Web Exclusives

AGA Institute releases practice update for managing patients cured of HCV infection

AGA Institute releases practice update for managing patients cured of HCV infection

Patients with chronic HCV infection who have achieved a sustained virologic response with treatment may still be at risk for complications such as hepatocellular carcinoma.

Probiotics may lower risk of gestational diabetes

Probiotics may lower risk of gestational diabetes

Women who took probiotics in their second trimester had lower rates of gestational diabetes.

Norepinephrine shortage led to higher mortality in septic shock patients

Norepinephrine shortage led to higher mortality in septic shock patients

Patients with septic shock taking phenylephrine during the 2011 norepinephrine shortage experienced higher in-hospital mortality rates.

Short-term oral corticosteroid use associated with increased risk for sepsis, venous thromboembolism

Short-term oral corticosteroid use associated with increased risk for sepsis, venous thromboembolism

Approximately 1 in 5 American adults use corticosteroids in the short term, which is associated with an increased risk for sepsis, venous thromboembolism, and fracture.

Marathon races linked to delayed emergency care and higher mortality in nonparticipants

Marathon races linked to delayed emergency care and higher mortality in nonparticipants

Road closures may create delays in emergency care for nonparticipants with acute medical conditions who live close to marathon routes.

Practice guideline released for sudden unexpected death in epilepsy

Practice guideline released for sudden unexpected death in epilepsy

The guideline highlights the incidence, risk factors, and preventive approaches of SUDEP.

Inpatient rehabilitation may not improve mobility in total knee arthroplasty

Inpatient rehabilitation may not improve mobility in total knee arthroplasty

Researchers conducted a randomized controlled trial to determine whether inpatient rehabilitation provided greater improvements compared with a monitored home-based program alone.

Metastatic pancreatic cancer: a new clinical practice guideline

Metastatic pancreatic cancer: a new clinical practice guideline

The guideline will help clinicians determine the appropriate treatment of patients with metastatic pancreatic cancer.

Psychiatric comorbid conditions may impact quality of life in bipolar disorder

Psychiatric comorbid conditions may impact quality of life in bipolar disorder

Patients with greater clinical symptom severity had lower quality of life and higher functional impairment.

Mobile apps for bipolar disorder may not address consumer needs

Mobile apps for bipolar disorder may not address consumer needs

Reviews containing "wishlists" indicate that consumer needs are not adequately addressed by the apps that are currently available.

NASEM report aims to eliminate hepatitis B and C by 2030

NASEM report aims to eliminate hepatitis B and C by 2030

Aggressive testing, diagnosis, treatment, and prevention methods, such as needle exchange for those who inject drugs, are some of the options that the NASEM explored to target hepatitis elimination.

Botulinum toxin may be safe and effective for overactive bladder

Botulinum toxin may be safe and effective for overactive bladder

Intradetrusor injection of onabotulinumtoxin A impairs afferent and efferent nerves, but an injection-free drug delivery approach only impairs the bladder afferent nerves.

Undiagnosed chest pain may increase long-term cardiovascular risk

Undiagnosed chest pain may increase long-term cardiovascular risk

Most patients in primary care with undiagnosed chest pain do not undergo diagnostic testing.

Managing elderly patients with COPD through empowerment

Managing elderly patients with COPD through empowerment

Use of the empowerment approach is necessary for health promotion in older patients with COPD, but little attention has been paid to the dimensions of empowerment in COPD management.

Monotherapy and combined therapy for bipolar II disorder have similar responses

Monotherapy and combined therapy for bipolar II disorder have similar responses

The findings show no significant difference among sertraline monotherapy, lithium monotherapy, or a combination of the 2 medications.

USPSTF recommends individualized approach to prostate cancer screening

USPSTF recommends individualized approach to prostate cancer screening

The USPSTF recommends that prostate cancer screenings should be an individual decision.

Utibron Neohaler available for long-term treatment of COPD

Utibron Neohaler available for long-term treatment of COPD

Utibron Neohaler inhalation powder is indicated for the long-term maintenance treatment of airflow obstruction in patients with COPD.

