Friday, August 16, 2019

Association of E-Cigarette Use With Smoking Cessation Among Smokers Who Plan to Quit After a Hospitalization: A Prospective Study.

e-cigarette use actually did not decrease tobacco abstinence at 6 months post-hospital discharge. Recommending complete cessation rather than attempting to taper off by using e-cigarettes probably is the best way to go. - TFH





Association of E-Cigarette Use With Smoking Cessation Among Smokers Who Plan to Quit After a Hospitalization: A Prospective Study.:

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Association of E-Cigarette Use With Smoking Cessation Among Smokers Who Plan to Quit After a Hospitalization: A Prospective Study.

Ann Intern Med. 2018 05 01;168(9):613-620

Authors: Rigotti NA, Chang Y, Tindle HA, Kalkhoran SM, Levy DE, Regan S, Kelley JHK, Davis EM, Singer DE

Abstract

Background: Many smokers report using e-cigarettes to help them quit smoking, but whether e-cigarettes aid cessation efforts is uncertain.

Objective: To determine whether e-cigarette use after hospital discharge is associated with subsequent tobacco abstinence among smokers who plan to quit and are advised to use evidence-based treatment.

Design: Secondary data analysis of a randomized controlled trial. (ClinicalTrials.gov: NCT01714323 [parent trial]).

Setting: 3 hospitals.

Participants: 1357 hospitalized adult cigarette smokers who planned to stop smoking, received tobacco cessation counseling in the hospital, and were randomly assigned at discharge to a tobacco treatment recommendation (control) or free tobacco treatment (intervention).

Measurements: Self-reported e-cigarette use (exposure) was assessed 1 and 3 months after discharge; biochemically validated tobacco abstinence (outcome) was assessed 6 months after discharge.

Results: Twenty-eight percent of participants used an e-cigarette within 3 months after discharge. In an analysis of 237 propensity score-matched pairs, e-cigarette users were less likely than nonusers to abstain from tobacco use at 6 months (10.1% vs. 26.6%; risk difference, -16.5% [95% CI, -23.3% to -9.6%]). The association between e-cigarette use and quitting varied between intervention patients, who were given easy access to conventional treatment (7.7% vs. 29.8%; risk difference, -22.1% [CI, -32.3% to -11.9%]), and control patients, who received only treatment recommendations (12.0% vs. 24.1%; risk difference, -12.0% [CI, -21.2% to 2.9%]) (P for interaction = 0.143).

Limitations: Patients self-selected e-cigarette use. Unmeasured confounding is possible in an observational study.

Conclusion: During 3 months after hospital discharge, more than a quarter of smokers attempting to quit used e-cigarettes, mostly to aid cessation, but few used them regularly. This pattern of use was associated with less tobacco abstinence at 6 months than among smokers who did not use e-cigarettes. Additional study is needed to determine whether regular use of e-cigarettes aids or hinders smoking cessation.

Primary Funding Source: National Heart, Lung, and Blood Institute.

PMID: 29582077 [PubMed - indexed for MEDLINE]

Saturday, August 10, 2019

Study: Fermented Dairy Products May Help Prevent Heart Disease

Preliminary findings suggest fermented dairy products such as yogurt, cheese, sour milk may be heart healthy. This study is hypothesis generating but by no means definitive. Still, I'll keep eating my yogurt (home made) and look at adding more cheese into my diet, without guilt! - TFH



Study: Fermented Dairy Products May Help Prevent Heart Disease:

KUOPIO, Finland — A study by researchers at the University of Eastern Finland found that fermented dairy products — such as cheese, yogurt, quark, kefir, or sour milk — may lower the risk of incident coronary heart disease in men. Conversely, the researchers warn that a very high consumption rate of non-fermented dairy products, like…

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Tuesday, August 6, 2019

Cost analysis of Omega-3 supplementation in critically ill patients with sepsis.

Should ICU sepsis patients get omega-3 supplements? This article suggests yes but the evidence still appears preliminary. I did not see a discussion of side-effects so would be cautious at this point. - TFH





Cost analysis of Omega-3 supplementation in critically ill patients with sepsis.:

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Cost analysis of Omega-3 supplementation in critically ill patients with sepsis.

Clin Nutr ESPEN. 2018 06;25:63-67

Authors: Kyeremanteng K, Shen J, Thavorn K, Fernando SM, Herritt B, Chaudhuri D, Tanuseputro P

Abstract

INTRODUCTION: Nutritional supplement of omega-3 fatty acids have been proposed to improve clinical outcomes in critically ill patients. While previous work have demonstrated that omega-3 supplementation in patients with sepsis is associated with reduced ICU and hospital length of stay, the financial impact of this intervention is unknown.

