This practice guideline (J Am Coll Radiol) proposes a simple, pragmatic approach that will allows for the development of an optimal imaging algorithm for stroke patients at their institution. It addresses imaging of patients with intracranial hemorrhage; imaging patients with acute ishemic stroke who are candidates for IV thrombolysis; imagine patients with acute ischemic stroke who are candidates for endovascular revascularization; imaging patients wth acute ischemic stroke who are not candidates for IV or endovascular therapy and patients with TIAs. Click here to read full text.
News You Can Use
“This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing ADHD in order to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of selv vs. informant ratings, diagnostic threshold, and introspective reporting of childhood symptoms were addressed. (J Consult Clin Psychol, Feb 2012) Click here to read full text.
“Tattoos and piercings are ancient practices of body modification that have gained widespread acceptance in modern society, particularly among young adults. Minor complications such as infection and bleeding occur frequently with piercings, but major complications have also been reported. Tattoos and piercings appear to be a marker for risk-taking behaviors.” A 2012 Harris poll indicated that 1 in 5 adults has at least 1 tattoo, up from 14% in 2008. This is a clinical review of the health risks. (JCOM, July) Click here to read full text.
“In light of the rapidly shifting landscape regarding the legalizaiton of marijuana for medical and recreational purposes, patients may be more likely to ask physicians about its potential adverse and beneficial effects on health. The popular notion seems to be that marijuana is a harmless pleasure, access to which should not be regulated or considered illegal. This article reviews the current state of the science related to the adverse health effects of the recreational use of marijuana, focusing on those areas for which the evidence is strongest. (NEJM, June 5) Click here to read full text.
Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physiciansby jmiller on July 9, 2014
Recommendations: “ACP recommends against performing screening pelvic examination in asymptomatic, nonpregnant, adult women. The current evidence shows that harms outweigh any demonstrated benefits associated with the screening pelvic examination. Indirect evidence showed that screening pelvic examination does not reduce mortality or morbidity rates in asymptomatic adult women, as 1 trial showed that screening for ovarian cancer with more sensitive tests (transvaginal ultrasonography and CA-125 also did not reduce mortality or morbidity rates. (Ann Intern Med, July 1) Click here to read full-text.
Article concludes”Patients in hospitals with better critical care nurse work environments and higher proportions of critical care nurses with bachelor’s degree in nursing experienced significantly lower odds of death.” (Crit Care Med, May) Click here to read full text.
This JAMA “Grand Rounds” CME article concludes that an increasing body of evidence has suggested benefits of mineralocorticoid receptor antagonists, such as eplerenone and spironolactone, in improving blood pressure control in patients with resistant hypertension, regardless of cirulating aldosterone levels. Thus, this class of drugs should be considered for patients whose blood pressure remains elevated after treatment with a 3-drug regimen to patients whose blood presure remains elevated after treatment with a 3-drug regimen to maximal or near maximal doses. Click here to read full text.
This JAMA “Piece of Mind”… This interesting vignette illustrates how an annual physical caused a healthy 85 year old to go through a battery of tests that left him impaired afterwards as a result of this “harmless” physical. The author’s intent was to show the impact of how “unnecessary testing” can cause harm. Click here to read full text.