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| SALARY
SURVEY How does your job measure up? Are your salary and benefits in line with what other nurses make? How much impact does your experience or specialty certification have on your earnings? Let us know in the 7th annual Nursing salary survey. Go to Nursing2006.com and scroll down to Nursing2006 Salary and Benefits Survey. Click on the link to be taken to the survey. Hurry—the deadline for responses is March 31, 2006! |
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AVIAN
FLU Called the Influenza A/H5 (Asian lineage) Virus Real-time RT-PCR Primer and Probe Set, the test provides preliminary results on suspected H5 influenza samples within 4 hours. Older tests took at least 2 to 3 days to deliver results. If this preliminary test detects the presence of an H5 strain of flu virus, further testing is done to positively identify the specific H5 subtype, like H5N1. The test was developed by the Centers for Disease Control and Prevention. Faster results will give public health and government officials additional time to put preventive and containment measures in place should avian flu be detected in the United States. Sources:
U.S. Department of Health and Human Services and the Centers for
Disease Control and Prevention |
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DRUG
NEWS Inhaled insulin approved The Food and Drug Administration has approved the first inhalable form of insulin for the treatment of type 1 and type 2 diabetes in adults. Exubera, an inhalable, rapid-acting, dry powder form of recombinant human insulin, is the first new insulin delivery option introduced since insulin was discovered in the 1920s. It’s inhaled into the lungs before a meal using a proprietary device. In studies, Exubera reached peak insulin concentration more quickly than regular insulin administered by injection. For type 1 diabetes, inhaled insulin may be added to longer-acting insulins as a replacement for short-acting insulin taken with meals. For type 2 diabetes, inhaled insulin may be used alone, along with oral antidiabetic agents, or with longer-acting insulins. Source: Food and Drug Administration Warning
about sulfonylureas The study, published in the January 17, 2006, issue of the Canadian Medical Association Journal, seems to reinforce observations made over the past 30 years that sulfonylureas can increase mortality. The researchers concluded that "clinicians should carefully assess the need for sulfonylurea therapy in subjects at high risk of cardiovascular events." Source: Simpson SH, et al. Dose–response relation between sulfonylurea drugs and mortality in type 2 diabetes mellitus: A population-based cohort study. Canadian Medical Association Journal. 174(2):169-174, January 17, 2006. Telithromycin
may damage the liver Telithromycin is the first ketolide antibacterial agent approved by the Food and Drug Administration. The authors of these case reports advise “caution in prescribing this drug pending further postmarketing surveillance data.” The report will be published in the
March 21, 2006, issue of Annals of Internal Medicine
but was released early online. Antivirals
a nonstarter for 2005-2006 flu season As of late January 2006, 18 states reported either widespread or regional flu activity, and in those states, hospitals are reporting unusually high numbers of cases. Source: Centers for Disease Control and Prevention Boxed
warnings for eczema drugs Source:
Food and Drug Administration |
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CARDIOVASCULAR
DISEASE A differing opinion on stress tests for diabetics Contrary to recommendations from the American Diabetes Association, a person with type 2 diabetes, no symptoms of coronary artery disease (CAD), and either no risk factors or one risk factor for CAD should be screened for the disease the same way as a person with type 2 diabetes and two or more risk factors for CAD, according to researchers in Italy. In their article published in the January 3, 2006, issue of The Journal of the American College of Cardiology, the researchers reported that they’d administered stress tests to 1,899 asymptomatic patients with type 2 diabetes; 1,221 had two or more CAD risk factors and 778 had none or one risk factor. The prevalence of abnormal stress test findings were similar in both groups, they said, as was the prevalence of significant CAD. Guidelines from the American Diabetes Association currently recommend testing only for asymptomatic individuals with type 2 diabetes who have two or more risk factors for CAD. Source: Scognamiglio R., et al. Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus. Journal of the American College of Cardiology. 47(1):65-71, January 3, 2006. Is
laughter really good medicine? Researchers took noninvasive measurements of blood flow in the brachial artery of 20 healthy young adults while they watched clips from a comedy film and then clips from a distressing film. On average, blood vessel dilation was more than 50% better after the comedy than after the depressing film—and the circulation boost was similar to what’s been seen with aerobic exercise. Source: Reuters Health online An
aspirin a day… Researchers from the Centers for Disease Control and Prevention found that 36.2% of adults at least 35 years old used aspirin every day or every other day in 2003. Among adults with cardiovascular disease and diabetes—who are at especially high risk for heart attack and stroke—the numbers were even higher: 82.8% and 62.6%, respectively. Source: Ajani UA, et al. Aspirin use among U.S. adults: Behavioral risk factor surveillance system. American Journal of Preventive Medicine. 30(1):74-77, January 2006. Sleep
well To find out, Italian researchers randomized 9 healthy women and 9 women being treated for hypertension to receive either a placebo or the melatonin supplement for 3 weeks. Then, all the women were switched to the other treatment. From this small sample, the researchers said it appears that melatonin treatment may decrease nighttime blood pressure. Their report was published in the December 2005 issue of the American Journal of Hypertension. Why is lowering nighttime blood pressure significant? A higher day-night difference in blood pressure may be heart protective; a low day-night ratio has been linked to heart disease. Source: Cagnacci A, et al. Prolonged melatonin administration decreases nocturnal blood pressure in women. American Journal of Hypertension. 18(12):1614-1618, December 2005.
