Interpretation of the evidence for the #efficacy and safety of #statin therapy
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/abstract
For, whereas the rare cases of myopathy and any muscle-related symptoms that are attributed to statin therapy generally resolve rapidly when treatment is stopped, the heart attacks or strokes that may occur if statin therapy is stopped unnecessarily can be devastating.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/abstract
For, whereas the rare cases of myopathy and any muscle-related symptoms that are attributed to statin therapy generally resolve rapidly when treatment is stopped, the heart attacks or strokes that may occur if statin therapy is stopped unnecessarily can be devastating.
Evidence for #energy conservation during pubertal #growth A 10-year longitudinal study (EarlyBird 71)
http://www.nature.com/ijo/journal/vaop/naam/abs/ijo2016158a.html
CONCLUSION: There appears to be a temporary but substantial reduction in energy expenditure during puberty which is unrelated to changes in body composition. If it means higher energy efficiency, the fall in REE could be advantageous in an evolutionary context to delivering the extra energy needed for pubertal growth, but unfavourable to weight gain in a contemporary environment.
http://www.nature.com/ijo/journal/vaop/naam/abs/ijo2016158a.html
CONCLUSION: There appears to be a temporary but substantial reduction in energy expenditure during puberty which is unrelated to changes in body composition. If it means higher energy efficiency, the fall in REE could be advantageous in an evolutionary context to delivering the extra energy needed for pubertal growth, but unfavourable to weight gain in a contemporary environment.
Nature
International Journal of Obesity - Abstract of article: Evidence for energy conservation during pubertal growth A 10-year longitudinal…
International Journal of Obesity is a monthly, multi-disciplinary forum for papers describing basic, clinical and applied studies in biochemistry, genetics and nutrition, together with molecular, metabolic, psychological and epidemiological aspects of obesity…
#Glucolipotoxicity initiates pancreatic #β-cell death through TNFR5/CD40-mediated STAT1 and NF-κB activation
http://www.nature.com/cddis/journal/v7/n8/full/cddis2016203a.html
Importantly, our data also show that the physiological ligand for TNFR5, CD40L, elicits NF-κB activity in β-cells, whereas selective knockdown of TNFR5 ameliorates glucolipotoxic induction of STAT1 expression and NF-κB activity. This data indicate for the first time that TNFR5 signalling has a major role in triggering glucolipotoxic islet cell death
http://www.nature.com/cddis/journal/v7/n8/full/cddis2016203a.html
Importantly, our data also show that the physiological ligand for TNFR5, CD40L, elicits NF-κB activity in β-cells, whereas selective knockdown of TNFR5 ameliorates glucolipotoxic induction of STAT1 expression and NF-κB activity. This data indicate for the first time that TNFR5 signalling has a major role in triggering glucolipotoxic islet cell death
Nature
Cell Death and Disease - Glucolipotoxicity initiates pancreatic [beta]-cell death through TNFR5/CD40-mediated STAT1 and NF-[kappa]B…
Brought to you by the editorial team of Cell Death and Differentiation, Cell Death and Disease is a peer-reviewed author-pays online journal in the field of translational cell death. It seeks to promote diverse and integrated areas of Experimental and Internal…
Estimating the reliability of glycemic #index values and potential sources of methodological and biological #variability
http://m.ajcn.nutrition.org/content/early/2016/09/06/ajcn.116.137208.abstract
Conclusions: These data indicate that there is substantial variability in individual responses to GI value determinations, demonstrating that it is unlikely to be a good approach to guiding food choices. Additionally, even in healthy individuals, glycemic status significantly contributes to the variability in GI value estimates.
http://m.ajcn.nutrition.org/content/early/2016/09/06/ajcn.116.137208.abstract
Conclusions: These data indicate that there is substantial variability in individual responses to GI value determinations, demonstrating that it is unlikely to be a good approach to guiding food choices. Additionally, even in healthy individuals, glycemic status significantly contributes to the variability in GI value estimates.