FDA approves first direct-acting antivirals for pediatric HCV patients

FDA approves first direct-acting antivirals for pediatric HCV patients

Harvoni and Sovaldi have been approved for pediatric patients with HCV genotypes.

Celiac disease linked to diagnosis of anorexia nervosa

Celiac disease linked to diagnosis of anorexia nervosa

Celiac disease is associated with anorexia nervosa before and after a diagnosis of celiac disease.

Antidepressant serum levels may be lower in cigarette smokers

Antidepressant serum levels may be lower in cigarette smokers

Serum concentration levels of several antidepressants were lower in cigarette smokers compared with nonsmokers.

FDA approves first direct-to-consumer genetic health risk test

FDA approves first direct-to-consumer genetic health risk test

The test will provide information on an individual's genetic predisposition to 10 diseases or conditions.

Managing COPD exacerbations: A new clinical guideline

Managing COPD exacerbations: A new clinical guideline

The European Respiratory Society and the American Thoracic Society have released a guideline for the treatment of patients with COPD exacerbations.

Vitamin D and calcium supplementation not effective for lowering cancer risk in postmenopausal women

Vitamin D and calcium supplementation not effective for lowering cancer risk in postmenopausal women

Vitamin D and calcium did not result in a significantly lower risk of all-type cancer, including breast cancer, in postmenopausal women.

Total knee replacement for osteoarthritis has minimal effect on quality of life

Total knee replacement for osteoarthritis has minimal effect on quality of life

Data from the Osteoarthritis Initiative show that total knee replacement has minimal effects on quality of life among patients with knee osteoarthritis.

Moderate alcohol consumption linked to lower risk of some types of cardiovascular disease

Moderate alcohol consumption linked to lower risk of some types of cardiovascular disease

The researchers found heterogeneity in the association between recorded alcohol consumption and the initial presentation of 12 cardiovascular diseases.

CDC's opioid guideline prompts clinician concerns

CDC's opioid guideline prompts clinician concerns

The recently released CDC guidelines on opioid prescribing remain a topic of debate.

Benign paroxysmal positional vertigo: a clinical practice guideline

Benign paroxysmal positional vertigo: a clinical practice guideline

The American Academy of Otolaryngology—Head and Neck Surgery foundation has released an updated clinical guideline for benign paroxysmal positional vertigo.

Radiofrequency treatment effective for refractory chronic joint pain

Radiofrequency treatment effective for refractory chronic joint pain

Radiofrequency treatment is an effective option for treating refractory chronic knee, hip, and shoulder joint pain.

Perioperative care for acute pain management

Perioperative care for acute pain management

Patients with chronic pain who are hospitalized have a higher risk of morbidity and mortality, longer lengths of stay, and more frequent readmissions than patients without chronic pain.

Oral, direct-acting antivirals effective for hepatitis C virus infection

Oral, direct-acting antivirals effective for hepatitis C virus infection

Regimens for the treatment of hepatitis C that included ribavirin had more mild or moderate adverse events than those without.

Screening for celiac disease: A USPSTF recommendation statement

Screening for celiac disease: A USPSTF recommendation statement

The USPSTF evaluated the benefits and harms of screening vs not screening, targeted vs universal screening, and treatment for celiac disease.

Gastric acid suppressants may increase risk of recurrent Clostridium difficile infection

Gastric acid suppressants may increase risk of recurrent Clostridium difficile infection

A meta-analysis suggests that patients who take gastric acid suppressants may have a higher risk for recurrent CDI.

Pharmacists can help optimize care in patients with hepatitis C virus

Pharmacists can help optimize care in patients with hepatitis C virus

Drug-drug interactions are common in patients taking hepatitis C virus medications, and consulting with a pharmacist can be beneficial.

Anti-inflammatory effects of linagliptin in diabetes patients

Anti-inflammatory effects of linagliptin in diabetes patients

Patients taking linagliptin had decreased HbA1c as well as reactive oxygen species generation and plasma lipid peroxide levels.

