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10-02-2013 | Article

Global medical news in review: February 4–10, 2013

medwireNews: A roundup of select stories of interest to US physicians from the MerckMedicus Medical News wire.

Questionable benefit

It is practically viewed as a given that calcium intake benefits bone health, as attested by the 50% of older men and 70% of older women in the USA who use calcium supplements.

Aside from the skeletal benefits that calcium may provide, however, studies have shown that calcium intake might also bring on cardiovascular (CV) risks. To straighten out the controversy surrounding the cardiovascular harm that might stem from calcium supplements, an Archives of Internal Medicine study looked at a large cohort of Americans to see whether calcium had any involvement with mortality from CV disease, heart disease, or cerebrovascular disease.

The results were mixed, with supplemental but not dietary calcium intake tied to increased CV disease mortality in men but not women.

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Antibiotic recovery

The ready-to-use therapeutic food that international consensus guidelines recommend for the management of severe acute malnutrition has resulted in a marked improvement in childhood morbidity and mortality that exists worldwide. Yet, 10% to 15% of children still do not manage to recover from severe wasting.

Part of this failure to recuperate could stem from infections that are highly prevalent among children who are hospitalized for severe malnutrition, which has led to guideline recommendations for routine antibiotic use.

To clinically test the necessity and efficacy of antibiotics in the management of severe acute malnutrition, a New England Journal of Medicine study assessed feeding clinics in Malawi and found that the treatment did, indeed, significantly improve recovery.

The finding validates the inclusion of antibiotics with nutritional therapy when treating malnutrition though long-term outcomes still need to be verified.

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Fishy toxicity

A sudden spike in cases of ciguatera fish poisoning in New York City occurred during 2010 to 2011, which the Centers for Disease Control and Prevention verified were linked to barracuda and grouper that were purchased in Queens, as noted in a Morbidity and Mortality Report.

The situation raised the department's eyebrow because the 28 cases that were recorded surpassed what was reported over the previous 10-year period.

The naturally occurring toxin giving rise to this relative surge in cases emphasized the need for general awareness about areas that are endemic for this type of fish poisoning - especially when practical field tests for fish monitoring programs are absent.

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Impressionable prescribers-to-be

The establishment of the PharmFree Campaign by the American Medical Student Association in 2002 advocated evidence-based prescribing free of market-based influences. The initiative has led to assessments of US medical schools and a degree of interaction between faculty and industry that is permissible.

PharmFree Campaign's vigilance is with reason as studies have found medical student exposure to pharmaceutical marketing efforts during medical education leads to favorable attitudes toward the industry and a higher probability of quickly adopting a new drug as a physician.

Taking a closer look at the influence that industry might have on a medical student's subsequent prescribing habits, a BMJ study found that attending a medical school with a gift restriction policy lessened the likelihood of prescribing newly marketed drugs.

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Unreliable surrogate

Interferon has been used to prevent the transition of benign chronic hepatitis C into life-threatening end-stage liver disease, which entails decompensated cirrhosis, cancer, or both.

Yet, researchers are not clear on what specific effects interferon treatment might have due to randomized trials being difficult to conduct. Researchers have thus resorted to surrogate outcomes based on the disappearance of viral RNA from the blood stream, the results of which have yet to be validated.

A systematic Cochrane review investigated the effects of interferon alone as a retreatment for individuals who had failed to develop a sustained viral response after previous courses of treatment - a form of monotherapy that is no longer used.

Several years of pegylated interferon treatment was not only associated with a higher mortality that was not directly related to liver disease, but also failed to link viral response to how liver disease progresses.

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By Peter Sergo, medwireNews Reporter