Longer Duration of #Diabetes Strongly Impacts #Fracture Risk Assessment: The Manitoba BMD Cohort
http://press.endocrine.org/doi/abs/10.1210/jc.2016-2569
Summary:
Diabetes is a FRAX-independent risk factor for MOF only in women with long-duration diabetes but diabetes increases hip fracture risk regardless of duration. Those with diabetes >10years are at particularly high risk of fracture, and this elevated risk is currently under-estimated by FRAX.
http://press.endocrine.org/doi/abs/10.1210/jc.2016-2569
Summary:
Diabetes is a FRAX-independent risk factor for MOF only in women with long-duration diabetes but diabetes increases hip fracture risk regardless of duration. Those with diabetes >10years are at particularly high risk of fracture, and this elevated risk is currently under-estimated by FRAX.
press.endocrine.org
Longer Duration of Diabetes Strongly Impacts Fracture Risk Assessment: The Manitoba BMD Cohort: The Journal of Clinical Endocrinology…
Article published by the Endocrine Society
Investigation of First Identified #mcr-1 Gene in an Isolate from a U.S. Patient — Pennsylvania, 2016
http://www.cdc.gov/mmwr/volumes/65/wr/mm6536e2.htm
Health departments are encouraged to rapidly investigate reports of colistin-resistant bacteria to prevent transmission to other patients and thereby decrease the risk for transmitting plasmid-encoded genes to bacteria that might already contain other resistance genes. The Pennsylvania Department of Health’s investigation suggests that focused screening of contacts at highest transmission risk can be recommended.
http://www.cdc.gov/mmwr/volumes/65/wr/mm6536e2.htm
Health departments are encouraged to rapidly investigate reports of colistin-resistant bacteria to prevent transmission to other patients and thereby decrease the risk for transmitting plasmid-encoded genes to bacteria that might already contain other resistance genes. The Pennsylvania Department of Health’s investigation suggests that focused screening of contacts at highest transmission risk can be recommended.
www.cdc.gov
Investigation of First Identified mcr-1 Gene in an Isolate from a U.S. Patient — Pennsylvania, 2016
| MMWR
| MMWR
The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC).
Patients' perspectives on the insufficiency of #scales to rate their #pain in the ED
http://www.ajemjournal.com/article/S0735-6757(16)30575-7/abstract
...However, although nursing staff find it useful to apply a method for the objective assessment of pain, it remains unknown if patients perceive that a number on a given scale well reflects their pain.
http://www.ajemjournal.com/article/S0735-6757(16)30575-7/abstract
...However, although nursing staff find it useful to apply a method for the objective assessment of pain, it remains unknown if patients perceive that a number on a given scale well reflects their pain.
Long-Term Survival Among Patients With Myocardial #Infarction Before #Age 50 Compared With the General Population
http://m.circoutcomes.ahajournals.org/content/early/2016/08/30/CIRCOUTCOMES.115.002661
Conclusions—The long-term mortality rate after MI before age 50 has decreased remarkably over the last 3 decades, but remains increased relative to the general population, mainly because of deaths from ischemic heart disease and other smoking-related diseases.
http://m.circoutcomes.ahajournals.org/content/early/2016/08/30/CIRCOUTCOMES.115.002661
Conclusions—The long-term mortality rate after MI before age 50 has decreased remarkably over the last 3 decades, but remains increased relative to the general population, mainly because of deaths from ischemic heart disease and other smoking-related diseases.
Worldwide #Thyroid-Cancer Epidemic? The Increasing Impact of #Overdiagnosis
http://www.nejm.org/doi/full/10.1056/NEJMp1604412#article
Dramatic increases have been seen over recent decades in the reported incidence of thyroid cancer, but owing to new modes of screening, hundreds of thousands of cases may be overdiagnoses — diagnosis of tumors that would not, if left alone, result in symptoms or death.
http://www.nejm.org/doi/full/10.1056/NEJMp1604412#article
Dramatic increases have been seen over recent decades in the reported incidence of thyroid cancer, but owing to new modes of screening, hundreds of thousands of cases may be overdiagnoses — diagnosis of tumors that would not, if left alone, result in symptoms or death.
New England Journal of Medicine
Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis | NEJM
Perspective from The New England Journal of Medicine — Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis
#Nifedipine vs Placebo for Treatment of Chronic #Chilblains: A Randomized Controlled Trial
http://www.annfammed.org/content/14/5/453
CONCLUSIONS In our study, nifedipine was not superior to placebo for treating chronic chilblains. These findings contrast with those of the older study and do not support routine use of nifedipine for this condition.
http://www.annfammed.org/content/14/5/453
CONCLUSIONS In our study, nifedipine was not superior to placebo for treating chronic chilblains. These findings contrast with those of the older study and do not support routine use of nifedipine for this condition.