Insulin pump therapy improves quality of life in adolescents with type 2 diabetes

Insulin pump therapy improves quality of life in adolescents with type 2 diabetes

Adolescents with type 2 diabetes decreased HbA1c levels after using insulin pump therapy for a 3-month period.

PCV10 vaccine decreases pneumonia rate in children

PCV10 vaccine decreases pneumonia rate in children

PCV10 decreases rate of pneumonia among vaccine-eligible children and older, unvaccinated children.

High cardiac troponin levels may predict mortality in community-acquired pneumonia

High cardiac troponin levels may predict mortality in community-acquired pneumonia

Elevated cardiac troponin T is also strongly prognostic of cardiac mortality observed in association with community-acquired pneumonia.

Antibiotic prescribing in primary care varies for community-acquired pneumonia

Antibiotic prescribing in primary care varies for community-acquired pneumonia

Factors that contribute to antibiotic choice for CAP include patient age, previous antibiotic receipt, and private insurance.

Knee osteoarthritis linked to increased risk of hypertension

Knee osteoarthritis linked to increased risk of hypertension

Researchers observed a higher incidence of hypertension in patients with knee osteoarthritis compared with patients without osteoarthritis.

Oral contraceptives may be protective against some types of cancer

Oral contraceptives may be protective against some types of cancer

Use of oral contraceptives did not increase the risk for cancer in women and decreased the risk for colorectal, endometrial, ovarian, and lymphatic and hematopoietic cancers.

Valvular heart disease: 2017 updated guideline from the AHA/ACC

Valvular heart disease: 2017 updated guideline from the AHA/ACC

The updated guideline includes recent advances in diagnostic imaging and improvements in catheter-based and surgical interventions for patients with valvular heart disease.

Clinical guideline released for functional hypothalamic amenorrhea

Clinical guideline released for functional hypothalamic amenorrhea

The Endocrine Society has released a clinical guideline for the diagnosis and treatment of functional hypothalamic amenorrhea.

Septic shock: early, goal-directed therapy versus usual care

Septic shock: early, goal-directed therapy versus usual care

Early, goal-directed therapy did not result in better outcomes for mortality for patients with septic shock.

Statins may reduce pulmonary artery pressure in COPD patients

Statins may reduce pulmonary artery pressure in COPD patients

A daily dose of atorvastatin could reduce pulmonary artery pressure among patients with COPD.

Early use of noninvasive techniques for clearing respiratory secretions in COPD

Early use of noninvasive techniques for clearing respiratory secretions in COPD

A novel technique involving NPPV reduced the risks of nosocomial infection, requirement for intubation, and hospital mortality in patients with COPD.

Diabetes and glucose intolerance increase with higher outdoor temperature

Diabetes and glucose intolerance increase with higher outdoor temperature

Diabetes incidence rates in the US and glucose intolerance worldwide increased per 1°C increase in temperature.

Obstructive sleep apnea in adults: a new clinical practice guideline

Obstructive sleep apnea in adults: a new clinical practice guideline

Six guidelines establish updated clinical practice recommendations for the evaluation, diagnosis, and treatment of obstructive sleep apnea in adults.

Dabigatran linked to fewer bleeding complications in patients with atrial fibrillation

Dabigatran linked to fewer bleeding complications in patients with atrial fibrillation

Anticoagulation with dabigatran was associated with fewer bleeding complications compared with warfarin among patients undergoing ablation for atrial fibrillation.

Early feeding, skin-to-skin contact improves hospital admission rates for infants at risk of hypoglycemia

Early feeding, skin-to-skin contact improves hospital admission rates for infants at risk of hypoglycemia

A hypoglycemia bundle was created in order to reduce hospital admission rates for infants at risk of hypoglycemia.

High BMI in late adolescence associated with increased risk of severe liver disease in men

High BMI in late adolescence associated with increased risk of severe liver disease in men

A high BMI is associated with an increased risk for severe liver disease, and the risk is higher in those who also have type 2 diabetes mellitus.

