Catch up with TMR's picks from the leading medical journals
TMR’s picks from the leading medical journals:
Teamwork really does work
Team-based primary-care practices have been associated with lower rates of post-discharge emergency department visits and death compared with traditional practices.
The researchers evaluated a new practice model of multidisciplinary team-based primary care in Quebec province in Canada. The model combined six to 12 GPs and one or two nurses, to provide services such as case management, extended hours and emergency on-call services for a group of enrolled patients.
The study of 621,000 hospital admissions, involving 312,000?older and chronically ill patients, found patients in team-based practices were less likely to visit the emergency department or die in the 30 days following discharge, but the rate of readmissions was not affected.
SSRI use and pregnancy
A comprehensive study has found no link between antidepressant use in early pregnancy and autism or attention deficit hyperactivity disorder, contrary to earlier research suggesting an association.
The findings suggested these drugs were safer in pregnancy than previously thought, the authors said.
But the study of 1.6 million Swedish infants also found there was a slight, but significant, increased risk of premature birth if mothers used antidepressants in the first trimester.
Mums who took the medication in early pregnancy had 1.3 times the risk of premature birth, compared with those that had no exposure, after accounting for confounding factors.
The vast majority of antidepressants used by the pregnant women were SSRIs.
Drug for maternal bleeding
One-third of deaths from post-partum haemorrhage could be prevented by using an old remedy for heavy periods.
In a multinational trial of more than 20,000 women, intravenous tranexamic acid given within three hours of giving birth reduced the risk of death from bleeding by 31%. The drug did not increase the risk of adverse events.
Tranexamic acid was discovered more than 50 years ago and has been used extensively for menorrhagia, but until now there had been no evidence for its effectiveness post-partum.
“We now have important evidence that the early use of tranexamic acid can save a woman’s life and ensure more children grow up with a mother,” said Associate Professor Haleema Shakur, who was the project director of the trial.
Mental health and obesity
Pre-existing mental health conditions have no impact on weight-loss results from bariatric surgery, research shows.
The review of the health records of more than 8000 adults with and without mental health illnesses in the US, found mental illness was not predictive of differential weight loss up to two years after bariatric surgery.
“Many clinicians are hesitant to consider bariatric surgery in the mentally ill population due to the assumption that they will not fare well. This research counters those assumptions,” an Obesity Society spokesman said.
