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In the news: Ocrevus (Ocrelizumab) approved by the FDA for Multiple Sclerosis

by jmiller on March 30, 2017

Ocrelizumab was just approved by the FDA for treating multiple sclerosis.  The New England Journal of Medicine (Jan 19) published “Ocrelizumab versus placebo in primary progressive multiple sclerosis” concluding “among patients with primary progressive multiple sclerosis, ocrelizumab was associated with lower rates of clinical and MRI progression than placebo.”  The Lancet also published an article on using it with relapsing-remitting multiple sclerosis, whereby it also showed promising results.  Click here to read full text of both of these articles.

2017 Recommendations for preventive pediatric care

by jmiller on March 30, 2017

A new Policy Statement was issued by the American Academy of Pediatrics (Pediatrics, April).  This article reflects changes made since the Periodicity Schedule was last published in January 2016.  Click here to read full text.

Opioid-prescribing patterns of emergency physicians and risk of long-term use

by jmiller on March 15, 2017

Article concludes: “Wide range of opioid prescribing existed among physicians practicing within the same emergency department, and rates of long-term opioid use were increased among patients who had not previously received opioids and received treatment from high-intensity opioid prescribers.”  (NEJM, Feb 16)  Click here to read full text.

Opioid Crisis – Annals of Surgery Special Series

by jmiller on March 9, 2017

Annals of Surgery (April) includes a special series dealing with the opioid crisis which includes:  It’s time to adopt electronic prescriptions for opioids by Atul Gawande’s Preoperative opioid use is independently associated with increased costs and worse outcomes after major abdominal surgery; Predictors of in-hospital postoperative opioid overdose after major elective operations; Wide variation and excessive dosage of opioid prescriptions for common general surgical procedures; Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery; and iatrogenic opioid dependence in the United States: are surgeons the gatekeepers.  Click here to read full text of these articles.

Management of sepsis and septic shock: new guidelines

by jmiller on March 2, 2017

“Management of sepsis and septic shock” and Viewpoint: “Surviving sepsis guidelines: a continuous move toward better care of patients with sepsis” (JAMA, Feb 28) and “A user’s guide to the 2016 surviving sepsis guidelines” (Critical Care Med, Feb) provide a synopsis to the new guidelines which have recently come out.  Click here to read full text.

In the news: increase in colorectal cancer in millenials. Colorectal cancer incidence patterns in the United States, 1974-2013

by jmiller on March 2, 2017

Article (JNCI, Feb 28) concludes:  “Age-specific CRC risk has escalated back to the level of those born circa 1890 for contemporary birth cohorts, underscoring the need for increased awareness among clinicians and the general public, as well as etiologic research to elucidate causes for the trend.  Further, as nearly one-third of rectal can cancer patients are younger than age 55 years, screening initiation before age 50 years should be considered.  Click here to read full text.

Assessing the risks associated with MRI in patients with a pacemaker of defibrillator

by jmiller on March 2, 2017

“The presence of a cardiovascular implantable electronic device has long been a contra-indication for the performance of MRI.  We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or ICD that was “non-MRI-conditional” (i.e. not approved by the FDA for MRI scanning).  The article concludes that in this study, “device or lead failure did not occur in any patient with a non-MRI conditional pacemaker of ICD who underwent clinically indicated nonthoracic MRI at 1.5 tesla, was appropriately screened, and had the device reprogrammed in accordance with the prespecified protocol.  (NEJM, Feb 23).  Click here to read full text

Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Practice Guideline Update

by jmiller on February 2, 2017

Recommendations:  “Inpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment.  Referral of patients to interdisciplinary palliative care teams is optimal, and services may complement existing programs.  Providers may refer family and friend caregivers of patients with early or advanced cancer to palliative care services.  (Journal of Clinical Oncology, Jan 1)  Click here to read full text.

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