New statin guidelines were issued by the American Heart Association this past week (Circulation, Nov 12). The guidelines recommend statin therapy for people without cardiovascular disease who are 40 to 75 years old and have a 7.5 % or higher risk for heart attack or stroke within 10 years; people with a hx of heart attack, stroke, stable or unstable angina, peripheral artery disease, tia or coroanary or other revascularization; people 21 and older wwho have a very high level of cholesterol (190 mg/dl or higher; people with Type 1 or Type 2 diabetes who are 40 to 75 years old. Click here to read full guidelines.
News You Can Use
“Safety and effectiveness of recombinant human bone morphogenetic protein-2 for spinal fusion”; “Effectiveness and harms of recombinant human bone morphogenic protein-2 in spine fusion” and editorial, “Closing in on the truth about recombinant morphogenetic protein-2″by jmiller on November 12, 2013
These two review articles and accompanying editorial (Ann Intern Med, June 18). Two independent studies suggesting that rhBMP-2 has no proven clinical advantage over bone graft and may be associated with important harms, making it difficult to identify clear indications for rhBMP-2. “The clinical question is of greta interest to orthopedic surgeons and relevant to internists who encounter patiens who have had or are considering having spinal fusion. These dual reviews spotlight the power of evidence sythesis, data sharing, peer review, and reproducible research.” Click here to read full text.
This article (Bull Am Coll Surg, Nov) was written by the daughter of one of our employees, Erin O’Neill, Senior Analyst, Supply Chain. Erin’s daughter is a 4th year medical student. “What are the best surgical apps? How are they actually used in practice? Have they changed the delivery of surgical care?. This article addresses these questions by examining apps for clinical practice. Click here to read ful text.
In this New England Journal of Medicine “Clinical Pracitce” summation (Oct. 17) , the potential benefits and harms of calcium intake are reviewed. Several studies have raised concerns about a possible increase in cardiovascualr ris associated with calcium supplementation as well as nephrolithiasis. Pending further data, “a reasonable approach is to preferentially encourage dietary calcium intake and discourage the routine use of calcium supplements”. click here to view full-text.
“Optimal management of patients with asymptomatic carotid artery stenosis remains unclear. Although 2 high quality clinical trials demonstrated reductions in stroke rates in patients without symptoms after carotid endarterectomy, medical therapy of asymptomatic carotid artery stenosis has reduced rates of stroke to approximately 1% per year, raising questions about generalizability of these previous trials to current medical practice. However, reductions in adverse events after revascularization can make revascularization more attractive. The emergence of percutaneous revascularization for arotid artery stenosis has raised further questions about optimal management of asymptomatic carotid artery stenosis. This Grand Rounds summarizes the factors to consider when counseling patients and making clinical decisions regarding medical therapy and revascularization for patients with asymptomatic carotid artery stenosis. This information should provide clinicians with the knowledge base to counsel patients about the risks and benefits of treatment options. (JAMA, Oct 16) Click here to read full text.
AAMC is in the process of treating its first patient using the cutting edge technology of the NOVOTTF-100A, a portable device delivering low intensity, intermediate frequency electric fields via non-invasive transducer rays. Tumor Treatment Fields, a completely new therapeutic modality in cancer treatments, physically interferes with cell division. The FDA has approved this device for use in recurrent glioblastoma after standard therapies have failed. The treatment device appears comparable to second line chemotherapy regimens that are commonly used, but toxicity and quality of life appear more favorable with TTF. Click here to read clinical article.
Long-term mortality after screening for colorectal cancer; Long-term colorectal-cancer incidence and mortality after lower endoscopy; and accompanying editorial “Colorectal-cancer screeing – coming of age”by jmiller on September 19, 2013
(NEJM, Sept 19) In summary, both colonscopy and fecal occult-blood testing are effective for colorectal-cancer screening, and these new studies support current screening guidelines. Click here to read full-text