Treatment of Chronic Insomnia in Adults.

Insomnia affects 30% of the U.S. population, with 5% to 15% meeting criteria for chronic insomnia.

Temporomandibular Disorders: Rapid Evidence Review.

Temporomandibular disorders affect between 5% and 12% of the population and present with symptoms such as headache, bruxism, pain at the temporomandibular joint, jaw popping or clicking, neck pain, tinnitus, dizziness, decreased hearing, and hyperacuity to sound. Common signs on physical examination include tenderness of the pterygoid muscles, temporomandibular joints, and temporalis muscles, and malocclusion of the jaw and crepitus. The diagnosis is based on history and physical examination; however, use of computed tomography or magnetic resonance imaging is recommended if the diagnosis is in doubt.

Diabetes-Related Foot Infections: Diagnosis and Treatment.

Diabetes-related foot infections occur in approximately 40% of diabetes-related foot ulcers and cause significant morbidity. Clinicians should consider patient risk factors (e.g.

Specialized oral nutritional supplement (ONS) improves handgrip strength in hospitalized, malnourished older patients with cardiovascular and pulmonary disease: A randomized clinical trial.

Background & Aims: Oral Nutritional Supplements (ONS) are used to treat malnutrition and improve clinical outcomes in malnourished patients. Poor handgrip strength (HGS) is associated with an increased risk of mortality, disability and other adverse health consequences. This analysis examined the effect of a specialized ONS on HGS and its relationship to nutritional status in hospitalized, older adults with malnutrition who were participants in the NOURISH trial.

Reduced mortality risk in malnourished hospitalized older adult patients with COPD treated with a specialized oral nutritional supplement: Sub-group analysis of the NOURISH study.

Background: Hospitalized, malnourished older adults with chronic obstructive pulmonary disease (COPD) have an elevated risk of readmission and mortality.

Objective: Post-hoc, sub-group analysis from the NOURISH study cohort examined the effect of a high-protein oral nutritional supplement (ONS) containing HMB (HP-HMB) in malnourished, hospitalized older adults with COPD and to identify predictors of outcomes.

Methods: The NOURISH study (n = 652) was a multicenter, randomized, placebo-controlled, double-blind trial.

Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis.

Malnutrition is a common yet under-recognized problem in hospitalized patients. The aim of this paper was to systematically review and evaluate malnutrition biomarkers among order adults. Eligible studies were identified through Cochrane, PubMed and the ProQuest Dialog.

Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: A randomized clinical trial.

Background: Hospitalized, malnourished older adults have a high risk of readmission and mortality.

Objective: Evaluation of a high-protein oral nutritional supplement (HP-HMB) containing beta-hydroxy-beta-methylbutyrate on postdischarge outcomes of nonelective readmission and mortality in malnourished, hospitalized older adults.

Design: Multicenter, randomized, placebo-controlled, double-blind trial.

Approach to acute headache in adults.

Approximately one-half of the adult population worldwide is affected by a headache disorder. The International Headache Society classification and diagnostic criteria can help physicians differentiate primary headaches (e.g.

Healthy lifestyle habits and mortality in overweight and obese individuals.

Background: Though the benefits of healthy lifestyle choices are well-established among the general population, less is known about how developing and adhering to healthy lifestyle habits benefits obese versus normal weight or overweight individuals. The purpose of this study was to determine the association between healthy lifestyle habits (eating 5 or more fruits and vegetables daily, exercising regularly, consuming alcohol in moderation, and not smoking) and mortality in a large, population-based sample stratified by body mass index (BMI).

Methods: We examined the association between healthy lifestyle habits and mortality in a sample of 11,761 men and women from the National Health and Nutrition Examination Survey III; subjects were ages 21 and older and fell at various points along the BMI scale, from normal weight to obese.

Impact of healthy lifestyle on mortality in people with normal blood pressure, LDL cholesterol, and C-reactive protein.

Background: To investigate the impact of healthy lifestyle on cardiovascular risk and mortality in people without a history of cardiovascular disease and without elevation of lipid, blood pressure, or inflammatory markers.

Design: Cohort study.

Methods: Study of a diverse sample of adults in the NHANES III follow-up Mortality Survey, to determine the benefit of adhering to healthy lifestyle habits (five or more fruits and vegetables/day, regular exercise, or being non-obese (body mass index 18.

Tea and coffee consumption and MRSA nasal carriage.

Purpose: Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA).

Methods: We performed a secondary analysis of data from the 2003-2004 National Health and Nutrition Examination Survey to investigate the relationship between the consumption of coffee, hot tea, cold tea, and soft drinks, and MRSA nasal carriage among the noninstitutionalized population of the United States.

Uric acid as a potential cue to screen for iron overload.

Background: It is suggested that targeted screening for hemochromatosis and iron overload may be worthwhile. The aim of this study was to examine uric acid as a potential indicator of the presence of iron overload.

Methods: We analyzed adults aged 20 and older in the National Health and Nutrition Examination Survey 1999 to 2002.

