Healthcare Safety Index December 2015

Here are noteworthy healthcare issues that have appeared in the news and medical journals throughout the last 30 days or so:

An article appearing in Pediatric Infectious Diseases concluded that it is reasonable to allow children treated with amoxicillin by 5:00 pm to attend school the next morning after diagnosed with streptococcal pharyngitis. Heretofore, a 24 hour wait-time following antibiotic treatment was the standard protocol.

New guidelines for the pharmacologic treatment of rheumatoid arthritis have been issued by the American College of Rheumatology which update and expand recommendations published in 2012.

The American Heart Association published updated guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

The US Preventive Services Task Force issued new recommendations for diabetes screening. Previously, the USPSTF recommended screening for diabetes in adults with hypertension, but now screening is recommended as part of a patient’s cardiovascular risk assessment in patients between 40 and 70 years old who have a body mass index (BMI) ≥25 kg/m.

A study published in the British Journal of Sport Medicine concluded that eccentric training is more effective than standard physical therapy for treating hamstring muscle and tendon injuries and that platelet-rich plasma injections had no therapeutic impact on acute hamstring injuries.

A study published in JAMA showed a reduction in blood pressure in patients suffering from sleep apnea who utilized mandibular advancement devices. The measurable benefit was the same that was found in patients utilizing continuous positive airway pressure devices.

In a study published in the Journal of Clinical Oncology, patients previously treated with conventional chemotherapy enjoyed significantly longer median progression-free survival (4.2 versus 1.5 months), when treated with Trabectedin or Dacarbazine for metastatic liposarcoma or leiomyosarcoma.

Nivolumab was approved by the FDA for treatment of advanced renal cell carcinoma.

A study published in Gastroenterology demonstrated that the risk of progression of acute pancreatitis to chronic pancreatitis is greater in smokers, alcoholics and men.

A study published in JAMA revealed that self-harm emergencies increase in patients after undergoing bariatric surgery.

An article published in the Lancet suggested that “tight control” (review every 4 weeks combined with escalation of treatment if minimal disease activity criteria not met) improves outcomes in newly diagnosed patients with psoriatic arthritis disease.

A study published in the British Journal of Sports Medicine demonstrated that wearing cleats that increase the shoe-surface traction in football players doubles the risk of lower extremity injuries.

A study published in the American Journal of Sports Medicine suggested that taking supplements to maintain levels of serum 25-hydroxyvitamin D levels might help avoid lower extremity fractures in distance runners and military personnel.

An article published in JAMA concluded that patients in the United Sates undergoing myocardial perfusion imaging to diagnose and manage coronary artery disease are exposed to higher risks from radiation, due to the failure of laboratories to adhere to radiation dose best practices.

According to a retrospective cohort study published online in JAMA Internal Medicine, two thirds of women receiving medication for osteoporosis did not actually need this treatment.

A study published in the January 2016 issue of Retina concluded that communications between ophthalmologists and primary care physicians increased adherence to published diabetic eye examination recommendations of the American Academy of Ophthalmology.  Diabetic retinopathy affects an estimated 28.5% of patients who are over 40 years even though early detection can reduce the risk of the disease.

Failures in medical device safety resulted in a proposal by the FDA to begin notifying members of the public about emerging signals of a possible device risk at a point in time before a determination is made that a risk actually exists.