Low #Thyroid Hormone in Early Pregnancy Is Associated with an Increased Risk of Gestational #Diabetes Mellitus
http://press.endocrine.org/doi/10.1210/jc.2016-1506
Conclusions:
Low thyroid hormone levels in early pregnancy are a risk factor for GDM incidence.
http://press.endocrine.org/doi/10.1210/jc.2016-1506
Conclusions:
Low thyroid hormone levels in early pregnancy are a risk factor for GDM incidence.
press.endocrine.org
Low Thyroid Hormone in Early Pregnancy Is Associated with an Increased Risk of Gestational Diabetes Mellitus: The Journal of Clinical…
Article published by the Endocrine Society
National Partnership for #Maternal Safety: Consensus Bundle on Venous #Thromboembolism
http://mobile.journals.lww.com/greenjournal/_layouts/15/oaks.journals.mobile/articleviewer.aspx?year=9000&issue=00000&article=98617
This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis.
http://mobile.journals.lww.com/greenjournal/_layouts/15/oaks.journals.mobile/articleviewer.aspx?year=9000&issue=00000&article=98617
This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis.
LWW
National Partnership for Maternal Safety: Consensus Bundle o... : Obstetrics & Gynecology
Obstetric venous thromboembolism is a leading cause of severe maternal morbidity and mortality. Maternal death from thromboembolism is amenable to prevention, and thromboprophylaxis is the most readily implementable means of systematically reducing the maternal…
#Acupuncture for Chronic #Constipation
http://annals.org/mobile/article.aspx?articleid=2552074
Objective: To determine the efficacy of electroacupuncture (EA) for chronic severe functional constipation (CSFC).
Conclusion: Eight weeks of EA increases CSBMs and is safe for the treatment of CSFC. Additional study is warranted to evaluate a longer-term treatment and follow-up.
http://annals.org/mobile/article.aspx?articleid=2552074
Objective: To determine the efficacy of electroacupuncture (EA) for chronic severe functional constipation (CSFC).
Conclusion: Eight weeks of EA increases CSBMs and is safe for the treatment of CSFC. Additional study is warranted to evaluate a longer-term treatment and follow-up.
Diurnal and circadian variation of #sleep and alertness in men vs. naturally cycling #women
http://m.pnas.org/content/early/2016/09/09/1524484113
Our results indicate that women are likely initiating sleep at a later circadian phase than men, which may be one factor contributing to the increased susceptibility to sleep disturbances reported in women. Lower nighttime alertness is also observed, suggesting a physiological basis for a greater susceptibility to maladaptation to night shift work in women.
http://m.pnas.org/content/early/2016/09/09/1524484113
Our results indicate that women are likely initiating sleep at a later circadian phase than men, which may be one factor contributing to the increased susceptibility to sleep disturbances reported in women. Lower nighttime alertness is also observed, suggesting a physiological basis for a greater susceptibility to maladaptation to night shift work in women.
Association Between Transcatheter Aortic #Valve Replacement and Subsequent Infective #Endocarditis and In-Hospital Death
http://jama.jamanetwork.com/mobile/article.aspx?articleid=2552209
Conclusions and Relevance Among patients undergoing TAVR, younger age, male sex, history of diabetes mellitus, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis. Patients who developed endocarditis had high rates of in-hospital mortality and 2-year mortality.
http://jama.jamanetwork.com/mobile/article.aspx?articleid=2552209
Conclusions and Relevance Among patients undergoing TAVR, younger age, male sex, history of diabetes mellitus, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis. Patients who developed endocarditis had high rates of in-hospital mortality and 2-year mortality.
Jamanetwork
Transcatheter Aortic Valve Replacement, Infective Endocarditis, and Death
This cohort study uses international registry data to characterize clinical risk factors, microbiology, and outcomes of patients who developed infective endocarditis following transcatheter aortic valve replacement.
#Sugar Industry and #Coronary Heart Disease Research
A Historical Analysis of Internal Industry
http://archinte.jamanetwork.com/mobile/article.aspx?articleid=2548255
This historical analysis uses internal sugar industry documents to describe how the industry sought to influence the scientific debate over the dietary causes of coronary heart disease in the 1950s and 1960s
A Historical Analysis of Internal Industry
http://archinte.jamanetwork.com/mobile/article.aspx?articleid=2548255
This historical analysis uses internal sugar industry documents to describe how the industry sought to influence the scientific debate over the dietary causes of coronary heart disease in the 1950s and 1960s
Jamanetwork
Sugar Industry and Coronary Heart Disease Research
This historical analysis uses internal sugar industry documents to describe how the industry sought to influence the scientific debate over the dietary causes of coronary heart disease in the 1950s and 1960s.
