Culture

A new definition of chronic kidney disease labels over 1 in 8 adults and around half of people over 70 years of age as having the disease. Yet low rates of kidney failure suggest many of those diagnosed will never progress to severe disease.

On bmj.com today, Ray Moynihan and colleagues argue this is evidence of overdiagnosis. They call for a re-examination of the definition and urge clinicians to be cautious about labelling patients, particularly older people.

Try to remember the last time that you inferred that another person was in an emotional state of mind – chances are that it was the sounds that he or she made that provided the clues. Emotional non-speech sounds (such as crying, hums, laughter, and sighs) are often considered an especially primitive form of emotional communication that in many ways resembles animal expressions more than human speech. But, this intriguing form of emotional signaling has received little attention from researchers.

About half of a small group of patients with fibromyalgia – a common syndrome that causes chronic pain and other symptoms – was found to have damage to nerve fibers in their skin and other evidence of a disease called small-fiber polyneuropathy (SFPN). Unlike fibromyalgia, which has had no known causes and few effective treatments, SFPN has a clear pathology and is known to be caused by specific medical conditions, some of which can be treated and sometimes cured.

SAN FRANCISCO (July 30, 2013) – A team of researchers led by Dr. Matt Lewin of the California Academy of Sciences, in collaboration with the Department of Anesthesia at the University of California, San Francisco, has pioneered a novel approach to treating venomous snakebites—administering antiparalytics topically via a nasal spray. This new, needle-free treatment may dramatically reduce the number of global snakebite fatalities, currently estimated to be as high as 125,000 per year.

(Edmonton) Family physicians regularly counsel patients about medical risks associated with heart disease, stroke, diabetes and smoking, and a team from the University of Alberta wants to add cellphone use and driving to the discussion.

Talking on a cellphone while driving raises the risk of collision by four to six times—comparable to getting behind the wheel while under the influence, studies show. Addressing the problem requires educating the public about the risks, and a good place to start is in the doctor's office.

OAKLAND, Calif., July 30, 2013 — Patients with diabetes who take certain types of medications to lower their blood sugar sometimes experience severe low blood sugar levels, whether or not their diabetes is poorly or well controlled, according to a new study by Kaiser Permanente and Yale University School of Medicine. The finding, published in the current online issue of Diabetes Care, challenges the conventional wisdom that hypoglycemia is primarily a problem among diabetic patients with well-controlled diabetes (who have low average blood sugar levels).

Does psychotherapy via the Internet work? For the first time, clinical researchers from the University of Zurich have studied whether online psychotherapy and conventional face-to-face therapy are equally effective in experiments. Based on earlier studies, the Zurich team assumed that the two forms of therapy were on a par. Not only was their theory confirmed, the results for online therapy even exceeded their expectations.

DURHAM, N.C. – Mandating outpatient treatment for certain people with severe mental illness, while controversial, results in substantial cost savings by cutting hospitalizations and increasing outpatient care, according to a financial analysis led by researchers at Duke Medicine.

Fewer states are holding alcohol retailers liable for harms caused by customers who were served illegally, according to a new report from researchers at Alcohol Policy Consultations and the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health. Published online by the American Journal of Preventive Medicine, the legal research study documents the gradual erosion of commercial host liability (also referred to as dram shop liability) from 1989 to 2011.

Medical noncompliance -- or failure to follow the doctor's orders -- is estimated to increase healthcare costs in the US by $100 billion per year. Patients sometimes opt not to take medicines, for instance, because the side effects are unbearable or the dosing regimens are too complicated. But medical noncompliance may also stem from sheer inertia -- the tendency to stay in the current state, even when that state is undesirable.

The remains of two large 6000-year-old halls, each buried within a prehistoric burial mound, have been discovered by archaeologists from The University of Manchester and Herefordshire Council -- in a UK first.

The sensational finds on Dorstone Hill, near Peterchurch in Herefordshire, were thought to be constructed between 4000 and 3600 BC.

Some of the burnt wood discovered at the site shows the character of the building's structure above ground level -- in another UK first.

Most ward nurses say they are forced to ration care, and not do or complete certain aspects of it—including adequate monitoring of patients—because they don't have enough time, indicates research published online in BMJ Quality & Safety.

The lower the nurse headcount, the greater the risk, the study shows, prompting the researchers to suggest that hospitals could use episodes of missed care as an early warning sign that nurse staffing levels are too low to provide safe, high quality care.

A screening tool used in general hospitals to detect suicide risk among patients who have self harmed should be ditched, concludes a study published online in Emergency Medicine Journal.

The technique (SADPERSONS Scale) fails to pick up most of those who require admission to a psychiatric unit, community psychiatric aftercare, or to determine those at risk of self harming again, say the researchers.

A systematic review of the evidence suggests that screening asymptomatic high-risk adults at risk for lung cancer using low-dose computed tomography (LDCT) may reduce mortality. Lung cancer is the third most common cancer in the United States and is the leading cause of cancer-related death for both men and women.

Management of back pain appears to be variable, despite numerous published clinical guidelines, according to a report published by JAMA Internal Medicine, a JAMA Network publication.

Spinal symptoms are among the most common reasons patients visit a physician and more than 10 percent of visits to primary care physicians relate to back and neck pain, the authors write in the study background.