Ocular Sealant Superior to Sutures After Cataract Surgery

BOSTON —The ocular ReSure Sealant (Ocular Therapeutix) provides a convenient, safe, and effective alternative to sutures after cataract surgery, according to results from a pivotal phase 3 randomized trial.

Corneal wound leaks are common after cataract surgery; the rate is as high as 85%, said Terry Kim, MD, professor of ophthalmology at the Duke University Eye Center in Durham, North Carolina.

"Even perfectly constructed wounds can be compromised with internal or external pressure or manipulation," he said.

Dr. Kim, who was among several speakers describing results with the ReSure Sealant, presented the findings here at the American Society of Cataract and Refractive Surgery 2014 Symposium.

The sealant, a synthetic polyethylene glycol hydrogel, was approved by US Food and Drug Administration in January. It is the first gel sealant approved in the United States to prevent wound leaks after cataract surgery.

> READ MORE to find out about the cost/risk/benefit tradeoffs from medscape.com

Antibiotics Often Used Inappropriately for Catheter-Associated Bacteriuria

NEW YORK (Reuters Health) - Clinicians often don't know how to manage catheter-associated asymptomatic bacteriuria, so they overtreat it with antibiotics, a new survey suggests.

"We found that health care providers' cognitive biases, or mental shortcuts, are set incorrectly," said principal investigator Dr. Barbara W. Trautner of the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, Texas.

"Certain cues ingrained during medical training, such as elevated white blood cells in the urine being diagnostic of urinary tract infection (UTI) in young women, are being applied incorrectly to patients with urinary catheters. These incorrect mental shortcuts lead to over-diagnosis of UTI in hospitalized patients with urinary catheters," she told Reuters Health by email.

>LEARN MORE about education and better methods to avoid overtreatment from medscape.com 

Diabetes Mellitus Due to Food Additives and Pollution?

The most commonly noted causes for the rise in diabetes mellitus are obesity and overeating but could food additives and pollution contribute? Type 2 diabetes accounts for 90-95% of all diabetes cases. In 2000, 171 million people worldwide had diabetes and that is expected to increase to 366 million by 2030. This epidemic has received a lot of attention but the fact remains that there is zero evidence that diabetes mellitus results from overeating and a sedentary lifestyle.

The problem with this disease, and many others, is that the mechanisms involved are so complex that approaches to managing the rise are more treatment-based than prevention-based.  The current model explaining type 2 diabetes assumes, without true evidence, that insulin resistance precedes elevated insulin levels. Hyperinsulinemia is thought to be the body’s compensatory response to insulin resistance but there is no understood mechanism by which such resistance triggers secretion.

In 2012, a meta-analysis published by the American Diabetes Association proposed that food additives may trigger type 2 diabetes. The study takes a critical view of the current disease model and the commonly blamed culprits: obesity, overeating, and an inactive lifestyle. Though the authors are of the opinion that hypersecretion of insulin is the catalyst of insulin resistance they conclude that there are likely many factors which could contribute.

READ MORE to find out previous medical conclusions were not scientifically based from  

The Trouble With Rice

 Consumers have already become alarmed over reports of rice-borne arsenic in everything from cereal bars to baby food. Some food manufacturers have stepped up screening for arsenic in their products, and agencies such as the Food and Drug Administration now recommend that people eat a variety of grains to “minimize potential adverse health consequences from eating an excess of any one food.”

But it’s not just arsenic and cadmium, which are present in soil both as naturally occurring elements and as industrial byproducts. Recent studies have shown that rice is custom-built to pull a number of metals from the soil, among them mercury and even tungsten. The findings have led to a new push by scientists and growers to make the grain less susceptible to metal contamination.

The highest levels often occur in brown rice, because elements like arsenic accumulate in bran and husk, which are polished off in the processing of white rice. The Department of Agriculture estimates that on average arsenic levels are 10 times as high in rice bran as in polished rice.

