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July 27, 2012 — Contrary to previous studies, there’s no significant relationship between epidural anesthesia and an increase in maternal body temperature during labor, according to a new  study published  in the August issue of  Anesthesiology . In contrast, the study, by Michael A. Frölich, MD, from the Department of Anesthesiology at the University of Alabama at Birmingham, and colleagues, did find significant associations between temperature increase during induced labor and both higher body mass index ( P  = .0067) and longer time from rupture of membranes to delivery ( P  = .0077). Reports over recent years suggest that possible causes of noninfectious maternal temperature elevations during labor include epidural analgesia, endogenous heat production by uterine contractions, and overheated delivery rooms. The authors sought to evaluate the first possible cause by conducting a prospective cohort trial. Of 90 women with induced labor who were enroll...

July 30, 2012 — Psychological maltreatment during childhood can scar children for life and result in developmental and educational problems, disorders of attachment, disruptive behavior, and psychopathology in later years,  new research  shows. "Psychological or emotional maltreatment of children and adolescents may be the most challenging and prevalent form of child abuse and neglect, but until recently, it has received relatively little attention," write Roberta Hibbard, MD, from Riley Children's Hospital, Indianapolis, Indiana, and colleagues of the Committee on Child Abuse and Neglect and the Child Maltreatment and Violence Committee of the American Academy of Child and Adolescent Psychiatry. The report was published online July 30 in  Pediatrics . A technical report by the American Academy of Pediatrics reviewed the issue in 2000. The current report was done to update pediatricians on current knowledge and approaches to psychological maltreatment, including ...

July 27, 2012 — Progress in getting teens to have safer sex largely has stalled over the last decade, a new CDC study suggests. Nearly half of high school students (47%) have had sex, according to the 2011 Youth Risk Behavior Survey (YRBS). That's almost the same percentage reported in the 2001 survey -- 46%. That means the decline in sexually active teens seen in the 1990s -- from a 1991 high of 54% -- is now stalled. So are other markers of safer sex (or abstinence) among teens: 34% of high school students had sex in the preceding three months. There's been little decline since the 1990s saw a slight decline from 38% in 1991. 15% of high school students had four or more sex partners, stable since 14% in 1991 but not as high as the 19% seen in 1991. 60% of high school students used a condom the last time they had sex. "We have to step back and think about the lack of urgency about the HIV/AIDS epidemic in the U.S.," Kevin Fenton, MD, director of the CDC...

July 27, 2012 — A bite from the lone star tick can cause a person to develop a delayed, life-threatening allergic reaction to eating beef or other mammalian meat, according to an article  published online  July 20 in the  Journal of General Internal Medicine . Susan E. Wolver, MD, from the Department of General Internal Medicine at Virginia Commonwealth University, Richmond, and colleagues advise that clinicians be aware of the new syndrome, which can produce pruritic hives and other symptoms 3 to 6 hours after eating, rather than the usual 1 hour. The syndrome has been confined, at least initially, to the southeastern United States, where the lone star tick is endemic. The tick bite is thought to produce immunoglobulin E (IgE) antibodies to the carbohydrate galactose-alpha-1.3-galactose (alpha-gal), a carbohydrate moiety in mammalian meat glycoproteins or glycolipids. In their description of the new syndrome, the researchers analyzed case studies of 3 patients, 2 ...

July 30, 2012 — Two US senators have introduced an act that would ensure a thorough review of the US government's approach to diabetes care, an effort experts hope will ultimately slow the pace of this burgeoning epidemic. Several major medical associations were quick to applaud the bipartisan effort, which came out of the Senate Diabetes Caucus and its cochairs, senators Jeanne Shaheen (D-NH) and Susan Collins (R-Maine). If approved, the National Diabetes Clinical Care Commission Act will create a public–private sector commission to recommend improvements to care. "This is a fabulous idea when it comes to diabetes," Joan Salge Blake, RD, LDN, a spokesperson for the Academy of Nutrition and Dietetics, said to  Medscape Medical News . "Prevention is key, it's absolutely key. Diabetes is the number 7 killer of Americans, and it's something we have a good chance of preventing. But more and more Americans are getting diabetes, and so many issues go along ...

July 30, 2012 — Routine screening for prostate cancer with the prostate-specific antigen (PSA) test has come under fire in recent months, but what would happen if there was no such screening? Three times as many men would have advanced prostate cancer on diagnosis, according to a new analysis,  published online  July 30 in Cancer . The researchers suggest that PSA testing in the United States prevents about 17,000 men each year from having advanced metastatic prostate cancer at diagnosis. "Our findings are very important in the light of the recent controversy over PSA testing," said lead researcher Edward Messing, MD, from the University of Rochester Medical Center in New York. The controversy erupted after the US Preventive Services Task Force recently  recommended against routine use of the PSA test for screening asymptomatic men for prostate cancer, concluding that the potential harms from doing so outweigh the potential benefits. The test can identify ca...

July 30, 2012 — Training physicians to engage patients in decision-making can reduce the prescription of unnecessary antibiotics for acute respiratory infections, according to a randomized trial of 359 patients published in the  Canadian Medical Association Journal . In the cluster randomized trial, the use of antibiotics for acute respiratory infection was reduced by 25% among patients of Canadian physicians from 5 family practices who were trained in physician–patient shared decision-making compared with use among patients of physicians who provided "usual care" (27.2% vs 52.2%; adjusted relative risk, 0.48; 95% confidence interval, 0.34 - 0.68). The reduction in antibiotic use had no significant effect on patient outcomes from respiratory infection 2 weeks after patients consulted with their physicians about symptoms of acute respiratory infection, according to lead author France Légaré, MD, PhD, from the Research Centre of the Centre Hospitalier Universitaire de Qu...