MD Consult - Find The Answer

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This week, MD Consult provided another reason to ensure that you don’t slack off on your flossing during the holidays – recent studies suggest that there may be bi-directional links between periodontal disease and rheumatoid arthritis. While the evidence seems to be growing for those connections, a previously-suggested relationship between low vitamin D and breast cancer is now being called into question; further analysis has made the picture somewhat murkier. Also in the news was an overview of the ongoing barriers to optimal epilepsy care faced by both physicians and patients.

In the Journals, the latest issue of Chest has arrived, and it covers a wide variety of topics. One paper explores the affect age has on obese asthma patients; the research suggests that obesity has a much greater impact on younger sufferers. The role of weight in coronary heart disease is also discussed, with an examination of weight loss and exercise training; patients who lost more weight had greater improvement in flow-mediated dilatation. The longer-term psychological effects of ARDS on its survivors were also studied. Another journal taking in a wide range of topics is the new American Family Physician – it looks at just about everything from childbirth to cirrhosis. An editorial regarding the former argues against elective deliveries before 39 weeks and includes links to useful charts, forms and toolkits, while another article looks at cirrhosis prevention and management. The diagnosis and treatment of Crohn’s disease in the general practice setting is also described. READ MORE >>

This week, the final new book of 2011 appeared on MD Consult – the sixth edition of Auerbach’s Wilderness Medicine. In addition to updates to the previous version, this edition features a number of entirely new sections: expedition medicine, global humanitarian medicine and disaster relief, and ultrasound and telemedicine in the wilderness. The book still explores subjects such as high-altitude medicine, which is especially pertinent as ever-larger numbers of tourists trek to mountaintops, as well as other travel-related specialties; however, its new sections cast a broader net, exploring the world far beyond the camper or holidaymaker in trouble.

Also new this week is the December issue of the American Journal of Surgery. One paper examined the effect of junior residents on surgical outcomes; it was found that their participation was safe and effective. Another article discovered that moped drivers involved in accidents have significantly higher rates of driving while intoxicated than car or motorcycle drivers, and that a large percentage of them had previously lost their license to drive a ‘real’ vehicle. More stringent laws for moped drivers were urged by the study’s authors. Another article of note looked at how patients and their families viewed the use of robotic telepresence in the surgical ICU – on the whole, the response was positive. Meanwhile, the December Disease-a-Month looks at simulation, rather than at a specific malady this time; simulations in obstetrics and surgery are both covered. READ MORE >>

This week on MD Consult, it was reported that state and school district laws mandating increased physical activity during the school day can help improve children’s health, and it argued that clinicians should help advocate for such reforms. Young children were also those most affected by the sharp increase in measles cases in Europe, and the goal of eradicating measles by 2015 will require additional steps to achieve in the current climate. Other News stories looked at bunion surgery alternatives, while another questioned why some epilepsy patients balk at brain surgery that could dramatically improve their condition.

An editorial in the latest American Journal of Medicine looks at the current state of primary care medicine and invites reader responses; other articles look at nonoutbreak-related Giardia infections, reversing endothelial damage in H. pylori infections and a report investigating ‘grateful patient’ philanthropy and its potentially positive effects on financially-strapped health centers. Also addressing primary care is the American Family Physician, whose December 1 edition shares tips for both managing and preventing falls in older patients, helping patients avoid kidney stones through diet, and a paper also suggests managing insomnia with melatonin, magnesium and zinc. READ MORE >>

Now that December has arrived, it is time to look back at the top searches in MD Consult during November to see what is trending in the medical topics that clinicians are researching.

Asthma was the top search term during November (diabetes was the top search term in October and September).  While the top 5 search terms have remained the same in recent months, there was some re-ordering of terms within the top 5 since September’s rankings.

MD Consult provides access to leading asthma resources, including Mason: Murray and Nadel’s Textbook of Respiratory Medicine, 5th ed. and the journal CHEST – the official publication of the American College of Chest Physicians.

We’ll be back a month from now with December’s results.

Dr. Martin Lee in training

It’s already December, and we’re back from our Thanksgiving break. As I write this, it is World AIDS Day, and a news report notes that large HIV testing and treatment gaps remain in the US, with only about 28% of those infected with the virus receiving appropriate treatment, and as many as 1 in 5 people not realizing they are among those infected. Also of concern was an article suggesting that excessive vitamin D intake may raise the risk for atrial fibrillation – something of a contrast to the ‘vitamin D deficiency’ stories we often post, but it’s clear that ‘too much’ is no better than ‘not enough’ in this instance. But there was also an inspiring story about a rheumatologist who plans to kayak the circumference of Great Britain to raise money for research in his field; inspired by his aunt’s struggle rheumatoid arthritis, he hopes to raise £100,000.

With the end of the year approaching, there are a number of Clinics finishing out their run for the year; Clinics in Laboratory Medicine is one of them. Among the articles there is a look at sex chromosome abnormalities, as well as one on chromosomal structural rearrangements that might be discovered during whole genome analyses. Another article explores the genetics of chronic lymphocytic leukemia. Also wrapping up their publication year is Psychiatric Clinics of North America, which takes a closer look at obesity and the role of mental health professionals in its treatment. Topics ranging from the relationship between obesity and psychiatric disorders to the treatment of night eating syndrome are discussed, as is a behavioral approach to the treatment of obesity. READ MORE >>