ShortCuts-This Week in the Journals

March 19, 2007

ShortcutWelcome to ShortCuts, yet another new feature of Clinical Correlations. Every week we will post what we feelare the 5 most interesting articles from the news and literature with links. We’re not attempting to digest any of this for you or to be all-inclusive, but rather make you aware of some of the more important articles that have been published that we simply do not have time to fully review here at Clinical Correlations. Please let us know your thoughts on this format at . Now for our first series of shortcuts…

1. Weekend Admissions-It appears that if you get admitted to a hospital on the weekend for an acute myocardial infarction you have a higher mortality rate than during the week (30 day mortality 12.9% vs. 12.0% NNT 111). It always did strike me that our society demands that stores such as 7-11are open 24 hours but our hospitals essentially shut down over the weekends. NEJM Link

2. Anxiety Disorders in Primary Care– A survey of 965 randomly selected primary care patients showed a prevalence of anxiety disorders of 19.5%, including 8.6% anxiety disorder, 7.6% post-traumatic stress disorder and 6.8% panic disorder. Annals Link.

3. Mental Health Disorders in Returning Veterans-25 % of of returning veterans returning from Operations Enduring Freedom and Iraqi Freedom receive mental health diagnoses, 56% of those had 2 or more distinct mental health diagnoses. Remember these are initial diagnosis, we obviously know these numbers likely grow over time. Youngest veterans between 18-24 were most at risk. Archives of Internal Medicine Link.

4. CPR-The Lancet had a study this week looking at resuscitation techniques of bystanders in 4000 cardiac arrests. Cardiac-only resuscitation without mouth-to mouth ventilation had better neurologic outcomes 6% vs. 4%. Lancet Link:

5. FDA Warns about Sleeping Aids-Just about every news organization carried a story about the FDA warning regarding the potential of drugs used to aid sleep (just about every drug available in this category)causing: 1. Anaphylaxis and angioedema as early as the first time the product is taken. 2. Complex sleep-related behaviors includingsleep-driving, making phone calls, and preparing and eating food while asleep…I can just see the conversation with my patients going like this, “You will probably find that you sleep better, the only side effect you may notice is that you may wake up while driving home from McDonalds eating a big mac while talking on your cell phone, other than that you shouldn’t have any side effects…FDA Warning