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.
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“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
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.
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.
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.