Trends in hospitalizations with antibiotic-resistant infections: U.S., 1997-2006.

Objectives: Antibiotic resistance is a significant global problem, but the trends in prevalence and impact of antibiotic resistance in hospitalizations in the United States are unclear. We evaluated the trends in hospitalizations associated with antibiotic-resistant infections in U.S.

Impact of Medicare Part D on seniors' out-of-pocket expenditures on medications.

Background: Medicare Part D, introduced in January 2006, was intended to decrease beneficiaries' out-of-pocket expenditures on medications.

Methods: We examined whether this policy was successful in achieving this goal, including effects on Medicare beneficiaries without previous drug coverage and those who previously received coverage through Medicaid, in a longitudinal study of out-of-pocket expenditures on medications in 1504 Medicare beneficiaries 65 years and older participating in the 2005 and 2006 waves of the Medical Expenditure Panel Survey.

Results: Mean annual out-of-pocket expenditures on medications decreased by 32% ($320; 95% confidence interval [CI], $250-$391), from $1011 to $691, in the year after Part D was implemented for all Medicare beneficiaries in the Medical Expenditure Panel Survey.

Use of the nutrition facts label in chronic disease management: results from the National Health and Nutrition Examination Survey.

Dietary modifications are common treatment strategies for patients with various chronic diseases, but it is unclear how often these individuals read food labels. The objective of this study was to determine whether patients with chronic disease who are advised to change their eating habits read nutrition labels more than patients who have not been so advised, and whether that impacts their energy and nutrient intake. Analysis of the 2005-2006 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional survey of the United States population, was performed.

Biomarkers of pesticide exposure and diabetes in the 1999-2004 national health and nutrition examination survey.

The associations of 8 pesticides and pesticide metabolites with total diabetes (diagnosed and undiagnosed) and pre-diabetes (glycohemoglobin 5.7-6.4%) were evaluated using the National Health and Nutrition Examination Survey (NHANES), 1999-2004.

Vitamin D and methicillin-resistant Staphylococcus aureus nasal carriage.

Studies have found that vitamin D plays an important role in mediating immune function via a number of pathways, including enhancing the release of antimicrobial peptides in the skin. Given these findings, we hypothesize that low serum vitamin D levels may increase the risk of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). A secondary data analysis of the National Health and Nutrition Examination Survey 2001-2004 was performed to investigate the association between serum vitamin D levels and MRSA nasal carriage for the non-institutionalized population of the USA.

The association between allergy skin testing, atopic respiratory conditions, and stroke mortality in middle-aged and elderly adults.

Background: A history of atopic respiratory conditions has been linked to an increased risk of stroke. What remains unclear is whether positive allergy skin testing is associated with an increased risk of stroke. The primary goal of this study was to determine whether positive allergy skin testing is associated with an increased risk of fatal stroke.

Association of urinary polycyclic aromatic hydrocarbons and serum C-reactive protein.

The association of 9 urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) with serum C-reactive protein (CRP) was investigated using the National Health and Nutrition Examination Survey (NHANES) 2003-2004. The unweighted number of participants included was 999, which represented 139,362,776 persons in the non-institutionalized US population. In adjusted logistic regressions, two OH-PAHs, 2-hydroxyphenanthrene and 9-hydroxyfluorene, were associated with elevated CRP (>3mg/l).

Shellfish consumption and risk of coronary heart disease.

A high-cholesterol diet has been associated with an increased risk of coronary heart disease, but it is unclear whether all high-cholesterol foods increase the risk of heart disease. The purpose of this study is to determine whether shellfish consumption is associated with an increased risk of coronary heart disease. Analysis was performed on the Atherosclerosis Risk in Communities study, a cohort of middle aged and elderly adults in the United States.

The association between onion consumption and bone density in perimenopausal and postmenopausal non-Hispanic white women 50 years and older.

Objective: The aim of this study was to determine whether frequent onion consumption is associated with increased bone density in perimenopausal and postmenopausal non-Hispanic white women 50 years and older.

Methods: An analysis of the National Health and Nutrition Examination Survey 2003-2004 was performed. Perimenopausal and postmenopausal non-Hispanic white female participants (unweighted N = 507; weighted N = 35.

Association of polychlorinated biphenyls with hypertension in the 1999-2002 National Health and Nutrition Examination Survey.

The association of 11 polychlorinated biphenyls (PCBs) with hypertension was investigated using the National Health and Nutrition Examination Survey (NHANES), 1999-2002. The unweighted number of participants assessed for hypertension ranged from 2074 to 2556 depending on the chemical(s) being analyzed. In unadjusted logistic regressions all 11 PCBs were associated with hypertension.

The association between hay fever and stroke in a cohort of middle aged and elderly adults.

Background: Asthma has been linked to stroke, but it is unknown if hay fever is related to stroke. This study was designed to investigate if there is an association between a reported history of hay fever and stroke during a 4.4-year study period.