News You Can Use

Calcium supplements and fracture prevention

by jmiller on October 29, 2013

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.

Management of asymptomatic internal carotid artery stenosis

by jmiller on October 29, 2013

“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.

TTF – A novel treatment for glioblastoma – here at AAMC!

by jmiller on October 29, 2013

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.

Access UpToDate REMOTELY through ALEC

by jmiller on October 10, 2013

UpToDate can be accessed REMOTELY through ALEC, our electronic health record.  Physicians can earn CME through UpToDate if they so choose.  Click here to see how!  If you need any help, call Joyce Miller on ext. 4877 or send an email to jmiller@aahs.org

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

Methylprednisolone injections for the carpal tunnel syndrome

by jmiller on September 19, 2013

 Despite the significant benefit from the steroid injection, nearly 3/4 of the 80 mg methylprednisolone group did ultimately have surgery. Nonetheless, for clinicians counseling their patients with persistent carpal tunnel syndrome symptoms, this trial demonstrates that in addition to providing short-term symptom relief, the injection may result in avoiding surgery in a sizable minority of patients.(Arch Intern Med, Sept 3) Click here to read full text.

Reduction in chemotherapy order errors with computerized physician order entry

by jmiller on September 12, 2013

Congratulations to Dr. Barry Meisenberg, Bob Wright (Pharm D.) and Cathy Copertino, with acknowledgements to Charles Mylander (staff statistician, Judy Smith (Pharmacy) and Sharon Kneesi (Asst.) for their recently published article in the Sept. issue of Journal of Oncology Practice..  The article concludes, “The number of problem-and error-containing chemotherapy orders was reduced sequentially by preprinted order sets and then by preprinted order sets and then by CPOE.  Click here to read full-text.

Association of autism with induced or augmented childbirth

by jmiller on August 19, 2013

This JAMA Pediatrics online first article concludes: “compared with children born to mothers who received neither labor induction nor augmentation, children born to mothers who were induced and augmentd, induced only, or augmented only experienced increased odds of autism after controlling for potential confounders related to socioeconomic status, maternal heatlh, pregnancy related events and conditions, and birth year.  The observed associations between labor inductions/augmentation were particularly pronounced in male children.  Click here to read full-text.

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