Prostate-specific antigen (PSA) screening for prostate cancer is controversial. Experts have suggested more personalized or more conservative strategies to improve benefit-risk tradeoffs, but the value of these strategies—particularly when combined with increased conservative management for low-risk cases—is uncertain. A new study published on JAMA suggests that for PSA screening to be cost-effective, it needs to be used conservatively and ideally in combination with a conservative management approach for low-risk disease.
Today is World TB Day and WHO calls on governments, communities, civil society, and the private sector to “Unite to End TB”. WHO and partners are promoting dialogue and collaboration that unites individuals and communities in new ways to end the tuberculosis (TB) epidemic. 43 million lives were saved through effective diagnosis and treatment, 2000-2014, yet 480,000 people developed multidrug-resistant tuberculosis (MDR-TB) in the world in 2014.
Sharing news within a peer community, such as the Among Doctors network, is a way of socially curating knowledge. Whether you wish to post your own piece of news, a guideline or a recently published article, or just start a new discussion within your own private group, Among Doctors is the right place to do all of that. So let’s have a look at what news have been shared lately on our network by fellow colleagues:
- CDC Guideline for Prescribing Opioids for Chronic Pain
This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.
- Opioid Pain Medicines: New Safety Warnings Added to Prescription Opioid Medications
FDA is warning about several safety issues with the entire class of opioid pain medicines. These safety risks are potentially harmful interactions with numerous other medications, problems with the adrenal glands, and decreased sex hormone levels. We are requiring changes to the labels of all opioid drugs to warn about these risks.
- Long-Term Results of Stenting versus Endarterectomy for Carotid-Artery Stenosis
Over 10 years of follow-up, no significant differences were found between patients who underwent stenting and those who underwent endarterectomy with respect to the risk of periprocedural stroke, myocardial infarction, or death and subsequent ipsilateral stroke.
- The ABC (age, biomarkers, clinical history) stroke risk score: a biomarker-based risk score for predicting stroke in atrial fibrillation
A novel biomarker-based risk score for predicting stroke in AF was successfully developed and internally validated in a large cohort of patients with AF and further externally validated in an independent AF cohort. The ABC-stroke score performed better than the presently used clinically based risk score and may provide improved decision support in AF.
The FDA is warning about several safety issues with the entire class of opioid pain medicines. See the FDA Drug Safety Communication for a complete listing. These safety risks are potentially harmful interactions with numerous other medications, problems with the adrenal glands, and decreased sex hormone levels.
A plethora of news were shared on the Among Doctors network last week by fellow physicians; a result of a community which starts to grow with members wishing to share what they have appraised. Primary care and mental health, asthma over diagnosis, updates on the Zika virus and a new report on eHealth from the European office of the WHO. Let’s see the latest top news:
- Getting Primary Care at the Psychiatrist’s Office
People with severe mental illnesses are more likely to die prematurely than those without, and it’s often from treatable chronic diseases—in part because many, don’t receive regular medical care.
- Overdiagnosis of asthma in children in primary care: a retrospective analysis
Overdiagnosis of childhood asthma is common in primary care, leading to unnecessary treatment, disease burden, and impact on quality of life. However, only in a small percentage of children is a diagnosis of asthma confirmed by lung function tests.
- From innovation to implementation – eHealth in the WHO European Region
A new report on e-Health in the WHO European Region reveals that tangible progress has been made, with clear benefits for many countries. In most Member States, it has become commonplace for technology to be used to deliver health services and public health improvements, such as electronic health records.
- Effects of Long-Term Low-Molecular-Weight Heparin on Fractures and Bone Density in Non-Pregnant Adults
Low-molecular-weight heparin (LMWH) for 3–6 months may not increase the risk of fractures, but longer exposure for up to 24 months may adversely affect bone mineral density (BMD). Clinicians should consider monitoring BMD in adults on long-term LMWH who are at increased risk of bone loss or fracture.
This week many news updates were shared by fellow colleagues on the Among Doctors network. As many of you have already experienced, with this feature we can all become editors by appraising and sharing new evidence and other piece of news with the rest of your network. Give it try by sharing something interesting from your home page on Among Doctors, and let us know your thoughts!
