Top News

Phytoestrogens: A safe side-effect profile Based on the available evidence, phytoestrogen supplements have a safe side-effect profile for treatment of the climacteric syndrome with moderately elevated rates of gastrointestinal side effects. Rates of vaginal bleeding, endometrial hyperplasia, endometrial cancer and breast cancer were not significantly increased among phytoestrogen users in the investigated studies. The American Journal of Medicine (10/2009)

Clinical Updates

   From AJM and other Elsevier publications

The benefits of chocolate: Only the beginning? Evidence shows that chocolate can lower blood pressure, reduce systemic inflammation, inhibit cavities, increase cerebral blood flow and stimulate the central nervous system. This article details how some particular qualities of cocoa remain unexplained. Nutrition (11/2009)

What's the prognosis from fasting glucose? Better than baseline This study concluded that persistent elevation of fasting glucose during acute myocardial infarction hospitalization has greater prognostic impact than baseline fasting glucose. Changes in fasting glucose during hospitalization are simple and sensitive indicators of dynamic changes in risk. The American Journal of Cardiology (10/2009)

How to reduce heroin and crack cocaine use: U.K. programs work The first six months of pharmacological or psychosocial treatment is associated with reduced heroin and crack cocaine use, but the effectiveness of pharmacological treatment is less pronounced for users of both drugs. New strategies are needed to treat individuals with combined heroin and crack cocaine addiction. (Free registration required.) The Lancet (10/10)

Risky behavior in teens? Look at their sleep habits In a study of brain function at different stages of pubertal maturation, poor sleep was related to lower activity in the portion of the brain associated with reward anticipation. Such a deficiency may then lead to compensatory increases in risky, reward-driven behavior. (Full-text access is time-limited.) Journal of Adolescent Health (10/2009)

When a surrogate tries to remember a patient's wishes This study showed that the likelihood of a surrogate recalling what decision the patient wished was aided by a video decision support tool designed for advanced dementia decision-making and proved more effective than solely listening to a verbal description of the disease. (Free abstract only.) Journal of the American Medical Directors Association (10/2009)

First pregnancy stillbirth often leads to later pregnancies with adverse outcomes This study demonstrates that the risk of adverse outcomes in pregnancies after stillbirth is increased. American Journal of Obstetrics & Gynecology (10/2009)

Medical News

• Hospitalized H1N1 patients often require critical care
  H1N1 flu patients who are sick enough to need hospitalization often decline quickly and require ventilators and critical care that could strain limited hospital resources, researchers report in the Journal of the American Medical Association. One expert said U.S. hospitals here need to be prepared to provide this critical life support. Reuters (10/12)

• Cardiologists suggest new name for heart disease in women
  Heart disease in women should be called ischemic heart disease because it is different from the coronary artery version most common in men, cardiologists suggest in a paper in the Journal of the American College of Cardiology. The authors, representing the Women's Ischemia Syndrome Evaluation, said the change could help focus attention on the greater symptom burden, functional disability and adverse outcomes experienced by women. Los Angeles Times/Booster Shots (10/12)

Business Practice News

• Patients at top-rated hospitals have lower risk of death
  HealthGrades' annual Hospital Quality in America Study found patients at top-rated U.S. hospitals had a 51.5% lower risk of death than hospital patients in general. The company based its evaluation on 17 procedures and diagnoses at 5,000 U.S. hospitals and said that while mortality rates generally have declined in recent years, a "quality chasm" persists. American City Business Journals/Denver (10/13), Modern Healthcare (free registration) (10/13)

• Emanuel: Physicians must be high-tech, high-touch
  White House health policy adviser Ezekiel Emanuel said physicians need to restructure their practices to be both high-tech and high-touch. Emanuel said that he supports the use of information technology to create a data-driven practice but that high-touch also means more patient contact, proactive monitoring of patient conditions and improved access to care. Healthcare IT News (10/12)

• Other News

• USA TODAY updates database of most influential doctors
  USA TODAY (10/13)

• Urgent care clinics a growing health industry niche
  Courier-Post (Camden-Cherry Hill, N.J.) (10/11)

Patient's Perspective

• Polls: Safety concerns widespread over H1N1 vaccine
  A survey of pharmacy directors at hospitals found many hospital employees have been asking if the H1N1 flu vaccine is safe. Americans in general also have ongoing concerns; an Associated Press-GfK poll found about 75% of respondents expressed safety concerns about the H1N1 flu vaccine and just half said they would get vaccinated. Experts and health officials continue to emphasize that the vaccine is safe. The Atlanta Journal-Constitution/HealthDay News (10/13)

SmartQuote

One does not discover new lands without consenting to lose sight of the shore for a very long time." --André Gide, Nobel laureate in literature