Catheter Ablation Tops Drug Therapy for A-Fib in Heart Failure

Meta-analysis shows 6.95 percent increase in LVEF with ablation

Incidence of End-Stage Kidney Disease Up in Australia

Incidence increased for nonindigenous people with type 2 diabetes; greatest increase for under 50s, over 80s

Nurse-Led Program in Primary Care Can Up Detection of Liver Dz

More incident cases identified in intervention arm with nurse-led primary care-based liver clinics

Risk for Breast Cancer Increased With False-Positive Screening Result

Increased risk for screen-detected and interval breast cancer persists for 12 years after false-positive result

Pregnancy Complications Up for Women Born at Low Birth Weight

Risk greatest for women born with birth weight <2,500 g who develop overweight/obesity

Toll on Health From Depression, Anxiety Akin to Smoking, Obesity

For older adults, effect of anxiety, depression on physical health similar to that of obesity, smoking

Many EDs Do Not Have Pediatric Area, Emergency Care Coordinator

Other studies detail concerns about pediatric telemedicine use, grassroots intervention to up PECC use

Obese Patients Exposed to Higher Radiation Doses for X-Rays

Higher dose area product seen for patients with obesity undergoing projection radiography

Sugar-Sweetened Drinks Linked to Chronic Kidney Disease Risk

Odds of CKD up with beverage pattern consisting of higher intake of sweetened soda, fruit drinks, water

High Sodium Intake Associated With New Atrial Fibrillation

Cumulative proportional probability for AF events greatest for those in the highest quartile of salt intake

New Guidelines Address Care for Malignant Pleural Effusions

Recs call for ultrasounds, advise against therapeutic pleural interventions in asymptomatic patients

Second-Line Antidiabetic Meds May Impact Cardiovascular Risk

Cardiovascular risk increased with sulfonylureas and basal insulin versus newer classes of ADM

Effect Sizes Uncertain for Meds Versus Placebo in Knee OA

Meta-analysis: large uncertainty versus placebo for all medications for pain relief

ACOG Updates Guidelines for Gestational HTN, Preeclampsia

Second bulletin provides recommendations for management of chronic hypertension in pregnancy

Many Veterans Oppose Cessation of Colorectal Cancer Screening

More than one-quarter of those surveyed not comfortable with stopping low-value screening

Delayed School Start Shows Benefits for Teens

Longer sleep time tied to better grades, some improvements in attendance

Review Highlights Lack of Tx Options for Prurigo Nodularis

Researchers call for more randomized controlled trials to investigate systemic treatments

Having Children Tied to Higher Risk for Cardiovascular Disease

Significant link identified, with nonlinear J-shaped dose-response relationship for increasing parity

Low Vitamin D Tied to Risk for Renal Hyperfiltration in Healthy Adults

Severe deficiency linked to increased prevalence of RHF in population with normal renal function

More Americans Reporting Less Than Six Hours Sleep Per Night

The number of Hispanics, blacks getting short sleep is growing at a fast rate

Opioid Prescribing Patterns Vary for Pediatric Patients

Geographic region, race, age, payment method associated with differences in opioid prescribing

Elevated Risk for Lung CA in Lung Transplant Recipients Explored

13-fold increased risk found in native lung for those receiving single lung transplant

Universal Vaccination for MenB at College Entry Not Cost-Effective

Incremental cost per quality-adjusted life-year gained $13.8 million under societal perspective

Oculomotor Response to Head Impacts Studied in Youth Football

Near point of convergence measured in players during a single high school football season

Health Care Screening Practices Impact Skin Cancer Diagnosis

Likelihood of being diagnosed with skin cancer increased for those undergoing health care screening

Low-Priced Generic Drugs Most Likely to Have Shortages

Shortages associated with modest increases in price, ranging from 6 to 14 percent

Dancing Tied to Lower Odds of Disability in Activities of Daily Living

For older women, dancing -- but not other exercise types -- linked to lower risk for ADL disability

30-Day Postdischarge Mortality Up With HRRP Implementation

Increase in 30-day postdischarge mortality after hospitalization for heart failure, pneumonia, not AMI

