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 "It's our job to help patients live as long as possible free of complications of cardiovascular disease. Although most patients share that goal, we don't always see the same pathways to get there. I want to believe that if patients knew what I know, they would take their medicine. What I've learned is that if I felt what they feel, I'd understand why they don't."
Lisa Rosenbaum MD

(In NEJM 2015 - Beyond belief: how people feel about taking medications for heart disease).

 

Statins benefit women

Previous meta-analyses of the effects of statin therapy in women have reached conflicting conclusions. Australian and international researchers have completed a meta-analysis of individual data from more than 174,000 trial participants, finding "conclusive" evidence that statins reduce cardiovascular disease (CVD) in women, including those who have never had a cardiovascular event. The study shows that statins also reduce all-cause mortality by 9% per 1mmol/L reduction in LDL-cholesterol - a finding never before shown in women.

Source: Lancet 9 Jan 2015; Online first.

CVD  guidelines - commentary:
Implications of the 2013 ACC/AHA Cholesterol Guidelines for Adults in Contemporary Cardiovascular Practice (Investigation) / Thomas M Maddox et al.

Insights from the NCDR PINNACLE (National Cardiovascular Data Registry Practice Innovation and Clinical Excellence) on implications of these guidelines for contemporary treatment and testing in cardiovascular practice. Data was derived from more than a million patients in 111 cardiology office practices (from 2008 to 2012) with hypertension, coronary artery disease, heart failure, and/or atrial fibrillation.

Source:
Journal of the American College of Cardiology Dec 2014; 64(21):2183-2195

 

Australian families’ organ donation decisions

In Australia deceased organ donors have increased; but rates of consent remain at 60%. Reasons for donation decisions is well reported in international literature, however little was known about Australian families. Authors discovered that while themes for consent were similar to those reported globally, themes for non-consent in Australia differed in that there was little emphasis on lack of trust of the medical profession or concerns regarding level of care, rather emphasis was on the lack of: knowledge of deceased's wishes; "social, cultural and religious beliefs; factors relating to the donation process, and family exhaustion...".

Source: Anaesthesia and Intensive Care Jan 2015; 43(1):42-50
Held in print @ Austin; accessible via website for ASA members

Related
Organ donation: how to increase the donor pool (Editorial) / T Oh
Source: Anaesthesia and Intensive Care Jan 2015; 43(1):12-13
Held in print @ Austin; accessible via website for ASA members

Attitudes toward reciprocity, preferred status and other organ donation policies: a survey of the Australian and New Zealand intensive care community (Correspondence) / FE Martinez, E Kelty.
Source: Anaesthesia and Intensive Care Jan 2015; 43(1):132-133
Held in print @ Austin; accessible via website for ASA members

A review of potential muslim organ donors' perspectives on solid organ donation: lessons for nurses in clinical practice / Muliira, R S., Muliira, J K.
Source: Nursing Forum 2014; 49(1):59-70
Also accessible via The Transplant Library - a database of evidence-based information on all aspects of solid organ transplantation.

 

Global impact of anti-microbial resistance – KPMG

This report aims to quantify some of the consequences of higher AMR levels, looking at the impact different AMR scenarios could have on the economies of 156 countries by 2050. Given the complexity involved in estimating the full impact of AMR, analysis was limited to a selection of 3 bacteria (Staphylococcus aureus; Escherichia coli and Klebsiella pneumoniae) and 3 diseases (HIV, tuberculosis and malaria) with reasonable incidence and coverage and relevant available data.

Source: KPMG LLP Dec 2014

 

Wearable health trackers

Technology companies are ramping up the production of devices that measure personal health variables such as physical activity, sleep quality and heart rates. A commentary in JAMA by doctors and academics says the collection of large amounts of bio-data needs to be matched by strategies which lead to the creation of "enduring new habits", this being particularly important for those with chronic disease. The gap between recording information and changing behaviour is substantial, and while these devices are increasing in popularity, little evidence suggests they are bridging the gap.

Source: JAMA 8 Jan 2015; Online first

 

Practical patient apps

For patients and clinicians there is a huge amount of information that can be extracted from app data to assist in the management of a chronic condition. For example recently a medical technology company released a smart phone app called AsthmaSense. The app is aimed at helping asthmatics follow their asthma action plan, providing active reminders to take medications or lung function tests and allowing the user to keep a journal of symptoms and recordings of peak flow and wheeze rate. It allows users to receive alerts when their asthma is judged to be well controlled or poorly controlled - alerting them to a potential attack - to add emergency contact information and review up to two months of medication use. The app will allow asthmatics to share their data with doctors or family members.

Source: Pulse+IT Nov 2014

 

Decision support tools

The Library provides access to a range of decision support and point-of-care tools for clinicians to readily access the latest clinical information. These tools are available from the Library page on the Hub or via our website if you are off-site.

Highlighting this week:

ClinicalKey - a search engine that supports clinical decisions by making it easier to find and apply relevant knowledge. It provides videos and multimedia resources, journals, books, guidelines, drug monographs and patient education resources.

ERS Monographs - the European Respiratory Society Monograph is the quarterly book series from the European Respiratory Society. Each Monograph covers a specific area of respiratory medicine, providing in-depth reviews that give clinicians at all levels a concise, comprehensive guide to symptoms, diagnosis and treatment.

UpToDate - includes more than 140 interactive medical calculators that allow you to enter the values in commonly used formulas to obtain numerical data. Explore the Calculator topics by searching for the term "calculators" in UpToDate; or by searching a particular topic.

 

Journals - Austin's top 10

These links provide access to the the current issue.

American journal of roentgenology

Blood

BMJ

Chest

Diabetes care

European respiratory journal

Journal of clinical oncology

Lancet

Lancet oncology

Pediatrics

Looking for the latest journal issues?
All our journal titles with electronic access are available via the A-Z Journal List
(outside the Austin Health network use your Library barcode no. & PIN for access)

If you require an article from a journal that is not on the A-Z Journal List, please use our online document delivery form.

Journals received in print-only format this week:

ACTA obstetricia et gynecologica Scandinavica, Vol. 94, no. 1, January 2015.

Journal of psychosomatic obstetrics & gynecology, Vol. 35, no. 4, December 2014.

Nature, Vol. 517, no. 7532; Vol. 517, no. 7533, 8 January 2015

The practising midwife, Vol. 18, no. 1, January 2015.

 

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