Mediterranean Diets Beat Low-Fat for CVD Prevention

Loma Linda, CA — A Mediterranean diet supplemented with either extra virgin olive oil or mixed nuts may cut the risk of cardiovascular events by as much as 30% in subjects at high risk of developing heart disease, as compared with people advised to eat a reduced-fat diet [1].

Those are the key findings from the randomized controlledPREDIMED primary-prevention trial presented here at theInternational Congress on Vegetarian Nutrition.

The Mediterranean diet already reigns supreme in secondary prevention of CV events. PREDIMED, which looked at diet effects on hard clinical end points, carves out an important role for this dietary eating pattern in primary prevention.

READ FULL ARTICLE from www.medscape.com

Are You Considering Complementary Medicine?

Millions of Americans use some form of complementary medicine. Like any decision concerning your health, decisions about whether to use complementary therapies are important. The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet to assist you in your decisionmaking about complementary practices and products.

READ FULL ARTICLE from 

• Key Points
• What Do “Complementary,” “Integrative,” and “Alternative” Mean?
• How can I get reliable information about a complementary therapy?
• Are complementary therapies safe? How can I minimize risks in using these therapies?
• How can I determine whether statements made about the effectiveness of a complementary therapy are true?
• Are complementary therapies tested to see if they work?
• I am interested in a therapy that involves treatment from a complementary medicine practitioner. How do I go about selecting a practitioner?
• Can I receive treatment or a referral to a complementary medicine practitioner from NCCAM?
• Can I participate in a clinical trial of a complementary therapy?

Universal Flu Vaccination: Are We Paying Attention?

Despite recommendations for universal vaccination of all individuals older than 6 months, influenza vaccine uptake in the United States remains dismal. Although there are clear benefits of large-scale vaccination in terms of both use of healthcare resources and improved work productivity, the issue of whether the influenza vaccine may prevent cardiovascular (CV) events has been controversial.

However, a new meta-analysis finds that the influenza vaccine may reduce the risk for CV events by more than one third among adults, and even more among adults at high risk for CV disease (CVD).^[1] These findings could have important implications for public health policy, as well as the way in which physicians counsel individual patients regarding the use of the influenza vaccine.

READ FULL ARTICLE from www.medscape.com

Google Makes Nutrition Data Comparison a Cinch

Google Makes Nutrition Data Comparison a Cinch (via http://eatdrinkbetter.com)

Is there anything Google can’t or won’t do? I know. That’s a silly question. So, what if you want to know the nutrition data comparison, say, between kale and beef? Just go to Google and type it in: “compare kale beef.” Or “kale vs. beef…

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Free Patient Websites. Nonprofit Organization. | CaringBridge

CaringBridge provides free websites that connect people experiencing a significant health challenge to family and friends, making each health journey easier. CaringBridge is powered by generous donors.

CaringBridge websites offer a personal and private space to communicate and show support, saving time and emotional energy when health matters most. The websites are easy to create and use. Authors add health updates and photos to share their story while visitors leave messages of love, hope and compassion in the guestbook.

via Free Patient Websites. Nonprofit Organization. | CaringBridge.

When to Argue With the Doctor - AllHealthcare.com

Most of our daily problems, including common annoyances such as arguments with coworkers, are dismissed as not life or death. However, when nurses, healthcare professionals, and doctors are involved, it can be a matter of life or death. Egos need to be left outside the hospital by the professionals entrusted with the health and safety of the patients they care for, which sometimes means you must argue with doctors.The problem is that a hospital isn’t really conducive to arguing. And doctors aren’t like lawyers, who argue for a living. They’re used to having everyone accept their opinion as gospel, and can take it as a personal affront when anyone disagrees with them. Unfortunately, doctors are people and people make mistakes, and with nurse practitioners and RNs taking on more and more duties, nurses and doctors butting heads is becoming increasingly common.

via When to Argue With the Doctor - AllHealthcare.com.