Opioid and benzodiazepine combination use significantly increases overdose risk

Opioid and benzodiazepine combination use significantly increases overdose risk

The drug combination significantly contributes to the overall population risk of opioid overdose.

Colorectal cancer characteristics different, outcomes worse among octogenarians

Colorectal cancer characteristics different, outcomes worse among octogenarians

Octogenarians with colorectal cancer have several differences in clinical and tumor characteristics, compared with younger patients with the disease.

Budesonide oral suspension may be effective for eosinophilic esophagitis

Budesonide oral suspension may be effective for eosinophilic esophagitis

Budesonide oral suspension treatment improved symptomatic, endoscopic, and histologic parameters in eosinophilic esophagitis.

Coronary reperfusion improved with longer time between antiplatelet therapy and PCI

Coronary reperfusion improved with longer time between antiplatelet therapy and PCI

A longer period between P2Y12 inhibitor administration and primary percutaneous coronary intervention improves coronary reperfusion.

Irritable bowel syndrome medication linked to pancreatitis in certain patients

Irritable bowel syndrome medication linked to pancreatitis in certain patients

The FDA has received 120 reports of serious cases of pancreatitis or death after the approval of Viberzi in May 2015.

Lithium not linked to increased cancer risk in patients with bipolar disorder

Lithium not linked to increased cancer risk in patients with bipolar disorder

No difference was observed in risk of overall cancer in patients with bipolar disorder who use lithium, compared with the general population.

Off-label antidepressant prescriptions not supported by strong scientific evidence

Off-label antidepressant prescriptions not supported by strong scientific evidence

For many off-label indications, the prescribed drug is often not supported by strong evidence for the respective indication.

Insulin initiation in primary care improves HbA1c levels

Insulin initiation in primary care improves HbA1c levels

The Stepping Up model of care produced a clinically and significantly significant improvement in HbA1c among adults with type 2 diabetes managed in primary care.

Same-day discharge may be safe for patients after percutaneous coronary intervention

Same-day discharge may be safe for patients after percutaneous coronary intervention

Same-day discharge after percutaneous coronary intervention for non-ST-segment elevation acute coronary syndromes was not predictive of 30-day readmission, death, or bleeding.

HPV educational session may boost vaccination rates in high school students

HPV educational session may boost vaccination rates in high school students

The students improved their basic knowledge of HPV and understood the benefits of the HPV vaccine.

Screening for spontaneous preterm birth has low predictive accuracy

Screening for spontaneous preterm birth has low predictive accuracy

Using measurements of vaginal fetal fibronectin levels and cervical length did not indicate spontaneous preterm birth among first-time pregnant women.

Sepsis risk calculator helps decrease antibiotic use in infants

Sepsis risk calculator helps decrease antibiotic use in infants

Data presented at NAPNAP show that an early-onset sepsis calculator can decrease the number of infants who received a sepsis work-up and prophylactic antibiotics.

First-year residents will be able to work 24-hour shifts

First-year residents will be able to work 24-hour shifts

The ACGME announces that residency programs can increase shift hours for first-year residents from 16 to 24 hours.

Antithrombotic drug use linked to higher risk of subdural hematoma

Antithrombotic drug use linked to higher risk of subdural hematoma

A higher incidence of subdural hematomas is associated with the increased use of antithrombotic drugs, particularly vitamin k antagonists among older patients.

FODMAP diet effective for irritable bowel syndrome

FODMAP diet effective for irritable bowel syndrome

Implementation of the FODMAP diet is an effective strategy to manage symptoms of IBS, including bloating and abdominal pain.

Postpartum depression incidence declining

Postpartum depression incidence declining

Reducing postpartum depression involves universal screening and appropriate referral and treatment by clinicians.

Nearly half of all cardiometabolic deaths linked to poor diet

Nearly half of all cardiometabolic deaths linked to poor diet

Suboptimal intake of 10 specific dietary factors is associated with a substantial proportion of deaths due to heart disease, stroke, or type 2 diabetes.