> READ MORE to find our where the levels are highest from the nytimes.com

More Smoking Equals Lower Quality of Life

ORLANDO, Florida ― Smoking cigarettes, even for a short time, is associated with a significantly lower quality of life (QoL), new research suggests.

A review of 54 studies that assessed QoL in relation to smoking showed that taking up smoking even for a brief duration was associated with lower physical, mental, and social functioning and increased depression.

"The message is important to get across to clinicians and to smokers and may help people quit," lead author Matthew Goldenberg, DO, from Banner Good Samaritan Medical Center, Phoenix, Arizona, told Medscape Medical News.

"We are trying to change the perception that our patients with mental illness or co-occurring addictions have about smoking. They feel that smoking actually helps their nerves and calms them down, when in fact it actually has a negative impact on their quality of life, even if they've been smoking for a few weeks or months," he added.

>READ MORE about the study from medscape.com

What's So Bad About E-Cigarettes?

The Food and Drug Administration says it plans to regulate e-cigarettes, along with cigars and other tobacco products. Health advocates say it’s about time, but many “vapers” who use e-cigarettes say regulation will damage a product that’s a far safer substitute for cigarettes.

“The FDA has over stepped their boundaries,” supporters wrote in an online petition posted this week. “Do Not, allow the FDA to take control of a life saving product .”

Even health experts agree that electronic cigarettes, which deliver nicotine in a heated mist of water, glycerin and propylene glycol, might be useful in helping people who want to quit smoking. So where’s the harm in them?

Mostly, it’s the unknown, the FDA says. “We can’t even tell you what the compounds are in the vapor,” FDA’s Mitch Zeller told reporters.

>READ MORE about risks to youth and watch Dr Nancy Snub out Myths at NBCNews

Marijuana Use Linked to Rising Cardiovascular Events

TOULOUSE, FRANCE — Researchers in France are warning that marijuana use may increase the risk of cardiovascular events, particularly in younger adults, with fatal consequences^[1].

Their concerns stem from a review of reports made to the French Addictovigilance Network between 2006 and 2010 indicating that almost 2% of reported events concerned cardiovascular complications. What's more, the average age of the people with CV complications was 34, with the number of cardiovascular complications tripling over the study period.

"The general public thinks marijuana is harmless, but information revealing the potential health dangers of marijuana use needs to be disseminated to the public, policymakers, and healthcare providers," lead author Prof Émilie Jouanjus(Centre Hospitalier Universitaire de Toulouse, France) commented in a press statement. This is especially important, given the growing move toward decriminalization of the drug and its use as medical treatment.

>LEARN MORE about the study from medscape.com

Upping Coffee Consumption Protects Against Type 2 Diabetes

The first study to examine whether a change in the amount of tea or coffee consumed has any effect on the subsequent risk for type 2 diabetes among healthy individuals has found that it does, at least for coffee. And the effects become apparent within a relatively short period of time, 4 years.

In this new observational analysis of 3 large US cohorts, those who increased their intake by around one-and-a-half cups of regular coffee per day, on average, had an 11% lower risk for type 2 diabetes over the following 4 years, compared with people who did not alter the amount of coffee they drank, report Shilpa N. Bhupathiraju, PhD, department of nutrition, Harvard Public School of Health, Boston, Massachusetts, and colleagues in the study, published online April 24 in Diabetologia.

> READ MORE on how much coffee and large study from medscape.com

Your Guide to Pain Relief

Got sore muscles or a raging headache? Before you reach for that bottle in your medicine cabinet for pain relief, know what you're taking -- and what side effects it might cause. Always read the label and follow directions before taking any medication.



Pain relievers come in two main varieties. Acetaminophen (Panadol, Tylenol) and nonsteroidal anti-inflammatory drugs -- better known as NSAIDs -- both help to relieve pain and reduce fever. NSAIDs include ibuprofen (Advil, Motrin), aspirin, and naproxen sodium (Aleve). Pain relievers come in many forms, including: tablets, caplets, gelcaps, and liquids.