Doctor Visit Preparation and Communication

The Empowered Patient Coalition Choosing a Doctor Fact Sheet

Prepare for Doctor’s Visits from the Partnership for Healthcare Excellence

Be Prepared for Doctor’s Visits from AHRQ

Tips for Talking to your Doctor from AHRQ

Communicating with your Doctor from the Ohio State University Medical Center

Questions to Ask the Doctor for Cancer Patients

How to Communicate Your Loved One's Symptoms from the National Family Caregiver Alliance

via Doctor Visits.

Speaking Up About Your Medical Care

The Empowered Patient Coalition’s Preparing for Discharge Fact Sheet

The Joint Commission Speak Up about Medications Program

The Joint Commission Speak Up Program to Prevent Errors in Your Care

Five Steps to Safer Healthcare from AHRQ

Become More Involved in your Healthcare from AHRQ

Getting the Health Care You Need from The Health Consumer Alliance

Know Your Rights from the Joint Commission

Anesthesia & Me Checklist from the American Society of Anesthesiologists

via Speaking Up About Your Medical Care.

Preparing for Surgery

World Health Organization (WHO) Surgical Safety Checklist

SCOAP Surgical Checklist Information Sheet from www.surgicalchecklist.org

Prepare for Surgery from the Institute for Healthcare Improvement

Prepare for Surgery (Spanish) from the Partnership for Healthcare Excellence

Having Surgery: What you need to know from AHRQ

Prepare for Surgery from the Partnership for Healthcare Excellence

Learning to ask Tough Questions of your Surgeon from the Wall Street Journal

A Sample Time Out Protocol from Beth Israel Deaconess Medical Center

Ten Questions to Ask Before Having an Operation from the American College of Surgeons

Quick Tips when Planning for Surgery from AHRQ

Time Out Protocol from the Minnesota Department of Public Health

via Preparing for Surgery.

Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy

AHRQ Director Carolyn Clancy, M.D., has prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They will address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan. Check back regularly for new columns.

via Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy.

Need a terrific doctor?

(Health.com ) -- When it comes to finding a doctor, chances are you spend a lot more time worrying about your man, your kids, or your parents than yourself. After all, you're strong enough to soldier through the occasional cold, right?

If this sounds like you, you're not alone: In a recent survey, nearly a third of Americans who don't have a primary care physician (PCP) said they didn't think they needed one.

The truth is, we all do. Not only do people with a regular doc receive better overall care, but it's easier for them to get an appointment on short notice -- helpful for reassurance on day-to-day health queries, and especially crucial if you should ever find yourself in a serious health crisis.

"Finding a doctor before you get sick is especially important now that more insurance plans are requiring that PCPs serve as gatekeepers for our medical needs," says Trisha Torrey, author of "You Bet Your Life: The Ten Mistakes Every Patient Makes".

Your mission: To locate an M.D. with great experience; an organized, friendly office staff; and, most of all, the ability to collaborate well with you (it is, after all, your body and health).

via Need a terrific doctor? - CNN.com.

Lists of Things Physicians and Patients Should Question

Nine United States specialty societies representing 374,000 physicians developed lists of "Five Things Physicians and Patients Should Question" in recognition of the importance of physician and patient conversations to improve care and eliminate unnecessary tests and procedures.

These lists represent specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate care based on their individual situation. Each list provides information on when tests and procedures may be appropriate, as well as the methodology used in its creation.

What tests and procedures should patients and physicians talk about? Read the lists:

• American Academy of Allergy, Asthma & Immunology
• American Academy of Family Physicians
• American College of Cardiology
• American College of Physicians
• American College of Radiology
• American Gastroenterological Association
• American Society of Clinical Oncology
• American Society of Nephrology
• American Society of Nuclear Cardiology

Via Medical Lists

Empowered Patient - The Wise Patient's Guide to Being an Empowered Patient

Patients find more and more that their healthcare is being compromised. Patient safety issues, money issues, lack of time and communication with their doctors... These days, wise patients are empowered patients, learning everything they can about the healthcare system, the obstacles to good care, and the steps they can take to get the best care possible.

via Empowered Patient - The Wise Patient's Guide to Being an Empowered Patient.

