Top News

Heart failure patients and sodium restrictions Clinicians document appropriate discharge instructions less frequently in heart failure with preserved systolic function than systolic heart failure. Selected heart failure patients with preserved systolic function who receive advice for sodium-restricted diet may have improved short-term outcomes after hospital discharge. The American Journal of Medicine (11/2009)

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Clinical Updates

   From AJM and other Elsevier publications

Capecitabine-containing chemotherapy reduces breast cancer recurrence The capecitabine-containing chemotherapy regimen reduced breast cancer recurrence compared with a control schedule of standard agents. Capecitabine administration was frequently discontinued because of adverse effects. (Free registration required.) The Lancet Oncology (11/2009)

Finding cardiac disease in childen with ADHD: What role for screening? The study found that electrocardiogram screening for children with attention-deficit/hyperactivity disorder can successfully identify cardiac disease in otherwise asymptomatic subjects, though the positive predictive value is low. Ongoing studies are needed to know what role electrocardiogram screening should play in the management of children with attention-deficit/hyperactivity disorder. The American Journal of Cardiology (11/1)

What do girls and young women think of the HPV vaccine? Few girls and young women believe that the HPV vaccine is protective beyond the true impact of the vaccine. Despite moderate uptake, many females at risk of acquiring HPV have not yet received the vaccine. These findings suggest the important role of both health care providers and parents in HPV vaccine adoption. (Full-text access is time-limited.) Journal of Adolescent Health (11/2009)

A long first stage in labor induction: What are the outcomes? In women with labor induction, a long first stage is associated with increased cesarean delivery in the second stage of labor and perinatal morbidity. American Journal of Obstetrics & Gynecology (11/2009)

The benefits of therapeutic hypothermia for oxygen-starved infants Therapeutic hypothermia decreases brain tissue injury in infants with hypoxic–ischaemic encephalopathy. The predictive value of MRI for subsequent neurological impairment is not affected by therapeutic hypothermia. (Free registration required.) The Lancet Neurology (11/2009)

Predicting discharge outcomes among the elderly Among the predictors of discharge to a nursing home (NH) in this study were lack of caregiving support, being more severely ill, longer hospitalizations, not understanding their illness, being female, living alone, needing assistance with dressing and being a fall risk. This points to a need for interventions that could postpone or prevent NH placement. (Free abstract only.) Journal of the American Medical Directors Association (11/2009)

Medical News

• Studies: Weather, air pollution can raise risk of heart attacks
  The risk of a heart attack increases with very hot or cold temperatures and heavy air pollution, according to two reviews of studies published in Heart. Researchers said a city that normally would have 10 heart attacks daily might get one to four more on very hot or cold days, and cold weather has a greater effect on the risk in areas that generally are warmer. Reuters (11/10)

• Many heart failure patients make quick return to hospital
  A study in Circulation: Heart Failure found that almost 25% of heart failure patients released from the hospital return within one month. The researchers said the entire clinical team, including physicians and nurses, must do a better job organizing patient care during the hospital stay and following up after discharge. The Atlanta Journal-Constitution/HealthDay News (free registration) (11/10)

• Breast cancer survivors report chronic, long-term pain
  Almost half of women who have breast cancer surgery still have pain two to three years later, Dutch researchers said. Breast cancer patients under age 40, those who had radiation treatment and those who had all of their lymph nodes removed were more likely to experience chronic, long-term pain, according to the study in JAMA. The New York Times (11/10)

Business Practice News

• 80-hour week for surgical residents compromises safety
  The 80-hour maximum work week has resulted in reduced patient safety and less education for surgical residents, according to an analysis by Vanderbilt University physicians in the British Medical Journal. They said the limits were designed to ensure physicians don't become so exhausted they make mistakes, but rates of surgical complications and reinterventions actually have increased since the rules were imposed in 2003. ABC News (11/8)

• Social networking plays growing role in physician practices
  South Florida physicians are increasing their use of social networking tools, including Facebook, Twitter and webcasts, to connect with patients, families and staff, even during surgical procedures. Dr. Camil Sader, a South Florida surgeon, has created his own iPhone application, "Dr. Rounds," that allows him to securely send patient information to other physicians and the billing office. The Miami Herald (11/9)

Patient's Perspective

• Web surfing of symptoms can lead to cyberchondria
  Microsoft researchers who studied Web usage found that people can Google themselves into a state of "cyberchondria," turning a Web search about one symptom into a panic over an array of serious diseases. They also found that two in five people who surfed for health information found that it made them feel more nervous about a perceived medical condition, while about half said it reduced their anxiety. The Washington Post (11/10)

SmartQuote

I have learned to use the word 'impossible' with the greatest caution." --Wernher von Braun, German-American rocket scientist