MedWorm: Medicine (General) Top 20

Acne risk higher for overweight teen girls

Modern Medicine — Mon, 23 Jan 2012 23:45:41 +0100

Teenage girls who are obese or overweight are significantly more likely to develop acne than their normal-weight peers, a new Norwegian survey suggests. (Source: Modern Medicine)

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Interventions for fatigue and weight loss in adults with advanced progressive illness.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: There is a lack of robust evidence for interventions to manage fatigue and/or unintentional weight loss in the advanced stage of progressive illnesses such as advanced cancer, heart failure, lung failure, cystic fibrosis, multiple sclerosis, motor neuron disease, Parkinson's disease, dementia and AIDS. The evidence contained within this overview provides some insight into interventions which may prove of benefit within this population such as exercise, some pharmacological treatments and support for self management.Researchers could improve the methodological quality of future studies by blinding of outcome assessors. Adopting uniform reporting mechanisms for fatigue and weight loss outcome measures would also allow the opportunity for meta-analysis of small studies.Researcher...

Statin Use and Musculoskeletal Pain Among Adults With and Without Arthritis

The American Journal of Medicine — Mon, 23 Jan 2012 23:45:00 +0100

Conclusion: In this population-based study, statin use was associated with a higher prevalence of musculoskeletal pain, particularly in the lower extremities, among individuals without arthritis. Evidence that statin use was associated with musculoskeletal pain among those with arthritis was lacking. (Source: The American Journal of Medicine)

Muscle relaxants for pain management in rheumatoid arthritis.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: Based upon the currently available evidence in patients with RA, benzodiazepines (diazepam and triazolam) do not appear to be beneficial in improving pain over 24 hours or one week. The non-benzodiazepine agent zopiclone also did not significantly reduce pain over two weeks. However, even short term muscle relaxant use (24 hours to 2 weeks) is associated with significant adverse events, predominantly drowsiness and dizziness. PMID: 22258993 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Sleep problems linked to risk of fibromyalgia

Modern Medicine — Thu, 26 Jan 2012 05:00:00 +0100

Women with sleep problems have a higher risk of developing fibromyalgia than women who don’t have trouble sleeping, according to a large prospective Norwegian study. (Source: Modern Medicine)

UK proposes tax on cosmetic surgery

Modern Medicine — Thu, 10 Nov 2011 05:00:00 +0100

The British government is proposing a value-added tax that could hike the cost of cosmetic surgery procedures by 20 percent, London’s Daily Mail reports. (Source: Modern Medicine)

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How to evaluate a patient with chronic cough?

Clinical Cases and Images — Mon, 23 Jan 2012 13:34:00 +0100

Initial evaluation of chronic cough (defined as more than 8 weeks' duration in adults and 4 weeks in children) should include a chest radiography (CXR) in most adult patients. Patients who are taking an angiotensin-converting enzyme inhibitor (ACEi) should switch to a medication from another drug class. Differential diagnosis of cough, a simple mnemonic is BAD CAT TOM (Bronchitis or pneumonia, Asthma, Drugs, CF or Cardiogenic, Aspiration, TB, Thyroid enlargement, Other, e.g. GERD, Malignancy, e.g. lung cancer). Click here to enlarge the image. The most common causes of chronic cough in adults are: - upper airway cough syndrome (post-nasal drip) - asthma - gastroesophageal reflux disease (GERD) - any combination of the above If upper airway cough syndrome is suspected, a trial of ...

Exercise, Talk Therapy by Phone May Help Relieve Fibromyalgia Pain

eMedicineHealth.com — Fri, 13 Jan 2012 07:00:00 +0100

(Source: eMedicineHealth.com)

Study: Anti-infective drug shortages affect clinical care, outcomes

Modern Medicine — Mon, 23 Jan 2012 23:45:41 +0100

Welcome to the latest public health emergency: Shortages of anti-infective agents. These shortages can adversely affect clinical care and patient outcomes according to a new study. (Source: Modern Medicine)

Neuraminidase inhibitors for preventing and treating influenza in children.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: Oseltamivir and zanamivir appear to have modest benefit in reducing duration of illness in children with influenza. However, our analysis was limited by small sample sizes and an inability to pool data from different studies. Oseltamivir reduces the incidence of acute otitis media in children aged one to five years but is associated with a significantly increased risk of vomiting. One study demonstrated that laninamivir octanoate was more effective than oseltamivir in shortening duration of illness in children with oseltamivir-resistant influenza A/H1N1. The benefit of oseltamivir and zanamivir in preventing the transmission of influenza in households is modest and based on weak evidence. However, the clinical efficacy of neuraminidase inhibitors in 'at risk' children is still...