Topics patients.about.com

• Diagnosis & Testing
• Treatment & Decision Making
• Medical Records & Codes
• Misdiagnosed/ Undiagnosed
• Doctors and Other Providers
• Research and Resources
• Medical Mistakes / Safety
• Patient / Health Advocacy
• Hospital Care
• Drugs, Supplements & Safety
• News / Issues / Debates
• Interviews, Books, Other Media
• Glossary of Med-Speak
• Medical Costs & Insurance

via Patient Empowerment at About.com - Teaching Patients to Take Charge for their Health & Medical Care.

Infection Control Certification May Lower MRSA Rates

April 10, 2012 — California hospitals appear to have significantly lower rates of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection if their infection control directors are board-certified, according to a study published in the March issue of the American Journal of Infection Control.

via Infection Control Certification May Lower MRSA Rates.

The Surprising Secret Behind Doctor Referrals

Advocates say patients now need to be more vigilant about how they're getting shipped around. Besides querying the doctor who's giving the name, they can use websites (like certificationmatters.org and castleconnolly.com) that verify and rate specialists. For those who want more details, the federal government will soon launch a major new resource: comprehensive physician "report cards." Based on the mother lode of records -- millions of Medicare files -- the reports will offer details on things like doctors' complication rates and their patients' hospital readmission rates. "It's an almost universal view into the behavior of doctors around the country," says David Lansky, CEO of Pacific Business Group on Health, a nonprofit coalition of employers concerned about quality and affordability in health care.

The Referral Road Map

With health care spending in the U.S. dipping after a 15-year rise, doctors and medical facilities are competing fiercely for patients.�

Take a look at what's at stake when your physician hands you a referral slip.

Still, that's months away, and most experts say referral marketing will only become more entrenched as health care cuts continue. Back at AdvisorsMD in Alabama, McKenzie says the company's expecting a strong 2012, with plans to launch new software that reps and doctors will be able to use to build more relationships. Like many in this field, she says, the firm is careful about which doctors it works with; she adds that the firm's efforts improve patient service by keeping doctors on their toes. After all, the best referral in the world won't keep the patients coming back if the doctor runs late, has bad bedside manners and overcharges. "We're not going to represent any Joe Blow who botches up patients," she says.

via The Surprising Secret Behind Doctor Referrals - SmartMoney.com.

Don't Let Medicines Cause Harm

We take more medicines than ever to maintain or improve our health. But over the last decade, many baby boomers and seniors have ended up in the hospital because the medications they expected to help them actually hurt them.

Many medical problems now can be treated with medicines that were not available just a few years ago. But taking more medicines can also result in some unexpected reactions, especially for people who take several drugs. Bad reactions to medications are on the rise, according to a new report by my agency, the Agency for Healthcare Research and Quality (AHRQ).

Between 1997 and 2008, hospital admissions doubled among Americans aged 45 and older for medication and drug-related conditions. These hospital admissions include the effects of prescription and over-the-counter medicines as well as illegal drugs.

This increase has been driven by three types of medication and drug-related conditions:

Drug-induced delirium, which is general confusion and agitation caused by drugs. Common causes are drugs for sleeping, nausea, and pain. Elderly patients are more sensitive to medicines than younger adults.

Poisoning or overdose from codeine and other narcotic medicines. Bad reactions from narcotic pain medicines are especially common in older adults.

Withdrawal from prescribed medicines or illegal drugs. Drug withdrawal occurs when someone suddenly stops or takes much less of a drug after being on it for a long time.

via Navigating the Health Care System: Don't Let Medicines Cause Harm.

How to Make an Emergency Department Visit a Safe One

You hope an accident or illness won't send you to an emergency department (ED). But being prepared for such an event can help you get good, timely, and safe care when the need arises.

Unfortunately, U.S. hospital EDs are severely overcrowded. In 2006, America's emergency rooms cared for 120 million patients, according to data from my agency, the Agency for Healthcare Research and Quality (AHRQ). And—because the Nation's health care system still relies on largely paper-based medical records—chances are, if you land in the ED, the doctors won't have information about your medical history.