Targeted Muscle Reinnervation Can Reduce Phantom Limb Pain

Authors report reduction in pain and no symptomatic neuromas in 22 below-the-knee amputees

More Than Two-Thirds of Drug OD Deaths in 2017 Involved Opioids

Significant increases seen in death rates involving synthetic opioids in 15 of 20 states from 2013 to 2017

ASH Develops Practice Guidelines for Venous Thromboembolism

Clinical practice guidelines presented for diagnosis, treatment, pediatric and pregnancy-linked VTE

New BP Treatment Cutoffs May Not Yield Survival Benefit

Survival benefit not seen with Stage 1 hypertension, only high-risk Stage 2 hypertension

Pediatric Asthma Risk Score Has Good Sensitivity, Specificity

PARS has improved ability over API for predicting asthma in children with mild-to-moderate risk

Home Oxygen Users Experience Problems Related to Equipment

Health care providers report lack of readily accessible resources for prescription of oxygen systems

Massage Offers Short-Term Relief of Knee Pain in Arthritis Patients

Findings among patients with knee osteoarthritis; long-term benefit unclear

Malnutrition Ups Risk of Postop Issues in Pediatric Crohn Disease

In propensity-matched analysis, mild, severe malnutrition linked to elevated odds of complications

ACOG: Interpregnancy Period Should Maximize Women’s Health

Components of postpartum care should be included as the initial components of interpregnancy care

New AAP Guideline Available for Infantile Hemangioma Treatment

Early intervention and/or referral recommended for potentially problematic infantile hemangiomas

Risk of Arterial Thromboembolic Events Up Prior to Cancer Diagnosis

In seniors, risk of arterial thromboembolic events peaked in the 30 days immediately before diagnosis

Most Nurses Unsatisfied With Hospitals’ End-of-Life Care

The nurse practice environment was the best predictor of poor-quality end-of-life care

Appalachia, Western States Have Highest Hep C Prevalence

Nine states account for more than 50 percent of all hepatitis C virus infections

Complications, Costs Up With Cardiac Sx in Opioid Use Disorder

No increased risk of mortality, but increase in incidence of major complications

Initiative Can Cut Gender Gap in Medical School Faculty Salaries

Overall mean salary gap by gender decreased from −2.6 to −1.9 percent after a decade

Updated Guidelines Developed for Diagnosing, Treating Influenza

Rapid molecular assays should be used to improve diagnosis; antivirals should begin as soon as possible

Study IDs Risk Factors for Violent Sleep Disorder

Authors say factors that reduce risk of disorder are important, given its link to other neuro disorders

Exome Sequencing Provides Genetic Diagnosis for Some With CKD

Genetic diagnosis for 9.3 percent of 3,315 patients with chronic kidney disease from two cohorts

Drug Use-Associated Infective Endocarditis Up 2007 to 2017

More than 12-fold increase in DUA-IE hospitalizations and valve surgeries during 2007 to 2017

Fecal Occult Blood Test May Improve CRC Outcomes in Some

For men with left-sided tumors, those undergoing screening had lower N, M categories, higher survival

Costs, Expected Weight Loss Impact Bariatric Surgery Choice

Complications, recovery time, other risks less influential in decision making

Vit C for Pregnant Smokers May Improve Newborn Lung Function

Newborn lung function improved as measured by forced expiratory flow at three months of age

EMS Treatment for Possible Heart Attack Varies by Sex

Women less likely to receive aspirin, resuscitation, ambulance transport with lights and siren

HPV Ups Cervical Cancer Risk, Even With No Cellular Signs

HPV-16/18 confers strong future risk, particularly in women younger than 30 years

FDA Approves Drugs for Treatment of Two Rare Blood Diseases

Elzonris approved to treat BPDCN; Ultomiris approved for paroxysmal nocturnal hemoglobinuria

Outcomes of Importance ID’d for Peritoneal Dialysis Patients

PD-related infection, mortality, fatigue are highest-ranked outcomes for patients, caregivers

