Thursday, January 31, 2013

"QT interval and antidepressant use: a cross sectional study of electronic health records"
BMJ Jan 2, 2013
http://www.bmj.com/content/346/bmj.f288
"Conclusions
This study confirmed a modest prolongation of QT interval with citalopram, and identified additional antidepressants with similar observed risk. Pharmacovigilance studies using electronic health record data may be a useful method of identifying potential risk associated with treatments."

Tuesday, January 29, 2013

"21st-Century Hazards of Smoking and Benefits of Cessation in the United States"
NEJM Jan 24
http://www.nejm.org/doi/full/10.1056/NEJMsa1211128?query=featured_home
"
CONCLUSIONS
Smokers lose at least one decade of life expectancy, as compared with those who have never smoked. Cessation before the age of 40 years reduces the risk of death associated with continued smoking by about 90%."
"Use of Hospital-Based Acute Care Among Patients Recently Discharged From the Hospital"
JAMA Jan 23/30 2013
http://jama.jamanetwork.com/article.aspx?articleid=1558277#qundefined
"Conclusions and Relevance 
After discharge from acute care hospitals in 3 states, ED visits within 30 days were common among adults and accounted for 39.8% of postdischarge hospital-based acute care visits. Improving care transitions should focus not only on decreasing readmissions but also on ED visits."

Monday, January 28, 2013

"Effects of folic acid supplementation on overall and site-specific cancer incidence during the randomised trials: meta-analyses of data on 50 000 individuals"
Lancet Jan 25, 2013
http://www.lancet.com/journals/lancet/article/PIIS0140-6736(12)62001-7/fulltext
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Interpretation
Folic acid supplementation does not substantially increase or decrease incidence of site-specific cancer during the first 5 years of treatment. Fortification of flour and other cereal products involves doses of folic acid that are, on average, an order of magnitude smaller than the doses used in these trials."
"Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial"BMJ Jan 24
http://www.bmj.com/content/346/bmj.f232
"Conclusion 
In this first high quality randomised controlled trial with minimal loss to follow-up, a strategy of rehabilitation plus early ACL reconstruction did not provide better results at five years than a strategy of initial rehabilitation with the option of having a later ACL reconstruction. Results did not differ between knees surgically reconstructed early or late and those treated with rehabilitation alone. These results should encourage clinicians and young active adult patients to consider rehabilitation as a primary treatment option after an acute ACL tear."
"Thirty-Year Trends in Outcomes of Percutaneous Coronary Interventions in Diabetic Patients"
Mayo Clin Proc Jan 2013
http://www.mayoclinicproceedings.org/article/S0025-6196(12)01035-X/fulltext
"Conclusion
Over 30 years, the improving outcomes in patients with diabetes who underwent PCIs have been similar to improvements in patients without DM. However, the risk-adjusted association of DM with long-term death, myocardial infarction, and stroke has decreased in the current era (group 4) compared with the bailout stent era (group 2)."
"When do Raynaud symptoms merit a workup for autoimmune rheumatic disease?"
Cleve Clin JM Jan 2013 
http://ccjm.org/content/80/1/22
"CLUES TO PRIMARY VS SECONDARY RAYNAUD PHENOMENON
A diagnostic algorithm of digital ischemia (FIGURE 2) illustrates the range of presentations and possible causes. In Raynaud phenomenon, cold temperature and emotional stress provoke reversible color changes of the fingers and toes. Intense vasospasm of the digital arteries produces three well-defined phases1: white (pallor resulting from vasospasm), blue (dusky cyanosis due to deoxygenation of static venous blood) (FIGURE 1), and red (reactive hyperemia after the restoration of blood flow). However, only about 60% of patients have all three color changes. The attacks are associated with paresthesias, an uncomfortable feeling of coldness in the fingers, and ischemic pain. . . "
"High-Frequency Oscillation for Acute Respiratory Distress Syndrome"NEJM Jan 22
http://www.nejm.org/doi/full/10.1056/NEJMoa1215716?query=featured_home
"CONCLUSIONS
The use of HFOV had no significant effect on 30-day mortality in patients undergoing mechanical ventilation for ARDS. (Funded by the National Institute for Health Research Health Technology Assessment Programme; OSCAR Current Controlled Trials number, ISRCTN10416500.)"
"Association of Prehospital Advanced Airway Management With Neurologic Outcome and Survival in Patients With Out-of-Hospital Cardiac Arrest"
JAMA Jan 21
"Conclusion and Relevance 
Among adult patients with OHCA, any type of advanced airway management was independently associated with decreased odds of neurologically favorable survival compared with conventional bag-valve-mask ventilation."
http://jama.jamanetwork.com/article.aspx?articleid=1557712#qundefined