OBJECTIVE: Perform a cost analysis to evaluate the impact of omega-3 supplementation on ICU and hospital costs.

METHODS: We extracted data related to ICU and hospital length of stay from the individual studies reported in a recent systematic review. The Cochrane Collaboration tool was used to assess the risk of bias in these studies. Average daily ICU and hospital costs per patient were obtained from a cost study by Kahn et al. We estimated the ICU and hospital costs by multiplying the mean length of stay by the average daily cost per patient in ICU or Hospital. Adjustments for inflation were made according to the USD annual consumer price index. We calculated the difference between the direct variable cost of patients with omega-3 supplementation and patients without omega-3 supplementation. 95% confidence intervals were estimated using bootstrap re-sampling procedures with 1000 iterations.

RESULTS: A total of 12 RCT involving 925 patients were included in this cost analysis. Septic patients supplemented with omega-3 had both lower mean ICU costs ($15,274 vs. $18,172) resulting in $2897 in ICU savings per patient and overall hospital costs ($17,088 vs. $19,778), resulting in $2690 in hospital savings per patient. Sensitivity analyses were conducted to investigate the impact of different study methods on the LOS. The results were still consistent with the overall findings.

CONCLUSION: Patients with sepsis who received omega-3 supplementation had significantly shorter LOS in the ICU and hospital, and were associated with lower direct variable costs than control patients. The 12 RCTs used in this analysis had a high risk of bias. Large-scaled, high-quality, multi-centered RCTs on the effectiveness of this intervention is recommended to improve the quality of the existing evidence.

PMID: 29779820 [PubMed - indexed for MEDLINE]

Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

This makes sense. The limiting factor is resource utilization and ability of the general cardiology service to handle the load of being primary admitters versus consultants only. - TFH



Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.:

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Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

Am J Cardiol. 2018 05 01;121(9):1076-1080

Authors: Salata BM, Sterling MR, Beecy AN, Ullal AV, Jones EC, Horn EM, Goyal P

Abstract

Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF.

PMID: 29548676 [PubMed - indexed for MEDLINE]

Study: Glass Ceiling For Women In The Workplace Still Exists, And It’s Hurting The Economy

We really need to work on this for moral and ethical reasons, not just for the economy although economic concerns are real and valid. 



Study: Glass Ceiling For Women In The Workplace Still Exists, And It’s Hurting The Economy:

Business woman looking up at glass ceiling in office
CHICAGO — Women have historically had a tough time succeeding in the workplace, but over recent years many have made great strides in the business world to become successful CEOs or hold other leadership positions. While some have said this means that the so-called “glass ceiling” blocking women from the top jobs in corporate America has…

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Friday, August 2, 2019

The reach of commercially motivated junk news on Facebook.

The science of creating clickbait undoubtedly is becoming mainstream in marketing and business circles, at the detriment of informing the public of "real" news.





The reach of commercially motivated junk news on Facebook.:

Related Articles
The reach of commercially motivated junk news on Facebook.

PLoS One. 2019;14(8):e0220446

Authors: Burger P, Kanhai S, Pleijter A, Verberne S

Abstract

Commercially motivated junk news-i.e. money-driven, highly shareable clickbait with low journalistic production standards-constitutes a vast and largely unexplored news media ecosystem. Using publicly available Facebook data, we compared the reach of junk news on Facebook pages in the Netherlands to the reach of Dutch mainstream news on Facebook. During the period 2013-2017 the total number of user interactions with junk news significantly exceeded that with mainstream news. Over 5 Million of the 10 Million Dutch Facebook users have interacted with a junk news post at least once. Junk news Facebook pages also had a significantly stronger increase in the number of user interactions over time than mainstream news. Since the beginning of 2016 the average number of user interactions per junk news post has consistently exceeded the average number of user interactions per mainstream news post.

PMID: 31369596 [PubMed - in process]

Tart Cherry Juice May Strengthen Memory, Cognition In Older Adults, Study Finds

This is fascinating news, but findings preliminary. Those adults who drank 8 oz of the tart cherry juice in the morning and at night showed improved cognition after 12 weeks compared to those taking a placebo drink. The study only included 17 people in each group.





Tart Cherry Juice May Strengthen Memory, Cognition In Older Adults, Study Finds:

Cherries
NEWARK, Del. — Tart juice made from Montmorency cherries, the most common type of tart cherries grown in the United States, has long been used to treat a variety of health problems such as gout or sleeplessness. Now, a new study conducted at the University of Delaware has found evidence that a daily serving of cherry…

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Find the Joy

Lyrics I don’t know why it happened. Where it’s going, a mystery. Somewhere there’s an answer, But the hurt is still inside. And time just k...