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.

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.

#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

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.

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.

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.

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.

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.

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.

#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.

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.

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.

#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.

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.

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.

#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

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.

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.

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.

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.

#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)