Gale Scott

Cross magnesium sulfate off the list of potential treatments to prevent post-stroke brain damage. Writing in the New England Journal of Medicine, Jeffrey Saver, MD and colleagues reported on FASTMAG, a test in which paramedic ambulance crews administered magnesium sulfate to apparent stroke patients at the site of the 911 call. The treatment was shown to be safe, with no difference in mortality between the treatment group and patients who got a placebo. But there was no significant shift in 90-day disability outcomes.

Gynecomastia-the growth of breast tissue in men-can be an embarrassment for adolescents, but for professional bodybuilders it can be a career-ender. Two plastic surgeons said steroid use is to blame and surgery-not liposuction-is the best treatment.

Implantable cardioverter-defibrillators (ICDs) have prevented cardiac arrests and deaths, but they carry a risk of giving patients shocks when they don't need them. That inappropriate shock rate has been estimated as occurring in 10 to 20% of patients with the devices, causing unnecessary hospital admissions, and a negative impact on patients' quality of life. They are also associated with increased morbidity and mortality for some patients. But in a study in Heart Rhythm Angelo Auricchio, MD, PhD, and colleagues report on technological improvements in a Medtronic device that has reduced those shocks to 1.5% with a dual/triple chamber defibrillator and 2.5% for a single chamber ICD after one year.

When it comes to ordering the correct test for Vitamin D, too many doctors just can't get it right, a new study found. A Seattle team found 66% of tests ordered for one type of test were made in error, delaying care and potentially putting patients at risk. But it took the laboratory specialists 2 years of trial and error--and a lot of patience--to get the doctors to order the right tests.

The ACA requires participating insurers to offer plans ranked by the quality and cost of their offerings. The cheapest is labeled bronze, then silver, gold, and platinum. Some policymakers have proposed creating a still cheaper plan that would protect someone from health care bankruptcy, but have high out-of-pocket costs for care.

Women tend to become addicted to drugs and relapse faster than men. In a study in the Journal of Neuroscience, Helen Scharfman and Teresa Miller write that high levels of estrogen may be responsible for this difference.

The for-profit insurance industry has a complicated relationship with the Affordable Care Act (ACA). Although the ACA promises millions of new customers and fees, it also places potentially burdensome new rules and requirements on the industry. The panelists look at cases where insurers have decided to jump into this new marketplace.

It has been up to the states to decide whether expanding Medicaid by raising income-eligibility rates is the most affordable way to get more people covered under the Affordable Care Act. But Medicaid expansion has had mixed results.

A Gallup survey shows that many American do not approve of the ACA, yet more than 10 million people have coverage because of it.

The 2014 midterm elections changed the balance of power in Washington. The Republicans now have majorities in both the US Senate and the US House of Representatives. Will that mean the end of the Affordable Care Act?

Addressing a controversy that arose in the UK, the Lancet published a study that concludes oseltamivir (Tamiflu/Roche) does show efficacy in treating influenza. Researchers in London and the US concluded "Our findings show that oseltamivir in adults with influenza accelerates time to clinical symptom alleviation, reduces risk of lower respiratory tract complications, and admittance to hospital, but increases the occurrence of nausea and vomiting." That refutes the findings of a 2014 British Medical Journal study that charged the drug had no antiviral effect, the authors said. The earlier study also alleged that the drug's adverse effects outweighed any benefits.

Major depressive episodes (MDEs) have physical symptoms such as anhedonia, anorexia and weight loss-all of which can be triggered by activation of the immune system.In a report in JAMA Psychiatry Elaine Setiawan, PhD and colleagues said their research shows that translocator protein density intensifies during an MDE, and that shows brain inflammation.They measured translocator protein by distribution volume (TSPOVt) assessed through PET scans.

Alzheimer 's disease (AD) has a long preclinical phase in which pathology develops years or decades before clinical symptoms. In study in JAMA Psychiatry, Robert Pietrzak, PhD, MPH and colleagues report that depression, anxiety and cognitive decline are associated with presence of Amyloidβ but that patients will benefit if their depression and anxiety are treated.

Everyone involved in the care of a child diagnosed with autism spectrum disorder (ASD) wants to know that child's long-term prognosis. In a study in JAMA Psychiatry Peter Szatmari, MD reports on his study of 421 newly diagnosed preschoolers in a Canadian multisite longitudinal study. Data were collected over 4 years, until each child was age 6.The author found that there are several trajectories ASD can take.

Hospitals in New York and New Jersey expect to return to normal by tomorrow morning, after making extensive blizzard readiness preparations that disrupted schedules and had the public on edge.State of emergency declarations were lifted this morning, as the storm that was supposed to be "snowpocalypse" or "snowmageddon" turned east from its predicted path by 50 miles and spared much of the NY-NJ region that was expecting it to be a winter version of 2012's Super Storm Sandy.