>READ THE FULL ARTICLE for the OTC guide at webmd.com

>VIEW VIDEOS ON PAIN RELIEF PRESCRIPTIONS at webmd.com

5 Sketchy Things We Still Don’t Know About E-Cigarettes

The FDA has cracked down on e-cigs by asserting its regulatory power and proposing a ban on sales to minors

On Thursday, the U.S. Food and Drug Administration (FDA) flexed its regulatory muscles and extended its authority over more tobacco products, including the highly debated electronic cigarettes, or e-cigarettes. In the announcement, the agency said it now has jurisdiction over items that meet the statutory definition of tobacco products—which includes e-cigarettes, pipe tobacco, and hookah tobacco, among others. The FDA says it also plans to crack down on e-cigarettes by proposing a ban of their sale to people under 18 and by requiring health warnings on packaging.

The UK already has stiff regulations on e-cigarettes and some cities in the U.S., like Los Angeles, have bannedthem in several public places. The trouble with e-cigarettes is that they are so new, and there’s not enough evidence to definitively determine either how effective they are at helping people quit smoking—or the health risks associated with inhaling vaporized nicotine. Here are five things we are still scratching our heads over.

> READ FULL ARTICLE to learn about the facts of  electronic cigarettes FROM TIME

Spinal Corticosteroids Run Risk of Severe Neuro Effects

Epidural injections of corticosteroids to relieve pain — a widespread, off-label use — run the rare risk for blindness, stroke, paralysis, and death, the US Food and Drug Administration (FDA) announced today.

The FDA is requiring manufacturers of corticosteroids to revise drug labels to include this warning.

In today's announcement, directed at anesthesiologists and pain management physicians, the agency said it has not established the effectiveness and safety of epidural administration of corticosteroids such as hydrocortisone and methylprednisolone. As a consequence, "the FDA has not approved corticosteroids for such use."

>READ MORE for advising from the FDA at medscape.com

15-Minutes or less Visits Take Toll on Doctor-Patient Relationship

 Patients – and physicians – say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements. 

It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes. 

And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems.

“Doctors have one eye on the patient and one eye on the clock,” said David J. Rothman, who studies the history of medicine at Columbia University’s College of Physicians and Surgeons.

By all accounts, short visits take a toll on the doctor-patient relationship, which is considered a key ingredient of good care, and may represent a missed opportunity for getting patients more actively involved in their own health. There is less of a dialogue between patient and doctor, studies show, increasing the odds patients will leave the office frustrated.

>READ FULL ARTICLE about the struggle for control from medscape.com

What Is the Invisible vaccine Threat?

Over the past few years, an increasing number of parents are choosing not to vaccinate their children -- for religious reasons, for philosophical reasons, and for various other reasons. More and more children are now being potentially exposed to these vaccine-preventable diseases, and the consequences have been what one would have predicted. Last year, we had 189 cases of measles in this country; as of March 22, 2014, we have had about 80 cases, and thus we could have twice the number of cases this year as last year. In addition, we are seeing more cases of pertussis, more cases of mumps, and more cases of bacterial meningitis. This has been a constant discussion, a discussion in the media, and in many different forms of the media.

>VIEW FULL ARTICLE at medscape.com

Reduced Salt Intake Lowers BP, Improves Stroke and Heart Disease Mortality Rates

LONDON, UK – Efforts to reduce salt intake in the UK are likely to have contributed to a significant reduction in blood pressure as well as ischemic heart disease (IHD) and stroke mortality over a recent eight-year period, according to a new analysis^[1].

From 2003 to 2011, average salt intake declined 15% and systolic blood pressure declined by 2.7 mm Hg in individuals not taking antihypertensive medications. Over the same time period, there was a significant 42% reduction in stroke mortality and 40% reduction in IHD mortality, report investigators.