Let’s see the latest top news:
- Cancer incidence in persons with type 1 diabetes: a five-country study of 9,000 cancers in type 1 diabetic individuals
On average, type 1 diabetes confers an excess incidence of several cancers: persons with type 1 diabetes had a higher incidence of cancer of the liver, pancreas, kidney, endometrium and ovary and a lower incidence of prostate cancer than those in the general population. However, similar to the findings for type 2 diabetes, the HRs of cancer were highest at time of diabetes diagnosis and declined over time.
- Diagnosis and Management of Diabetes: Synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes
The synopsis focuses on 8 key areas that are important to primary care providers. The recommendations highlight individualized care to manage the disease, prevent or delay complications, and improve outcomes.
- Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices
Among primary care practices, the use of accountable justification and peer comparison as behavioral interventions resulted in lower rates of inappropriate antibiotic prescribing for acute respiratory tract infections.
The last days were quite busy for our fellow colleagues of the Among Doctors network! Many shared selected opinion papers and blogs, systematic reviews, and new evidence regarding a wide range of conditions. Let’s have a look at the top picks of these news:
- Association of Proton Pump Inhibitors With Risk of Dementia
The avoidance of PPI medication may prevent the development of dementia. This finding is supported by recent pharmacoepidemiological analyses on primary data and is in line with mouse models in which the use of PPIs increased the levels of β-amyloid in the brains of mice.
- Efficacy and Safety of Corticosteroids for Community-Acquired Pneumonia
Short-term treatment with corticosteroids is safe and may reduce the risk of ARDS, shortening the length of the disease in patients with community-acquired pneumonia.
- Zika Outbreak Signals the Urgent Need for Strong Primary Health Care Systems
Despite the wide-ranging functions of primary health care -immunizations, family planning, diagnostics, antenatal care, maternity services, rehabilitation, counseling, and referrals- it is often underfunded and deprioritized, forcing people to use whatever cash they have for low-quality private services. The volatile Zika outbreak should remind health advocates and policymakers alike that investments in strong comprehensive primary health care systems is the very best precaution for such emergencies.
This week many of the shared updates focused on the presently ongoing, large outbreak of the Zika virus. Let’s have a look at the top news that were shared on the Among Doctors network:
- Zika virus: all the updates
All the latest evidence on DynaMed Plus, a map of the outbreak and the European Medicines Agency to provide support to global response on the emerging epidemic of the Zika virus.
- WHO joins the world in marking the International Day of Zero Tolerance for Female Genital Mutilation
More than 125 million girls and women alive today have undergone some form of Female Genital Mutilation in the 29 countries in Africa and the Middle East where the harmful practice is most concentrated.
- Recommendations for screening for depression in adults
Although major depressive disorder is one of the world’s great public health problems, the morbidity and increased mortality associated with this common illness can be attenuated by the large number of effective treatments that are now widely available. It is therefore important to ensure that efficient methods for population screening are in place and directly linked to health care systems so depressed patients receive appropriate treatment.
Plenty of news were posted on the Among Doctors network over the past days. Some of the highlights of what our fellow colleagues shared include the clinical assessment of patients with chest pain and practical guidelines for the lung cancer screening. Let’s have a more in-depth look at this week’s top updates:
- Clinical assessment of patients with chest pain: a systematic review of predictive tools
The risk of coronary artery disease can be estimated on clinical grounds in patients with chest pain in different clinical settings with high accuracy. The estimation of probabilities of coronary artery disease could be used for a better management of patients with chest pain and also in the development of future predictive tools.
- Lung cancer screening: a systematic review of clinical practice guidelines
The use of low-dose computed tomography presents an exciting development for high-risk individuals. Several expert bodies and governments have recently issued and updated their clinical practice guidelines for lung cancer screening. In this review the clinical practice guidelines are evaluated and the recommendations are compared between them.
- Smoking associated with increased mortality in breast cancer patients
In a prospective cohort study of over 4500 women with invasive breast cancer, patients who actively smoked prior to breast cancer diagnosis demonstrated a 25% increase in overall mortality compared to never smokers. Patients who continued to smoke post-breast cancer diagnosis demonstrated a significant increase in both cancer-specific and overall mortality. Patients who quit smoking after breast cancer diagnosis demonstrated a 9% risk reduction in overall mortality.
Everyday all of us curate information, appraise much content and select what is relevant for our profession based on our interests. We are very delighted to see that the result of this information curation can be useful for other colleagues too; the sharing of appraised information is taking off on the Among Doctors network indeed! Many news were posted once again this week by our fellow colleagues and we have a selection of them below: