Myocardial infarction: Length of hospital stay | Risks of self-weighing | Topiramate and oral cleft risk
November 29, 2012
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Myocardial infarction: Length of hospital stay
Patients with longer length of stay have more comorbidities and in-hospital complications, yet paradoxically, are less often treated with evidence-based medications and are less likely to receive percutaneous coronary intervention. Hospital admission on a Friday afternoon or evening and delays to catheterization appear to significantly impact length of stay. A better understanding of factors associated with length of stay in patients with non-ST-segment elevation myocardial infarction is needed to promote safe and early discharge in an era of increasingly restrictive health care resources. The American Journal of Medicine (11/2012) Share: Email
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
Clinical Updates
Risks of self-weighing
Frequent self-weighing among young adults is associated with greater engagement in both healthy and unhealthy weight-control practices. Health care professionals should monitor young adults who engage in self-weighing behaviors and screen for unhealthy weight-control practices and poor psychological well-being. (Full-text access is time-limited.) Journal of Adolescent Health (11/2012) Share: Email
Topiramate and oral cleft risk
First-trimester use of topiramate may be associated with cleft lip and/or palate in offspring. American Journal of Obstetrics & Gynecology (11/2012) Share: Email
Efficacy of statins in the elderly
Many patients ?80 years of age receive statin therapy for primary prevention and are treated to aggressive low-density lipoprotein levels. Since efficacy is uncertain and potential adverse effects are many, we urgently need to define the cost, benefit and risk of statin use in the very elderly. The American Journal of Cardiology (11/15/2012) Share: Email
Dysnatremias in the emergency department
Dysnatremias are common in the emergency department. Hyponatremia and hypernatremia have different symptoms. Contrary to recommendations, serum sodium is not corrected more rapidly in symptomatic patients. The American Journal of Medicine (11/2012) Share: Email
Statin nonadherence and therapy escalation
This study found that nearly half of patients with therapy escalation were nonadherent to statins. Clinicians should inquire about adherence and consider adherence prior to escalating statin therapy. The American Journal of Cardiology (11/15/2012) Share: Email
How to increase immunization rates in health care workers
Health care workers (HCWs) in long-term care (LTC) facilities are often not compliant with receiving their influenza vaccinations. Yet, they are vectors of influenza transmission to the frail elderly. The RISE (Impact of the Raising Immunizations Safely and Effectively) program managed to increase vaccination rates among HCWs to the primary goal of 60% and the secondary goal of 80% in all 14 participating LTC facilities. In addition, 20% of 14 facilities reached the Healthy People 2020 goal of 90%. (Free abstract only.) Journal of the American Medical Directors Association (11/2012) Share: Email
Medical News
CDC data show state rates for COPD vary
CDC data showed rates of chronic obstructive pulmonary disease varied regionally, affecting less than 4% of people in Washington state and Minnesota but more than 9% in Alabama and Kentucky. The survey showed 62.5% of patients said COPD harmed their quality of life, and 50.9% reported taking at least one daily medication for the condition. United Press International (11/25) Share: Email
USPSTF advises hepatitis C screening for baby boomers
The U.S. Preventive Services Task Force on Monday in a draft recommendation advised primary care physicians to consider hepatitis C screening for adults born between 1945 and 1965, and it said those with a history of IV drug use or blood transfusions prior to 1992 should be tested. The recommendations were an update to the group's 2004 statement and urge screening for all high-risk adults. Reuters (11/26), HealthDay News (11/26) Share: Email
FDA finds bacteria, fungi in 2 other NECC steroids
The FDA added to its list of contaminated medicines after discovering fungal growth and bacteria in New England Compounding Center's steroids betamethasone and triamcinolone, which have not been tied to the recent meningitis outbreak. The CDC is not aware "of infections among patients that can be definitively linked to exposure to these drugs," CDC spokesman Curtis Allen said. The Tennessean (Nashville) (tiered subscription model) (11/22) Share: Email
Business Practice News
AMA delegates adopt recommendations for team-based care
The American Medical Association House of Delegates has adopted new recommendations to help physician-led health care teams serve a greater patient population while facing a looming physician shortage. Among the recommendations are to focus on quality, efficiency, patient- and family-centered care, collaboration and accountability. American Medical News (free content) (11/26) Share: Email
Study links EHR portal access to higher health care use
Patients who used Web-based portals for EHR systems visited physician's offices more often and made more phone calls to providers than nonusers, according to a study in the Journal of the American Medical Association. Increased after-hours clinic visits, emergency department utilization and hospitalizations were also associated with EHR portal use among patients, researchers said. They speculated that the portals might help uncover health issues or patients more likely to utilize health care were more inclined to sign up for the portal. Modern Healthcare (subscription required) (11/20) Share: Email
Patient's Perspective
Survey finds higher ideal body weight over time
A Gallup survey found 59% of men and 69% of women were heavier than their average ideal weight by at least one pound. Researchers also found 60% of adults said their weight was just about right, despite the worsening obesity epidemic, suggesting that Americans are moving to higher ideal weights to change their expectations as their actual weights increase. (11/22) Share: Email
The foolish man seeks happiness in the distance; the wise grows it under his feet."
-- James Oppenheim,
American poet, novelist and editor Share: Email
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