>READ FULL REPORT from medscape.com

Brain Foods

Medscape's 2-part Brain Food slideshow series looked at how what we eat can benefit the brain. From salmon cutting stroke risk to coffee curbing depression, the data are copious. But the past couple of years have seen countless studies also looking at how certain foods and dietary patterns can impair neurologic and psychiatric function. Based primarily on Medscape Medical News coverage and expert opinion, this slideshow examines recent data on what foods we should potentially avoid in the interest of preserving our cognitive capacities, and fending off -- or at least slowing -- diseases of the brain

SEE SLIDE SHOW from medscape.com

Low Back Pain: What Can You Do?

You may feel like resting, but moving is good for your back. Exercises for lower back pain can strengthen back, stomach, and leg muscles. They help support your spine, relieving back pain. Always ask your doctor before doing any exercise for back pain. Depending on the cause and intensity of your pain, some exercises may not be recommended and can be harmful.

SEE SLIDE SHOW from medscape.com

READ ARTICLE on Using Exercise to Ease Low Back Pain

Vaccine Resources for Your Practice or to Share With Your Adult Patients

For Educating Your Adult Patients

Every year tens of thousands of adults needlessly suffer, are hospitalized, and even die as a result of diseases that could be prevented by vaccines.

While adults believe immunization is important, a recent national survey showed that most adults are not aware that they need vaccines throughout their lives to protect against diseases like shingles, pertussis, and hepatitis.

Patients trust you to give them the best advice on how to protect their health. Use the resources below to educate your patients on recommended vaccines and help them make informed decisions about vaccinations.

READ MORE from medscape.com

The Pitfalls of Friend Doctor's Advice

Everyone Wants Free Advice

There are some situations for which medical school simply doesn't prepare you. Consider Thanksgiving dinner, when Aunt Myrtle buttonholes you about a recurring rash that's been bothering her. Or the sideline consult that one of the parents at your kid's football game wants to have, right after her son lands awkwardly trying to catch a pass.

When you're a physician, informal requests for information are simply part of the conversational landscape. Sometimes those requests are a quick and easy way to help someone out with a bit of information, a simple clarification, or a reassuring affirmation. Other times they can escalate and become annoyances: A simple question can result in a follow-up phone call and more requests. And, in a worst-case scenario, they can present ethical landmines that may tempt physicians to cross professional boundaries.

How do you address or deflect such requests? Unfortunately, there are no easy answers. It depends a lot on you, your boundaries, and the situation.

READ FULL ARTICLE to find out more from medscape.com

Consumer, be aware: Quality of health-related Internet searches varies

GAINESVILLE, Fla. — If you’re like most people, you’ve gone online to find out what’s causing that ringing in your ears or whether a gluten-free diet is worth considering. Be careful.

University of Florida researchers have found that, as with so much on the Internet, the quality of the information you dig up may depend on what you ask for and the results could be hazardous to your health.

The researchers discovered that Web searches related to the diagnosis and treatment of physical disease or injuries tend to yield higher-quality information than online searches for preventive health and social health information. The findings appeared in the January issue of the journal Decision Support Systems.

A search for the word “health” returned first-page results from well-respected health care providers, for example, while a search for “newborn vaccines” yielded hits for blogs and forums that discuss delaying or refusing medically recommended vaccinations. So when it comes to health information, search results may vary.

READ FULL ARTICLE to find out how to understand your search results fromthe  University of FloridaNewsUNIVERSITY of FLORIDA

Preeclampsia Pregnancies and benefits of Low-Dose Aspirin

Daily low-dose aspirin starting as early as the second trimester of pregnancy appears to prevent morbidity and mortality from preeclampsia among high-risk women, according to a systematic review published online April 8 in the Annals of Internal Medicine. However, potential rare or long-term harms could not be ruled out.

"Preeclampsia, which is characterized by hypertension and proteinuria during the second half of pregnancy, is a leading cause of maternal and perinatal death," write Jillian T. Henderson, PhD, MPH, from the Kaiser Permanente Center for Health Research in Portland, Oregon, and colleagues.

"Previous comprehensive systematic reviews have found antiplatelets (primarily low-dose aspirin) to be beneficial for the prevention of preeclampsia among women at heightened risk. We conducted this systematic review to support the US Preventive Services Task Force [USPSTF] in updating its 1996 recommendation, which is no longer active."

