sleep-disordered breathing, and decreasing exercise is associated with worsening of sleep-disordered breathing. The effect of exercise on sleep-disordered breathing appears to be largely, but perhaps not entirely, mediated by changes in body habitus.
Fifteen months after being identified as only partially vaccinated against HPV, only about half of these teen girls had completed the series. There were important disparities in completion rates. (Full-text access is time-limited.)
CDC officials reported that 13% of more than 6,000 U.S. adults between 2009 and 2010 had high total cholesterol levels, down from more than 18% 10 years earlier. Increasing use of cholesterol-lowering drugs played a significant role in reducing cholesterol levels, but other factors, such as reduced smoking rates, also contributed to the decline, experts said.
Cases of central line bloodstream infection decreased by 32% in 2010, according to a state-by-state report based on data from the CDC's National Healthcare Safety Network. Dr. Scott Fridkin of the CDC attributed the reduction to prevention programs on the national and state levels. Among other findings in the report, a decrease in surgical site infections was attributed to fewer infections after coronary artery bypass grafts.
The American Academy of Neurology and the American Headache Society released new guidelines on treatments to prevent migraines. The guidance lists drugs that can reduce the frequency and severity of migraine attacks, as well as appropriate migraine medications for people with conditions such as epilepsy and depression. The guidelines appear in the journal Neurology.
Financial issues increasingly are part of the doctor-patient conversation as physicians say they are questioned about the cost and necessity of care. Some ways patient compliance can be improved include explaining the value of a medication or test, offering an opportunity for adjusting office visit schedules, or suggesting lower-cost ways of filling prescriptions.
Data from a survey by the American Academy of Family Physicians showed 3% of members reported adopting some form of retainer services, an increase from 1.2% in 2009. "I think it's still a relatively minor percentage, but I think they are growing. I certainly hear more about it from members around the country," said AAFP President Dr. Glen Stream.
An online poll of more than 1,000 adults conducted by Walgreen found that 42% don't know the recommended immunizations and 53% do not get regular checkups. Flu ranked the highest among diseases or illnesses that people said they were concerned about, followed by pneumonia and shingles.