High-dose steroids increase infection risk in pregnant women with inflammatory conditions

High-dose steroids increase infection risk in pregnant women with inflammatory conditions

Risk of serious infections is similar among pregnant women with systemic inflammatory conditions using steroids, non-biologics, and TNF inhibitors.

USPSTF: evidence insufficient for pelvic exams in asymptomatic nonpregnant women

USPSTF: evidence insufficient for pelvic exams in asymptomatic nonpregnant women

The USPSTF concludes that evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic women for the early detection and treatment of a range of gynecologic conditions.

Ultrasound vs radiology for diagnosing pneumonia

Ultrasound vs radiology for diagnosing pneumonia

Point of care lung ultrasound is an accurate tool for the diagnosis of pneumonia, according to researchers.

ACOG recommends genetic screening in all women before pregnancy

ACOG recommends genetic screening in all women before pregnancy

ACOG recommends that carrier screening should be provided to all women who are pregnant but ideally should be provided to women as they are considering pregnancy.

Managing diabetic retinopathy: ADA releases new position statement

Managing diabetic retinopathy: ADA releases new position statement

The position statement by the ADA incorporates updates in treatment and screening for patients with diabetic retinopathy.

Evaluating abnormal liver chemistries: a clinical guideline

Evaluating abnormal liver chemistries: a clinical guideline

The American College of Gastroenterology has released recommendations of preferred approaches for diagnosing and evaluating patients with abnormal liver test results.

Cystic fibrosis: consensus diagnostic guidelines for clinicians

Cystic fibrosis: consensus diagnostic guidelines for clinicians

The guidelines outline the diagnosis of CF and clarify diagnostic criteria and terminology for other disorders associated with CFTR mutations.

Life expectancy for some may exceed 90 years by 2030

Life expectancy for some may exceed 90 years by 2030

Researchers report that women and men in the United States will have lower life expectancy gains, compared with those in other countries.

Pharmacologic treatment of insomnia: a new clinical practice guideline

Pharmacologic treatment of insomnia: a new clinical practice guideline

The American Academy of Sleep Medicine recommends that the new pharmacologic guidelines be used in conjunction with other AASM guidelines for insomnia.

Stem cell therapy may be effective for multiple sclerosis

Stem cell therapy may be effective for multiple sclerosis

Younger age, relapsing forms of MS, fewer prior immunotherapy treatments, and lower baseline EDSS score were factors associated with better outcomes for stem cell transplantation.

Vitamin D supplementation reduces the risk of acute respiratory tract infection

Vitamin D supplementation reduces the risk of acute respiratory tract infection

Patients receiving vitamin D for deficiency without bolus doses experienced the most benefit.

Proton pump inhibitor use may decrease healthcare visits in GERD patients

Proton pump inhibitor use may decrease healthcare visits in GERD patients

Among GERD patients, the mean annual ARI episode dropped from 4.39 during the year before PPI treatment to 3.89 after treatment with a PPI.

More antimicrobial treatments needed in community-acquired pneumonia

More antimicrobial treatments needed in community-acquired pneumonia

Findings from a US claims-based retrospective study call for more effective antimicrobial treatments for patients with community-acquired pneumonia.

Acute pancreatitis may reveal pancreatic cancer at earlier stage

Acute pancreatitis may reveal pancreatic cancer at earlier stage

Surgical intervention after 24.5 days of acute pancreatitis may be beneficial for reducing postoperative complications.

Opioids for chronic pain: a new clinical guideline from the VA and Department of Defense

Opioids for chronic pain: a new clinical guideline from the VA and Department of Defense

The Veterans Administration and Department of Defense issue a clinical practice guideline regarding opioid therapy for chronic pain in veterans.

Personalized treatment for very early stage hepatocellular carcinoma

Personalized treatment for very early stage hepatocellular carcinoma

Investigators have proposed an algorithm to facilitate the decision-making process of clinical care for patients with very early hepatocellular carcinoma.