READ FULL ARTICLE to learn what to do from medscape.com

NSAIDs: Not as Safe as You May Think

A survey of over 9000 patients published in 2005 concluded that over-the-counter (OTC) analgesics, including nonsteroidal anti-inflammatory drugs (NSAIDs), are widely used, frequently by patients who are generally unaware of the potential for dangerous adverse side effects.^[1] Given recent concerns about use of acetaminophen products, particularly products with 500 mg or more per tablet,^[2] and the potential that patients will turn to NSAIDs as an alternative, it is more important than ever that clinicians provide accurate education about their use. Medscape spoke with Bill H. McCarberg, MD, founder of the Chronic Pain Management Program at Kaiser Permanente in Escondido, California, and a board member of the Alliance for the Rational Use of NSAIDs, about the latest evidence regarding these ubiquitous products.

READ FULL ARTICLE for more detail about side affects for GI damage and CV events from medscape.com

Adolescent Carotenoid Intake Linked to Lower Risk of Benign Breast Disease

NEW YORK (Reuters Health) - Teenage girls who eat more colorful fruits and vegetables are less likely to develop benign breast disease as young adults, according to an observational study.

Benign breast disease, or a group of lumps that can develop during adolescence or young adulthood, is not in itself dangerous. But benign breast disease does increase the risk of breast cancer later in life, the authors of the new study write.

Seeing the same association between certain antioxidants and benign breast disease among teen girls as has been seen for breast cancer among adults is exciting, said Caroline E. Boeke who worked on the study at Brigham and Women's Hospital in Boston.

"Consumption of these vegetables might be a way to prevent benign breast disease," Boeke said. However, she noted that this is an observational study, and can't prove veggies ward off the disease.

READ FULL ARTICLE for more details about the links of which foods decrease risk of breast cancers from medscape.com

Paper Money and Coins as Potential Vectors of Transmissible Disease

Paper currency and coins may be a public health risk when associated with the simultaneous handling of food and could lead to the spread of nosocomial infections. Banknotes recovered from hospitals may be highly contaminated byStaphylococcus aureus. Salmonellaspecies, Escherichia coli and S. aureus are commonly isolated from banknotes from food outlets. Laboratory simulations revealed that methicillin-resistant S. aureus can easily survive on coins, whereas E. coli, Salmonella species and viruses, including human influenza virus, Norovirus, Rhinovirus, hepatitis A virus, and Rotavirus, can be transmitted through hand contact. Large-scale, 16S rRNA, metagenomic studies and culturomics have the capacity to dramatically expand the known diversity of bacteria and viruses on money and fomites. This review summarizes the latest research on the potential of paper currency and coins to serve as sources of pathogenic agents.

READ FULL ARTICLE to learn more from medscape.com

Old Antibiotic for Uncomplicated Urinary Tract Infection

CAPE TOWN, South Africa — In hospitalized patients with uncomplicated urinary tract infections (UTIs), cure rates with oral fosfomycin, an old antibiotic, are excellent, even in those colonized with resistant organisms, a new study shows.

"Results from this project showed an 83% cure rate. Even in patients who did not achieve a clinical cure, only about 3% overtly failed therapy," said investigator Shauna Jacobson, PharmD, from the Orlando Regional Medical Center in Florida.

"We recently restricted fluoroquinolones at our hospital, and then we went on to restrict meropenem," she told Medscape Medical News. Although "fosfomycin has been studied pretty well in community patients, especially in patients with uncomplicated cystitis, it hasn't been well studied in hospitalized patients," she said. "We wanted to see how our patients did on it."

The study results were presented here at the 16th International Congress on Infectious Diseases.

READ FULL ARTICLE for use in low risk patients from medcape.com

Just 10 Minutes! Getting Older Patients to Exercise

Hi. I am David Brown, from the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention (CDC). I am pleased to speak with you today, as part of the CDC Expert Commentary Series on Medscape, and I am here to talk to you about the 2008 Physical Activity Guidelines for Older Adults.

