November 4, 2008
Project seeks volunteers to make their DNA profiles public for researchers
People may be thinking about genetic testing again, after reading recent press reports about the Personal Genome Project.
Late last month, the first few volunteers saw some of their genetic information made public on the Internet.
This effort seeks 100,000 volunteers willing to have their DNA sequenced, databased, and stored online, along with identifying medical and personal information, in order to speed the development of medical genomics.
For a quick brush-up on the pros and cons of reading your own gene map, the search term
risks genetic testing
offers some balanced reflections.
In some cases, diagnosis by history and examination has already given way to genetic testing. For instance, it’s now time to think “genotype first” when you see a child with a developmental issue, said an editorial in the New England Journal of Medicine a few weeks ago.
See what you can find by searching through the article categories with the search term “genetic testing”.
Evidence-based Articles
Scroll down first page of results for genetic testing to find a recent systematic review in JAMA about genetic testing for chronic adult diseases.
Practical Articles/News
This category holds a news article showing that an inconclusive genetic result can be as distressing as a positive one.
Patient Education
Scroll down here to find a Mayo Clinic blog for patients who may want to learn more about the topic on their own time.
No Comments » | 
Cancer, Cardiovascular, Diabetes_Endocrine, Family Medicine, Gastrointestinal, Internal Medicine, Medical ethics, Nervous System, Psychiatry, Respiratory_Infectious | Tagged: genetic testing, Personal Genome Project | 
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Posted by smnewsletters
October 21, 2008
Spiriva doesn’t slow COPD decline, but it really helps a lot anyway
Tiotropium (Spiriva) did not achieve the main study objective of lowering the rate of decline in forced expiratory volume (FEV1) among COPD patients in the large multicenter UPLIFT trial.
However, the drug was responsible for significant improvements in
* lung function,
* quality of life, and
* time to first exacerbation
Patients in the study were allowed to use any respiratory medications they wanted, except for other inhaled anticholinergic agents.
Data from the same study just prompted the FDA to lift its earlier warning about tiotropium and the risk of stroke.
Like the TORCH study reported earlier this year, the UPLIFT study came close to (but did not succeed in) finding a significant effect on mortality.
The best way to slow the rate of FEV1 decline, of course, is to quit smoking. This helps even patients with severe COPD, according to a new review in the European Respiratory Journal.
Research/Reviews
In this category, you’ll find the latest research into the predictive value of the BODE index in COPD.
Related searches
Find reports from earlier trials of interventions to slow the respiratory decline in COPD:
EUROSCOP
ISOLDE
BRONCUS
No Comments » | 
Cardiovascular, Family Medicine, Geriatrics, Internal Medicine, Respiratory_Infectious, Uncategorized | Tagged: stroke, COPD | 
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Posted by smnewsletters
August 12, 2008
Calories—not sugar, carbs, or fat—cause type 2 diabetes in those at risk
What people eat controls what they weigh, and that (setting aside genes and exercise) seems to determine the risk of type 2 diabetes—not the types of macronutrients themselves. That’s the upshot of two new studies in the Archives of Internal Medicine, according to a review in the same issue.
It’s not the sugar in soft drinks or juices but the poundage they so easily add that predisposes to type 2 diabetes, according to a study of young African-American women in the July 28 issue of Archives.
It was probably weight loss per se, not the low-fat or high-fiber diet, that reduced glycemia among postmenopausal women in the other study.
Which is best for weight loss: low carbs, low fat, or the Mediterranean diet? Depends on the patient’s underlying risk profile. The latter may be best for people at risk of diabetes, according to another new report, this one in the New England Journal of Medicine.
Related searches
Mediterranean diet diabetes
obesity children juice
menopause metabolic syndrome testosterone
Research/Reviews
How much exercise do patients need to maintain weight loss? Find more new reports in this article category.
Patient Education
Look in this category for trustworthy information for patients about physical activity and diabetes.
No Comments » | 
Adolescent, Cardiovascular, Diabetes_Endocrine, Family Medicine, Gastrointestinal, Geriatrics, Internal Medicine, Pediatrics, Women | Tagged: calories, carbohydrates, Diabetes_Endocrine, fat, menopause, obesity, weight loss | 
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Posted by smnewsletters
August 5, 2008
When MI complicates sleep apnea, it tends to strike in the wee hours
Onset of myocardial infarction in the middle of the night is significantly associated with obstructive sleep apnea (OSA), according to a new report in the Journal of the American College of Cardiology.
In a prospective study of 92 MI patients, those found to have sleep apnea were more than five times as likely to have had their coronary events between midnight and 6 AM.
Using SearchMedica’s new Practice Management tab (above the main search box), you can quickly find information about Medicare policy regarding OSA treatment.
Research/Reviews
Has CPAP been shown to have any effect on myocardial infarction in OSA? Find the latest here.
CME
Review the management of obstructive sleep apnea with a new online CME course.
No Comments » | Cardiovascular, Family Medicine, Internal Medicine, Respiratory_Infectious | Tagged: apnea, heart attack, myocardial infarction, sleep apnea | Permalink
Posted by smnewsletters
October 11, 2007
A new meta-analysis finds that stroke patients function better in daily activities after they have specific occupational therapy (training in dressing, self-feeding and the like). The researchers say that this should advance the discussion beyond merely whether occupational therapy helps outcomes in stroke, to what kind of OT is best for these patients.
Previous systematic reviews about occupational therapy, they say, have not focused specifically on stroke (although you’ll find a Cochrane review by the same authors on the topic of stroke also published this year).
Clinical Trials for Patients
A look at current clinical trials suggests that this topic is not yet high on the research agenda.
Patient Education Materials
Quickly find an article for patients about what to expect during stroke recovery.
No Comments » | Cardiovascular, Geriatrics | Tagged: occupational therapy, stroke | Permalink
Posted by Cranky Aged Mama
June 7, 2007
A Cleveland Clinic team brewed a storm when their meta-analysis of 42 placebo-controlled studies involving rosiglitazone turned up a significantly increased risk of myocardial infarction and an increase of “borderline significance” in cardiovascular deaths. An accompanying editorial in the New England Journal of Medicine questions whether the drug was approved and used too soon, on the basis of a mere secondary effect (lowering blood glucose). Another in the Lancet urges doctors to wait for further evidence before leaping to judgment.
Is this the letdown after a happy fantasy? Only six months ago, the results of the aptly named DREAM trial were prompting suggestions that the drug might prevent type 2 diabetes.
Refine your search with these clinically useful categories:
Practical Articles and News
In the news category, you can find the safety alert that the Food and Drug Administration swiftly issued in response to the new study.
Evidence-based Articles and Meta-analyses
Critics argue that the FDA approved the drug without sufficient evidence of benefit regarding primary outcomes such as mortality. What does evidence-based research show about the effects of rosiglitazone?
Clinical Trials for Patients
Learn what clinical trials now underway may provide new information about the use of this drug.
No Comments » | Cardiovascular, Diabetes_Endocrine | Tagged: Cleveland Clinic, rosiglitazone | Permalink
Posted by Cranky Aged Mama
