Medscape (11/19) reports that “the rate of prescriptions fell off exponentially after the guidelines were introduced.” But “at the same time, the number of cases of endocarditis per month” increased “by 0.11 cases per 10 million people in England, and by March 2013 this amounted to an extra 35 cases per month.” The data indicated that “there were 420 additional hospitalizations and 18 additional deaths related to endocarditis” annually.
Study links UK decline in use of predental antibiotics to increase in endocarditis cases.11/22/2014 The AP (11/19, Marchione) reports that research presented at the American Heart Association meeting and published in the Lancet suggests that reducing “the routine use of preventive antibiotics” prior to “dental work may have contributed to a rise in heart valve infections in England.” Researchers found that “in the U.S., the highest risk patients still get these” medications “and no similar trend has been seen.” Back in “2007, the American Heart Association and others said” these medications “should only be used for the highest risk patients; a year later, regulators in England recommended stopping them for all patients.”
Medscape (11/19) reports that “the rate of prescriptions fell off exponentially after the guidelines were introduced.” But “at the same time, the number of cases of endocarditis per month” increased “by 0.11 cases per 10 million people in England, and by March 2013 this amounted to an extra 35 cases per month.” The data indicated that “there were 420 additional hospitalizations and 18 additional deaths related to endocarditis” annually.
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The New York Times (11/19, Reynolds) “Well” blog reports that according to the results of a 171-participant study, “exercise really does change the brain and may, in the process, improve thinking.” The findings were published Oct. 7 in the journal PLoS One
TIME (11/18, Worland) reports that a study published in the Annals of Internal Medicine “suggests that nearly 30% of adults with diabetes remain undiagnosed—the same rate as people with HIV.” The study also suggests that “just like many HIV patients, only about 20% of diabetes patients are treated satisfactorily.”
Medscape (11/18, Tucker) reports that the study found that “the majority of people with undiagnosed diabetes in the United States not only have a usual healthcare provider but have made two or more visits in the past year. On the CBS Evening News (11/17, story 7, 1:50, Pelley), CBS’ Dr. Jon Lapook reported that a study presented at a meeting of the American Heart Association “may change the way” physicians “treat patients with heart attacks or severe chest pain.”
The New York Times (11/18, Kolata, Subscription Publication) reports that “the six-year study...involved 18,000 people who had had heart attacks or episodes of chest pain so severe they went to a hospital.” Participants “were randomly assigned to take” simvastatin or Vytorin (ezetimibe and simvastatin). Investigators found that “there were 6.4 percent fewer cardiac events — heart disease deaths, heart attacks, strokes, bypass surgeries, stent insertions and hospitalizations for severe chest pain — in those assigned to take Vytorin.” USA Today (11/18, Weintraub) reports that participants given Vytorin “had an average LDL cholesterol of 54 mg/dL, compared with 69 mg/dL for those treated with just the statin.” Study leader Dr. Christopher Cannon “said the study shows that patients and doctors need to continue focusing on lowering cholesterol.” USA Today adds that the study is “the first to show that a different type of cholesterol-lowering drug can improve upon statins.” The AP (11/18, Marchione) reports that the data indicated that “for every 56 people taking Vytorin for seven years, one additional heart attack, stroke or heart-related death would be prevented.” A new guideline issued by the American College of Physicians recommends increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent kidney stones. It also recommends treatment with a thiazide diuretic, citrate, or allopurinol to prevent recurrent kidney stones in patients with active disease in which increased fluid intake fails to reduce the formation of stones. The guideline is published in the Annals of Internal Medicine.
The risk of developing amyotrophic lateral sclerosis (ALS) within 4 years was reduced by 17% in individuals prescribed ACEIs with a >449.5 cumulative defined daily dose (CDDD) in an analysis of data from the Taiwanese National Health Insurance database. Individuals who had been prescribed ACEIs with a <449.5 CDDD experienced a risk reduction of 57%. The JAMA Neurology analysis pertained to 729 patients who had received an ALS diagnosis between 2002 and 2008 and compared with 14,580 individuals without the disease. Previous research had indicated that ACEIs may be neuroprotective in motor neuron disease.
Among 2960 patients >40 years old who were admitted to a hospital in Greater Copenhagen and were followed for a median of 5.16 years, the 1-year mortality rate was higher for patients with hyponatremia (plasma sodium level <137 mmol/L) at hospital admission than in those with normonatremia (27.5% vs. 17.7%). Hyponatremia was linked with a 60% and 40% increased risk of all-cause mortality after 1 year and after the entire observation period, respectively. Patients with hyponatremia had a hospital stay of 7.6 days compared to 5.6 days for those with normonatremia. The findings are published in theInternal Medicine Journal
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