Top News

What do you get from alcohol and illicit drugs? Sometimes, atrial fibrillation Alcohol and illicit drugs are arrhythmogenic and are associated with atrial fibrillation. The authors of this case series and literature review point out that, apart from abstinence, the optimal management of such patients and the long-term effects of these substances on the heart and atrial fibrillation recurrences are still unclear. The American Journal of Medicine (9/2009)

Clinical Updates

   From AJM and other Elsevier publications

Success in a tough case: Intravenous zanamivir for H1N1 pneumonitis A 22-year-old woman, whose immune system was impaired due to recent chemotherapy, has survived a serious case of swine flu after being treated with the unlicensed intravenous form of relenza, in combination with high-dose corticosteroids. Free registration required. The Lancet (9/4)

Clues to CV risk in the young? Try waist-to-height ratio The findings of this study underscore the utility of waist-to-height ratio in detecting central obesity and related adverse cardiovascular risk among normal weight younger adults. The American Journal of Cardiology (9/2009)

Can sexual orientation predict types of eating disorders? Gay and bisexual boys are more likely to report purging and binge eating than heterosexual boys. On the other hand, gay and bisexual girls report higher frequency of binge eating, while "mostly heterosexual" and bisexual girls report higher frequency of purging. Full text access is time-limited. Journal of Adolescent Health (9/2009)

Avoiding proton-pump inhibitors. Or not? The current findings do not support the need to avoid concomitant use of PPIs, when clinically indicated, in patients receiving clopidogrel or prasugrel. Free registration required. The Lancet (9/1)

Socioeconomic status and polypharmacy in the elderly: Any correlates? This study of 1,430 elderly in various geographical regions of Turkey found polypharmacy was correlated with age, sex, marital status, number of children, status of retirement and chronic conditions, but no correlation was found regarding educational status. Free abstract. Journal of the American Medical Directors Association (9/2009)

The risks and management of preterm premature membrane ruptures Preterm premature rupture of the membranes before viability is associated with significant maternal, fetal and neonatal risks which must be considered when pursuing expectant management. American Journal of Obstetrics & Gynecology (9/2009)

Medical News

• CDC releases guidance on use of antiviral drugs
  Antiviral drugs such as Tamiflu and Relenza, which are being used as treatment for H1N1 flu, should be administered only to patients hospitalized with the flu or patients at risk of complications from the disease, including children younger than 5, adults 65 and older, pregnant women and people with chronic conditions, the CDC said. The move is in line with efforts to prevent resistance of H1N1 virus to the drugs. U.S. News & World Report/HealthDay News (9/8)

• Health benefits of exercise vary by gender, race
  People who added about 60 minutes of mild exercise or 30 minutes of moderate exercise per week had increased levels of heart-healthy HDL, according to a study of more than 15,000 middle-aged black and white men and women. Researchers also found that whites had significant decreases in harmful triglycerides, women had improved levels of LDL cholesterol and black women had lower total cholesterol levels. The study was published in the Journal of Lipid Research. Reuters (9/7)

• Antioxidant supplements don't lower metabolic syndrome risk
  A study of 5,220 middle-aged adults found those taking antioxidant supplements didn't have a lower risk of developing metabolic syndrome over more than seven years compared with a placebo group. However, researchers did find that people with the highest vitamin C levels and beta-carotene levels at the study's start had a one-half and one-third lower risk of metabolic syndrome, respectively, than people with the lowest levels. The study was published in the American Journal of Clinical Nutrition. Reuters (9/4)

Business Practice News

• Survey: 80% of doctors are satisfied with their career
  A new survey found 80% of doctors are "very satisfied" or "somewhat satisfied," with their career, with pediatrics having the most satisfied and least dissatisfied doctors among all of the specialties. Seventy-four percent of doctors also said they accept all or most new Medicare patients and 53% said they take all or most new Medicaid patients, according to the survey by the Center for Studying Health System Change. The Wall Street Journal (tiered subscription model)/Health blog (9/3)

• Handoffs pose risk for patients, concern for physicians
  Patients handoffs from one doctor to another can create miscommunications and misunderstandings, writes Dr. Pauline Chen in a New York Times blog post. Researchers increasingly are looking at ways to improve handoffs, taking cues from other industries, such as aviation, transportation and nuclear power, as well as from handoffs conducted by nurses and other health professionals. NYTimes.com (9/3)

• Other News

• USA TODAY offers 24-hour snapshot of busy hospital ED
  USA TODAY (9/8)

Patient's Perspective

• Lack of trust in medical system leads to delayed care
  A survey of 401 Baltimore residents found people who didn't trust the health care system were more likely to ignore medical advice, postpone care or follow-up care, and fail to fill prescriptions. Researchers said the next step is to find ways to build patients' trust in the medical system. The study will be published online in Health Services Research. Yahoo!/HealthDay News (9/3)

SmartQuote

Without labor nothing prospers." --Sophocles, Greek playwright and philosopher