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
October 7, 2008
CDC says far too few tots get influenza vaccine, urges shots from 6 months
All children older than six months should get the flu shot, according to a new advisory from the Centers for Disease Control and Prevention.
Infants between six and 23 months old are at particular risk of hospitalization with influenza. Yet last year only one in five tots in this age range received the influenza vaccine.
The agency is paving the way for your conversation with parents, using a major mass media campaign that targets consumer health blogs and parenting websites.
Twenty two leading agencies, including the American Academy of Family Physicians and the American Academy of Pediatrics, joined last month in a new alliance to bolster public confidence in immunization.
Infants younger than six months can be protected from influenza if the expectant mother gets a flu shot, according to a new study in the New England Journal of Medicine.
Practice Guidelines
Quickly find the latest guidelines on prevention and treatment of influenza in children.
Patient Education
Here’s the place to find reliable information for parents on the question of preventing and treating flu in their kids.
No Comments » | 
Adolescent, Family Medicine, Influenza, Internal Medicine, Pediatrics, Women | Tagged: pregnancy, Influenza, vaccinations, children, flu | 
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Posted by smnewsletters
September 2, 2008
CDC reports highest measles rates for more than a decade
Measles cases in the US this year are at their highest in more than a decade, as the Centers for Disease Control and Prevention (CDC) reports in Morbidity and Mortality Weekly Reports. In 2000, the CDC declared the disease eradicated in the US.
The increase was due not to people catching measles abroad but largely to unvaccinated children catching it from those who carried the infection from outside the US.
(Source: Centers for Disease Control and Prevention)
States with more lenient vaccine exemption policies have increased infection rates, according to a recent report in the Journal of the American Medical Association.
Patient Education
Look in this category (in the list above the main search results) for take-home information for parents about measles.
Practice Management
This tab (above the search box) offers practical information about what to do when patients (or their parents) refuse immunization.
No Comments » | Family Medicine, Pediatrics, Respiratory_Infectious | Tagged: immunization, measles, vaccination | Permalink
Posted by smnewsletters
August 19, 2008
New HIV guidelines urge treating healthier infected people sooner
The CD4+ T-cell threshold for treating HIV should be raised from 200 to 500 CD4+ cells/ml, which will include infected individuals whose immune systems are still fairly healthy, according to new guidelines published in the Journal of the American Medical Association.
The change is spurred by the increase in available drug regimens, as well as by new insights into the comorbidities of longstanding HIV infection such as renal disease.
The guidelines were released to coincide with the 17th International AIDS Conference in Mexico City, where Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said a cure for AIDS is theoretically possible.
For news reports like this (from a less selective variety of sources), choose the option “The entire Web” just below the search box.
HIV remains most common in in the US among men who have sex with men and among African Americans. This information comes from the first estimates of HIV incidence in the US based on new tests that can distinguish recent infections from longstanding HIV, which appear in another article in the same issue of JAMA.
Related searches
NNTRI (non-nucleoside reverse transcriptase inhibitor)
nRTI (nucleoside reverse transcriptase inhibitor)
abacavir hypersensitivity
Selzentry
Remember: For authoritative drug information, there’s a link to epocrates.com in the left column of every SearchMedica page.
Also in the News
Determined effort has conquered XDR-TB in a community program, according to a recent article in the New England Journal of Medicine.
In most cases, TB drug resistance in patients with HIV has its origins in another country. This suggestion comes from a new study published by the CDC.
Worldwide, TB is the leading cause of death for HIV patients, according to other information from CDC.
No Comments » | Family Medicine, HIV, Internal Medicine, TB | Tagged: AIDS, guidelines, HIV, TB | Permalink
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
July 15, 2008
Late treatment effects—not so much the virus—threaten new HIV patients
People diagnosed with sexually transmitted HIV in the industrialized world today have no greater risk of death within five years than the general population, according to the latest report from the multicenter European CASCADE study.
Those still at somewhat greater risk:
* Intravenous drug users
* People not treated immediately with the HAART regimen.
* In general, men compared with women.
Patients may yet face some excess mortality risk, starting a decade after they first show evidence of anti-HIV antibodies. This is probably due to the cardiac effects of the treatment regimen.
Related searches
CASCADE Collaboration HIV (Other results from the European study)
DAD study HIV (First evidence of heart risks from antiviral drugs)
SMART study HIV (Why restricting antivirals because of this risk is a bad idea)
CME
Find a free government-sponsored online CME course about HIV management.
Practice Guidelines
Find recent guidelines from the New York State Department of Health that address HIV management in primary care.
These guidelines give special attention to management of anxiety and depression, including increased risk of suicide, in this patient population.
Research/Reviews
Look to this category for more information about HAART toxicity.
No Comments » | Family Medicine, Internal Medicine, Respiratory_Infectious | Tagged: AIDS, drug abuse, HAART, HIV | Permalink
Posted by smnewsletters
February 19, 2008
Banked blood shows cat parasite infection precedes schizophrenia onset
Here’s the latest and strongest of the provocative links between toxoplasmosis and behavior change: A case-control study using blood samples taken routinely from members of the U.S. military has shown a strong (P = 0.01) association between Toxoplasma gondii infection and the onset of schizophrenia within six months.
Antibodies to the parasite carried by pet cats were associated with a 26% increase in schizophrenia risk, according to the team from the Walter Reed Army Institute of Research.
This new study strengthens earlier evidence of an association, because of its large numbers and the use of blood samples drawn before diagnosis as well as after.
After using SearchMedica to locate a provocative study, turn to the categories to help decide what you should do next.
Patient Education Materials
What can you say to patients newly concerned about cats? You can use this category to find answers. Try the query Toxoplasma cats, and read the information for pregnant women and HIV patients. (See what the Mayo Clinic article has to say about working in the garden.)
Practical Articles & News
Inform patients that this is not really new, and for now has few practical implications. In this category you’ll find an article suggesting that the cause could just as easily be something caught in preschool, or even something Mom caught. Another reviews the long history of links between infection and mental disorders.
1 Comment | Respiratory_Infectious, Schizophrenia | Tagged: feline, infectious, Schizophrenia, toxoplasma | Permalink
Posted by Cranky Aged Mama