ED staff won't know what medicines you take or what medical problems you have unless you are able to tell them. Even if you are alert, you're likely to forget important information about your health, such as medicine allergies or your blood type.

Being prepared for a trip to the ED—whether because of an accident or illness—increases your chances of getting safe, high quality health care. It might even save you money, depending on your health plan's policy for ED visits. Know what your health plan policy is. Some health plans require that you get authorization for emergency care other than for life-threatening emergencies.

That's why it's important to have handy, updated, and thorough information at hand. Keeping your information either on paper or in an electronic form, like on your cell phone, may help you receive better, safer care in a medical emergency.

via Navigating the Health Care System: How to Make an Emergency Department Visit a Safe One.

Talking About End-of-life Treatment Decisions

It's natural to avoid thinking—never mind talking—about dying. As a result, most people do not make their wishes clear to their loved ones or their health care providers. This includes many people who are nearing the end of life.

One way to communicate your wishes about future health care decisions is through "advance directives," which are legal documents that allow you to convey your decisions about your health care, especially end-of-life care. But fewer than half of severely or terminally ill patients have advance directives in their medical records, according to research sponsored by my agency, the Agency for Healthcare Research and Quality (AHRQ).

Even before you become old or ill, you need to think and talk about the kind of care you would want should a stroke, terminal illness, or life-threatening event occur. Ideally, these discussions should take place long before you need care. If such conversations don't take place, your family and physician must make decisions based on what they think you would want. As a physician, I know making decisions on behalf of a loved one is particularly difficult during an already stressful time.

End-of-life planning involves some thought and effort, such as completing advance directives. In addition to talking about your wishes with your family members, you should also talk with your doctor. Most doctors welcome the chance to discuss such issues but may be hesitant to raise the topic.

via Navigating the Health Care System: Talking About End-of-life Treatment Decisions.

Keeping Track of Your Health Information

Say you're out of town, and you become ill. You go to the local hospital emergency room, where you are quizzed about your medications and allergies. Unfortunately—in the confusion and stress of the moment—you forget to mention that you're allergic to penicillin until it's too late.

It's not farfetched. Visiting a hospital or a doctor can be a stressful experience. Some situations—if you're weak from illness or a trauma, or are in place you don't know—may be confusing. You may not be able to remember every important detail.

But, good health care depends on good and thorough information. Your health information—the medicines you're taking, your allergies, your family history, what illnesses or surgeries you have had—is what makes you medically unique, and can affect your treatment. The one thing you forget to mention could be the detail that might save your life.

Many Americans receive care from doctors in many places. We are a mobile society; we change towns, we change doctors, we change jobs and we change health insurers. But, your doctor's medical charts and other health information don't automatically appear at different doctors' offices or hospitals. Don't assume your doctor has all the relevant information at his or her fingertips. Usually, in fact, the doctor does not.

Because of this, it's up to you to keep track of your own health information.

via Navigating the Health Care System: Keeping Track of Your Health Information.

Poll: Doctors Fall Short in Helping Many Seniors

April 24, 2012 — Large numbers of seniors aren’t receiving recommended interventions that could help forestall medical problems and improve their health, according to a new survey from the John A. Hartford Foundation.

Notably, one-third of older adults said doctors didn’t review all their medications, even though problems with prescription and over-the-counter drugs are common among the elderly, leading to over 177,000 emergency room visits every year.

Falls cause over 2 million injuries in people age 65 and older annually, but more than two-thirds of the time doctors and nurses didn’t ask older patients whether they’d taken a tumble or provide advice about how to avoid tripping on carpets or slipping on the stairs, the Hartford poll found.

Similarly, depression can cause people to become socially isolated, suicidal, or stop taking care of themselves, but 62 percent of seniors said doctors and nurses hadn’t inquired about whether they were sad, depressed or anxious.

The results, which cover a period of 12 months, speak to doctors’ and nurses’ lack of training in geriatric medicine.  Providers need to recognize that “care of an 80 year old differs from that of a 50 year old,” said Dr. Rosanne Leipzig, professor of geriatrics at the Mount Sinai School of Medicine in New York. But too often, this doesn’t happen.