The guidelines say that older adults need to do 2 types of physical activity each week to improve health: aerobic andmuscle-strengthening.

For aerobic physical activity, the guidelines recommend that adults 65 years and older do:

• 2.5 hours of moderate-intensity aerobic physical activity per week; or

• 1 hour and 15 minutes of vigorous intensity aerobic physical activity; or

• An equivalent combination of moderate and vigorous intensity physical activity weekly.

There are even greater health benefits from doing more than 2.5 hours of moderate-intensity aerobic physical activity every week. Activities should last at least 10 minutes at a time. Doing 10-minute sessions of physical activity 3 times a day counts as much as doing a single 30-minute session.

The guidelines also recommend:

• Muscle strengthening on 2 or more days a week, preferably not on consecutive days, for all major muscle groups; and

• Balance exercises at least 3 days per week for those at risk for falling.

READ FULL ARTICLE for more details from medscape.com

Vaccine Reduces Influenza Risk in Mothers and Newborns

CAPE TOWN, South Africa — When pregnant women receive the flu vaccine, their risk of developing influenza is halved, as is the risk to their newborns in the first 24 weeks of life, new research shows.

"This is the first randomized controlled study to actually confirm that vaccination is efficacious in pregnant women, and only the second randomized controlled trial to show protection of the infant," said Shabir Madhi, MD, PhD, professor of vaccinology at the University of Witwatersrand in South Africa.

"Our data support the recent WHO recommendation in terms of prioritizing pregnant women for influenza vaccination, not just for the protection of the mother, but protection of the infant as well," he told Medscape Medical News.

Dr. Madhi presented the results here at the 16th International Congress on Infectious Diseases.

READ FULL ARTICLE why pregnant women are more at risk from medscape.com

Eating Cruciferous Vegetables May Curb Inflammation

NEW YORK (Reuters Health) - In a study of more than 1,000 Chinese women, those who ate the most cruciferous vegetables had substantially less inflammation than those who ate the fewest.

Cruciferous vegetables include cabbage, broccoli, bok choy, Brussels sprouts, kale and cauliflower, and eating them is often encouraged as a way to lower risk for heart disease and cancer.

Based on their findings, the study authors say the health benefits of these vegetables may be at least partly a result of their anti-inflammatory effects.

"Our group and others have found that consumption of fruits and vegetables, particularly cruciferous vegetables, was associated with lower total mortality and cardiovascular disease mortality - however, the potential mechanisms behind this association are not well understood," Dr. Gong Yang told Reuters Health by email.

READ MORE from medscape.com

E-Cigarette-Related Poison Center Calls Surge

Calls to poison centers involving e-cigarettes have surged during the last 3 and half years, a new study shows.

The number of calls shot up from 1 per month in September 2010 to 215 per month in February 2014, researchers for the Centers for Disease Control and Prevention report in the April 4 issue of the Morbidity and Mortality Weekly Report.

"This report raises another red flag about e-cigarettes — the liquid nicotine used in e-cigarettes can be hazardous," said CDC Director Tom Frieden, MD, MPH, in a CDC press release. "E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children."

More than half (51.1%) of the calls to poison centers because of e-cigarettes involved children 5 years and younger, the researchers report. Many states do not restrict the sale of e-cigarettes to minors.

READ MORE from medscape.com

Multivitamins: Is the Jury Still Out?

Hello. This is Dr. JoAnn Manson, Professor of Medicine at Harvard Medical School and Brigham and Women's Hospital in Boston. Today I want to talk about multivitamins. Is the jury still out? Should we be recommending multivitamins for our patients? Do we know who is a good candidate and who is not?

