Navigation Links
Embargoed news from Annals of Internal Medicine
Date:5/2/2011

1. For Older COPD Patients, Long-acting Inhaled Beta-agonists Increase Survival Over Anticholinergics

Long-acting medications such as inhaled beta-agonists and anticholinergic agents are commonly prescribed to manage chronic obstructive pulmonary disease (COPD). Both drugs have been shown to decrease exacerbations and hospitalizations and improve COPD symptoms, lung function, quality of life, and possibly mortality. However, it is not known which therapy is a better choice for initial therapy. Researchers studied patients aged 66 years or older who were diagnosed with COPD and were newly prescribed either an inhaled, long-acting beta-agonist or an anticholinergic between 2003 and 2007. The patients were followed for up to 5.5 years to compare survival rates between the two treatment groups. The researchers found that older adults initially prescribed long-acting inhaled beta-agonists had lower mortality than those initially prescribed long-acting anticholinergics. The researchers recommend further study regarding the relative benefits of long-acting anticholinergics.


2. Omalizumab Improves Symptoms for Patients with Uncontrolled Severe Allergic Asthma

Patients with uncontrolled allergic asthma are often prescribed a combination of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs). Even with both medications, these patients can have flare ups that require use of a "rescue inhaler" or require treatment with oral or intravenous steroids. Omalizumab is a medication that blocks the ability of a blood protein to increase airway inflammation and constriction. Researchers studied 850 patients aged 12 to 75 years with severe, uncontrolled asthma resulting in nighttime awakenings, frequent daytime rescue inhaler use, and at least one acute exacerbation of asthma in the past year requiring the use of steroids. Patients were randomly assigned to receive either placebo or an injection of omalizumab every two to four weeks for 48 weeks in addition to ongoing treatment with ICS and LABAs. Patients that received omalizumab in addition to ongoing ICS and LABAS had fewer asthma exacerbations, reduced rescue inhaler use, and improved symptom and quality-of-life scores over 48 weeks.


3. Patient-tailored Guidelines Can Save Money, Improve Outcomes, But May be Out of Reach

Clinical guidelines make it simple and efficient for physicians to make evidence-based treatment decisions for their patients. A common criticism of guidelines is that they narrowly focus on specific risk factors to determine who should and should not receive treatment. Researchers sought to determine if individualized guidelines based on patient characteristics (age, sex, blood pressure, cholesterol, family history, etc.) could achieve better outcomes and save costs compared to current guidelines. Researchers used the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines as a basis for comparison. According to the JNC 7 guidelines, patients should receive hypertensive treatment if their blood pressure exceeds 140/90 or 130 /80 if they have diabetes or chronic kidney disease. Using a computer model, patients were treated using either JNC 7 guidelines, individualized guidelines (treatment in decreasing order of expected benefit), or random care (treatment of persons selected at random). The researchers found that compared to random care, individualized guidelines could prevent the same number of myocardial infarctions (MIs) and strokes as JNC 7 guidelines at a cost that is 67% lower than using JNC 7 guidelines, or could prevent 43% more MIs and strokes for the same cost as treatment according to the JNC 7 guidelines. According to the author of an accompanying editorial, tailoring recommendations is not as easy as it sounds. Guidelines tailored for individuals will be more complex and more difficult to implement in practice. Experts are faced with a challenging opportunity to figure out how to create guidelines that are tailored for individual patients but are still easy to implement.


4. AHRQ Technical Brief: No Evidence to Support Clinical Use of Stereotactic Body Radiation Therapy Over Other Radiation Therapies

Stereotactic body radiation therapy (SBRT) is a treatment technique that uses special equipment to position a patient and precisely deliver external radiation therapy to tumors in the body. SBRT is typically delivered in one to five treatments, with a very high radiation dose of 20 to 60 Gy. This type of radiation therapy can be preferred by patients because of the convenience of fewer sessions. Researchers reviewed 124 relevant published studies to develop a technical brief on the current state of SBRT for solid malignant tumors. They found several limitations in the available literature that raise concerns about the widespread use of SBRT. According to the authors, there is limited research comparing the safety and efficacy of SBRT to other forms of external-beam radiation therapy. In addition, the technique is used on various cancer types, but most of the published studies were for tumors located in the lung or thorax. There were fewer than 10 studies each for tumors of the pancreas, liver, colon, uterus, pelvis, sacrum, kidney, and prostate. While there were many studies for cancer, comparative studies are needed to provide convincing evidence that SBRT will have advantages over other radiation therapies in the clinical setting.


'/>"/>

Contact: Angela Collom
acollom@acponline.org
215-351-2653
American College of Physicians
Source:Eurekalert

Related medicine news :

1. Embargoed News from Annals of Internal Medicine
2. Annals of Surgical Oncology adds new society affiliation
3. March/April 2010 Annals of Family Medicine tip sheet
4. March/April 2011 Annals of Family Medicine tip sheet
5. Prix Galien winners published in Annals of the New York Academy of Sciences
6. Annals and ACP announce recipients of Junior Investigator Recognition Award
7. Convert2XHTML.com Now Introduces Separate Team for Quality Check and Internal Audit to Improve Quality PSD to HTML Conversion
8. Internal Anthem Blue Cross/WellPoint Document: Only Patients Who Push Back Get Covered Out of State Liver Transplants
9. Keynote Speaker Presents Top Business Plan For Internal Communication Through Social Media
10. All you need to know about adult medicine is at Internal Medicine 2010
11. TPG Capital Selects MetricStream GRC Platform to Boost its Internal Controls and Compliance
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... ... to revolutionize the emergency ambulance transport experience for the millions of people who ... Uber has disrupted the taxi industry through the use of technology. Now, SmartEMS ...
(Date:6/26/2016)... ... June 26, 2016 , ... PawPaws brand pet supplements owned by ... to enhance the health of felines. The formula is all-natural and is made from ... the PawPaws Cat Kidney Support Supplement Soft Chews are Astragalus Root Extract ...
(Date:6/25/2016)... , ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on ... Observer , brings up a new, often overlooked aspect of head lice: the parasite’s ability ... fumigation is not a common occurrence, but a necessary one in the event that lice ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of ... award to iHire in recognition of their exemplary accomplishments in worksite health promotion. , ... Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was ... his family verbally and physically. , “When something upset him, he couldn’t control his emotions,” ... He would throw rocks at my other children and say he was going to kill ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)...  MedSource announced today that it has selected ... of choice.  This latest decision demonstrates MedSource,s commitment ... clients by offering a state-of-the-art electronic data capture ... as the EDC platform of choice in exchange ... has long been a preferred EDC platform by ...
(Date:6/23/2016)... 23, 2016  In a startling report released today, National ... by lacking a comprehensive, proven plan to eliminate prescription opioid overdoses. ... of how states are tackling the worst drug crisis in recorded ... – Kentucky , New Mexico ... . Of the 28 failing states, three – Michigan ...
(Date:6/23/2016)... , June 23, 2016 Research and ... News Issue 52" report to their offering. ... influenza treatment creates a favourable commercial environment for MedImmune to ... patient base that will serve to drive considerable growth for ... would serve to cap sales considerably, but development is still ...
Breaking Medicine Technology: