Physicians Academy
Established in December 2006 by the Kashmir Academy Of Private Physicians
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
Feb 2018 ( Volume -12 Number -2)

Abstracts from Other Journals
Abstracts from Other Journals-February 2018
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Abstracts from Other Journals

Meta-Analysis: Just a Week of NSAID Use Tied to Increased Heart Attack Risk

Use of nonsteroidal anti-inflammatory drugs (NSAIDs) for even 1 week is associated with increased risk for myocardial infarction, a meta-analysis in The BMJ finds.

Using individual patient data from four studies from healthcare databases, researchers identified over 61,000 cases of acute MI and 385,000 controls without MI. Compared with NSAID nonuse, current use of each NSAID studied — including diclofenac, ibuprofen, naproxen, and celecoxib — was associated with increased MI risk. The elevated risk was not higher for celecoxib than for other NSAIDs.

The increased risk generally emerged during the first week of use and was highest during the first month. Higher doses were also associated with greater risks.

Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, weighed in: "People, particularly those at high risk for cardiac disease, should be aware of these risks as they contemplate use of these popular medications. This large study further reinforces that these risks are large enough to be meaningful for many patients."

The BMJ article (Free)

Background: NEJM Journal Watch General Medicine coverage of the cardiovascular safety of celecoxib(Free)

Global Influenza Deaths May Be Underestimated

Seasonal influenza could be responsible for more respiratory deaths worldwide than previously estimated, according to a Lancet study.

Researchers looked at rates of influenza-associated respiratory mortality for 33 countries from 1999 to 2015. They found an estimated 290,000 to 650,000 seasonal influenza-associated respiratory deaths annually. Previously, the World Health Organization estimated the number at 250,000 to 500,000, including both respiratory and circulatory deaths. Because the new figures include only respiratory deaths, they may still underestimate the flu's effects, the authors note.

Sub-Saharan Africa, the western Pacific, and southeast Asia had the highest rates of flu-related respiratory deaths. The authors say their results could inform the work of organizations trying to increase flu vaccination coverage in low- and middle-income countries.

A commentator concludes, "The study ... has clearly highlighted the considerable mortality burden associated with seasonal influenza and the need for effective prevention strategies. What is less clear is whether our current prevention strategies are adequate to reduce this burden."

Lancet article (Free abstract)

Lancet comment (Subscription required)

Background: Physician's First Watch recent coverage of rising flu activity(Free)


Moderate Drinking Associated with Structural Brain Changes

Drinking several high-alcohol beers — or their equivalent — each week is associated with adverse changes to the brain's structure, suggests a study in The BMJ.

Some 530 U.K. adults regularly reported their alcohol intake and underwent cognitive function testing over 30 years. At the end of follow-up, participants underwent brain MRI.

Higher alcohol intake was associated with reduced gray matter density, hippocampal atrophy, and reduced white matter microstructural integrity. Greater consumption was also linked to reduced lexical fluency (i.e., information retrieval based on spelling). Alcohol's effects were dose-dependent, with negative effects emerging with 7–14 units per week (14 units are equivalent to 4 pints of strong beer or 5 large glasses of wine). Light drinking (1–7 units/week) didn't have a protective effect.

An editorialist says the results "strengthen the argument that drinking habits many regard as normal have adverse consequences for health. With publication of this paper, justification of 'moderate' drinking on the grounds of brain health becomes a little harder."

The BMJ article (Free)

The BMJ editorial (Free)

Background: NEJM Journal Watch Psychiatry coverage of adolescent alcohol use and brain harm (Your NEJM Journal Watch registration required)

Zika-Related Microcephaly Outcomes at Age 19–24 Months Detailed

Most children born with Zika-related microcephaly will have severe motor impairment and other functional and medical difficulties as they age, according to an analysis in MMWR.

Researchers studied 19 infants who were born with microcephaly in Brazil during the Zika outbreak and had laboratory evidence of Zika infection. Among the findings, when the children were aged 19–24 months:

  • 11 children had possible seizure disorders.
  • 8 had previously been hospitalized, most often for bronchitis or pneumonia.
  • 15 had severe motor impairment, including 14 who appeared to have cerebral palsy.
  • 13 children had hearing impairment, and 11 had vision impairment.
  • 10 had sleeping problems, and 9 had feeding challenges.

Four children showed typical growth and development; they may have been misdiagnosed at birth, the authors say.

"As children born affected by Zika virus grow up, they will need specialized care from many types of healthcare providers and caregivers," a CDC official said in a news release. "It's important that we use these findings to start planning now for their long-term care and stay vigilant in Zika prevention efforts in the United States and around the world."

MMWR article (Free)

Background: Full NEJM Journal Watch and Physician's First Watchcoverage of Zika (Free)

NEJM Zika website (Free)

CDC Warns Against Consumption of Dried Placenta Capsules

New mothers should not consume capsules containing their dried placenta and should be warned about the risks of doing so, the CDC cautions in MMWR.

In addition, in instances of late-onset group B Streptococcus (GBS) infection among newborns, the agency is telling clinicians to ask new mothers about whether they have ingested placenta.

In September, a newborn developed early-onset GBS bacteremia and was discharged after completing ampicillin treatment. Five days later, the child was admitted for late-onset GBS. An investigation found that the mother had ingested capsules containing her dried placenta. While the company that encapsulated the placenta asks mothers to report HIV, hepatitis, herpes, chlamydia, syphilis, and Lyme disease, it doesn't ask about mothers' intra-or postpartum infections.

The GBS isolates from the child's blood and placenta capsules were indistinguishable on pulsed-field gel electrophoresis.

The CDC says that the dehydration process may not have been hot enough or long enough to reduce GBS bacterial counts. Consuming the contaminated capsules may have increased the mother's GBS intestinal and skin colonization, possibly allowing bacterial transmission to the infant.

MMWR article (Free)

US Weekly story on Kim Kardashian and placenta capsules (Free)

Flu Activity on the Rise

Influenza activity has been increasing in the U.S. since early November, according to a CDC analysis of influenza surveillance system data from October 1 to November 25.

Among the findings reported in MMWR:

  • Influenza A (H3N2) viruses predominated in all age groups.
  • All viruses tested were sensitive to oseltamivir, zanamivir, and peramivir.
  • Four states — Georgia, Louisiana, Massachusetts, and Oklahoma — had widespread influenza activity.

"Although influenza vaccine effectiveness can range widely from season to season, influenza vaccination is the most effective currently available method to prevent influenza and its complications," the authors note. They recommend that healthcare providers offer the vaccine to all eligible patients throughout flu season.

CDC's flu site (Free)

MMWR article (Free)




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