It would be an understatement to say that there is a lot of confusion out there about multivitamins. This is surprising given the high prevalence of use of multivitamins. In the United States among women overall, more than one third use multivitamins; and among mid-life and older women, more than 50% use multivitamins.^[1] Thus, it is very important that we understand the balance -- the benefits and risks -- of the use of multivitamins. It is surprising that in the year 2014, there has not been a single completed large-scale randomized trial of multivitamins that includes women. I am talking about the full comprehensive multivitamins that contain at least 20 vitamins and minerals in the usual doses that would be achievable through diet. I am not talking about megadoses of individual, isolated micronutrients.

The one randomized trial that has been completed was the US Physicians Health Study-II,^[2,3] which included only men but suggested some benefits. The Physicians Health Study-II showed a modest (about 8%) reduction in cancer with use of a daily multivitamin, which could translate into quite a few cases of cancer prevented.^[2] Among the men who were aged 70 years and older, there was a statistically significant 18% reduction in cancer.^[2] The study also found about a 10% reduction in cataract risk and 10% reduction in cardiovascular disease.^[3] Findings suggested that the older men might do better than the younger men with multivitamin use. Overall results favored multivitamin use in men, but it is important to understand whether women may also benefit.

READ MORE from medscape.com

Nighttime Light May Alter Circadian Rhythm, Lead to Obesity

"Innocuous" exposure to light at night alters circadian rhythms, which may in turn lead to weight gain, a new review suggests.

Clues that this might be a problem were first found in mice, which, when exposed to even low levels of light at night, "would shift their timing of food intake, and even though they were not eating any more calories, they were still gaining weight," coauthor Laura Fonken, PhD, from Ohio State University, Columbus, told Medscape Medical News.

"We think these results could be important to humans as well, [because] we all use computers late at night. We leave lights on late at night," she continued. "We have streetlights that come in our windows. All these different sources of light may be affecting the circadian system, which has consequences for metabolism."

READ MORE from medscape.com

Pneumonia Protection With PCV-13 vaccine in the Elderly

CAPE TOWN, South Africa — The 13-valent pneumococcal conjugate vaccine (PCV-13) offers moderate protection against the most common forms of pneumococcal community-acquired pneumonia in healthy elderly people, a large prospective trial shows.

"Pneumococcal conjugate vaccines are effective in preventing invasive pneumococcal disease and pneumonia in children, but vaccine efficacy has not been investigated in adults older than 65," said Marc Bonten, MD, professor of molecular epidemiology of infectious disease at the Julius Center for Health Sciences and Primary Care in Utrecht, the Netherlands.

"A clear medical need exists among adults to prevent pneumococcal disease, including pneumococcal community-acquired pneumonia. Whether the benefit we demonstrated in individuals translates into an overall public health benefit needs further analyses," he said.

The study results were presented here at the 16th International Congress on Infectious Diseases.

READ MORE from medscape.com

CDC Videos on Physical Activity

These videos help explain the guidelines, give you tips on how to meet them and show you how to do muscle strengthening exercises properly. 

SEE VIDEOS by the CDC

Alcohol Mouthwash use 'linked to oral cancer'

Mouthwash use 'linked to oral cancer': People who use products more than three times a day increase risk. Warning from Dr David Conway of University of Glasgow Dental School

Major study examined the health of 4,000 people across nine countries
British Dental Association argued results of study were not conclusive
Read more: http://www.dailymail.co.uk/health/article-2596497/Mouthwash-use-linked-oral-cancer-People-use-products-three-times-day-increase-risk.html#ixzz2xvK0jyBV Follow us: @MailOnline on Twitter | DailyMail on Facebook

Heavy use of mouthwashes may lead to a higher risk of oral cancer, an expert claims.

Research suggests that people rinsing with such products more than three times a day have a greater chance of developing mouth and throat cancer.

Dr David Conway, a senior lecturer at the University of Glasgow Dental School, said people should not routinely use a mouthwash and stick to brushing and flossing instead.

Will Medicine Ever Become Safer?

Hello and welcome. I am Dr. George Lundberg and this is At Large at Medscape.