2017 Adult immunization schedule released by the CDC

2017 Adult immunization schedule released by the CDC

The ACIP has released the 2017 recommended immunization schedule for adults.

MRI may detect autism before age 1

MRI may detect autism before age 1

MRI scans showed that the brain size of infants grew faster between 12 and 24 months, the same time that behavioral signs of autism appeared.

Apixaban linked to higher rates of stroke than warfarin in patients with atrial fibrillation

Apixaban linked to higher rates of stroke than warfarin in patients with atrial fibrillation

Rivaroxaban once daily and dabigatran twice daily showed evidence of lower thromboembolic rates.

Hepatitis C infection linked to nonhepatic cancers among elderly patients

Hepatitis C infection linked to nonhepatic cancers among elderly patients

HCV infection is associated with cancers such as bile duct and pancreatic cancers and diffuse large B-cell lymphoma.

Noninvasive treatment for low back pain: a new clinical guideline from ACP

Noninvasive treatment for low back pain: a new clinical guideline from ACP

The ACP has released 3 recommendations for the treatment of patients with acute, subacute, and chronic low back pain.

Licorice consumption during pregnancy may be harmful for offspring

Licorice consumption during pregnancy may be harmful for offspring

Girls whose mothers consumed high amounts of licorice during pregnancy have more advanced pubertal maturation at age 12 years.

Prolapse surgery outcomes not improved with transvaginal mesh or biological graft

Prolapse surgery outcomes not improved with transvaginal mesh or biological graft

Using transvaginal mesh and biological graft in prolapse surgery did not improve outcomes of effectiveness, quality of life, or adverse events.

2017 immunization schedule for children and adolescents released by CDC

2017 immunization schedule for children and adolescents released by CDC

The schedule includes new or revised recommendations for several vaccines for children and adolescents.

Radiation exposure and cancer risk from CT screening: a risk-benefit analysis

Radiation exposure and cancer risk from CT screening: a risk-benefit analysis

After 10 years of low-dose CT screening in patients, 1.5 lung cancers and 2.4 major cancers per 10,000 people screened were induced by radiation.

Prestroke psychosocial factors linked to poststroke depression risk in women

Prestroke psychosocial factors linked to poststroke depression risk in women

Women with a good recovery after stroke and a moderate level of optimism had a 0.40‐fold reduction in the odds of developing new-onset poststroke depression.

Atypical antipsychotic therapy with mood stabilizers effective after bipolar episode

Atypical antipsychotic therapy with mood stabilizers effective after bipolar episode

Atypical antipsychotic adjunctive therapy and mood stabilizers may be a more effective treatment than mood stabilizer monotherapy.

NSAID use for respiratory infection increases myocardial infarction risk

NSAID use for respiratory infection increases myocardial infarction risk

NSAID use during ARI was associated with a 3.4-fold increased risk of AMI compared with 2.7-fold increased risk without NSAID use.

CDC expands investigation into Seoul virus outbreak

CDC expands investigation into Seoul virus outbreak

Symptoms of Seoul virus infection typically begin within 1 to 2 weeks after contact with infectious material and include fever, headache, and back pain.

Anxiety and depression may have predictive role in cancer mortality

Anxiety and depression may have predictive role in cancer mortality

Researchers measured vital status records to ascertain death from 16 site-specific malignancies.

Intervention during labor and birth: new recommendations from ACOG

Intervention during labor and birth: new recommendations from ACOG

The ACOG releases an updated committee opinion suggesting that low-risk women can benefit from minimal intervention during labor and delivery.

FDA approves first newborn screening system for rare metabolic disorders

FDA approves first newborn screening system for rare metabolic disorders

The Seeker System is approved to screen for four rare lysosomal storage disorders in newborns.

Death rate high in elderly within 7 days of discharge from emergency department

Death rate high in elderly within 7 days of discharge from emergency department

More than 10,000 Medicare beneficiaries die each year within 7 days of being discharged from emergency departments.

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