Family Medicine | Page 370 of 374 | Links Medicus Content Curation & Alerts in Medicine

New warnings about the use of codeine and tramadol

24 Apr, 2017 | 15:32h | UTC

FDA Safety Alert: Codeine and Tramadol Medicines: Drug Safety Communication – Restricting Use in Children, Recommending Against Use in Breastfeeding Women (free)

FDA Statement: New warnings about the use of codeine and tramadol in children & nursing mothers (free)

Commentaries on the statement: FDA: Codeine Now Contraindicated for Pain and Cough in Kids – Physician’s First Watch (free) AND Codeine cough syrup should not be given to kids, FDA warns – STAT News (free)

These drugs should not be used at all for children younger than 12 years, and their use should also be limited in some older children.

Association between active commuting and incident cardiovascular disease, cancer, and mortality

21 Apr, 2017 | 15:19h | UTC

Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study – The BMJ (free)

Editorial: Active commuting is beneficial for health (free)

Why Physician Burnout Is Endemic, and How Health Care Must Respond

24 Apr, 2017 | 15:24h | UTC

Survey and commentaries: Why Physician Burnout Is Endemic, and How Health Care Must Respond – NEJM Catalyst (free)

Increased in clerical burden seems to be one of the leading causes, heavily influenced by expanded and more comprehensive use of electronic health records. More on the burden of administrative tasks in healthcare in our April 21 issue, see #5.

Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes

21 Apr, 2017 | 15:22h | UTC

Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes – New England Journal of Medicine (link to abstract – $ for full-text)

In patients who have had type 1 diabetes for 5 years, annual retinal examinations are currently recommended. Based on their findings, the authors suggest an individualized screening schedule, with less frequent screening for patients at low risk and more frequent screening for patients at higher risk, leading to decreased cost without delaying the diagnosis of clinically significant disease.

Syncope and Its Impact on Occupational Accidents and Employment

20 Apr, 2017 | 14:29h | UTC

Syncope and Its Impact on Occupational Accidents and Employment: A Danish Nationwide Retrospective Cohort Study – Circulation: Cardiovascular Quality and Outcomes (free)

News release: Fainting spells may increase risk of workplace accidents, job loss – American Heart Association News (free)

Use of Medications of Questionable Benefit at the End of Life

20 Apr, 2017 | 14:34h | UTC

Use of Medications of Questionable Benefit at the End of Life in Nursing Home Residents with Advanced Dementia – Journal of the American Geriatrics Society (link to abstract – $ for full-text)

“Too much use of meds of questionable benefit at the end of life: Just Stop.” (RT @DeeMangin see Tweet)

Approaches for Evaluation of Asymptomatic Microscopic Hematuria

20 Apr, 2017 | 14:27h | UTC

Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria – JAMA Internal Medicine (free)

Invited commentary: Asymptomatic Microscopic Hematuria – Rethinking the Diagnostic Algorithm (free)

Routine urinalysis for screening is not presently recommended by any major health organization, but asymptomatic microscopic hematuria is a common incidental finding. This study suggests that the combination of renal ultrasound and cystoscopy is the most cost-effective approach for the evaluation of these patients.

β-Blocker Exposure in Pregnancy and Risk of Fetal Cardiac Anomalies

20 Apr, 2017 | 14:28h | UTC

β-Blocker Exposure in Pregnancy and Risk of Fetal Cardiac Anomalies – JAMA Internal Medicine (link to abstract – $ for full-text)

See also: No Fetal Heart Risk from Mom’s Beta-Blocker Use – MedPage Today (free registration required)

Australasian Society for Infectious Diseases: low value interventions

20 Apr, 2017 | 14:30h | UTC

Australasian Society for Infectious Diseases: low value interventions – The Medical Journal of Australia (free) (RT @ChooseWiselyAU and @ASIDANZ see Tweet)

See also: Choosing Wisely initiative was launched 5 years ago in our April 5 issue.

The society has just released a selection of 5 low value interventions (details in the text):

– Prescribing antibiotics for asymptomatic bacteriuria.

– Taking a swab of a leg ulcer without signs of clinical infection and treating the patient with antibiotics against the identified bacteria.

– Treating upper respiratory tract infections with antibiotics.

– Investigation for fecal pathogens in the absence of diarrhea or other gastrointestinal symptoms.

– Ordering multiple serological investigations for patients with fatigue without a clinical indication or relevant epidemiology.

