Top News

D-dimer testing: When is it useful? This study found that the specificity of D-dimer testing in patients with suspected pulmonary embolism and decreased glomerular filtration rate is significantly decreased. Nonetheless, performing D-dimer tests is still useful because computed tomography scanning can be withheld in a significant proportion of these patients. The American Journal of Medicine (11/2009)

Clinical Updates

   From AJM and other Elsevier publications

Predicting cardiovascular disease with physical activity Physical activity was associated with cardiovascular disease, independent of the common cardiometabolic risk factors, in men and women. The association between PA and CVD risk was not mediated by the measured cardiometabolic risk factors. The American Journal of Cardiology (11/19)

What cetuximab can do in colorectal cancer Chemotherapy with cetuximab yields high response rates compared with historical controls, and leads to significantly increased resectability. (Free registration required.) The Lancet Oncology (11/2009)

Stillbirth: Race is a higher risk This study found that African-Americans are at higher risk of stillbirth than whites, especially at preterm gestations. The factors contributing to stillbirth risk vary by race and gestational age. American Journal of Obstetrics & Gynecology (12/2009)

Waist circumference: Second only to age This study concluded waist circumference is second only to age in the impact of the independent association with early-to-late (atrial) transmitral velocity (E/A) in a population sample with a high prevalence of excess adiposity. This effect was not accounted for by left ventricular hypertrophy or remodeling, 24-hour blood pressure, or arterial stiffness. The American Journal of Cardiology (12/1)

How will adolescents seek help? The lack of experimental effect on health care utilization suggests that certain aspects of the Telephone Support Services (TSS) require modification in future work. On a positive note, given that each of the three TSS calls was completed by a strong majority of participants, TSS appears feasible and acceptable to adolescents with psychosocial problems. (Full-text access is time-limited) Journal of Adolescent Health (12/2009)

Tools to reduce hospitalizations Communication and clinical practice tools were given to nursing homes (NHs) to help them reduce the number of avoidable hospitalizations over a 15-month period. NH staff were favorable to the tools, but they did not fully implement all of them. This was not a controlled study and was a pilot with small numbers, but the tools tested show promise for the future avoidance of unnecessary hospitalizations. (Free abstract only.) Journal of the American Medical Directors Association (11/2009)

Medical News

• H1N1 flu activity in the U.S. may be on downward trend
  Health officials say the second wave of the H1N1 flu in the U.S. may have reached its peak after cases of the flu continued to drop over the past four weeks. However, there is a possibility of "another uptick of activity late this year or early next year" similar to what happened during the 1957 flu pandemic, said Thomas Skinner, spokesman for the CDC. The Washington Post (12/1)

• High stroke risk for people born in 7 Southern states
  A report published in Neurology found a higher lifelong risk of dying from stroke among people born in North and South Carolina, Georgia, Tennessee, Arkansas, Mississippi and Alabama. Researchers said the risk, which continued even when people moved elsewhere, probably was not genetic but related instead to social factors such as diet and access to medical care. HealthDay News (11/30)

• Most adopted children in U.S. healthy, study finds
  U.S. data on adopted children showed 85% were in excellent or very good health, according to their parents, and 88% of those age 6 and older had positive social behaviors. However, the study, written by the HHS and nonpartisan research group Child Trends, also found adopted children were more likely to have been diagnosed with depression, ADHD or a behavioral disorder and 54% had some special health care need. National Public Radio (11/30)

Business Practice News

• U.S. hospitals get better marks for patient safety
  U.S. hospitals over the past five years improved their grade for patient safety from a C-plus to a B-minus, according to safety expert Robert Wachter. His report in Health Affairs said the industry has made overall progress in accreditation, regulation and error reporting but lags behind in health care information technology. Healthcare Finance News (12/1)

• Many medical residents don't report needlesticks
  Researchers who interviewed 699 surgery residents at 17 medical centers found 59% had experienced at least one needlestick but many failed to report it to hospital officials, which means they didn't have a chance to get treatment to prevent HIV or hepatitis C infection. "Medical schools are not doing enough to protect their students, and hospitals are not doing enough to make medical school safe," the lead researcher said. The report was published in Academic Medicine. U.S. News & World Report/HealthDay News (11/30)

Patient's Perspective

• Patients cautious when making treatment decisions
  A study of 216 patients found they were less likely to try a potentially risky "new" drug when given total responsibility for making medical decisions, as opposed to having a physician recommend a treatment. Researchers said patients gave greater consideration to side effects when given a choice rather than being told by their physician to take a drug. The study was published in the journal Arthritis Care & Research. ABC News/Reuters (11/30)

SmartQuote

Dream no small dreams for they have no power to move the hearts of men." --Johann Wolfgang von Goethe, German poet, playwright, novelist and statesman