Physicians Academy
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Table Of Contents
Editorial :
 The Real Paradigm Shift in Management of T2DM
Article 1 :
 Introduction of DMS irrigation to heal Endo–Perio lesions and Cysts
Article 2 :
 Alagille Syndrome in a Neonate
Picture of The Month :
 POTM-April 2018
Drug Update :
 SEGLUROMET (ertugliflozin+metformin)
Abstracts from Other Journals :
 Abstracts from Other Journals-April 2018

Locations of visitors to this page
Apr 2018 ( Volume -12 Number -4)

Abstracts from Other Journals
Abstracts from Other Journals-April 2018
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APRIL 2018

Abstracts from Other Journals

Use of Acid-Suppressive Drugs, Antibiotics in Infancy Linked to Increased Allergy Risk

Use of acid-suppressive medications and antibiotics early in infancy is associated with elevated risk for developing allergic diseases in childhood, an observational study in JAMA Pediatrics finds.

Using a military healthcare database, researchers identified 790,000 children free of allergic conditions at age 6 months. Children who received prescriptions for histamine-2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs) in the first 6 months of life were at greater risk for all allergic diseases studied except seafood allergy during a median 4.6 years' follow-up. The increased risk was highest for food allergies (adjusted hazard ratios, 2.18 for H2RAs and 2.59 for PPIs), and the relationship was dose-dependent.

Antibiotics were also tied to increased risk for most allergies, with asthma risk being most elevated (adjusted HR, 2.09).

JAMA Pediatrics article (Free)

Heart Failure Patients, Sacubitril/Valsartan Improves Physical and Social Activities Better Than Enalapril

The heart failure drug sacubitril/valsartan (marketed as Entresto) leads to greater improvements in patients' physical and social activities relative to enalapril, according to a secondary analysis from the industry-supported PARADIGM-HF trial. Sacubitril is a neprilysin inhibitor that affects natriuretic peptide levels. The findings appear in JAMA Cardiology.

In the main trial, roughly 8400 adults with symptomatic heart failure and reduced ejection fraction were randomized to receive sacubitril/valsartan or enalapril twice daily. In this new analysis, researchers followed the 7600 participants who completed health-related quality-of-life assessments at baseline.

At 8 months, quality-of-life scores significantly favored sacubitril/valsartan for most outcomes measured, including walking on level ground, household chores, jogging or hurrying, and sexual relationships. The benefits of sacubitril/valsartan generally persisted at 36 months, with the greatest effect seen for sexual relationships.

The researchers say the overall improvement in scores with sacubitril/valsartan "was comparable to a difference of approximately 9 years in aging."

JAMA Cardiology article (Free)

Boys Who Lose Excess Weight Lower Their Risk for Developing Type 2 Diabetes

Overweight boys who achieve a healthy body-mass index are no longer at elevated risk for incident type 2 diabetes as adults, according to a New England Journal of Medicine study.

Roughly 63,000 boys in Denmark had their BMIs assessed at ages 7 and 13 years. By age 30 and older, 11% had developed type 2 diabetes. For overweight boys who lost weight between ages 7 and 13 and then maintained a healthy BMI into early adulthood, the risk for incident type 2 diabetes was similar to that among men who were never overweight.

NEJM Journal Watch Pediatrics and Adolescent Medicine summary (Your NEJM Journal Watch subscription required)

NEJM article (Free abstract)

COPD Risk Factors Evident Early in Life

Risk factors for chronic obstructive pulmonary disease (COPD) are evident in childhood and present opportunities to minimize one's risk, suggest two studies in the Lancet Respiratory Medicine.

In the first, researchers examined forced expiratory volume (FEV1) scores from ages 7 to 53 years in over 2400 people. They identified six trajectories of lung function, of which three — persistently low; early below average with accelerated decline; and below average — predicted increased COPD risk at age 53. These three trajectories accounted for 75% of the COPD burden. Childhood factors associated with these trajectories included asthma, allergic rhinitis, bronchitis, pneumonia, and maternal smoking. Risk was exacerbated in those who smoked or had asthma as adults.

In the second study, researchers showed that individuals with low FEV1 scores from childhood into early adulthood had persistent wheezing and asthma. Childhood factors linked to persistently low scores included recurrent wheeze, early allergic sensitization, and tobacco smoke exposure. The researchers call for "aggressive strategies to reduce environmental tobacco smoke exposure and novel strategies to prevent early-life sensitization and exacerbations of early-childhood wheezing."

Lancet Respiratory Medicine article #1 (Free abstract)

Lancet Respiratory Medicine article #2 (Free abstract)

Lancet Respiratory Medicine comment (Subscription required)

Background: Physician's First Watch coverage of COPD guidelines (Free)


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