Omni Health Services, Ltd.

The old folks & AF

Paul Rega, MD — Fri, 18 May 2012 15:22:02 +0000

Sex Differences in Stroke Risk Among Older Patients With Recently Diagnosed Atrial Fibrillation

Meytal Avgil Tsadok,
Cynthia A. Jackevicius,
Elham Rahme,
Karin H. Humphries,
Hassan Behlouli,
Louise Pilote

JAMA. 2012;307(18):1952-1958.doi:10.1001/jama.2012.3490

Among older patients admitted with recently diagnosed AF (Atrial Fibrillation), the risk of stroke was greater in women than in men, regardless of warfarin use.

http://jama.ama-assn.org/content/307/18/1952.abstract

Acupuncture in patients with COPD

Paul Rega, MD — Wed, 16 May 2012 17:28:43 +0000

Suzuki M, et al “A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): the COPD-acupuncture trial (CAT)” Arch Intern Med 2012; DOI: 10.1001/archinternmed.2012.1233.

http://archinte.jamanetwork.com/article.aspx?articleid=1151703

After 12 weeks, the Borg scale score after the 6-minute walk test was significantly better in the real acupuncture group compared with the placebo acupuncture group. Patients with COPD who received real acupuncture also experienced improvement in the 6-minute walk distance during exercise, indicating better exercise tolerance and reduced DOE.

This study clearly demonstrates that acupuncture is a useful adjunctive therapy in reducing DOE (dyspnea on exertion ) in patients with COPD.

Intranasal corticosteroids

Paul Rega, MD — Wed, 16 May 2012 17:27:51 +0000

Hayward G, et al “Intranasal corticosteroids in management of acute sinusitis: A systematic review and meta-analysis” Ann Fam Med 2012; 10: 241-249; DOI: 10.1370/afm.1338.

http://www.annfammed.org/content/10/3/241.abstract

Intranasal corticosteroids offer a small therapeutic benefit in acute sinusitis, which may be greater with high doses and with courses of 21 days’ duration. Further trials are needed in antibiotic-naïve patients.

Antibiotic-Associated Diarrhea

Paul Rega, MD — Wed, 16 May 2012 17:26:51 +0000

Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea (AAD): A Systematic Review and Meta-analysis

Susanne Hempel,
Sydne J. Newberry,
Alicia R. Maher,
Zhen Wang,
Jeremy N. V. Miles,
Roberta Shanman,
Breanne Johnsen,
Paul G. Shekelle

JAMA. 2012;307(18):1959-1969.doi:10.1001/jama.2012.3507

Context Probiotics are live microorganisms intended to confer a health benefit when consumed.

Conclusions The pooled evidence suggests that probiotics are associated with a reduction in AAD.

http://jama.ama-assn.org/content/307/18/1959.abstract

Troponins as the Only Biomarker

Paul Rega, MD — Thu, 10 May 2012 18:20:15 +0000

2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker: The ADAPT Trial

Martin Than, Louise Cullen, Sally Aldous, William A. Parsonage, Christopher M. Reid, Jaimi Greenslade, Dylan Flaws, Christopher J. Hammett, Daren M. Beam, Michael W. Ardagh, Richard Troughton, Anthony F.T. Brown, Peter George, Christopher M. Florkowski, Jeffrey A. Kline, W. Frank Peacock, Alan S. Maisel, Swee Han Lim, Arvin Lamanna, and A. Mark RichardsJ Am Coll Cardiol published 9

May 2012, 10.1016/j.jacc.2012.02.035
http://content.onlinejacc.org/cgi/content/abstract/j.jacc.2012.02.035v1

Using the ADP (Accelerated Diagnostic Protocol ), a large group of patients was successfully identified as at low short-term risk of a MACE and therefore suitable for rapid discharge from the emergency department with early follow-up. This approach could decrease the observation period required for some…

U.S. Hospitals Improved Disaster Preparedness

Paul Rega, MD — Thu, 10 May 2012 18:19:30 +0000

http://www.beckershospitalreview.com/capacity-management/report-us-hospitals-improved-disaster-preparedness.html

Report: U.S. Hospitals Improved Disaster Preparedness

Written by Sabrina Rodak | May 07, 2012

“U.S. hospitals have improved their preparedness for disasters due to a focus on medical surge planning, according to a Federal Emergency Management Agency report.

The 2012 National Preparedness Report said HHS’ Hospital Preparedness Program, which has awarded approximately $4 billion to states since 2002, has strengthened hospitals’ communications, medical evacuation and fatality management abilities. ….”

a soccer team & norovirus

Paul Rega, MD — Thu, 10 May 2012 18:18:52 +0000

Repp KK, Keene WE. A point-source norovirus outbreak caused by exposure to fomites. J Infect Dis 2012 Jun;205(11):1639-41 [Abstract]

http://jid.oxfordjournals.org/content/205/11/1639.abstract

Abstract

“…..We investigated a norovirus outbreak (genotype GII.2) affecting 9 members of a soccer team…… By polymerase chain reaction, GII norovirus was recovered from the bag, which had been stored in a bathroom used before the outbreak by a person with norovirus-like illness. …”

STEC O111 & Inmates

Paul Rega, MD — Tue, 27 Mar 2012 01:47:39 +0000

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6109a1.htm?s_cid=mm6109a1_e

Outbreak of Shiga Toxin–Producing Escherichia coli O111 Infections Associated with a Correctional Facility Dairy — Colorado, 2010

Weekly

March 9, 2012 / 61(09);149-152

Intro: An outbreak of STEC O111 at a correctional facility in Colorado was associated with an onsite dairy. Ten inmates had laboratory-confirmed infection, including eight with the same strain found in fecal specimens from dairy cows, suggesting that inmates employed at the dairy might have acquired STEC O111 infection on the job or transported contaminated items into contact with other inmates. Several conditions conducive to STEC O111 transmission were found, including poor adherence to standard food-service protocols and other infection control and hygiene practices. Dairy operations are a source of STEC O111 infection. A correctional facility that operates a dairy should institute infection control practices and…

Paul Rega, MD — Tue, 27 Mar 2012 01:47:01 +0000

Cryptosporidiosis Associated with a Firefighting Response

Paul Rega, MD — Wed, 14 Mar 2012 20:33:51 +0000

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6109a2.htm?s_cid=mm6109a2_e

Outbreak of Cryptosporidiosis Associated with a Firefighting Response — Indiana and Michigan, June 2011

Weekly

March 9, 2012 / 61(09);153-156

Intro: This is the first report of cryptosporidiosis being a potential occupational hazard for rural firefighters. Twenty of 34 firefighters responding to a fire in a barn housing week-old calves became ill with gastrointestinal symptoms; three of six tested were positive for Cryptosporidium. Cryptosporidium parvum was identified in samples from two of the firefighters, the calves, and a nearby swimming pond. Firefighters, like other visitors to facilities housing livestock, are at potential risk for Cryptosporidium infection. This investigation highlights the continued importance of public education regarding cryptosporidiosis prevention and control, in particular the importance of minimizing contact with animal feces, practicing thorough hygiene, and not drinking from untreated…