July 2016 - Among Doctors

28th July: World Hepatitis Day

Posted on July 28, 2016 by

On this year’s World Hepatitis Day, WHO calls for a rapid action to raise awareness of the disease, and increase access to testing and treatment services. Globally, 400 million people are affected by a viral hepatitis infection -a number that represents more than 10 times that of people infected with HIV. According to WHO, it is estimated that approximately 95% of people with chronic hepatitis are unaware of their infection, and less that 1% have access to treatment.

Moreover, WHO has recently published guidelines for the screening and treatment of people with hepatitis C infection, providing recommendations on the preferred regimens, and encouraging the employment of direct-acting antiviral combinations when appropriate.

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Posted in Clinical Highlights guidelines, hepatitis, WHO

Picks of the Week: New recommendations for HIV, fibromyalgia and more!

Posted on July 24, 2016 by

Over the last days fellow colleagues shared articles, recommendations, and other noteworthy news on the Among Doctors network. Among them, there is also a very interesting blog post on Psychological And Mental Health by Professor Gabriel Ivbijaro (President of the World Federation for Mental Health and Chair of The World Dignity Project) that worths reading. Let’s have a look at the top picks of these news:

Migraine and risk of cardiovascular disease in women: prospective cohort study
Results of this large, prospective cohort study in women with more than 20 years of follow-up indicate a consistent link between migraine and cardiovascular disease events, including cardiovascular mortality.
EULAR revised recommendations for the management of fibromyalgia
Updated guidelines on fibromyalgia have been published by the European League Against Rheumatism (EULAR).
2016 Recommendations for Use of ARVs to Treat and Prevent Adult HIV Infection
Updated recommendations on the treatment and prevention of HIV infection, reflecting on the substantial advances of the ARVs, discussing the preexposure and post exposure prophylaxis, and considering the generics and their impact on pharmacoeconomics.
Effects of Pictorial Health Warnings on Smoking Cessation Attempts
Pictorial warnings effectively increased intentions to quit, forgoing cigarettes, quit attempts, and successfully quitting smoking over 4 weeks.
Association of Dietary Fats and Total and Cause-Specific Mortality
Dietary saturated and trans-fats were linked to increased rates of mortality. Replacing 5% of energy from saturated fats with equivalent energy from polyunsaturated fatty acid and MUFA was associated with estimated reductions in total mortality of 27%.
Making Psychological And Mental Health First Aid For All A Global Reality
The 2016 World Mental Health Day theme ‘Dignity in mental health – psychological and mental health first aid for all’ provides an opportunity for us to focus on an area that continues to provide challenges for people with mental ill health and their families, getting the right help in crisis.

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Photo credit: CC BY 2.0 by jonrawlinson

Posted in Picks of the week cardiovascular disease, dietary fats, fibromyalgia, HIV, mental health, migraine, mortality, smoking cessation

New recommendations on antiretroviral drugs for HIV infection

Posted on July 14, 2016 by

The International Antiviral Society – USA Panel published their updated recommendations on antiretroviral drugs (ARVs) for the treatment and prevention of HIV infection. With more than 37 million people living with an HIV infection in the world, and 20 million not receiving an antiretroviral therapy, the new guidelines reiterate that all individuals diagnosed with the infection should initiate treatment as soon as possible, regardless of the CD4 cell count.

Moreover, the guidelines reflect on the substantial advances of the ARVs since the last recommendations were released in 2014, recommending initial regimens of two nucleoside reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (InSTI) for most patients. Further points on preexposure and postexposure prophylaxis are discussed, as well as the pharmacoeconomics of the treatment, especially considering the introduction of less-expensive generic formulations.

In the accompanying editorial on JAMA, Kenneth Mayer and Douglas Krakower consider the guidelines a reflection of a successful 35-year research effort and argue that, “Historians may wonder whether the pace of discovery in the early days of the epidemic could have been accelerated, but no one can doubt the signal accomplishments of biobehavioral research and community engagement in forging a common strategy to deal with this global pandemic, one that continues to pose new challenges.”

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Posted in Clinical Highlights antiretroviral drugs, guidelines, HIV

Picks of the Week: Endometriosis, menopausal symptoms and more!

Posted on July 8, 2016 by

More and more medical news are shared by fellow colleagues on the Among Doctors network on a daily basis. Here’s a selection of those the latest ones:

Diagnostic accuracy of cancer antigen 125 for endometriosis: a systematic review and meta-analysis
CA 125 performs well as a rule-in test facilitating expedited diagnosis and ensuring investigation and treatment can be confidently tailored for the management of endometriosis -however, a negative test is unable to rule out endometriosis.
Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis
This meta-analysis of clinical trials suggests that composite and specific phytoestrogen supplementations were associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats.
Patient Navigation for Comprehensive Cancer Screening in High-Risk Patients Using a Population-Based Health Information Technology System
Patient navigation as part of a population-based IT system significantly increased screening rates for breast, cervical, and colorectal cancer in patients at high risk for nonadherence with testing. Integrating patient navigation into population health management activities for low-income and racial/ethnic minority patients might improve equity of cancer care.
Multimodal Randomized Functional MR Imaging of the Effects of Methylene Blue in the Human Brain
Using functional MRI, it was found that a single oral dose of methylene blue increased brain activity in the bilateral insular cortex, as well as the prefrontal cortex and parietal and occipital lobes, compared with placebo.
Hepatitis C Core Antigen Testing for Diagnosis of Hepatitis C Virus Infection
The HCVcAg assays with signal amplification have high sensitivity, high specificity, and good correlation with HCV RNA levels greater than 3000 IU/mL and have the potential to replace NAT in settings with high HCV prevalence.
Effect of Escitalopram on All-Cause Mortality and Hospitalization in Patients With Heart Failure and Depression
Chronic systolic heart failure patients treated for 18 months with escitalopram, an SSRI, did not demonstrate significantly reduced all-cause mortality.
Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults
There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches.

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Posted in Picks of the week endometriosis, escitalopram, heart failure, hepatitis C, menopause