“Based on the current available evidence, the US Food and Drug Administration recently issued a Consumer Update that does not support aspirin for primary prevention and warns patients about the risk of serious bleeding complications. Moreover, current guidelines and consensus panels for aspirin in primary prevention differ from one another, making it challenging for clinicians to determine which patients would benefit. One message is clear in the most current clinical guidelines, namely, that routine use of aspirin for primary prevention is not recommended.” (Cleve Clin J, April) Click here to read full-text.
News You Can Use
Society of Gynecologic Oncology statement on risk assessment for inherited gynecologic cancer predispositionsby Medical Staff Office on March 27, 2015
Women with germline mutations in the cancer susceptibility genes, BRCA1 or BRCA2, associated with Hereditary Breast and Ovarian Cancer syndrome, have up to an 85% lifetime risk of breast cancer and up to a 46% lifetime risk of ovarian, tubal and peritoneal cancers. The article addresses lynch/Hereditary Non-Polyposis Colorectal Cancer (HNPCC) syndrome as well. This commentary provides guidance on identification of patients who may benefit from assessment for the presence of a hereditary breast and/or gynecologic cancer syndrome. (Gynecol Oncol, April 2014) Click here to read full text.
Screening for Vitamin D deficiency in adults: U.S. Preventive Services Task Force Recommendation Statementby Medical Staff Office on March 27, 2015
The USPSTF concluded that the current evidence is insufficient to asssess the balance of benefits and harms of screening for Vitamin D deficiency in asymptomatic adults. (Ann Intern Med, Jan) Click here to read full text.
Postoperative delirium in older adults: best practice statement from the American Geriatrics Societyby Medical Staff Office on March 27, 2015
This practice guideline (J Am Coll Surg, Feb) reviews risk factors; diagnosis; delirium screening; intraoperative measures to prevent delirium; medication as risk factors for postoperative delirium; pharmacologic prevention nonpharmacologic prevention and treatment ; medical evaluation; pharmacological treatment; and implementation of these guidelines. Click here to read full-text.
This review article (NEJM, March 25) provides an update on the anatomy of the sciatic nerve; symptoms and examination findings’ imaging and electrological testing; nonspinal causes; conservative treatment; surgical treatment caused by lumbar disk disease; surgical techniques; and guidelines and systematic reviews. Click here to read full text.
“An initiative of the National Physicians Alliance, the project titled “Promoting Good Stewardship in Clinical Practice”, developed a list of the top 5 activities in primary care for which changes in practice could lead to higher-quality care and better use of finite clinical resources. One of the top 5 recommendations was “Don’t do imaging for low back pain within the first 6 weeks unless red flags are present.” This article presents data that support this recommendation. (Arch Intern Med, July 2012) Click here to read full-text
Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case-control, cohort and intervention studiesby jmiller on March 3, 2015
“Increasing evidence suggests that the Mediterranean diet can reduce the risk of CVD, Olive oil is the hallmark of this dietary pattern. Available studies support an inverse association of olive oil consumption with stroke (and with stroke and CHD combined), but no significant association with CHD.” (Br J Nutr April 2015) Click here to read full text.
The rise of the medical scribe industry: implications for the advancement of electronic health recordby jmiller on January 16, 2015
Use of medical scribes – unlicensed individuals hired to enter information into the EHR under clinician supervision – has increased substantially. This article addresses the risks engendered by the rise of a medical scribe industry and its potential for becoming integral to US health care delivery. Despite scribes’ reported value, this industry should be viewed as what it is: a workaround or adaptation to the suboptimal state of today’s EHRs. The use of scribes can pose potential risks to patients if they are allowed to enter orders into the EHR. Further, it should not be a substitute for much-needed EHR innovation and transition to more highly effective and more functionally efficient EHR systems. Click here to read full text.