Since children diagnosed with autism spectrum disorders (ASD) may also have epileptic disorders, physicians usually want electroencephalograms (EEGs) of their brains.One sign of autism is staring spells. That can also be a form of epilepsy, an absence seizure.But an Australian study of children referred for these episodes showed EEGs offer little diagnostic benefit.

The US Food and Drug Administration approved the first generic version of AstraZeneca's heartburn blockbuster, Nexium.

Abandonment alters children's brain tissue.Children who experienced extreme neglect showed physical changes in the white matter of their brains, a Boston team found.Writing in JAMA Pediatrics Johanna Bick PhD and colleagues at Boston Children's Hospital reported on the Bucharest Early Intervention Project.

Finding brain beta amyloid is usefull in assessing Alzheimer's Disease. In a report in JAMA Neurology, Craig Curtis, MD, and colleagues report on a multicenter PET imaging study on terminally ill dementia patients using flutemetamol injections tagged with radioactive fluorine 18. In cases where autopsy was later possible, the team assessed how accurate the tests had been in diagnosing Alzheimer's.

Isolated systolic hypertension (ISH) in young and middle-aged adults is on the rise. A study in the Journal of the American College of Cardiology found that ISH puts these patients at higher relative risk for heart disease and mortality than their peers with normal blood pressure. That raises the question of whether these younger ISH patients should be getting drug therapy.

Opioids can be effective in controlling back pain, but their use carries risk of complications, misuse, and abuse. Clinicians have to decide when it is a good idea to prescribe them and when it is not.

Avoiding intracranial hemorrhage (ICH) is a major concern for physicians treating patients with anticoagulation drugs. Iatrogenic ICH related to anticoagulants occurs in 0.3% to 1.8% of patients a year who are taking warfarin.

Cerebral microbleeds (CMBs) following a transient ischemic attack (TIA) may be a sign a patient is likely to have another stroke. All patients who have a TIA are at risk of a recurrence, but that risk can be modified by optimal treatment, Jae-Sung Lim, MD, MSc and colleagues report. In fact, 80% of those recurrences could be eliminated, Lim wrote in a study in JAMA Neurology. But that may not be the case with TIA patients who have CMBs

As a blizzard predicted to break snowfall records bears down upon the Northeast, hospitals and physicians are shifting into disaster-planning mode. With the worst of the blizzard expected to hit coastal New England, Mass. Gov. Charlie Baker has declared a state of emergency and instituted a travel ban that will take effect at midnight. , per Boston.com. Shriner's Hospital in Boston canceled elective procedures and clinic visits. New Jersey Gov. Chris Christie declared a state of emergency at noon Monday, closing state offices and urging motorists to stay off the roads. In a news conference this afternoon, he said the state's emergency workers and transportation department can handle the storm.

The US Food and Drug Administration (FDA) has approved a polypill for hypertension, a combination of perindopril arginine and amlodipine (Prestalia/ Symplmed Pharma-Servier).

The US Food and Drug Administration approved ferric pyrophosphate citrate (Triferic/Rockwell) for use as an iron replacement therapy in patients with end-stage renal disease, the company announced. It is also indicated for chronic kidney disease. The drug is for adults.

The US Food and Drug Administration (FDA) approved Bexsero, a Novartis vaccine to prevent meningococcal disease caused by Neisseria meningitides serogroup B. It is meant for children age 10 and up and young adults through age 25.

Handwritten prescriptions will soon be illegal in New York. The Medical Society of the State of New York (MSSNY) and 18 national and NY State medical organizations are trying to delay for a year the onset of a law that would require electonic prescriptions, ban prescription pads, and drastically restrict phoned-in prescriptions. The measure, due to take effect March 27, would require electronic prescriptions for all medications-not just for controlled substances but antibiotics, allergy medications or anything else that requires a prescription.

A commonly used sensitive Troponin detection test to confirm heart attacks is often not being used in a way that will consistently detect these events, a UK research team has found. Writing in the British Medical Journal, Zhivko Zhelev PhD, a diagnostics research fellow at the University of Exeter and colleagues reported on their meta-analysis of studies that assessed the accuracy of a widely used diagnostic test, the Elecsys Troponin T high-sensitivity assay.

The hospital shooting death of Boston cardiac surgeon Michael Davidson, MD, 44, has shocked the cardiology world-far beyond his colleagues at Brigham and Women's Hospital where he was director of endovascular cardiac surgery. On a remembrance page and in formal statements, tributes are pouring in. Davidson, a respected innovator in heart valve replacement, died late Jan. 20, hours after he was shot by the son of a former patient who then turned his gun on himself.He leaves his wife Teri Davidson, who is 7 months pregnant, and 3 children ages 2 to 9.