Tens of millions of patients with chronic diseases in this country are not receiving the type of care management proven to be effective, according to a new nationwide survey of physician organizations by researchers at the University of California, Berkeley, and the University of Chicago. The researchers found that physician groups on average use only 32 percent of 16 recommended care management processes – which include the use of nurse case managers, programs to help patients care for their illness, disease registries, reminder systems, and feedback to physicians on their quality of care. The study, published today (Wednesday, Jan. 22) in the Journal of the American Medical Association, also found that one physician group in six uses none of these processes.
Between 1977 and 1996, portion sizes for key food groups grew markedly in the United States, not only at fast-food restaurants but also in homes and at conventional restaurants, a new study shows. The observation is one more indication of broad changes in the way Americans eat and another reason for the widespread, unhealthy rise in obesity among U.S. children and adults, University of North Carolina at Chapel Hill researchers say. It is believed to be the first documentation that at any given meal, on average, the typical American eats more than he or she did only a few decades ago.
Patients who develop melanoma on their face, head or neck can have the same early-diagnosis surgical procedure to see if their cancer might spread as patients whose cancer is on less delicate areas of the body, a new study finds. The report, from a team at the University of Michigan Comprehensive Cancer Center, opens the door for many more melanoma patients to benefit from a potentially life-saving technique called sentinel lymph node mapping. The results will be published in the Archives of Otolaryngology, a journal of the American Medical Association.
For over 30 years, physicians have assumed that any expectant mother with genital herpes lesions at delivery must deliver her baby by Caesarian section to minimize chances of transmission of the disease to the infant, although there was no clinical or research information supporting that practice. A study by University of Washington physicians confirms that Caesarian section is indeed the way to go to prevent transmission of HSV (herpes simplex virus).
More than one-fourth of adults over age 45 have abnormalities in the way their heart fills with blood and are at significantly increased risk for premature death, according to results of a study of 2,042 randomly selected residents of Olmsted County, Minn. The study is published in the Jan. 8 issue of the Journal of the American Medical Association (JAMA).
A study of Northern Plains Indians found that infants were less likely to die of Sudden Infant Death Syndrome (SIDS) if their mothers received visits from public health nurses before and after giving birth. The study also found that binge drinking (five or more drinks at a time) during the mother’s first trimester of pregnancy made it eight times more likely that her infant would die of SIDS. Any maternal alcohol use during the periconceptional period (three months before pregnancy or during the first trimester) was associated with a six-fold increased risk of SIDS. The study also found that infants were more likely to die of SIDS if they wore two or more layers of clothing while they slept.
A substantially higher death rate and inability to recover from kidney failure was documented in a study of 552 critically ill, hospitalized patients who were given diuretics, the most commonly used therapy for kidney failure. Published in the November 27, 2002 issue of the Journal of the American Medical Association (JAMA), the study suggests that physicians treating patients in acute kidney failure should reassess the use of diuretics, particularly when there is a limited response in terms of increased urine output.
A study sponsored by the National Institutes of Health has found that postmenopausal women with heart disease who took hormone therapy and high dose antioxidant vitamins ? either alone or in combination with hormones ? did not have fewer heart attacks, deaths, or progression of coronary disease. In fact, both treatments showed a potential for harm. Although the actual numbers of deaths in the study were small, participants taking both active hormones and vitamins had the highest death rate while participants on placebo versions of both treatments had the lowest death rate.