Incident Concussion 5.1 Percent Per Season for Youth Football

Risk increased for youth with depression or history of concussion

CDC: Weight, Waist Size, BMI Increased for Many U.S. Adults

1999-2000 to 2015-2016 saw increase in mean weight, waist circumference, BMI for many subgroups

Mental, Behavior, Developmental Disorders Up With Low-Income

Children in lower- versus higher-income households more often diagnosed with MBDDs

Incorrect Prescribing Alerts Common for Psychotropic Meds

One-third with electronic Rx system that provides alerts believe system provides incorrect warnings

FDA Announces Safety Monitoring Measures for the Essure Device

Measures include having women in the postmarket surveillance study followed for five years, not three

FDA Warns Companies on Unsafe, Unapproved Stem Cell Treatments

Patients contracting deadly infections at clinics offering the unapproved treatments

FDA: Teething Jewelry Linked to at Least One Infant Death

Threats from these products include choking, strangulation, injury to the mouth, infection

FDA: Fluoroquinolones Tied to Heart Vessel Ruptures, Tears

Patients at risk include those with hypertension or certain genetic disorders and the elderly

A-Fib Risk Up for Antidepressant Users, but Higher Before Tx

Antidepressant treatment linked to threefold increased risk during first month; link decreased over year

Evidence on ED Diversion Strategies Inconclusive

But prehospital diversion does not seem to decrease proportion of patients transferred to ED

Endurance Exercise Tied to Anti-Aging at Cellular Level

Effect seen with aerobic endurance and high-intensity training but not resistance training

Age, BMI Predict Obstructive Sleep Apnea Treatment Success

Upper airway stimulation more effective with older age, lower body mass index

Number of People With Dementia Rose Twofold From 1990 to 2016

Overall, 28.8 million disability-adjusted life years due to dementia; 6.4 million attributed to modifiable risks

Infection Control Compliance Not Tied to Knowledge

Rather, home health care nurses' beliefs and perceptions seem to have most impact on compliance

Restrictive, Obstructive Lung Disease Linked to Dementia Risk

Associations seen for both Alzheimer's disease-related dementia and cerebrovascular etiologies

Overlapping Orthopedic Surgery Noninferior for Patient Safety

Reduced odds of perioperative complications seen for overlapping surgery versus nonoverlapping surgery

Hospitalization for Upper GI Bleed Highest With Rivaroxaban

Upper gastrointestinal bleeding hospitalization risk lower for anticoagulant tx with PPI cotherapy

Pembrolizumab Promising for Metastatic Head, Neck SCC

Prolongs survival among patients with recurrent, metastatic head and neck squamous cell carcinoma

Structured Family-Centered Peds Rounds Improve Patient Safety

Forty percent decrease seen in harmful errors; decrease also in nonpreventable adverse events

Exposure to Metals, Pesticides Tied to CVD in Hispanics/Latinos

Prevalence ratio for any cardiovascular disease was 2.18 for those working with pesticides

Global Lifetime Risk for Stroke About 25 Percent in 2016

Estimated risk from age 25 years onward is 24.9 percent, with geographic variation in risk

Sorafenib for Desmoid Tumors Ups Progression-Free Survival

Two-year progression-free survival rate 81 percent with sorafenib vs. 36 percent with placebo

ADA 2019 Standards of Care Emphasize Patient-Centered Care

Updates include use of SGLT-2 inhibitors and GLP-1 receptor agonists for T2DM, CVD; endorsed by ACC

OCT Imaging Needle Can Detect Blood Vessels in Neurosurgery

OCT probe integrated into standard brain biopsy needle IDs vessels with high sensitivity, specificity

Joint Mobilization Plus Exercise Beneficial for Knee Osteoarthritis

At 24 weeks, improvements seen in pain, function for osteoarthritis patients who did patellar mobilization

Shifting Pattern Seen for Primary Care Office Visits

Primary care physician visits down, but visits to nurse practitioners, physician assistants up

