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AudioDigest Platinum – NEW to our electronic Medical Library – Earn CME and MOC credits in your car on the way to work or from your laptop at home!

by jmiller on September 13, 2017

AudioDigest Platinum allows for unlimited CME with institutional access to 16 medical specialties.  Listen to lectures on the go with the Audio Digest Mobile app available on Apple iTunes or Google Play.  Customize auto-loading playlists tailored to an individual user’s areas of interest.  Current clinical updates, best practice, and MOC activities.  Obtain your username and password through the Medical Library on the Intranet. Please register ensuring the previous user is logged out if you are on a shared computer.   Questions:  Call Joyce Miller, 443.481.4877.  Click here to view flyer.

JAMA Clinical Guideline Symposia: Routine preoperative laboratory tests for elective surgery

by jmiller on August 8, 2017

Major recommendations: For ASA grade 1 or 2 patients undergoing minor surgery, do not routinely offer preop tlab tests.  For ASA grade 3 or 4, consider renal function testing in patients at risk of acute kidney injury.  For ASA grade 1 patients undergoing intermediate surgery do not routinely offer any preop lab tests.  For all patients undergoing major or complex surgery, offer preop lab testing with CBC counts and renal function.  Consider coagulation testing in ASA grade 3 or 4 patients with chronic liver disease or taking anticoagulants.  Click here to read full text.

Amyotrophic lateral sclerosis

by jmiller on August 8, 2017

This review article (NEJM, July 13) covers epidemiological features; pathological characteristics; genetic features; concepts in pathogenesis; and therapeutics and beyond. Click here to read full-text.

Subarachnoid hemorrhage

by jmiller on August 8, 2017

This clinical practice article (NEJM, July 20) reviews the signs and symptoms; strategies and evidence; medical interventions to reduce the risk of re-rupture; treatment of ruptured cerebral aneurysms; treatment of complications arising from subarachnoid hemorrhage and aneurysm treatment; areas of uncertainty; guidelines; and conclusions and recommendations.  To read full text, click here.

In the news: Longer sleep is associated with lower BMI and favorable metabolic profiles

by jmiller on August 2, 2017

“After adjustment for age, ethnicity, sex, smoking, and socioeconomic status, sleep duration was negatively associated with body mass index, waist circumference, and positively associated with body mass index, waist circumference, and positively associated with high-density lipoprotein cholesterol.  Sleep duration tended to be positively associated with free thyroxine levels and negatively associated with HbA1c and CRP.  Findings show that short-sleeping adults are more likely to have obesity, a disease with many comorbidities.  (PLOS, July 27) Click here for full text.

In the news: Coffee drinking and mortality in 10 European countries; Association of coffee consumption with total and cause-specific mortality among Nonwhite populations; and Association of coffee drinking with total and cause-specific mortality

by jmiller on July 12, 2017

“Coffee consumption was inversely associated with total and cause-specific mortality.  Higher consumption of coffee was associated with lower risk for death in African Americans, Japanese Americans, Latinos and whites.  Bottom line:  “Although drinking coffee cannot be recommended as being good for your health on the basis of these kinds of studies, the studies do suggest that for many people, no long-term harm will result from drinking coffee.”  Two of these studies are from the most recent posting in Ann Intern Med, and one from NEJM.  Click here to read full-text.

Coconut oil consumption and cardiovascular risk factors in humans

by jmiller on July 6, 2017

According to the AHA report, Dietary Fats and Cardiovascular Disease: A Presidential Advisory from the AHA” (Circulation, June 16) research has long shown that coconut oil—which has more saturated fat than lard or butter—increases “bad” LDL cholesterol, which thickens arterial walls, making them hard and narrow. But polling shows that 70 percent of Americans consider the oil a health-conscious choice.  A special article was put out by Natural Reviews, confirms that coconut consumption adds to cardiovascular risk factors in humans with overwhelming evidence.   Click here to read full text.

Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline

by jmiller on July 6, 2017

An expert panel produced these recommendations based on a linked systematic review, which found that, among patients with a degenerative medial meniscus tear, knee arthroscopy was no better than exercise therapy.  The panel make a strong recommendation against arthroscopy for degenerative knee disease. The article appears in the May 10th issue of BMJ.  Click here to read full-text.

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