Annals of Internal Medicine tip sheet for June 21, 2011
2011-06-21
(Press-News.org) 1. For Hypertension Patients, Single Reading Not Enough to Assess Blood Pressure Control
Using Multiple Readings Increases Measurement Accuracy
For patients with hypertension, physicians typically use a single in-office blood pressure (BP) reading to assess how well medical interventions are working and then adjust hypertension medications accordingly. However, some patients may experience a phenomenon known as "white coat" hypertension, meaning they have a higher than normal BP due to the anxiety associated with the office visit. Researchers sought to determine how many readings would be needed to accurately determine whether a patient's BP was under control. They followed 444 veterans with hypertension for 18 months to compare three different strategies for BP measurement: standardized research BP measurement every six months; in-office BP measurements taken during outpatient visits; and home BP measurements using a monitor that transmitted results electronically. The researchers found that taking an average BP reading from several measurements resulted in substantially greater accuracy in diagnosis. The authors recommend that home monitoring could improve the quality of blood pressure care.
2. Experts Recommend Multidetector Computed Tomography as Standard Preoperative Care for Suspected Appendicitis
Acute appendicitis can be difficult to diagnose, as the symptoms of appendicitis mirror those of other illnesses. Accurate diagnosis is important because patients with appendicitis go to surgery, while those that do not have appendicitis do not. Computed tomography is often used to help diagnose appendicitis, but high quality studies of its effectiveness in this situation have been lacking. Researchers reviewed hospital records for 2,871 adult patients with suspected appendicitis between 2000 and 2009 to determine if multidetector computed tomography (MDCT) could accurately rule in or rule out appendicitis. The researchers found that MDCT was sensitive and specific enough to identify the approximately one quarter of patients with actual appendicitis who needed urgent surgery, and it identified a probable alternative cause of symptoms in those who did not have appendicitis. In addition, preoperative MDCT can reduce rates of perforation and negative findings at appendectomy. The researchers recommend MDCT as the standard of care for suspected appendicitis in adults.
3. Insufficient Evidence to Support Preemptive Assessment of Thiopurine S-Methyltransferase Activity in Patients Prescribed Thiopurines
Thiopurine-based drugs are sometimes used to treat patients with chronic inflammatory autoimmune diseases such as rheumatoid arthritis and inflammatory bowel disease. Because thiopurine-based drugs can lead to severe lowering of blood counts in patients with reduced or absent thioputine S-methyltransferase (TPMT) enzyme, some experts recommend routine measurement of TPMT activity before prescribing these drugs. Another approach is to start the drugs, monitor blood counts, and stopping the drug if blood counts fall. Researchers reviewed 55 published studies to examine the sensitivity and specificity of TPMT genotyping for several purposes: measuring TPMT enzymatic activity; reducing harm from thiopurine; and to determine the association of thiopurine toxicity with TPMT status in adults and children with chronic inflammatory diseases. The researchers found insufficient evidence that TPMT pretesting guides appropriate prescribing or improves patient outcomes (such as by limiting toxicity) compared with routine blood count monitoring in patients receiving thiopurine therapy. The authors of this study and the author of an accompanying editorial call for more research about biological testing to preempt prescribing mediations with potentially harsh side-effects in particular patients.
###
END
ELSE PRESS RELEASES FROM THIS DATE:
2011-06-21
A new study published in the Canadian Medical Association Journal by University of Calgary Faculty of Kinesiology researcher Dr. Carolyn Emery and colleagues has shown that when bodychecking is introduced into Bantam ice hockey there is no difference between overall injury rates or concussion, regardless of whether players have prior bodychecking experience in Pee Wee.
Emery, co-chair of the Sport Injury Prevention Research Centre at the University of Calgary Sport Medicine Centre, began by comparing injury and concussion rates in Alberta where bodychecking is allowed, ...
2011-06-21
A shorter pause in CPR just before a defibrillator delivered an electric shock to a cardiac arrest victim's heart significantly increased survival, according to a study in Circulation: Journal of the American Heart Association.
