Article concludes: “The evidence for the viability of bone-targeted pharmacotherapy in preventing hip fracture and other clinical fragility fractures is mainly limited to women aged 65-80 years with osteoporosis, whereas the proof of hip fracture-preventing efficacy in women over 80 years of age and in men at all ages is meagre or absent. Further, the antihip fracture efficacy shown in clinical trials is absent in real-life studies. Many drugs for the treatment of osteoporosis have also been associated with increased risks of serious adverse events. There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20-25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures associated with this treatment. This “Key Symposium” appears in the August issue of Journal of Internal Medicine.Click here to read full-text.
News You Can Use
An official ATS/AACN/ACCP/ESICM/SCCM policy statement: responding to requests for potentially inappropriate treatments in Intensive Care Unitsby jmiller on July 16, 2015
“The multisociety statement on responding to requests for potentially inappropriate treatments in intensive care units provides guidance for clinicians to prevent and manage disputes in patients with advanced critical illness.” (Am J Resp Crit Care Med, June 1) Click here to read full-text.
How slow is too slow? Correlation of operative time to complications? An analysis from the Tennessee Surgical Quality Collaborativeby jmiller on July 16, 2015
“Duration of operation correlates with complications and time longer than a statewide established standard carries higher risk. to reduce risk of complications, these data support expeditious surgical technique and preoperative pulmonary training, and offer accurate outcomes assessment for patient counseling based on case duratio. These data can be used directly to counsel individual surgeons to improve outcomes.” (Bull Am Coll Surg, July) Click here to read full-text.
“When analyzed at the county level, the clearest result of mammography screening is the diagnosis of additional small cancers. Furthermore, there is no conocomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the overall rate of death from the disease. Together, these findings suggest widespread overdiagnosis. As is the case with screening in general, the balance of benefits and harms is likely to be most favorable when screening is directed to those at high risk.” (JAMA Intern Med, early online) Click here to read full-text.
“The FDA has approved edoxaban (Savaysa), a once-daily, oral, direct factor Xa inhibitor, for treatment of venous thromboembolism (VTE) and for prevention of stroke and systematic embolism in patients with nonvalvular atrial fibrillation. It is the fourth new oral anticoagulant to be approved for VTE and non-valvular atrial fibrillation.” (Jama, July 7) To read full-text, click here.
What is VisualDx?
VisualDx is one of the most widely used medical apps in the world to improve diagnostic accuracy, medical education and patient education. VisualDx is already licensed by more than 50% of US medical schools including Harvard, Yale, Cornell, University of Pennsylvania, UCLA, USC, UNC, University of Washington, and many more. Over the past 3 years, it has been voted among the top favorite apps multiple times at Harvard and University of Pennsylvania. It is one of the top rated databases in KLAS, which is the Consumer Reports of databases. It will give any visual pictures connected with a disease, as well as the new ICD10 codes; pearls of wisdom; treatment and references connected with dresources. There is also a mobile app. Questions: call Joyce Miller, Medical Librarian ext. 4877.
Innovation in maternal-fetal therapy: a positon statement of the NA Fetal Therapy Network and Expanded carrier screening in reproductive medicine – points to consider: A joint statementby jmiller on June 26, 2015
Innovative medical therapy often occupies an uncomfortable space between formal research and established clinical practice.. Because fetal medicine is unique in that other fields do not have to consider the well being of two individuals at the same time, the North American Fetal Therapy Network offers these expanded guidelines. Expanded genetic carrier screening in reproductive medicine is provided in the Joint Statement of ACOG, the Society for Maternal-Fetal Medicine, and the National Society of Genetic Counselors. (Obstet Gynecol, March) Click here to read full-text.
ACOG Practice Bulletin148: Thyroid disease in pregnancy and ACOG Practice Bulletin 149: Endometrial Cancerby jmiller on June 26, 2015
ACOG issued two new Practice Bulletins (Obstet Gynecol, April) . The thyroid bulletin expresses concerns over uncontrolled thyrotoxicosis and hypothyroidism having adverse pregnancy outcomes. It also impacts fetal development. In addition, medications that affect the maternal thyroid gland can cross the placenta and affect the fetal thyroid glancd. Endometrial carcinoma is the most commonly diagnosed gynecologic malignancy. This article reviews the epidemiology, pathophysiology, and diagnostic and management startegies for this type of cancer. To read full-text, click here.