Vital Signs: Disparities in #Antihypertensive Medication #Nonadherence Among Medicare Part D Beneficiaries — United States, 2014
https://www.cdc.gov/mmwr/volumes/65/wr/mm6536e1.htm?s_cid=mm6536e1_x
Conclusions More than one in four Medicare Part D beneficiaries using antihypertensives were nonadherent to their regimen, and certain racial/ethnic groups, states, and geographic areas were at increased risk for nonadherence. These findings can help inform focused interventions among these groups, which might improve blood pressure control and cardiovascular disease outcomes.
https://www.cdc.gov/mmwr/volumes/65/wr/mm6536e1.htm?s_cid=mm6536e1_x
Conclusions More than one in four Medicare Part D beneficiaries using antihypertensives were nonadherent to their regimen, and certain racial/ethnic groups, states, and geographic areas were at increased risk for nonadherence. These findings can help inform focused interventions among these groups, which might improve blood pressure control and cardiovascular disease outcomes.
www.cdc.gov
Vital Signs: Disparities in Antihypertensive Medication Nonadherence Among Medicare Part D Beneficiaries — United States, 2014…
The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC).
Association of Age at Onset of #Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause #Mortality
A Systematic Review and Meta-analysis
http://cardiology.jamanetwork.com/mobile/article.aspx?articleid=2551981
Conclusions and Relevance The findings of this review indicate a higher risk of CHD, CVD mortality, and overall mortality in women who experience premature or early-onset menopause.
A Systematic Review and Meta-analysis
http://cardiology.jamanetwork.com/mobile/article.aspx?articleid=2551981
Conclusions and Relevance The findings of this review indicate a higher risk of CHD, CVD mortality, and overall mortality in women who experience premature or early-onset menopause.
Jamanetwork
Association of Age at and Time Since Menopause With Cardiovascular Outcomes
This meta-analysis systematically reviews and meta-analyzes studies evaluating the effect of age at onset of menopause and time since onset of menopause on intermediate cardiovascular disease end points, cardiovascular disease outcomes, and all-cause mortality.
Efficacy of the Herpes #Zoster Subunit #Vaccine in Adults 70 Years of Age or Older
http://www.nejm.org/doi/full/10.1056/NEJMoa1603800
CONCLUSIONS
In our trial, HZ/su was found to reduce the risks of herpes zoster and postherpetic neuralgia among adults 70 years of age or older.
http://www.nejm.org/doi/full/10.1056/NEJMoa1603800
CONCLUSIONS
In our trial, HZ/su was found to reduce the risks of herpes zoster and postherpetic neuralgia among adults 70 years of age or older.
New England Journal of Medicine
Efficacy of the Herpes Zoster Subunit Vaccine in Adults 70 Years of Age or Older — NEJM
Original Article from The New England Journal of Medicine — Efficacy of the Herpes Zoster Subunit Vaccine in Adults 70 Years of Age or Older
Why are acute ischemic #stroke patients not receiving IV #tPA?
Results from a national registry
http://m.neurology.org/content/early/2016/09/14/WNL.0000000000003198
Conclusions: Overall, about one-quarter of eligible patients with AIS presenting within 2 hours of stroke onset failed to receive tPA treatment. Thrombolysis has improved dramatically over time and is strongly associated with stroke center certification. Additionally, some groups, including older patients, milder strokes, women, and minorities, may be undertreated.
Results from a national registry
http://m.neurology.org/content/early/2016/09/14/WNL.0000000000003198
Conclusions: Overall, about one-quarter of eligible patients with AIS presenting within 2 hours of stroke onset failed to receive tPA treatment. Thrombolysis has improved dramatically over time and is strongly associated with stroke center certification. Additionally, some groups, including older patients, milder strokes, women, and minorities, may be undertreated.
#Aspirin Use for the Primary #Prevention of CVD and CRC
http://annals.org/mobile/article.aspx?articleid=2513179
The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement)The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I statement)
http://annals.org/mobile/article.aspx?articleid=2513179
The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement)The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I statement)