Seven interventions examined in the Hartford study are part of Medicare’s annual wellness visit, which became a no-cost benefit available to all seniors in the government health program in January 2011.  Yet 54 percent of older people surveyed by the foundation had never heard of the Medicare wellness visit while another 14 percent weren’t sure if they had.

Via Poll: Doctors Fall Short in Helping Many Seniors

Doctor directory is first step to new “Physician Compare” website

 HEALTHY LIVING

Doctor directory is first step to new “Physician Compare” website

Jan 5, 2011 4:07 PM

The federal government recently took the first step toward a website that, if all goes well, will eventually help consumers shop for doctors based on patient reviews and the quality of the care they provide.

The program is part of the new health-reform law, which among many other things, required Medicare to launch the website, called Physician Compare, by January 1. For now, it’s mainly an up-dated nationwide list of health-care providers who accept Medicare patients.

Still, it's helpful. The directory is searchable by zip code or city and state, as well as by medical specialty.  Results show the doctor’s name, address, gender, phone number, and languages spoken. Those closest to you are listed first. And it includes not just M.D.s, but also chiropractors, clinical psychologists, dietitians, nurse practitioners, occupational therapists, optometrists, osteopaths, physical therapists, physician assistants, and podiatrists—932,000 providers in all.

You don’t have to be a Medicare patient to use the tool, since doctors and other health-care providers who see Medicare beneficiaries also see people under age 65.Doctors who are already reporting quality information to Medicare—under a program called the Physician Quality Reporting System—have a mention of that participation in their profiles. That's a plus since it indicates they are committed to divulging such information. Later this year, Medicare will also list doctors who participate in a voluntary effort to encourage doctors to prescribe medicines electronically.Addition information will be added over time including, by 2015, the first actual measures of quality of care. Data for those measures will come from patient surveys, payment records, and electronic health records.Via http://news.consumerreports.org/health/2011/01/physician-compare-website-doctor-directory-is-first-step-to-new-physician-compare-website-.html

The Patient Will Rate You Now

These days, I’d never consider trying a new restaurant or hotel without reading the on-line ratings on TripAdvisor or Yelp. I seldom even bother with professional restaurant or travel critics.

Until recently, there was little patient-generated information about doctors, practices or hospitals to help inform patient decisions. But that is rapidly changing, and the results may be every bit as transformative as they have been in traditionally consumer-centric industries like hospitality. Medicine has never thought much of the wisdom of crowds, but the times, as the song goes, they are a-changin’.

Even if one embraces the value of listening to the patient, several questions arise. Should we care about the patient’s voice because of its inherent value, or because it can tell us something important about other dimensions of quality? How best should patient judgments be collected and disseminated – through formal surveys or that electronic scrum known as the Internet? And what are some of the unanticipated or negative consequences of measuring patient satisfaction and experience? All of these questions are being debated actively, and some newly published data adds to the mix.

Via The Patient Will Rate You Now

Rating the Raters: Physician Compare

By NAOMI FREUNDLICH

Let’s say you’ve enrolled in a new health insurance plan and need to find an internist who participates. How do you decide which doctor to choose? My (long deceased) grandmother made her choices by using the following criteria: She looked for a male doctor with a Jewish-sounding last name who graduated from an American medical school—preferably one located in New York City. Nowadays her narrow (and culturally biased) criteria would have excluded some of the most esteemed practitioners around.

If you are like most people, you don’t depend on your grandmother’s advice to find a physician, but rather ask friends, colleagues or other doctors for recommendations. But taking one person’s experience with an internist or surgeon as a signal that he or she is “really good” is still far from the optimal way to choose a practitioner.

Over the years, several commercial websites like HealthGrades and Angie’s List have cropped up that provide such consumer-friendly information as the distance a doctor’s office is from the patient, and whether foreign languages are spoken there. They usually include ratings that reflect consumers’ personal experiences with the practitioner. For people who want to dig deeper, most state medical boards collect data that can be searched to find out where your doctor went to medical school, where he did his residency and what board certifications she has. In some states you can also search to see if the doctor in question has received disciplinary action or been sued for malpractice.