Neuromodulators for pain management in rheumatoid arthritis.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: There is currently weak evidence that oral nefopam, topical capsaicin and oromucosal cannabis are all superior to placebo in reducing pain in patients with RA. However, each agent is associated with a significant side effect profile. The confidence in our estimates is not strong given the difficulties with blinding, the small numbers of participants evaluated and the lack of adverse event data. In some patients, however, even a small degree of pain relief may be considered worthwhile. Until further research is available, given the relatively mild nature of the adverse events, capsaicin could be considered as an add-on therapy for patients with persistent local pain and inadequate response or intolerance to other treatments. Oral nefopam and oromucosal cannabis have more signif...

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Suit claims Allergan encouraged unsafe use of Botox

Modern Medicine — Thu, 08 Dec 2011 05:00:00 +0100

A Las Vegas plastic surgeon is suing Botox-maker Allergan, claiming the Irvine-based company sold the drug in large vials and encouraged physicians to unsafely reuse them, the Los Angeles Times reports. (Source: Modern Medicine)

Interventions for pregnant women with hyperglycaemia not meeting gestational diabetes and type 2 diabetes diagnostic criteria.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: This review found interventions including providing dietary advice and blood glucose level monitoring for women with pregnancy hyperglycaemia not meeting GDM and T2DM diagnostic criteria helped reduce the number of macrosomic and LGA babies without increasing caesarean section and operative vaginal birth rates. It is important to notice that the results of this review were based on four small randomised trials with moderate to high risk of bias without follow-up outcomes for both women and their babies. PMID: 22258997 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: We found a high risk of publication and reporting biases in the trial programme of oseltamivir. Sub-population analyses of the influenza infected population in the oseltamivir trial programme are not possible because the two arms are non-comparable due to oseltamivir's apparent interference with antibody production. The evidence supports a direct oseltamivir mechanism of action on symptoms but we are unable to draw conclusions about its effect on complications or transmission. We expect full clinical study reports containing study protocol, reporting analysis plan, statistical analysis plan and individual patient data to clarify outstanding issues. These full clinical study reports are at present unavailable to us. PMID: 22258996 [PubMed - in process] (Source: Cochrane Dat...

Obesity linked with high rates of prostate Ca screening

Modern Medicine — Mon, 23 Jan 2012 23:45:41 +0100

Obesity appears to be associated with higher rates of prostate cancer screening across all races and ethnicities, recent study findings indicate. (Source: Modern Medicine)

Actavis launches generic equivalent of long-acting ADHD Drug, with 180-day exclusivity

Modern Medicine — Mon, 23 Jan 2012 23:45:41 +0100

FDA recently approved methylphenidate hydrochloride extended-release capsules (LA) CII, USP, the generic equivalent of Ritalin LA. Actavis Group, an international generic pharmaceuticals company, received first-to-file exclusivity on the 20-mg, 30-mg, and 40-mg strengths. (Source: Modern Medicine)

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Pain management for inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other spondylarthritis) and gastrointestinal or liver comorbidity.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: On the basis of the current review, there is scant evidence to guide clinicians about how gastrointestinal or liver comorbidities should influence the choice of pain treatment in patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis or other spondylarthritis. Based upon additional studies that included a mixed population of participants with a range of rheumatic conditions, NSAIDs should be used cautiously in patients with inflammatory arthritis and a history of gastrointestinaI comorbidity as there is consistent evidence that they may be at increased risk. PMID: 22258995 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

External counterpulsation for acute ischaemic stroke.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: The methodological quality of the included studies was poor, and reliable conclusions could not be drawn from the present data. High-quality and large-scale RCTs are needed. PMID: 22259001 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Non-drug therapies for lower limb muscle cramps.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: There is limited evidence on which to base clinical decisions regarding the use of non-drug therapies for the treatment of lower limb muscle cramp. Serious methodological limitations in the existing evidence hinder clinical application. There is an urgent need to carefully evaluate many of the commonly recommended and emerging non-drug therapies in well designed randomised controlled trials. PMID: 22258986 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Imaging in arthritis: quantifying effects of therapeutic intervention using MRI and molecular imaging.

Swiss Medical Weekly — Fri, 20 Jan 2012 11:24:09 +0100

Authors: Cimmino MA, Barbieri F, Zampogna G, Camellino D, Paparo F, Parodi M Abstract Modern imaging techniques are becoming increasingly important in assessing the course of arthritis and in permitting measurement of response to treatment as part of the follow-up of patients. They include ultrasonography (US), MRI, PET/CT, and biofluorescence. In patients with rheumatoid arthritis, clinical evaluation is significantly less sensitive than either US or MRI in detecting synovitis. As a result, imaging is a useful alternative to achieving proper assessment of disease activity. The different areas in which the new imaging techniques could help practicing rheumatologists and internal physicians include the following: early and differential diagnosis of arthritis, evaluation of disease a...