Troponin levels in normal and hypertensive pregnancy | Fertility treatment use and breastfeeding outcomes | Skin tests for diagnosis of immediate hypersensitivity reactions to taxanes
March 14, 2019
AJM: From the publisher of The American Journal of Medicine
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Troponin levels in normal and hypertensive pregnancy
This study was initiated to examine the association of circulating concentrations of high-sensitivity cardiac troponin I in the various trimesters of pregnancy in patients with and without hypertension. In the absence of complications such as hypertension, high-sensitivity cardiac troponin I values typically remain low throughout all trimesters. However, cardiac troponin was found to be a strong independent predictor of pregnancy-induced hypertension or preeclampsia in pregnant and postnatal women.
The American Journal of Medicine (3/2019) 
On-demand Relapsed/Refractory Multiple Myeloma CME
In this webcast, three experts discuss the clinical implications of some of the latest important research on relapsed/refractory multiple myeloma (RRMM). The roundtable discussion covers new data presented at the 2018 annual meetings of EHA and EBMT. 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
Fertility treatment use and breastfeeding outcomes
Breastfeeding initiation was similar among women who conceived with and without fertility treatment. Assisted reproductive technology may be associated with lower breastfeeding continuation rates, mediated by an increased likelihood of multiples and preterm births.
American Journal of Obstetrics & Gynecology (3/2019) 
Skin tests for diagnosis of immediate hypersensitivity reactions to taxanes
In this multicenter prospective study, 84 patients with immediate hypersensitivity reactions (HSRs) to taxanes (63 to paclitaxel and 21 to docetaxel) were evaluated. Prick tests were negative in all the cases, while intradermal tests were positive in 14 patients, 10 with paclitaxel (15.9 %) and 4 with docetaxel (19%). The positivity of skin tests significantly correlated with grade 3 reactions and cutaneous involvement during HSRs. Graded challenge was performed in 16 patients with grade 1 reactions without problems, and 58 subjects with grade 2-3 plus reactions and/or positive skin tests underwent desensitization, which was well tolerated in all but two cases. Skin tests for taxanes seem useful as part of the work-up of subjects with HSRs to these agents.
The Journal of Allergy and Clinical Immunology: In Practice (3/2019) 
The long-term impact of anorexia nervosa on bone health
While prior studies have shown the acute effects adolescent anorexia nervosa can have on bone health, this report highlights the long-term impact that may place individuals at increased risk of osteoporosis and fracture long after recovery from a severely low BMI.
Journal of Adolescent Health (3/2019) 
Symptoms of dementia can be reduced with simple environment changes
Our environment can greatly impact our sense of well-being and our behavior. This study showed this is true for patients living with dementia as well. Data was collected before interventions and again six months after the interventions. It showed that disruptive behavioral and psychological symptoms of dementia (BPSD) can be reduced following simple environmental rearrangements which aimed to improve spatial and temporal orientation.
Journal of the American Medical Directors Association (3/2019) 
Children's body composition and allocation of daily activity
This study explored the relationship between reallocation of time among daily activity behaviors and children's body composition. Twenty-four hour activity composition via accelerometry (minutes/day of sleep, sedentary time, light, and moderate-to-vigorous physical activity [MVPA]) and 3-part body composition (percentages of truncal fat, nontruncal fat, and fat-free mass) via bioelectrical impedance analysis were measured. MVPA was the most important activity behavior for body composition, with reallocation of time away from MVPA being associated with greater worsening of body composition than improvements for reallocating the same duration to MVPA. Interventions should target contexts where MVPA is likely to decline.
The Journal of Pediatrics (3/2019) 
Repeat teen pregnancies can be prevented in medical home intervention
A medical home intervention was implemented with the goal of reducing unintended repeat teen pregnancy rates in the first two years postpartum. Mothers in the intervention group were half as likely as mothers in the control group to have a repeat pregnancy within two years and had higher rates of contraceptive use. Authors found depression was associated with higher odds of repeat pregnancy but did not mediate the effect of the intervention on repeat pregnancy. This intervention may be an effective method to prevent rapid repeat pregnancies in teen mothers.
American Journal of Preventive Medicine (3/2019) 
Medical News
CDC: 228 measles cases in 12 states reported so far this year
The CDC says there have been 228 measles cases reported to the agency this year as of March 7, with 12 states affected. There were 372 cases reported for all of last year.
CNN (3/12),  CNBC (3/12) 
Muscle strength linked to type 2 diabetes risk, study shows
Researchers evaluated 4,681 individuals without type 2 diabetes at baseline, ages 20 and older, and found that those in the middle muscular strength level had a 32% reduced diabetes risk, compared with those in the lower third level. The findings, published in the journal Mayo Clinic Proceedings, found no significant association between diabetes risk and those in the upper level of strength, compared with the lower level.
CNN (3/11) 
PCV13 introduction reduced pediatric otitis media prevalence
Researchers found that the incidence of acute otitis media episodes among US children younger than 2 rose from 88.6 per 100 person-years in 2006-07 to 98.6 in 2009-10 during the use of the 7-valent pneumococcal conjugate vaccine, but declined from 98.1 per 100 person-years in 2011-12 to 89.3 in 2013-14 after the 13-valent pneumococcal vaccine dose was implemented. The findings in Clinical Infectious Diseases also showed that children in the most recent PCV13 birth cohort had an 8% reduced otitis media risk and 24% lower odds of pressure equalization tube insertions, compared with those in the last PCV7 birth cohort.
Medscape (free registration)/Reuters (3/11) 
Business Practice News
Report outlines top 10 patient safety concerns
ECRI Institute's annual safety report revealed that improper management of diagnostic tools and test results within EHRs was the top patient safety concern this year, with physician burnout and mobile health-related patient safety also at the top of the list. "Organizations across the continuum of care are striving to become high-reliability organizations, and part of being highly reliable means staying vigilant and identifying problems proactively," the report stated.
Healthcare IT News (3/11) 
Study analyzes readmissions with home vs. SNF discharge
Hospital discharge to home was associated with a lower readmission rate than discharge to a skilled nursing facility until proximity to a home health agency was factored in, resulting in a lower readmission rate for SNFs, a study in JAMA Internal Medicine found. Discharges to home or an SNF did not lead to significant differences in improvement in functional status or 30-day mortality.
MedPage Today (free registration) (3/11),  HealthLeaders Media (3/11) 
Patient's Perspective
Study examines link between education, heart-healthy diets
Research published in The Journal of the American Osteopathic Association revealed that adults with a college education were seven times more likely to adhere to a Mediterranean diet than those who had a high-school education. Findings also showed that college-educated women were three times more likely to eat a heart-healthy diet than male peers.
United Press International (3/11) 
Never be limited by other people's limited imaginations.
Mae Jemison,
engineer, physician, NASA astronaut and first black woman to travel into space

March is Women's History Month

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