Via Rating the Raters: Physician Compare

Should More Patients Continue Aspirin Therapy Before Surgery?

By Megan Brooks

NEW YORK (Reuters Health) Apr 20 - The practice of empirically interrupting chronic aspirin therapy before surgery "should be abandoned," according to the authors of a contemporary literature review.

They say the evidence they found in a PubMed and Medline literature search "strongly supports" continued perioperative use of aspirin in patients taking it for secondary prevention of coronary artery disease, cerebrovascular disease, and peripheral vascular disease.

"Many patients need to be on lifelong aspirin therapy for various cardiovascular indications and...other than for a select group of operative procedures, the risks of aspirin cessation exceed the benefit," Dr. Neal Stuart Gerstein from the Department of Anesthesiology and Critical Care Medicine, University of New Mexico in Albuquerque told Reuters Health by email.

via Should More Patients Continue Aspirin Therapy Before Surgery?.

Experimental treatment may help food allergies – - CNN.com Blogs

Food allergies are tricky business. Theyre on the rise in the United States and no one knows why.Some children are allergic to many foods, and its impossible to know based on preventive testing whether someone will have a mild or severe reaction. And so far theres no cure.Researchers at Johns Hopkins University and Duke University are working on a treatment that may one day allow kids with allergies to safely eat the foods that cause them life-threatening reactions. Its still in the early stages, but Dr. Robert Wood of Johns Hopkins, who has been on the forefront of food allergy research, estimates the treatment could be brought to the public within six to eight years.In his new study, researchers explored a treatment for children with cows milk allergies. The strategy is to desensitize the child by giving small amounts of the allergen milk. Oral immunotherapy, swallowing small amounts of the allergen, has shown to be more effective than sublingual therapy, which involves putting even tinier quantities of milk under the persons tongue.

via Experimental treatment may help food allergies – - CNN.com Blogs.

Hospitals Cut Central-Line Infections 40% With Safety Plan

September 10, 2012 — More than 1000 hospitals in 44 states lowered their rate of central line-associated bloodstream infections (CLABSIs) by 40% over 4 years through a program that features a checklist of precautions such as hand washing and donning sterile apparel, the federal Agency for Healthcare Research and Quality (AHRQ) announced today.

AHRQ estimates that the program prevented more than 2000 CLABSIs, saved more than 500 lives, and avoided more than $34 million in healthcare costs.

The AHRQ-funded program, called Comprehensive Unit-based Safety Program (CUSP), was developed by Peter Pronovost, MD, PhD, senior vice president for patient safety and quality at Johns Hopkins Medicine in Baltimore, Maryland.

Participating hospitals in a national rollout of CUSP reduced the CLABSI rate in their adult intensive care units on average from 1.903 infections per 1000 central-line days to 1.137 infections, according to AHRQ preliminary findings. At some hospitals already excelling at infection control, the CLABSI rate fell to zero. AHRQ funded the use of CUSP nationally through the research arm of the American Hospital Association.

via Hospitals Cut Central-Line Infections 40% With Safety Plan.

Popular Antibiotics May Carry Serious Side Effects - NYTimes.com

Antibiotics are important drugs, often restoring health and even saving lives. But like all drugs, they can have unwanted and serious side effects, some of which may not become apparent until many thousands of patients have been treated.

Such is the case with an important class of antibiotics known as fluoroquinolones. The best known are Cipro (ciprofloxacin), Levaquin (levofloxacin) and Avelox (moxifloxacin). In 2010, Levaquin was the best-selling antibiotic in the United States.

But by last year it was also the subject of more than 2,000 lawsuits from patients who had suffered severe reactions after taking it.