Why it’s a bad idea to space out your child’s vaccination shots

19 Apr, 2017 | 14:17h | UTC

Why it’s a bad idea to space out your child’s vaccination shots – The Washington Post (a few articles per month are free)

“Splitting immunizations into several visits only increases children’s stress” (RT @IDSAInfo see Tweet)

Preventing Sports Injury and Illness: Key Resources for Family Physicians

19 Apr, 2017 | 14:18h | UTC

Preventing Sports Injury and Illness: Key Resources for Family Physicians – American Family Physician (free)

Selection of resources for primary care providers to improve their ability to prevent and treat injuries from sports and physical activity.

Irritable bowel syndrome in adults: diagnosis and management

20 Apr, 2017 | 14:26h | UTC

Updated Guideline: Irritable bowel syndrome in adults: diagnosis and management – National Institute for Health and Care Excellence (NICE – UK) (free)

Alcohol-use disorders: diagnosis and management of physical complications

20 Apr, 2017 | 14:25h | UTC

Updated Guideline: Alcohol-use disorders: diagnosis and management of physical complications – National Institute for Health and Care Excellence (NICE – UK) (free)

Associations of Maternal Antidepressant Use and Complications in Offspring

19 Apr, 2017 | 14:12h | UTC

Associations of Maternal Antidepressant Use During the First Trimester of Pregnancy With Preterm Birth, Small for Gestational Age, Autism Spectrum Disorder, and Attention-Deficit/Hyperactivity Disorder in Offspring – JAMA (link to abstract – $ for full-text)

Contradicting a previous study showing increased risk of autism with antidepressant use during pregnancy (free), this large retrospect cohort study of 1 580 629 Swedish offspring did not show an association of antidepressant use during pregnancy and autism or other neurodevelopment problems.

Maternal asthma: Management strategies

19 Apr, 2017 | 14:16h | UTC

Maternal asthma: Management strategies – Cleveland Clinic Journal of Medicine (free)

ACC/AHA vs. USPSTF statin guidelines

19 Apr, 2017 | 14:11h | UTC

Comparison of Recommended Eligibility for Primary Prevention Statin Therapy Based on the US Preventive Services Task Force Recommendations vs the ACC/AHA Guidelines – JAMA (link to abstract – $ for full-text)

Although recommended by most guidelines for individuals at high risk, there is still some controversy over prescribing statins for primary prevention and over what patients benefit the most – see related commentary: Cholesterol-lowering statin therapy for healthy people is not as simple as ‘yes’ or ‘no’ – The Pharmaceutical Journal (free)

Adherence to the 2016 USPSTF recommendations for statin therapy, compared with the 2013 ACC/AHA guidelines, could lead to a lower number of individuals (an estimated difference of 9.3 million individuals in the U.S. population) recommended for primary prevention statin therapy.

The Breastfeeding-Friendly Pediatric Office Practice

18 Apr, 2017 | 14:03h | UTC

The Breastfeeding-Friendly Pediatric Office Practice – American Academy of Pediatrics (free)

Source: AAP: Pediatricians Should Support Breastfeeding Moms – MedPage Today (free registration required)

Recent recommendation from another organization: Breastfeeding: Primary Care Interventions – U.S. Preventive Services Task Force (free)

Summary of USPSTF recommendations: Primary Care Interventions to Support Breastfeeding: Recommendation Statement – American Family Physician (free)

The American Academy of Pediatrics and the U.S. Preventive Services Task Force have issued recommendations for promoting and supporting breastfeeding.

Insulin pump didn’t improve glycemic control compared to training on injections

18 Apr, 2017 | 13:58h | UTC

Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE) – The BMJ (free)

Too Clean for Our Children’s Good?

18 Apr, 2017 | 14:04h | UTC

Too Clean for Our Children’s Good? – The New York Times (10 articles per month are free)

According to the “hygiene hypothesis”, some exposure to germs and microorganisms might be good for us because it helps develop the immune system.

Amsterdam’s solution to the obesity crisis: no fruit juice and enough sleep

17 Apr, 2017 | 13:55h | UTC

Amsterdam’s solution to the obesity crisis: no fruit juice and enough sleep – The Guardian (free) (RT @DrAseemMalhotra see Tweet)

“The city is successfully fighting fat by promoting tap water in its schools, along with healthy cooking classes and a ban on fast food sponsorship”