Annals of Internal Medicine tip sheet for Nov. 13, 2012
2012-11-13
(Press-News.org) 1. Prophylactic Probiotics Reduce Clostridium difficile-associated Diarrhea in Patients Taking Antibiotics
Prophylactic use of probiotics can reduce Clostridium difficile-associated diarrhea (CDAD). Clostridium difficile is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. CDAD most commonly affects older adults in hospitals or in long term care facilities and typically occurs after use of antibiotics. Probiotics are microorganisms thought to counteract disturbances in intestinal flora, and thereby reduce the risk of Clostridium difficile infection. Probiotics are inexpensive and readily available in capsules and dairy-based food supplements, making them an attractive option for the prevention of CDAD. Researchers reviewed 20 published randomized trials to assess the efficacy and safety of probiotics (any strain or dose) for the prevention of CDAD in adults and children receiving antibiotics. The evidence suggests that prophylactic use of probiotics reduces the incidence of CDAD in adults and children without risk for serious adverse events.
Note: For an embargoed PDF, contact Angela Collom or Megan Hanks. To interview the study author, Dr. Bradley Johnston, please contact Polly Thompson at polly.thompson@sickkids.ca or 416-813.7654, ext. 2059
2. Epidural Corticosteroids Offer Only Short-term Relief from Sciatica Pain and Disability
Sciatica is a common type of low back pain characterized by intense unilateral leg pain, tingling or numbness, and shooting pain that radiates below the knee. Since symptoms of sciatica can be debilitating and persistent, patients are nearly four times more likely to have back surgery compared with those who have persistent low back pain only. Conservative treatment options often offer little relief, so more invasive procedures such as epidural corticosteroid injections have become increasingly popular. Currently, there are no clear guidelines for treating sciatica with epidural corticosteroid injections. Researchers reviewed published studies to determine the efficacy of epidural corticosteroid injections for reducing pain and disability from sciatica, compared to placebo controls. At short-term follow-up between two weeks and three months, 14 studies (n = 1,316 patients) showed that compared to placebo, corticosteroid injections offered significant relief from leg pain. Ten trials (n = 1,154) revealed a significant effect of epidural corticosteroid injections for reducing disability. Six trials (n = 723) showed that corticosteroid injections had no effect on back pain. Follow up at one year or later showed no difference in leg pain, back pain, or disability for patients given epidural corticosteroid injections or placebo.
Note: For an embargoed PDF, contact Angela Collom or Megan Hanks. For an interview with the lead author, please contact Maya Kay at mkay@georgeinstitute.org.au.
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2012-11-13
52,000 More Primary Care Physicians Needed by 2025 to Meet Anticipated Demand
Researchers project the United States will need 52,000 additional primary care physicians by 2025 — a 25 percent increase in the current workforce — to address the expected increases in demand due to population growth, aging, and insurance expansion following passage of the Affordable Care Act. Analyzing nationally representative data, the researchers conclude population growth will be the single greatest driver of increased primary care utilization, requiring approximately 33,000 additional ...
2012-11-13
MINNEAPOLIS – A new study shows that people who have had a head injury and have lived or worked near areas where the pesticide paraquat was used may be three times more likely to develop Parkinson's disease. The study is published in the November 13, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology. Paraquat is a herbicide commonly used on crops to control weeds. It can be deadly to humans and animals.
"While each of these two factors is associated with an increased risk of Parkinson's on their own, the combination is associated ...
2012-11-13
Erosion caused by flowing water does not only smooth out objects, but can also form distinct shapes with sharp points and edges, a team of New York University researchers has found. Their findings, which appear in the latest edition of the journal the Proceedings of the National Academy of Sciences (PNAS), reveal the unexpected ways that erosion can affect landscapes and artificial materials.
The impact of erosion is widely recognized by environmentalists and geologists, but less clear is how nature's elements, notably water and air, work to shape land, rocks, and artificial ...
2012-11-13
ANN ARBOR—At hospital shift changes, doctors and nurses exchange crucial information about the patients they're handing over—or at least they strive to. In reality, they might not spend enough time talking about the toughest cases, according to a study led by the University of Michigan.
These quick but important handoff conversations can have a major effect on patient care in the early parts of a shift. More than a half billion of them happen in U.S. hospitals every year, and that number has substantially increased with enforcement of work-hour regulations. Studies have ...
2012-11-13
Two studies published in BioMed Central's open access journal BMC Medicine examined the cost of delivering the human papillomavirus (HPV) vaccine to primary school girls in Tanzania. Both studies found that the cost of HPV vaccine delivery to adolescent girls may be substantially higher compared with the cost of delivering a new vaccine to an infant where the delivery schedule matches the existing infant immunization schedule.
Cervical cancer is the second largest cancer-related killer of women in the world, with half a million new cases of cervical cancer worldwide ...
2012-11-13
There are substantial inequalities in the stage at which cancer patients receive their diagnosis – a critical factor for cancer survival – a new study by the University of Cambridge reveals. The researchers found that age, sex and income as well as the type of cancer influenced the risk of a patient being diagnosed at an advanced stage of the disease. Eliminating these inequalities would help improve the chances of a cure for up to 5,600 patients with seven common cancers each year. The research was published today in the Annals of Oncology.
The scientists studied ten ...
2012-11-13
Tumor cells circulating in a patient's bloodstream can yield a great deal of information on how a tumor is responding to treatment and what drugs might be more effective against it. But first, these rare cells have to be captured and isolated from the many other cells found in a blood sample.
Many scientists are now working on microfluidic devices that can isolate circulating tumor cells (CTCs), but most of these have two major limitations: It takes too long to process a sufficient amount of blood, and there is no good way to extract cancer cells for analysis after their ...
2012-11-13
BOSTON, MA—A research team at Brigham and Women's Hospital has developed a novel device that may one day have broad therapeutic and diagnostic uses in the detection and capture of rare cell types, such as cancer cells, fetal cells, viruses and bacteria. The device is inspired by the long, elegant appendages of sea creatures, such as jellyfish and sea cucumbers.
The study will be published online on November 12, 2012 in Proceedings of the National Academy of Sciences.
The device, a microchip, is inspired by a jellyfish's long, sticky tentacles that are used to capture ...
2012-11-13
CHICAGO – Fasting prior to blood lipid tests appears to have limited association with lipid subclass levels, suggesting that fasting for routine lipid level determinations may be unnecessary, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.
"Although current guidelines recommend measuring lipid levels in a fasting state, recent studies suggest that nonfasting lipid profiles change minimally in response to food intake and may be superior to fasting levels in predicting adverse cardiovascular outcomes," write Davinder ...
2012-11-13
CHICAGO – A dance intervention program improved the self-rated health of Swedish girls with internalizing problems, such as stress and psychosomatic symptoms, according to a report of a study published Online First by Archives of Pediatrics & Adolescent Medicine, a JAMA Network publication.
Exercise is considered a strategy to prevent and treat depression in school-aged youth and has been shown to promote positive feelings, enhance confidence to cope with problems, and increase confidence and self-control, the authors write in the study background.
Ann Duberg, R.P.T., ...
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[Press-News.org] Annals of Internal Medicine tip sheet for Nov. 13, 2012
