Physicians Academy
Established in December 2006 by the Kashmir Academy Of Private Physicians
Table Of Contents
Editorial :
 The Metabolic Menace
Article 1 :
 Time to evolve Universal Health Coverage policy framework for the state of Jammu and Kashmir
Article 2 :
 Meningocele in a Neonate
Medicine Plus :
 Consequences of Braid Chopping in Kashmir
Picture of The Month :
 Picture of The Month October 2017
Drug Update :
 ADEMPAS (Riociguat)
Abstracts from Other Journals :
 Abstracts from Other Journals-October 2017

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Sep 2017 ( Volume -11 Number -9)

Abstracts from Other Journals
Abstracts from Other Journals-September 2017
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SEPTEMBER 2017

Abstracts from Other Journals

Intensive BP-Lowering Seems Cost-Effective, Doesn't Adversely Affect Quality of Life

Two new analyses from SPRINT (Systolic Blood Pressure Intervention Trial), published in the New England Journal of Medicine, suggest that intensive blood pressure-lowering (target, <120 mm Hg) in high-risk hypertensive patients is both cost-effective and acceptable in terms of patient-reported outcomes.

The first analysis found that intensive treatment lowered risk for cardiovascular events and prolonged survival "at a cost that was below common willingness-to-pay thresholds." The second analysis, meanwhile, found that physical and mental health-related quality-of-life, as well as depression, did not differ between patients assigned to intensive treatment and those assigned to standard care over roughly 3 years' follow-up.

NEJM Journal Watch General Medicine coverage (Your NEJM Journal Watch subscription required)

NEJM article on cost-effectiveness (Free abstract)

NEJM article on patient-reported outcomes (Free abstract)

2017–18 Flu Vaccine Recommendations Issued

The CDC has published its recommendations on influenza vaccination for the 2017–18 season in MMWR.

Among the changes from last year's recommendations:

Afluria Quadrivalent and Flublok Quadrivalent are now available for patients aged 18 and older.

FluLaval Quadrivalent may be given to children as young as 6 months old; previously, it was limited to those aged 3 years and up.

Pregnant women may receive any FDA-approved, recommended, age-appropriate flu vaccine.

The CDC continues to recommend vaccination for all people aged 6 months and older without contraindications, preferably by the end of October. For those aged 65 and older, the agency says standard-dose or high-dose vaccine is acceptable.

The CDC is again recommending against use of the live attenuated influenza vaccine (FluMist), given its low effectiveness against (H1N1)pdm09 viruses during 2013–14 and 2015–16.

MMWR article (Free)

Background: NEJM Journal Watch General Medicine coverage of flu vaccine effectiveness in 2015–16 (Your NEJM Journal Watch subscription required)

Natriuretic Peptide-Guided Therapy No Better Than Usual Care in Heart Failure Patients

In high-risk patients with heart failure, using natriuretic peptide levels to guide medical therapy is no better than optimal medical therapy alone, aJAMA study finds.

Nearly 900 adults with chronic heart failure and reduced ejection fraction, plus recently elevated amino-terminal pro–B-type natriuretic peptide (NT-proBNP) levels, were randomized to receive either NT-proBNP-guided therapy or optimal medical therapy alone (controls). In the intervention group, medical therapy was titrated to achieve NT-proBNP levels below 1000 pg/mL.

During roughly 15 months' follow-up, the primary outcome — a composite of heart failure hospitalization or cardiovascular death — was similar between groups (37%). Accordingly, the trial was stopped early owing to the intervention's futility.

Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, comments: "For years, many have flocked to this test as a way to monitor — now BNP joins many other tests/monitoring methods that have added cost without benefit. Should we start treating testing/monitoring like drugs, insisting on evidence of benefit before widespread adoption?"

JAMA article (Free abstract)

JAMA editorial (Subscription required)

Background: NEJM Journal Watch Cardiology coverage of 2017 heart failure guideline update (Free)

ACOG Offers Tips for Managing Obesity in Adolescents

The American College of Obstetricians and Gynecologists offers several recommendations for managing obesity during adolescence. Among them:

Obstetricians and gynecologists should be alert for obesity in this age group and be prepared to start behavioral counseling and participate in team care of overweight and obese adolescents.

Clinicians should not withhold oral emergency contraception from overweight or obese adolescents or women. It is not known at what weight emergency contraception becomes ineffective.

Overweight and obese adolescents should be screened for bullying, depression, and peer victimization.

Clinicians should warn against using supplements to lose weight.

ACOG committee opinion (Free)

 

Courtesy:

Journal Watch

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