Physicians Academy
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Table Of Contents
Editorial :
 Bacterial Infections in Patients with Leukemia
Article 1 :
 What after a Suicide Attempt?
Article 2 :
 Neglected Child with severe Bronchopneumonia
Picture of The Month :
 Picture of The Month November 2017
Drug Update :
 VELCADE (Bortezomib)
Abstracts from Other Journals :
 Abstracts from Other Journals-November 2017

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Nov 2017 (Volume -11Number -11)

Abstracts from Other Journals
Abstracts from Other Journals-November 2017
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OCTOBER 2017

Abstracts from Other Journals

New BP Guidelines Expand Hypertension Definition to 130 Systolic or Above

New guidelines from the American College of Cardiology and American Heart Association, among others, define substantially more U.S. adults as having hypertension than the 2003 Joint National Committee (JNC 7) report's definition. The new ACC/AHA guidelines — unveiled on Monday at the AHA's annual meeting — define systolic blood pressure at or above 130 mm Hg as constituting hypertension, while the older definition set the threshold at 140 or above. On the basis of nationally representative data on roughly 10,000 adults, some 46% of Americans have hypertension under the new guidelines — versus 32% under the older definition — according to an analysis in the Journal of the American College of Cardiology. Despite the expanded definition, the percentage of adults recommended to take drug therapy would rise modestly under the new guidelines — by about two percentage points over the JNC 7 recommendations.

ACC/AHA 2017 guidelines (Free PDF)

Guideline executive summary (Free PDF)

JACC analysis (Free abstract)

Systemic — Not Inhaled — Corticosteroids Tied to Fracture Risk in Youth with Asthma

Systemic corticosteroids are associated with increased fracture risk among children with asthma, a JAMA Pediatrics study finds. Meanwhile, there was no association with inhaled corticosteroids (ICSs). Using Ontario administrative databases, researchers matched nearly 4000 children aged 2 to 18 who experienced a fracture after an asthma diagnosis with roughly 16,000 children with asthma who were fracture-free. After multivariable adjustment, filling a prescription for a systemic corticosteroid in the past year was associated with a 17% higher risk for fracture, relative to not filling such a prescription. However, ICS prescription was not associated with fracture risk. The authors conclude: "Clinicians using ICSs to optimize the control of childhood asthma should be reassured by the lack of association with fractures; fear of fracture is not a reason to limit the therapeutic use of ICSs. Furthermore, asthma control with ICSs might decrease the likelihood of asthma exacerbations requiring systemic corticosteroid use, so wider appropriate use of ICSs may potentially lead to a reduced fracture risk."

JAMA Pediatrics article (Free abstract)

Oncologists Recommend Limiting Alcohol Consumption

The American Society of Clinical Oncology is calling for reduced alcohol consumption given that cancer risk rises with increasing use. Even light drinking is associated with increased risk for some cancers. The statement includes a table that could be used to counsel patients. For instance, "moderate" drinking is associated with cancers of the oral cavity, pharynx, esophagus, larynx, breast, and colorectum.

Among the other recommendations in the statement, published in the Journal of Clinical Oncology:

  • Clinicians should screen for alcohol use and provide brief interventions.
  • Strategies to control alcohol use should be part of a cancer care plan.
  • Prices and taxes on alcohol should be increased.
  • Alcohol companies should not engage in pink-washing — a practice in which companies use pink ribbons or the color pink to raise awareness for breast cancer — given alcohol's role in breast cancer risk.

Journal of Clinical Oncology article (Free abstract)

High-Pesticide Fruits and Veggies Might Interfere with Fertility Treatment Outcomes

Greater intake of high-pesticide fruits and vegetables is associated with poorer outcomes in women undergoing assisted reproductive technology (ART) treatment for infertility, a JAMA Internal Medicine study finds. Some 325 women completed food-frequency questionnaires before beginning ART treatment at a Boston fertility center. Department of Agriculture data on pesticide residues were used to classify fruits and vegetables as high or low pesticide. Of nearly 550 ART cycles, 42% resulted in live births. As women's intake of high-pesticide fruits and vegetables increased, their likelihood of achieving a clinical pregnancy or live birth decreased. For example, compared with women in the lowest quartile of consumption (<1 high-pesticide item daily), those in the highest quartile (2.3 servings or more daily) were 18% less likely to have a clinical pregnancy and 26% less likely to have a live birth. A commentator urges clinicians to "educate our patients about the hidden dangers of pesticides in the modern environment and urge reductions in exposure wherever possible."

JAMA Internal Medicine article (Free)

JAMA Internal Medicine commentary (Free)

Background: Physician's First Watch coverage of analysis showing lower pesticide content of organic foods (Free)

 

 

 

Courtesy:

Journal Watch

 

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