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Ten out of 17 observational studies showed significantly lower levels of vitamin B12 in patients on metformin than not on metformin in a systematic review and meta-analysis, Meta-analysis performed on 4 clinical trials demonstrated a significant overall average B12 reducing effect of metformin of 57 pmol/L after 6 weeks to 3 months of use. The Diabetes & Metabolism findings suggest that clinicians should monitor B12 levels in patients on metformin who are at increased risk of deficiency.
Shortages of many drugs that are essential in emergency care have gotten worse in terms of both number and duration, despite passage of the Food and Drug Administration Safety and Innovation Act of 2012 that gave the agency regulatory powers to respond to drug shortages. Estimates based on reported national drug shortages from 2001 to 2014 show that half of all drug shortages in the study period involved acute care drugs. Shortages affecting acute care drugs became increasingly frequent and prolonged compared with nonacute care drugs (median duration of 242 vs. 173 days). The results are published in Health Affairs.
The CBS Evening News (5/3, story 7, 1:35, Pelley) reported that research indicates that “medical errors are now the third largest cause of death behind heart disease and cancer.”
USA Today (5/3, O'Donnell) reports that the study authors “wrote that strategies to reduce death from medical care should include making errors ‘more visible’ when they occur, having remedies available to ‘rescue patients,’ and making errors less frequent by following principles that take ‘human limitations’ into account.” According to the Washington Post (5/3, Cha), “in 1999, an Institute of Medicine report [pdf] calling preventable medical errors an ‘epidemic’ shocked the medical establishment and led to significant debate about what could be done.” The institute, “based on one study, estimated deaths because of medical errors as high as 98,000” annually. The new research, published in the BMJ, “involves a more comprehensive analysis of four large studies...that took place between 2000 to 2008.” The New York Times (5/3, Bakalar) “Well” blog reports that the researchers “estimated that an average of 251,454 deaths per year in the United States are caused by medical error.” ABC World News Tonight (5/3, story 11, 0:25, Muir) reported that a study conducted by the Centers for Disease Control and Prevention revealed that “one-third of antibiotics are not needed.”
The Washington Post (5/3, Sun) reports that most of the unnecessary prescriptions given out each year “are for conditions that don’t respond to antibiotics, such as colds, sore throats, bronchitis, flu and other viral illnesses.” The findings were published in the JAMA. NBC News (5/3, Fox) reports on its website that the investigators “took a deep dive into data on antibiotic prescriptions written in 2010 and 2011-- the most recent data they could work with.” The researchers found that approximatley “13 percent of all outpatient doctor visits – that would add up to 154 million visits a year – result in an antibiotic prescription.” Close to “30 percent of these prescriptions, or 47 million of them, are unnecessary, they calculated.” CBS News (5/3, Welch) reports that for the purposes of their study, “the researchers defined inappropriate antibiotic use as an instance in which an antibiotic was prescribed for an illness that cannot be treated by one, such as the common cold.” CDC urges parents of preschool kids with AD/HD to try behavior therapy before medications In “To Your Health,” the Washington Post (5/3, Cha) reports officials with the Centers for Disease Control and Prevention are now “urging parents of preschoolers with attention-deficit/hyperactivity disorder (AD/HD) to try behavior therapy first before trying” medications. In addition, the CDC is “calling on insurers to cover the treatments.” Currently, about 75 percent of children with AD/HD are receiving medication for treatment. CDC principal deputy director Anne Schuchat, MD, MPH, said in a call with reporters yesterday, “Until we know more, the recommendation is to first refer parents of children under six years of age who have AD/HD for training and behavior therapy.” The CBS News (5/3, Marcus) website reports the CDC made its recommendations in a Vital Signs report released May 3. The recommendations echo those made by the American Academy of Pediatrics. That AAP recommends that “the first line of treatment for the youngest of children with AD/HD should be behavior therapy, even before medications are tried.” In a retrospective study of patients with advanced CKD (25 treated with niacin and 25 controls), the average serum phosphorus level over the course of 6 months was significantly lower in the niacin than the control arm (3.4 vs. 4.2 mg/dL). There was no significant association between niacin dose and phosphorus level. Research has shown that niacin lowers serum phosphorus by inhibiting the expression of type IIb sodium-phosphate co-transporters, which are responsible for absorption of phosphate through the gastrointestinal tract. The findings were reported in Poster 200 at the National Kidney Foundation 2016 Spring Clinical Meetings.
Dieting may help improve health, mood, sex drive, and stress levels among normal-weight people5/3/2016 The Los Angeles Times (5/2, Healy) reports in “Science Now” that a study indicated “normal-weight people who ate 25% less than they wanted for” two years appeared to be “happier and less stressed, slept better and had more robust sex drives,” compared to “healthy adults” who ate whatever they wanted during that same time frame. The findings were published in JAMA Internal Medicine.
TIME (5/2, Park) reports that “in a new report published in the Journal of the American College of Cardiology,” investigators found that a formula “created by the American Heart Association (AHA) and the American College of Cardiology (ACC)” for predicting heart risk “overestimates the risk of heart trouble up to five to six times.” This “means that five to six times as many people may be prescribed drugs like...statins who won’t necessarily benefit from them.”
AFP (5/2) points out that “the tool in question is known as the American College of Cardiology and American Heart Association Pooled Cohort risk equation for estimating the likelihood of atherosclerotic...and cardiovascular disease.” According to AFP, “It was published in 2013 and was ‘considered an important step forward,’ said the study.” USA Today (5/2, O'Donnell) reports that a study concluded that states which “spend more money on social services and public health programs relative to medical care have much healthier residents than states that don’t.” According to the study, “Washington, D.C., and states including Colorado and Nevada had the highest ratios of social service and public health spending relative to medical costs...and were much healthier,” while “traditionally poor-health states” such as West Virginia, Kentucky and Louisiana had “the lowest ratios of medical spending to spending on social services.”
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