Impact of Fructose Varies With Energy Control, Food Source

Harmful effects for sugar-sweetened beverages when excess energy from sugar added to diet

Core Language Skill Stable From Infancy to Adolescence

Consistency in core language skill is stable through childhood in typically, atypically developing children

Risk of Sudden Death in Epilepsy Can Decline Over Time

Those with a low risk for SUDEP generally remain in this categorization during three years of tracking

New BP Goals Could Prevent 3 Million CVD Events Over 10 Years

Maintaining ACC/AHA goals would result in fewer events than current BP levels, prior guideline goals

Targeted Hep C Testing Misses High Number of Cases in Prisons

Findings based on birth cohort, risk-based testing versus opt-out testing in prison system

More People Worldwide Now Know Their HIV Status

However, millions of people still do not know their status and do not have a suppressed viral load

Higher Staffing Linked to Lower C-Section Rates

Findings based on staffing of obstetricians and midwives in France

ASH: High Response to Tx After Checkpoint Blockade in NHL, HL

Immunotherapy boosts later therapy for relapsed, refractory non-Hodgkin, Hodgkin lymphoma

Rare Variants Associated With Interval Breast Cancers

The presence of these variants is also linked to increased risk for death

Prevalence of Ever-Diagnosed ASD 2.79 Percent in U.S. Children

~70 percent of children with current ASD are treated; 20.3 percent receive behavioral tx and meds

Cost-Related Insulin Underuse May Affect One in Four Patients

Patients reporting cost-related underuse more likely to have poor glycemic control

ASH: Ibrutinib Tops Bendamustine + Rituximab for CLL

Improved progression-free survival with ibrutinib for older adults with untreated CLL

CDC: Acute Flaccid Myelitis Cases Appear to Have Peaked for 2018

As of Nov. 30, 134 cases of AFM have been confirmed in 33 states

Teva Recalls Two Blood Pressure Medications

Tablets tainted with N-nitrosodiethylamine, a suspected human carcinogen

Results of Pediatric Genomic Epilepsy Tests Often Reclassified

Over 30 percent of pediatric patients with genetic dx, undiagnosed conditions had results reclassified

Several Risk Factors More Strongly Linked to MI in Women

Blood pressure, smoking, type 1 and 2 diabetes linked to higher hazard ratios for women than men

Burnout, Satisfaction Vary With Age, Sex Among Neurologists

Sex does not independently predict burnout, fatigue, overall quality of life after controlling for age

Rotating Night Shift Work, Lifestyle Factors Linked to T2DM

Significant additive interaction identified for night shift work, unhealthy lifestyle for female nurses

Higher Cardiovascular Risk Seen With Psoriatic Arthritis

Risk seems to be increased especially in patients with a high inflammatory burden, late-onset psoriasis

Hypnotherapy Beats Education for Relief of IBS Symptoms

Group, individual hypnotherapy both effective; group hypnotherapy noninferior to individual tx

Care for Chronic Kidney Disease Varies Across VA Facilities

Findings observed for veterans with diabetes and concomitant chronic kidney disease

Increase Seen in Amphetamine, Opioid Use in Pregnant Women

Increase in amphetamine-, opioid-related deliveries disproportionate between rural vs. urban counties

For Teen Girls, Depression May Predict Subsequent Alcohol Use

Depression severity predicts increased likelihood of alcohol use; link for reverse pathway inconsistent

Bone Indices on CT Scan Predict Fracture Risk in Older Adults

Peripheral CT indices address risk for fracture contributed by changes in bone microarchitecture

Presence of Antiphospholipid Antibodies Tied to First-Time MI

With validation, findings may impact management, outcomes of high-risk patients

Limiting Social Media May Improve Psychological Well-Being

Limiting exposure to 30 minutes per day cut loneliness and depression in undergraduates

Family Functioning Does Not Impact Family Dinner, Diet Link

Frequent family dinners tied to higher-quality dietary intake, regardless of level of family functioning

Case Description Can Reliably Define Acute Flaccid Myelitis

Differences between patients with AFM, other diagnoses include asymmetry of weakness