Top News

How bad for the heart is psychosocial stress? And how do you reduce it? Psychosocial stress is an independent risk factor for mortality in patients with coronary artery disease, and exercise training can effectively reduce its prevalence. Exercise training reduces mortality in patients with coronary artery disease, and this effect seems to be mediated in part because of the salutary effects of exercise on psychosocial stress. The American Journal of Medicine (10/2009)

	Enhancing physiology; Mechanism targets 2 key defects: insulin release and hepatic glucose production. Click here to learn more.

Clinical Updates

   From AJM and other Elsevier publications

What's the relationship between moderate alcohol consumption and heart disease in hypertensives? Alcohol has diverse effects on the cardiovascular system. Moderate drinking is associated with a reduced risk of cardiovascular disease, and yet increasing amounts of alcohol consumption are known to elevate blood pressure. Data from this study demonstrated an inverse relationship between moderate alcohol consumption and coronary heart disease in hypertensive men. The American Journal of Cardiology (10/2009)

Better for neuropathic pain: Nortriptyline plus gabapentin Combined gabapentin and nortriptyline seems to be more efficacious than either drug given alone for neuropathic pain. These authors therefore recommend use of this combination in patients who show a partial response to either drug given alone and seek additional pain relief. Future trials should compare other combinations to their respective monotherapies for treatment of such pain. (Free registration required.) The Lancet (9/29)

Primary cesarean delivery: Indications matter but so do race and ethnicity The rate of primary cesarean delivery increased over the past two decades with wide variation in indication subtype by race/ethnicity. American Journal of Obstetrics & Gynecology (10/2009)

Kids who smoke have friends who smoke Longitudinal data from a nationally representative sample of adolescents shows that peer smoking is a significant determinant of adolescent smoking. Teens with close friends who smoke are even more likely to smoke themselves. Policy development should address this issue. (Full-text access is time-limited.) Journal of Adolescent Health (10/2009)

The benefits of pemetrexed maintenance therapy in lung cancer Maintenance therapy with pemetrexed is well tolerated and offers improved progression-free and overall survival compared with placebo in patients with advanced non-small-cell lung cancer. (Free registration required.) The Lancet (9/20)

Who's watching makes a difference in identifying the need for feeding assistance This study used trained research staff as well as government survey staff to observe mealtime care in 20 nursing homes in five states. The trained research staff proved better at spotting residents that received inadequate feeding assistance than did the government survey staff. This included the fact that less than half of the residents who refused their meals were offered an alternative meal. (Free abstract only.) Journal of the American Medical Directors Association (10/2009)

Medical News

• Research links diabetes with antioxidants
  Antioxidants, the compounds in foods that can prevent cell damage, might increase the risk of Type 2 diabetes, according to a study published in Cell Metabolism. Research in mice indicated that the antioxidants remove a mechanism that can help the body use insulin. Reuters (10/6)

• Child's weight affects hospital admission, length of stay
  Researchers said at a recent meeting of the American College of Emergency Physicians that overweight or underweight children treated in hospital emergency departments are more likely to be admitted and have longer lengths of stay than normal-weight pediatric patients. The study "gives us yet another reason to emphasize the importance of optimizing weight and preventing obesity in children," one researcher said. Reuters (10/6)

• Study: Depression less likely among those on Med diet
  A study published in the Archives of General Psychiatry followed more than 10,000 adults in Spain and found that those who were on a Mediterranean diet were 42% to 51% less likely to suffer from depression. Although the diet, which is rich in fish, fruits, vegetables, whole grains and nuts, might help prevent depression, researchers say it should not be used to treat people who have been diagnosed with the condition. HealthDay News (10/5)

Business Practice News

• Report: Federal incentives encourage doctors to e-prescribe
  The number of physicians and other prescribers using e-prescription increased from 74,000 in 2008 to 143,000 now. By the end of August, 110 million of more than 3.7 billion prescriptions filled yearly among retail pharmacies in the country were made electronically, a report from Surescripts said. The figures indicate that "federal incentives are working," a Surescripts official said. The Wall Street Journal (tiered subscription model)/Dow Jones Newswires (10/5)

• Switch to EMR will mean physician office staff changes
  Physician practices that switch to an electronic medical records system will likely see their staffing needs change. Whether that means adding or reducing staff will depend in part on the problems the practice is looking to solve by using EMRs, writes Pamela Lewis Dolan. American Medical News (subscription required) (10/5)

• HHS touts Wash. group as rural health IT success story
  A report on the Columbia Basin Health Association's use of information technology was touted by HHS Secretary Kathleen Sebelius as evidence that IT can improve health care in rural areas. The Othello, Wash., group was one of the first health centers to switch to an electronic health record system and since then has ranked above the 95th percentile nationally in total medical and dental team productivity. Healthcare IT News (10/1)

• Other News

• Survey: 87% favor mandatory H1N1 shots for health workers
  Los Angeles Times (10/1)

Patient's Perspective

• Study finds men sleep less than they think
  A study of 956 older adults in the Netherlands found men got less sleep than they thought, while women got a little more. "Men completely, and much more than women, overestimate the quality of their sleep," said the study leader, whose research was published in the journal SLEEP. Reuters (10/2)

SmartQuote

Be sincere; be brief; be seated." --Franklin D. Roosevelt, 32nd U.S. president