Researchers found the odds of surviving until hospital discharge were significantly lower for patients whose rescuers paused CPR for 20 seconds or more before delivering a shock (the pre-shock pause), and for patients whose rescuers paused CPR before and after defibrillation (the peri-shock pause) for 40 seconds or more, compared to patients with ...
2011-06-21
In a landmark newly published study (http://www.hindawi.com/journals/ecam/2011/985345/), scientists from State University, New York working collaboratively with researchers from HairGenesis, report the positive outcome of a set of basic science experiments designed to test an advanced hair regrowth formula in a cell-based model of human hair follicle keratinocytes. Combining naturally derived 5 alpha-reductase inhibitors with highly potent anti-inflammatory agents, the scientific team showed how their proprietary composition could potentially outperform single agent hair ...
2011-06-21
Chapel Hill, NC – Ongoing research into the problem of how Hepatitis C becomes a chronic disease has uncovered a deeper mystery about its sister strain, Hepatitis A.
Hepatitis C is a continuing public health problem, which is difficult to measure because symptoms occur months to years after infection. The World Health Organization estimates as many as 2 to 4 million people in the United States may have chronic Hepatitis C, and most do not know they are infected. More than a third of those who are long-term carriers may develop chronic liver disease or liver cancer.
"Hepatitis ...
2011-06-21
An exercise training program worked better than a commonly used beta blocker, significantly improving — even curing — patients with a debilitating heart syndrome, according to research published in Hypertension: Journal of the American Heart Association.
Postural Orthostatic Tachycardia Syndrome (POTS) — called "The Grinch Syndrome" because most patients have a heart that's "two sizes too small" — affects about 500,000 Americans, primarily young women.
POTS is characterized by a rapid increase in heartbeat of more than 30 beats per minute or a heart rate that exceeds ...
2011-06-21
Millions of adults with peripheral artery disease are not receiving the medications needed to reduce their risk of heart attack, stroke and death, according to research in Circulation: Journal of the American Heart Association.
Most patients are not receiving recommended therapies such as cholesterol and blood pressure-lowering medications, the study's authors found. Peripheral artery disease is the result of atherosclerosis, or blockages in the arteries in the legs caused by plaque. People with this disease have a significantly increased risk of having either a non-fatal ...
2011-06-21
For grownups, drifting off for an afternoon snooze is often easier said than done. But many of us have probably experienced just how simple it can be to catch those zzz's in a gently rocking hammock. By examining brain waves in sleeping adults, researchers reporting in the June 21 issue of Current Biology, a Cell Press publication, now have evidence to explain why that is.
The study finds that napping on a slowly swinging bed really does get us to sleep faster. To the researchers' surprise, rocking also changes the nature of our sleep, encouraging deeper sleep.
"It ...
2011-06-21
Scientists have developed a new method to make proteins form crystals using 'smart materials' that remember the shape and characteristics of the molecule. The technique, reported today in Proceedings of the National Academy of Sciences, should assist research into new medicines by helping scientists work out the structure of drug targets.
The process of developing a new drug normally works by identifying a protein that is involved in the disease, then designing a molecule that will interact with the protein to stimulate or block its function. In order to do this, scientists ...
2011-06-21
New research at the University of Leicester is investigating a growing fascination with 'chav' culture among middle-class gay men in Britain.
Professor Joanna Brewis, from the University of Leicester School of Management, UK, will conduct primary empirical research into gay class tourism following publication of findings reported last year in the journal Sociology.
Research she carried out with her former colleague Professor Gavin Jack, now at La Trobe University in Australia, revealed the complex consumer patterns of middle-class homosexual men who go 'slumming' at ...
2011-06-21
PHILADELPHIA — An international research team including University of Pennsylvania scientists has shown that the rate of sea-level rise along the U.S. Atlantic coast is greater now than at any time in the past 2,000 years and that there is a consistent link between changes in global mean surface temperature and sea level.
The research was conducted by members of the Department of Earth and Environmental Science in Penn's School of Arts and Science: Benjamin Horton, associate professor and director of the Sea Level Research Laboratory, and postdoctoral fellow Andrew Kemp, ...
LAST 30 PRESS RELEASES:
[Press-News.org] Annals of Internal Medicine tip sheet for June 21, 2011
