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June

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June

Picks of the Week: The USPSTF advises on colorectal cancer and syphilis screening

Posted on June 28, 2016 by

During the past weeks two important recommendations were published from the US Preventive Services Task Forse (USPSTF) on the screening for colorectal cancer and syphilis. Let’s have a look at them, alongside other news that our members shared in the Among Doctors community:

  • The US Preventive Services Task Force (USPSTF) published its recommendations on screening for colorectal cancer
    The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation).
  • Screening for Syphilis: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
    Screening HIV-positive men or MSM for syphilis every 3 months is associated with improved syphilis detection. Treponemal or nontreponemal tests are accurate screening tests but require confirmation.
  • Exercise during pregnancy protects against hypertension and macrosomia: randomized clinical trial
    Maternal exercise may be a preventative tool for hypertension and excessive GWG, and may control offspring size at birth while reducing comorbidities related to chronic disease risk.
  • Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage
    The treatment of participants with intracerebral hemorrhage to achieve a target systolic blood pressure of 110 to 139 mm Hg did not result in a lower rate of death or disability than standard reduction to a target of 140 to 179 mm Hg.
  • Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries
    Receipt of industry-sponsored meals was associated with an increased rate of prescribing the brand-name medication that was being promoted. The findings represent an association, not a cause-and-effect relationship.
  • Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children
    Current evidence does not support increasing the dose of ICS as part of a self initiated action plan to treat exacerbations in adults and children with mild to moderate asthma. Increased ICS dose is not associated with a statistically significant reduction in the odds of requiring rescue oral corticosteroids for the exacerbation, or of having adverse events, compared with a stable ICS dose.

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Posted in Picks of the week acute cerebral hemorrhage, asthma, blood pressure, chronic asthma, colorectal cancer, inhaled corticosteroids, pregnancy, screening, syphilis

Screen for colorectal cancer, urges USPSTF

Posted on June 19, 2016 by

The US Preventive Services Task Force (USPSTF) recently published its recommendations on screening for colorectal cancer on JAMA, concluding that screening is beneficial in average-risk, asymptomatic adults starting at age 50 and continuing until age 75 years (A recommendation). In adults aged 76 to 85 years, the decision should take into consideration the health and history of the patient (C recommendation).

Screening for colorectal cancer can reduce mortality, whichever strategy is employed, says the USPSTF. Seven different screening approaches are included in the recommendations, despite their difference in effectiveness and potential harm: colonoscopy, fecal immunochemical testing for occult blood (FIT), multitargeted DNA stool test (FIT-DNA), guaiac-based fecal occult blood test, sigmoidoscopy, sigmoidoscopy with FIT, and CT colonography. The economic impact of such a screening is not addressed either.

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Image credit: Blausen Medical Communications, Inc. – Donated via OTRS, see ticket for details, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=27639260

Posted in Clinical Highlights colonoscopy, colorectal cancer, USPSTF

Unrestricted-calorie, high-vegetable-fat Mediterranean diet associated with no weight gain

Posted on June 7, 2016 by

In a study published yesterday in The Lancet Diabetes & Endocrinology, Ramon Ostrich and colleagues reported on the Spanish PREvención con DIeta MEDiterránea (PREDIMED) randomized controlled trial and on the long-term weight change. In their five-year intervention, nearly 7500 asymptomatic men and women with type 2 diabetes mellitus or more than two cardiovascular risk factors were randomly assigned to receive either one of the two unrestricted-calorie Mediterranean diets (one supplemented with extra-virgin olive oil and one supplemented with nuts) or the control diet which included advice to reduce dietary fat.

The authors reported that although the dietary fat consumption was higher for the participants of the Mediterranean diets, in the five-years follow-up not only was there no weight gain, but they even noticed some evidence of decrease in the weight and waist circumference. The results of the study support the hypothesis that restricting calorie intake of healthy fats does not contribute to bodyweight maintenance.

Read the article and comment the story on Among Doctors

Posted in Clinical Highlights calorie intake, diet, mediterranean diet, type 2 diabetes, waist circumference, weight maintenance

Picks of the Week: Chronic insomnia, NSAIDs, opioids for low back pain and more!

Posted on June 4, 2016 by

Besides the 69th World Health Assembly in Geneva that saw the release of many reports and news, this was a week of  a plethora of other articles and evidence published worldwide. Fellow physicians selected the most important ones and shared them on the Among Doctors network:

  • Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline
    The American College of Physicians recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder. (Grade: strong recommendation, moderate-quality evidence)
  • Comparative effectiveness and safety of strategies for preventing NSAID-associated gastrointestinal toxicity: Systematic Review & Metanalysis
    The combination of selective COX-2 inhibitors plus PPIs provides the best gastrointestinal protection, followed by selective COX-2 inhibitors, and thirdly by nonselective NSAIDs plus PPIs.
  • Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: Systematic Review & Meta-analysis
    For people with chronic low back pain who tolerate the medicine, opioid analgesics provide modest short-term pain relief but the effect is not likely to be clinically important within guideline recommended doses.
  • A Systematic Review With Meta-Analysis of Dual Bronchodilation With LAMA/LABA for the Treatment of Stable COPD
    Dual bronchodilation is better than a LAMA or a LABA alone, regardless of the drugs used.
  • Blood-Pressure Lowering in Intermediate-Risk Persons without Cardiovascular Disease
    Therapy with candesartan at a dose of 16 mg per day plus hydrochlorothiazide at a dose of 12.5 mg per day was not associated with a lower rate of major cardiovascular events than placebo among persons at intermediate risk who did not have cardiovascular disease.
  • World No Tobacco Day 2016
    For this year’s World No Tobacco Day, the WHO are calling on countries to get ready for plain (standardized) packaging of tobacco products.
  • WHO releases report on Attacks on Health Care
    Over the two-year period from January 2014 to December 2015, there were 594 reported attacks on health care that resulted in 959 deaths and 1561 injuries in 19 countries with emergencies.
  • Prevention of sexual transmission of Zika virus
    An updated guide to inform the general public, and to be used by health care workers and policy makers to provide guidance on appropriate sexual practices in the context of Zika virus.

Do you wish to comment on these news or share your own? Join Among Doctors here and start exploring the physician-exclusive social network right away!

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Posted in Picks of the week COPD, emergencies, insomnia, low back pain, opioid, WHO, World No Tobacco Day, Zika, Zika virus

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