WHO Releases the Global Report on Diabetes

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On the occasion of World Health Day 2016, WHO issued a call for action on diabetes, drawing attention to the need to step up prevention and treatment of the disease. The first WHO Global report on diabetes demonstrates that the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults. Factors driving this dramatic rise include overweight and obesity. In 2012 alone diabetes caused 1.5 million deaths. Its complications can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation.

Read the report or comment the story on Among Doctors

Image credit: WHO / Eduardo Martino

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Comparing the Effects of Contraceptive Method Choice and Initiation

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The prevailing emphasis on long-acting contraception is somewhat misplaced. Women’s decisions about which methods to use are less impactful than their decisions about whether to use contraception at all. Policymakers and practitioners will have the largest effects on fertility outcomes if they can change the behavior of sexually active women who neglect to use birth control when they are not seeking pregnancy.

Read the article or comment the story on Among Doctors

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Picks of the Week: Mediterranean diet, PSA screening, and risks in using antidepressants and fluoroquinolones

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This week many news updates were shared by colleagues on the Among Doctors network. As many of you have already experienced, with this feature you can appraise and share new articles and evidence with the rest of your network. Why don’t you try it right away: share something interesting from the home page!

Let’s see the latest top news:

  • Dietary Patterns and Fractures in Postmenopausal Women
    Higher adherence to a Mediterranean diet is associated with a lower risk for hip fractures. These results support that a healthy dietary pattern may play a role in maintaining bone health in postmenopausal women.
  • Avoidance of sun exposure as a risk factor for major causes of death
    The longer life expectancy amongst women with active sun exposure habits was related to a decrease in CVD and noncancer/non-CVD mortality, causing the relative contribution of death due to cancer to increase.
  • Economic Analysis of Prostate-Specific Antigen Screening and Selective Treatment Strategies
    The study reports that if PSA screening is to be cost-effective, it should be used conservatively and in combination with conservative management for low-risk disease.
  • Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database
    This study found no evidence that selective serotonin reuptake inhibitors are associated with an increased risk of arrhythmia or stroke/transient ischaemic attack in people diagnosed as having depression between the ages of 20 to 64 or that citalopram is associated with a significantly increased risk of arrhythmia.
  • Oral fluoroquinolone use and serious arrhythmia
    Oral fluoroquinolone treatment was not associated with an increased risk of serious arrhythmia in the general adult populations of Denmark and Sweden, contrary to previous reports. However, the majority of fluoroquinolones were ciprofloxacin, and it is possible that the risk is with other less frequently used fluoroquinolone.
  • Gradual Versus Abrupt Smoking Cessation
    Quitting smoking abruptly is more likely to lead to lasting abstinence than cutting down first, even for smokers who initially prefer to quit by gradual reduction.
  • Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis
    Bedside lung US and echocardiography appear to the most useful tests for affirming the presence of acute heart failure while natriuretic peptides are valuable in excluding the diagnosis.

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PSA Screening: How can we get physicians to follow best practice?

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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.

Read the article or comment the story on Among Doctors

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United to End TB

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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.

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Picks of the Week: New guidelines and safety warnings on opioids

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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.
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Opioid Pain Medicines: New Safety Warnings Added to Prescription Opioid Medications

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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.

Read the article or comment the story on Among Doctors

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Picks of the Week: Primary care, mental health and more!

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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.
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diabetes

Picks of the Week: Updates on diabetes mellitus

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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.
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Picks of the Week: Dementia risk, corticosteroids for CAP, and much more!

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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.
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