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CANCER
The decline may seem small, but it’s important, says Dr. Michael Thun, director of epidemiological research for the American Cancer Society. For more than a decade, the cancer death rate (the calculated number of deaths per 100,000 people) has dropped about 1% annually, but the actual number of deaths still rose each year because population growth outpaced declining cancer death rates. The year 2003 marked the first time that the declining death rate surpassed the population growth. Experts attribute the drop to fewer people smoking, earlier detection of tumors, and more effective treatment of tumors. Death rates fell for lung, breast, prostate and colorectal cancer—the four most common cancers, which account for 51% of all U.S. cancer deaths. Even if the number of cancer deaths rises again in 2004, say cancer experts, the new statistics suggest that the “war” on cancer is at a crossroads. Genetics research and recent scientific innovations may offer more hope in the ongoing battle. Source: American Cancer Society Hormone
levels and breast cancer risk A study from the University of California, San Francisco, looked at median plasma levels of estradiol, testosterone, and sex-hormone-binding globulin in 135 women with postmenopausal breast cancer and 275 postmenopausal women without breast cancer. The women were judged to be at high risk for breast cancer. There were no significant differences, lending doubt to conventional wisdom that sex-hormone levels are a reliable predictor of breast cancer. Source: Beattie MS, et al. Endogenous sex hormones, breast cancer risk, and tamoxifen response: An ancillary study in the NSABP breast cancer prevention trial (P-1). Journal of the National Cancer Institute. 98(2):110-115, January 18, 2006. Palladium:
Seeds of hope Advantages over external beam radiation are a lower dose to the skin and greater convenience for the patient. About 70 seeds are implanted using brachytherapy needles; the patient is given fentanyl/midazolam anesthesia. Patients report little or no discomfort, and follow-up has shown that the implants stay put. The palladium brachytherapy is currently in a Phase I/II clinical trial. Source: Pignol JP, et al. First report of a permanent breast 103Pd seed implant as adjuvant radiation treatment for early-stage breast cancer. International Journal of Radiation Oncology, Biology, Physics. 64(1):1760181, January 1, 2006. Coping
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DEPRESSION
Polishing tarnished images Despite negative publicity of late, antidepressant medications and electroconvulsive therapy (ECT) remain the most effective treatments for moderate to severe depression, according to researchers at the University of Edinburgh in Scotland. Antidepressant medications are widely—and perhaps incorrectly—perceived as being linked to an increased risk of suicide, and many people see ECT as outdated and downright cruel, like lobotomy. The Scottish study, published in the January 14, 2006, issue of The Lancet, challenges those assumptions and concludes that antidepressants are an effective mainstay of treatment and that ECT is not only "highly humane," but also "the most effective treatment for deep depression, especially if it presents with psychotic symptoms." Source: Ebmeier K, et al. Recent developments and current controversies in depression. Lancet. 367(9505):153-167, January 14, 2006. Risk
of depression relapse The researchers looked at 201 pregnant women with a history of depression; overall, 43% experienced a relapse in depression, and half of those relapsed during the first trimester. Here’s where the numbers get interesting: Women who kept taking their antidepressant medication relapsed at a rate of 26%, while those who stopped the medication relapsed at a rate of 68%. These findings, published in the February 1, 2006, issue of JAMA, may help providers and patients better balance the risks vs. benefits when deciding on the best course of action for women who have depression and who are or who want to become pregnant. Source:
Cohen LS, et al. Relapse of major depression during pregnancy
in women who maintain or discontinue antidepressant treatment.
JAMA. 295(5):499-507, February 1, 2006. |
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| OLDER
ADULTS
Exercise may delay Alzheimer's onset Older adults who engage in minimal exercise at least three days a week may be able to cut their risk of developing Alzheimer’s and other forms of dementia by 30% to 40%, according to a study published in the January 17, 2006, issue of Annals of Internal Medicine. The finding appears to be true even for older adults who aren’t already in good physical shape. According to the study’s lead author, the more frail a person is, the more he or she will benefit from exercise. Suggested activities included walking, hiking, bicycling, aerobics, calisthenics, swimming, water aerobics, weight training, and stretching. Source: Larson EB, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine. 144(2):73-81, January 17, 2006. Moxifloxacin
edges out levofloxacin Researchers at the University of South Texas Veterans Health Care System, San Antonio, Tex., included 394 patients with CAP in a randomized, double-blind study. Patients were treated with either moxifloxacin or levofloxacin for 7 to 14 days. At 5 to 21 days after completion of therapy, 92.99% of patients treated with moxifloxacin were considered to be cured, versus 87.9% treated with levofloxacin. Clinical recovery within 3 to 5 days after the start of treatment was 97.9% in the moxifloxacin group versus 90% in the levofloxacin group. Source:
Anzueto A, et al. Community-acquired pneumonia recovery in the
elderly (CAPRIE): Efficacy and safety of moxifloxacin therapy
versus that of levofloxacin therapy. Clinical Infectious Diseases.
42(1):73-81, January 1, 2006. |
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GUIDELINE
UPDATES CPR/ECC The American Heart Association (AHA) has revised the 2005 guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC). Among the changes:
Information: http://www.circulationaha.org Cancer
screening Thyroid
nodules, thyroid cancer |
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