More Evidence That Perioperative Beta-Blockers in Noncardiac Surgery Can Be Harmful

HYPOTHESIS: We hypothesized that the relationship among beta-blocker use, heart rate control, and perioperative cardiovascular outcome would be similar in patients at all levels of cardiac risk. DESIGN: Retrospective cohort study. SETTING: Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas. PATIENTS: Among all patients who underwent various noncardiac surgical procedures in 2000, those who received perioperative beta-blockers were matched and compared with a control group from the same patient population. MAIN OUTCOME MEASURES: Thirty-day stroke, cardiac arrest, myocardial infarction, and mortality, as well as mortality at 1 year. RESULTS: Patients at all levels of cardiac risk who received beta-blockers had lower preoperative and intraoperative heart rates. The beta-blocker group had higher rates of 30-day myocardial infarction (2.94% vs 0.74%, P =.03) and 30-day mortality (2.52% vs 0.25%, P =.007) compared with the control group. In the beta-blocker group, patients who died perioperatively had significantly higher preoperative heart rate (86 vs 70 beats/min, P =.03). None of the deaths occurred among the patients at high cardiac risk. CONCLUSION: Among patients at all levels of cardiac risk undergoing noncardiac surgery, administration of beta-blockers should achieve adequate heart rate control and should be carefully monitored in patients who are not at high cardiac risk. Arch Surg. 2008 Oct;143(10):940-4; discussion 944.

Google Flu Trends

How does Google Flu Trends work?
Google believes that certain search terms are good indicators of flu activity. Google Flu Trends uses aggregated Google search data to estimate flu activity by state.

Each week, millions of users around the world search for online health information. As you might expect, there are more flu-related searches during flu season, more allergy-related searches during allergy season, and more sunburn-related searches during the summer. You can explore all of these phenomena using Google Trends.

Can search query trends provide an accurate, reliable model of real-world phenomena?

Exercise is Safe, Improves Outcomes for Patients with Heart Failure

From Duke Health.org...Working out on a stationary bicycle or walking on a treadmill just 25 to 30 minutes most days of the week is enough to modestly lower risk of hospitalization or death for patients with heart failure, say researchers from Duke Clinical Research Institute (DCRI).

The findings stem from the HF-ACTION trial (A Controlled Trial Investigating Outcomes Exercise TraiNing), the most comprehensive study to date examining the effects of exercise upon patients with heart failure. The study was reported today as a late-breaking clinical trial at the American Heart Association's Scientific Sessions 2008 by Christopher O'Connor M.D., director of the Duke Heart Center and principal investigator of the trial, and David Whellan, M.D., of Thomas Jefferson University, co-principal investigator. Full story.

Household Products Database

What's under your kitchen sink, in your garage, in your bathroom, and on the shelves in your laundry room? Learn more about what's in these products, about potential health effects, and about safety and handling through the Household Products Database.
http://householdproducts.nlm.nih.gov/

This database links over 8,000 consumer brands to health effects from Material Safety Data Sheets (MSDS) provided by manufacturers and allows scientists and consumers to research products based on chemical ingredients. The database is designed to help answer the following typical questions:

• What are the chemical ingredients and their percentage in specific brands?
• Which products contain specific chemical ingredients?
• Who manufactures a specific brand? How do I contact this manufacturer?
• What are the acute and chronic effects of chemical ingredients in a specific brand?
• What other information is available about chemicals in the toxicology-related databases of the National Library of Medicine?

New Treatment for Low Back Pain

Free workshop on new, non-invasive treatment recently given FDA clearance. Tuesday, Nov. 18th; 5p and 7p; Medical Center Library-Room 104 Lower Level. Call 919.620.7900 to reserve a seat. Read more

Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein

Intensive lipid-lowering with rosuvastatin (Crestor) for not even two full years significantly and dramatically reduced the rate of myocardial infarction, stroke, and cardiovascular death in "apparently healthy men and women," researchers reported here.

Participants who took 20 mg of rosuvastatin for 1.9 years reduced median LDL cholesterol to 55 mg/dL, down from a median of 108 mg/dL, said Paul M. Ridker, M.D., of Brigham and Women's Hospital in Boston and principal investigator of the JUPITER trial. The corresponding reduction in the rate of MI stroke, arterial revascularization, or cardiovascular death was 44% (P<0.00001).

Dr. Ridker presented the findings at a late-breaking clinical trials session at the American Heart Association meeting here and the findings were published concurrently online in the New England Journal of Medicine.

Calling all Bloggers and Writers!

Interested in exploring issues in medicine, nursing, information, research and education? Here is your opportunity! The Medical Center Library is seeking guest bloggers for the Library's Crossroads blog. Topics for posts could include:

• making evidence-based practice a reality
• spotlighting significant new articles from the literature
• using technology in health care
• life as a student or clinician
• other topics of interest

No previous blogging experience required! Guest bloggers will receive free interlibrary loan privileges or copy cards for their participation.

Interested? Questions? Contact Megan von Isenburg at megan.vonisenburg@duke.edu or (919) 660-1131.