underwriting

Johns Hopkins Health Alert – Updated Guidelines for Knee OA

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Updated Guidelines for Knee Osteoarthritis

Many nonsurgical treatments are touted as being able to ease the symptoms of knee osteoarthritis, but which ones really work? Last year, the American Academy of Orthopaedic Surgeons (AAOS) issued revised recommendations, updating its 2009 guidelines. The group made two important changes that may affect the way you manage knee osteoarthritis.

  • First, if you use acetaminophen (Tylenol) for osteoarthritis pain relief, take no more than 3,000 mg per day. The AAOS formerly advised not exceeding 4,000 mg daily. The change was made to reflect the Food and Drug Administration’s current guidelines for safe use of acetaminophen.
  • Second, the AAOS found insufficient evidence that intra-articular hyaluronic acid provides significant symptom relief for knee osteoarthritis so the organization no longer recommends the therapy.

The AAOS continues to give a thumbs-up to some familiar commonsense strategies, such as exercising and a minimum 5 percent weight loss for people whose body mass index (BMI) is greater than 25.

Other highlights: The AAOS is unable to recommend for or against the use of bracing, growth factor injections and/or platelet-rich plasma knee osteoarthritis. In addition, although acupuncture continues to grow in popularity, there is not sufficient scientific evidence to support its use in patients with knee osteoarthritis.

Published online in Treatment of Osteoarthritis of the Knee. Evidence-Based Guideline, 2nd Edition, May 18, 2013

Click to access TreatmentofOsteoarthritisoftheKneeGuideline.pdf

Here’s the link if you want to download the entire set of guidelines in pdf format.

Demystifying the Congenital Long QT Diagnosis

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Demystifying the Congenital Long QT Diagnosis.

The incidence of the congenital long QT syndrome is about 1 in 2500 births. This is likely an underestimate as sudden death with a normal autopsy may be the first and only presentation. There are 12 genes responsible for 3 main types of c-LQTS. The presentation is one of aborted sudden death or brief arrhythmia. This usually manifests as sudden, without warning syncope, near syncope or prolonged syncope with seizures. Many are misdiagnosed with seizure disorder or vasovagal syncope.

Most Emergency Room Super Frequent Users Have Addiction Disorder – MedicalResearch.com

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Most Emergency Room Super Frequent Users Have Addiction Disorder | Medical Research News and Interviews: MedicalResearch.comMedical Research News and Interviews: MedicalResearch.com.

MedicalResearch: What are the main findings of the study?

 

Answer: We found that within our group of 255 known Emergency Department “super-frequent users,” 77% had with some type of addiction disorder, and 47 percent visited the Emergency Department seeking narcotics for pain. Women were more likely to be narcotic seeking. Using our individualized Electronic Medical Record care plan intervention, created and overseen by our multidisciplinary team (comprised of Emergency Department staff physicians, a psychologist, residents, nurses and support staff), we found that our plan significantly decreased annual rates of visits by these super-frequent users and those who sought pain-relief narcotics and other super-frequent users.

How Does Music Benefit the Brain? – Medical News Today

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I work from a home office located in Edmond, OK.  At the AHOU meeting several years ago in San Antonio, I met up with an underwriting professional whom I hadn’t seen in years.  He asked what I was doing.  I told him I worked from home.

I’m not surprised.  You always talked about working from home.

I listen to music all day long while working.  The music is mostly classical, occasionally acoustic guitar, sometimes jazz.  I didn’t realize I was feeding my brain.

How does music benefit the brain? – Medical News Today.

But music can do so much more, notes Michael Huckabee, professor and director of the University of Nebraska Medical Center Division of Physician Assistant Education.

In an article about the benefits of music on human health, he writes:


”Music does something beyond our understanding. We can call it an endorphin release or a distraction, but it goes much deeper than that. Somehow music just does us good. And the good it does was just proven to be better.”

He speaks of a finding from researchers in Taiwan, who recently reviewed over 360 published studies on music therapy and concluded the data from these studies suggest cancer patients who routinely listen to music exhibit significantly fewer symptoms of depression, pain, fatigue and anxiety.

Safety Alerts – Pradaxa dabigatran – Lower Risk for Stroke and Death, but Higher Risk for GI Bleeding Compared to Warfarin

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Safety Alerts for Human Medical Products > Pradaxa dabigatran: Drug Safety Communication – Lower Risk for Stroke and Death, but Higher Risk for GI Bleeding Compared to Warfarin.

ISSUE: The FDA recently completed a new study in Medicare patients comparing Pradaxa to warfarin, for risk of ischemic or clot-related stroke,  bleeding in the brain, major gastrointestinal (GI) bleeding, myocardial infarction (MI), and death. The new study included information from more than 134,000 Medicare patients, 65 years or older, and found that among new users of blood-thinning drugs, Pradaxa was associated with a lower risk of clot-related strokes, bleeding in the brain, and death, than warfarin. The study also found an increased risk of major gastrointestinal bleeding with use of Pradaxa as compared to warfarin. The MI risk was similar for the two drugs.

Importantly, the new study is based on a much larger and older patient population than those used in FDA’s earlier review of post-market data, and employed a more sophisticated analytical method to capture and analyze the events of concern. This study’s findings, except with regard to MI, are consistent with the clinical trial results that provided the basis for Pradaxa’s approval. As a result of these latest findings, the FDA still considers Pradaxa to have a favorable benefit to risk profile and have made no changes to the current label or recommendations for use.

Safety Alerts – Eszopiclone Containing Sleep Aids Can Cause Next-Day Impairment

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Safety Alerts for Human Medical Products > Eszopiclone Containing Sleep Aids: Drug Safety Communication – Can Cause Next-Day Impairment.

A study of Lunesta found that the previously recommended dose of 3 mg can cause impairment to driving skills, memory, and coordination that can last more than 11 hours after receiving an evening dose (see Data Summary). Despite these driving and other problems, patients were often unaware they were impaired.  The new lower recommended starting dose of 1 mg at bedtime will result in less drug in the blood the next day.