Hospitals are dangerous places. I no longer work in a hospital, and I try never to go to hospitals even to visit, unless, of course, I or my family were to become really sick and would obviously stand to benefit from hospitalization. I feel almost the same about surgicenters, free-standing emergency rooms, and urgent care facilities.

...

In 1999, the Institute of Medicine published the sentinel report To Err is Human, ^[2] still a best-seller. They pegged the annual number of American hospital deaths secondary to errors and adverse effects of treatment to be 44,000 to 98,000. In an interview earlier this year, I asked Lucian Leape whether that number still held. He said no, it was much larger. I asked whether we had made any progress. He said yes, but only in narrow fields.

In 2013, a new report^[3] in the Journal of Patient Safetyestimated American hospital deaths following adverse events at 210,000 to 440,000 per year. Medicare patients are reported to die at a rate of 180,000 per year from or with nosocomial infections and other medical care-related problems

READ MORE from medscape.com

Wisely Choosing the Right Care

Hello and welcome. I am Dr. George Lundberg, at large for Medscape.

In about 1989, then-Secretary of Health and Human Services of the US government Dr. Louis Sullivan stated that between 30% and 40% of American medical care was unnecessary, wasted, or inappropriate. In 2013, Massachusetts health dignitaries stated that 30% of medical care in Massachusetts is unnecessary or inappropriate.

If they are correct, why have we in the American medical profession not fixed that in more than 20 years? Could it be that generation after generation of people who populate the system simply like it the way it is -- veritable pigs addicted to the money trough?

READ MORE from medscape.com

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The clinical information represents the expertise and practical knowledge of top physicians and pharmacists from leading academic medical centers in the United States and worldwide.

The topics provided are comprehensive and span more than 30 medical specialties.

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Our Drug Interaction Checker provides rapid access to tens of thousands of interactions between brand and generic drugs, over-the-counter drugs, and supplements. Check mild interactions to serious contraindications for up to 30 drugs, herbals, and supplements at a time.

Formulary Information

Access health plan drug formulary information when looking up a particular drug, and save time and effort for you and your patient. Choose from our complete list of over 1800 insurance plans across all 50 US states. Customize your Medscape account with the health plans you accept, so that the information you need is saved and ready every time you look up a drug on our site or in the Medscape app. Easily compare tier status for drugs in the same class when considering an alternative drug for your patient.

Medical Calculators

Medscape Reference features 129 medical calculators covering formulas, scales, and classifications. Plus, more than 600 drug monographs in our drug reference include integrated dosing calculators.

Image Collections

Hundreds of image-rich slideshow presentations visually engage and challenge readers while expanding their knowledge of both common and uncommon diseases, case presentations, and current controversies in medicine.

Resources for Physical Exercise

Regular physical activity helps improve your overall health and fitness, and reduces your risk for many chronic diseases.

Physical activity is anything that gets your body moving. Start at a comfortable level. Once you get the hang of it, add a little more activity each time you exercise. Then try exercising more often.

READ FULL PAGE from The HealthCare Advocate

Remote Patient Visits/Prescriptions - Playing with Scorpions

Prescribing by Phone Is Like Playing With Scorpions

Can you practice medicine over the phone? What is an appropriate way to use communication technology to help treat patients? Recently on Medscape Connect, an all-physician discussion group, members discussed how they had used the phone and other devices to diagnose, prescribe, or otherwise deal remotely with medical issues.

A primary care physician started things off: "Given my experiences with my own patients, I always insist they come into the office before I prescribe antibiotics if I haven't just seen them. Have you had experiences where you were glad you made your patient come in to your office before treating them based on what they told you over the phone, or a time when you wish you had?"

READ FULL ARTICLE from medscape.com

Electronic Patient–Physician Communications Face Barriers

Telephone calls and emails by patients can be very efficient, but these electronic communications may never be widely used unless physicians are reimbursed for them and are given extra time to do the work, according to a new study published in the August issue of Health Affairs.

Despite the potential advantages associated with e-communications, a 2008 study has found that less than 7% of physicians regularly communicate with their patients electronically.

READ FULL ARTICLE from medscape.com