Part of the problem is that fluoroquinolones are often inappropriately prescribed. Instead of being reserved for use against serious, perhaps life-threatening bacterial infections like hospital-acquired pneumonia, these antibiotics are frequently prescribed for sinusitis, bronchitis, earaches and other ailments that may resolve on their own or can be treated with less potent drugs or nondrug remedies — or are caused by viruses, which are not susceptible to antibiotics.

via Popular Antibiotics May Carry Serious Side Effects - NYTimes.com.

High Glucose Levels Predict Mortality in Pneumonia

September 12, 2012 Vienna, Austria — Nondiabetic patients who have elevated serum glucose levels when they are admitted to the hospital for community-acquired pneumonia CAP have an increased risk of dying within 90 days, compared with similar normoglycemic patients.Acute hyperglycemia associated with CAP can identify at-risk patients who need additional care to reduce their risk for mortality, according to findings presented here at the European Respiratory Society 2012 Annual Congress.Studies have suggested that high serum glucose levels predispose people to CAP by increasing the risk for aspiration, decreasing immunity, and causing impaired lung function.Philipp M. Lepper, MD, from the University Hospital of Saarland in Homburg, Germany, headed a team of investigators who evaluated whether acute dysglycemia could predict a poor outcome in patients with CAP who had not been diagnosed with diabetes.

via High Glucose Levels Predict Mortality in Pneumonia.

Physician Empathy Linked to Better Patient Outcomes

September 13, 2012 — High levels of empathy in primary care physicians correlate with better clinical outcomes for their patients with diabetes, according to a new study of more than 20,000 patients in Italy.The retrospective correlational study of 20,961 patients with diabetes and 242 generalist physicians who treated them in Parma, Italy, found that patients whose physicians scored highest on a validated empathy test had the lowest rates of acute metabolic complications requiring hospitalization. The research was published in the September issue of Academic Medicine.The current study builds on a smaller study from 2011, conducted by several of the same researchers, that found that US physicians level of empathy correlated with the ability of their patients with diabetes to manage their disease, as measured by the patients hemoglobin A1c and low-density lipoprotein cholesterol test results. The 2011 study included 29 family physicians and 891 diabetic patients.These studies are "the first 2 [trials] that were aware of that have actually related empathy to tangible patient outcomes," explained Daniel Z. Louis, MS, managing director of the Center for Research in Medical Education at Jefferson Medical College in Philadelphia, Pennsylvania. Louis worked on both of the studies."Theres real evidence that these patients with diabetes mellitus had fewer complications" when their physicians were more empathic, Louis told Medscape Medical News. "Thats incredible."

via Physician Empathy Linked to Better Patient Outcomes.

Topical NSAIDs May Be a Better Choice for Elderly With OA

September 18, 2012 — Topical diclofenac is about as effective as oral diclofenac in knee and hand osteoarthritis OA, is probably as effective as other oral NSAIDs, and might be a safer choice for elderly patients and others at risk for gastrointestinal adverse effects, according to an intervention review published online September 12 in the Cochrane Database of Systematic Reviews.Sheena Derry, PhD, and colleagues from the University of Oxford in the United Kingdom based their conclusions about topical NSAIDs on a review of randomized, double-blind studies with placebo or active comparators in which at least a single treatment was a topical NSAID used to treat chronic pain caused by OA, and in which treatment lasted at least 2 weeks. The analysis included data from 7688 participants in 34 studies, 23 of which compared a topical NSAID with placebo."Topical NSAIDs were significantly more effective than placebo for reducing pain due to chronic musculoskeletal conditions," the authors conclude. "Direct comparison of topical NSAID with an oral NSAID did not show any difference in efficacy." Topical NSAIDs were associated with more local adverse events, such as mild rash, but with fewer gastrointestinal adverse events than oral NSAIDs.

via Topical NSAIDs May Be a Better Choice for Elderly With OA.

FREE ONLINE MERCK HEALTH MANUALS - Trusted Medical and Scientific Information

Merck and The Merck Manuals

Merck is committed to bringing out the best in medicine and scientific research. As part of that effort, Merck provides all of The Merck Manuals as a service to the community. Click the Computer Icon then click on subjects to the left.

via THE MERCK MANUALS - Trusted Medical and Scientific Information.