The study, which was published in the Journal of Adolescent Healthanalyzed medical claims and pharmacy data from 8,373, 13- to 17-year-olds who visited a clinician for headache, which is a common ailment in adolescents.
Forty-six percent received one prescription for an opioid; 23% got two prescriptions and 29% got three or more prescriptions.
Medical News
Killing Pain: Script by Script
Primary care doctors wrote about 53 million benzodiazepine prescriptions in 2013, roughly four times the number written by psychiatrists, a group that penned 13 million benzo scripts.
Nurse practitioners and physician assistants were close behind with 11 million prescriptions for the drugs, according to data obtained by MedPage Today and the Milwaukee Journal Sentinel.
In 2013, non-doctors wrote 30 million opioid prescriptions, compared with 92 million written by primary care doctors that year, according to data provided by IMS Health, a drug market research firm.
In 2010, the most recent year for which data were available, 30% of the 16,651 people who died of an opioid overdose also had taken a benzodiazepine, according to the U.S. Centers for Disease Control and Prevention.
via Killing Pain: Script by Script.
Pancreatitis May Confer Higher Risk for Cancer
In an effort to quantify the relationship between acute pancreatitis and pancreatic cancer, Agarwal and colleagues reviewed inpatient and outpatient records for 495,504 patients who received care through the Veterans Health Administration from 2000 through 2007. The authors identified 5,720 patients who had one or more episodes of acute pancreatitis, 710 of whom subsequently had diagnoses of pancreatic cancer.
Median follow-up was 60 months for the entire cohort, 26 months for patients who developed pancreatic cancer, and 60 months for patients who did not develop pancreatic cancer.
The patient cohort was predominately male (89%). A third of the patients smoked, a fourth had a history of heavy alcohol use, and 3% had a history of gallstones.
The 710 patients included 86 who had one or more episodes of acute pancreatitis prior to cancer diagnosis. The authors found that 76 of the 86 patients had a least one episode of acute pancreatitis within 2 years of cancer diagnosis.
In 69 of the 76 cases, the preceding pancreatitis occurred within a year of pancreatic cancer diagnosis. In fewer than half of the cases (N=34), acute pancreatitis preceded pancreatic cancer diagnosis by 2 months or less.
Cardiac Catheterization: A New Route – Johns Hopkins Health Alerts
Cardiac Catheterization: A New Route: Johns Hopkins Health Alerts.
Cardiac Catheterization: A New Route
Doctors use cardiac catheterization to diagnose and treat heart conditions. The technique involves threading a thin tube called a catheter through an artery (usually the femoral artery in the upper thigh or groin) to the heart. Serious complications during cardiac catheterization are rare. But the procedure comes with risks of bleeding and damage to arteries.
Increasingly, cardiologists perform cardiac catheterization from an alternate site — the radial artery in the wrist — an equally effective tactic that’s linked to fewer bleeding and vascular complications, according to a review published in Circulation.
Why the wrist? After patients undergo cardiac catheterization through the femoral artery, they must remain flat on their back with their leg immobile for two to six hours to allow the artery to heal and help prevent both internal and external bleeding. Because the radial artery is smaller and closer to the skin’s surface, there’s no risk of internal bleeding, and external bleeding is easier to stop or prevent, an advantage for obese patients or those taking blood thinners.
Patients who undergo cardiac catheterization through the wrist can sit up, walk and eat immediately after the procedure — good news for people with back problems who find it difficult to lie still. A compression device is worn around the wrist for two hours. Patients must refrain from heavy lifting with the hand for a few days.
Radial cardiac catheterization most benefits patients in the highest risk groups — women, patients 75 and older and people with acute coronary syndrome. Yet doctors have been less likely to use the wrist site for these groups.
The decision to use radial versus femoral artery cardiac catheterization is largely based on the abilities and the experience of the cardiologist who’ll perform the procedure. The radial procedure is more technically challenging, and a greater number of U.S. doctors have more experience with the femoral approach — something that’s likely to change in the near future.
Yogurt and Diabetes
Eating yogurt can reduce the risk of getting Type 2 diabetes by 28 percent, compared with consuming none, according to a study published today by Diabetologia. Higher consumption of low-fat fermented dairy products, such as yogurt and some cheeses, also lowered the relative risk of diabetes by 24 percent overall, the study showed.
via Yogurt May Be an Ally in Fight Against Diabetes: Study – Bloomberg.
Update 03.28.14
I’ve started eating yogurt every day.
PodMed From Johns Hopkins 01.31.14
Testosterone Treatment and MI Risk
Filling a prescription for testosterone therapy was associated with a greater risk of having a nonfatal myocardial infarction (MI) in the next 3 months, a large observational study showed.
The risk after a prescription was filled was more than doubled in men 65 and older overall compared with that in the year before the prescription (rate ratio 2.19, 95% CI 1.27-3.77), according to Robert Hoover, MD, ScD, of the National Cancer Institute in Bethesda, Md., and colleagues.
The study was limited, however, by the observational design, the use of administrative data that lacked information on indications for treatment, and the inclusion of nonfatal MIs only.
via Study Feeds Concerns About MI Risk With Testosterone Tx.
Acetaminophen Prescription Combination Drug Products with more than 325 mg: FDA Statement – Recommendation to Discontinue Prescribing and Dispensing
ISSUE: FDA is recommending health care professionals discontinue prescribing and dispensing prescription combination drug products that contain more than 325 milligrams (mg) of acetaminophen per tablet, capsule or other dosage unit. There are no available data to show that taking more than 325 mg of acetaminophen per dosage unit provides additional benefit that outweighs the added risks for liver injury. Further, limiting the amount of acetaminophen per dosage unit will reduce the risk of severe liver injury from inadvertent acetaminophen overdose, which can lead to liver failure, liver transplant, and death.
You like your liver? You can keep your liver.
Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes — NEJM
Conclusions
We observed a J-shaped association between BMI and mortality among all participants and among those who had ever smoked and a direct linear relationship among those who had never smoked. We found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal-weight counterparts, or of an obesity paradox.
via Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes — NEJM.
Cardiologists Should Mind Radiation Doses, ESC Says
Because radiation used in imaging tests is proven to cause cancer, they wrote, “cardiologists should make every effort to give ‘the right imaging exam, with the right dose, to the right patient.’
via Cardiologists Should Mind Radiation Doses, ESC Says.
We are seeing more applicant/patient initiated cardiac scans. I recently became aware of a life insurance application where the underwriter requested a repeat cardiac CT scan. The applicant’s cardiologist flatly rejected this course of action in an a asymptomatic patient with a correspondingly low CHD risk score.
Now you understand the cardiologist’s thinking.
Did I hear someone say “litigation risk”?
lifeunderwriter.net 
You must be logged in to post a comment.