May
18

FDA Proposal Aims at Lower Doses for Pediatric X-Ray

The realization that 1-size-fits-all radiography can be bad for children has forged a coalition between federal regulators, physicians, physicists, and medical device manufacturers to make medical imaging involving exposure to ionizing radiation safer for young patients.

The US Food and Drug Administration (FDA) took action May 9 as part of this collaboration by releasing proposed guidance encouraging manufacturers to consider the safety of children in the design of new X-ray imaging devices. The federal agency recommended equipment features that would alter the performance of X-ray imaging devices designed for general clinical use to address the specific requirements of younger patients.

The guidance was published after more than a decade of explosive use growth linked to medical applications of multislice computed tomography (CT), positron emission tomography, fluoroscopically guided biopsies, and other minimally invasive image-guided interventional procedures. All these events expose patients to ionizing radiation. Read the rest of this entry »

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May
16

Irritable Bowel Syndrome

Irritable Bowel Syndrome: New Dietary Guidelines
The British Dietetic Association (BDA) has issued evidence-based guidelines for the dietary management of irritable bowel syndrome (IBS) in adults. The new recommendations were published online April 10 and in the June print issue of the Journal of Human Nutrition and Dietetics.

“[IBS] is a chronic and debilitating functional gastrointestinal disorder that affects 9–23% of the population across the world,” write Y.A. McKenzie, MSc, from Nuffield Health the Manor Hospital, Oxford, United Kingdom, and colleagues from the BDA Gastroenterology Specialist Group. “Diet and lifestyle changes are important management strategies. The aim of these guidelines is to systematically review key aspects of the dietary management of IBS, with the aim of providing evidence-based guidelines for use by registered dietitians.” Read the rest of this entry »

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May
9

More Evidence Soda Consumption May Raise Stroke Risk

A new analysis from the Nurses’ Health Study provides more evidence that drinking sugar-sweetened and low-calorie soda may raise the risk for stroke, independent of established dietary and nondietary cardiovascular risk factors.

Compared with sweetened and unsweetened soda, coffee and decaffeinated coffee consumption was associated with lower stroke risks.

“At this point, we don’t have a good biologic mechanism to explain the association we found with low-calorie soda and stroke, so we are cautious in our interpretation of this finding,” Adam Bernstein, MD, ScD, research director of the Wellness Institute of the Cleveland Clinic in Lyndhurst, Ohio, who led the study, told Medscape Medical News.

“There is good reason, on the other hand, why sugar-sweetened beverages may be associated with stroke,” he said. The sugar load may lead to rapid increases in blood glucose and insulin, which over time lead to glucose intolerance, insulin resistance and inflammation, which in turn may influence atherosclerosis, plaque stability and thrombosis, he explained. Read the rest of this entry »

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May
7

Deadline for Avoiding 2013 E-Prescribing Penalty Is June 30

Physicians who enjoy an adrenaline spike from doing something at the last minute will jump at this challenge: electronically transmit 10 prescriptions to the pharmacy by June 30 to avoid a Medicare penalty in 2013.

The federal government is serious about digitizing healthcare, and in addition to rewarding physicians who e-prescribe for their Medicare patients, it is penalizing those who are still writing on prescription pads or even computer-faxing scripts (a true electronic prescription goes from the clinician’s computer to the pharmacy’s). This year the Centers for Medicare and Medicaid Services (CMS) began to reduce Medicare reimbursement by 1% for physicians and other prescribers who failed to e-prescribe at least 10 times during the first half of 2011. This downward “adjustment,” as Medicare calls it, will grow to 1.5% in 2013 and 2% for 2014.

Doing what it takes to stave off the penalty does not earn anyone a bonus, as another set of requirements governs the upside of the carrot-and-stick program. However, physicians who earn the bonus, known as “successful e-prescribers” in CMS parlance, are exempt from a given year’s penalty, depending on when they qualified for their reward. Successful prescribers in 2011 automatically escape the 1.5% penalty in 2013. Those who earn a bonus in 2012 will get off the hook in 2014. Read the rest of this entry »

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May
6

Coffee Stains Teeth More Indelibly Than Tobacco

Coffee stains return on bleached teeth, whereas cigarette stains may not. In addition, coffee stains cannot be removed by brushing alone, researchers report in an article published in the May issue of the Journal of the American Dental Association.

Soaking cows’ teeth in coffee and exposing them to cigarette smoke darkened them about the same amount, but tooth brushing only lightened the smoke-stained teeth, not the coffee-stained teeth, note Juliana Zavala Bazzi, DDS, MDS, from Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil, and colleagues.

“We didn’t expect that cigarette staining would be so easily removed either by tooth bleaching or toothbrushing,” corresponding author Evelise M. Souza, DDS, MDS, PhD, a professor of restorative dentistry at the Pontifical Catholic University, told Medscape Medical News in an email. Read the rest of this entry »

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Apr
26

Moderate Alcohol Consumption Post-MI Lowers Risk of Mortality

Drinking alcohol, albeit moderately, appears to provide some protective benefit to individuals who survived a first MI, research shows. Drinking up to two drinks per day was associated with a significant reduction in the risk of all-cause and cardiovascular mortality, but the relationship was U-shaped, with data showing no significant benefit and in fact hinting at harm among men who consumed more than the daily recommended serving of alcohol.

“The well-known side effects of excessive alcohol consumption should be considered carefully when providing recommendations to individuals post-MI,” caution Dr Jennifer Pai (Brigham and Women’s Hospital, Boston, MA) and colleagues in their report, published online March 27, 2012 in the European Heart Journal. “For example, heavy alcohol intake decreases LVEF [left ventricular ejection fraction], increases blood pressure, and acutely inhibits fibrinolysis.” Read the rest of this entry »

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