Trial confirms as-needed inhalers suffice for mild to moderate asthma.
By Ted Bosworth.
Yet another trial supports as-needed inhaled steroids for mild to moderate asthma

California bans “Pay for Delay,” promotes black maternal health, PrEP access.
Two laws signed by Gov. Gavin Newsom addressed black maternal health and made PrEP available without a prescription.

Firearm-related deaths show recent increase.
Mortality from suicides and homicides began to rise in 2015. 

Lifetime indoor tanning raises risk of cutaneous squamous cell carcinoma.
Researchers found a dose-response association between number of indoor tanning sessions and SCC risk in Norwegian women.

Influenza vaccination modestly reduces risk of hospitalizations in patients with COPD. 
Older patients with COPD need more effective influenza vaccines and other preventive strategies.

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New practice guideline: CRC screening isn't necessary for low-risk patients aged 50-75 years
By Michele Sullivan

For individuals aged 50-79 with no symptoms and an estimated 15-year CRC risk below 3%, no screening is recommended.

Too few pregnant women receive both influenza and Tdap vaccines
But strong provider recommendations can increase vaccine uptake.

Set reasonable expectations for managing refractory rheumatoid arthritis
The definition of difficult-to-treat rheumatoid arthritis varies among experts, and the reasons for refractoriness are often unknown.

Consider centralized pain in patients with rheumatic disease
Every patient with chronic pain should complete a fibromyalgia survey.

Intensive cognitive training may be needed for memory gains in multiple sclerosis
Patients with MS saw the best results with the most intensive memory strategies.

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Clinician burnout can impact quality of care
By Heidi Splete
A meta-analysis suggests that burnout may be associated with lower quality of care, but the effect may be less because of study limitations.

Corticosteroid use in pregnancy linked to preterm birth
Women with rheumatoid arthritis taking oral corticosteroids during pregnancy may be at increased risk of preterm birth.

New York declares end to 2018 measles outbreak
Reports of unrelated measles cases in the state continue.

Hypoxia-related discoveries net Nobel Prize
A trio of physician-scientists has won the Nobel Prize for their work, which has implications for the treatment of anemia, cancer, and other diseases.

Liraglutide an ‘option’ for treating pediatric type 2 diabetes
The ELLIPSE trial shows clinicians aren’t limited to metformin and insulin for children with diabetes.

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SUDs are almost always comorbid with other disorders
By Randy Dotinga
It’s crucial to treat the accompanying mental illness that is almost always present.

Other news:

Histologic analysis of vaping-associated lung injury suggests chemical pneumonitis
Foamy macrophages and pneumocyte vacuolization were seen in all cases.

Massachusetts tops state vaccination rankings
Where did your state finish?

Consider cognitive reframing of osteoporosis to improve adherence
Counter negative patient perceptions by explaining the risks of not undergoing treatment.

Viral cause of acute flaccid myelitis eludes detection
Acute flaccid myelitis shows a viral etiology but analysis of specimens from affected individuals fails to identify a single viral cause.

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One-third of patients with severe asthma are overusing corticosteroids

By Ted Bosworth

A Dutch study suggests up to 90% of asthma patients taking oral steroids could reduce exposure.

Other news:

Vaping-associated lung injury cases exceed 1,000

As of Oct. 1, there have been 1,080 confirmed and probable cases of lung injury associated with the use of e-cigarettes, or vaping.

Continuous NSAID use for ankylosing spondylitis may raise hypertension risk

Prospective cohort study results help to resolve findings from previous studies that left unclear results about NSAIDs’ hypertensive effects on patients with ankylosing spondylitis.

Tennessee’s Medicaid block grant proposal could have deep impacts

Tennessee Republican Gov. Bill Lee is requesting the federal government convert the state's Medicaid financing into a $7.9 billion lump sum.

Measles 2019: Most cases occurred in close-knit, undervaccinated communities

CDC researchers report on 22 outbreaks in 17 states.

Osteoporosis remains a costly burden to older U.S. adults

By Jeff Craven

The direct cost of osteoporosis was more than $70 billion between 2012 and 2014, according to the report.

Other stories:

Six factors predicted benefit from asthma triple therapy

Not smoking and younger age were two of the factor that helped predict better response to therapy.

High maternal lead levels linked to children’s obesity

The risk was mitigated with adequate maternal plasma levels of folate.

Higher teen pregnancy risk in girls with ADHD

While the overall rate of teen births was 3%, the rate for teens with ADHD was more than 15%.

Novel cardiac troponin protocol rapidly rules out MI

Adoption of the accelerated rule-out pathway could add up to more than $3 billion in annual savings for hospitals, according to researchers.

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Smoking, inactivity most powerful lifestyle post-MI risk factors

By Bruce Jancin

Insufficient physical activity is a much stronger predictor of adverse outcomes after a first MI than is obesity or above-target LDL cholesterol.

Other stories:

Few antidepressant adverse effects backed by convincing evidence

Increased suicide risk in children and adolescents is one of the few adverse health outcomes of antidepressants that is backed by evidence.

Vitamin C infusion falls short for sepsis and ARDS patients

Vitamin C failed to improve organ dysfunction, inflammation, or vascular injury in adults with sepsis and ARDS.

IBS complaints differ with diarrhea versus constipation

Most irritable bowel syndrome patients report discomfort but specific symptoms vary with IBD type.

Lefamulin found noninferior to moxifloxacin for bacterial pneumonia

The pleuromutilin antibiotic has demonstrated activity against many CABP-causing pathogens.

You can contact the MDedge Daily Medical News by emailing us at [email protected] or following us on Twitter at @MDedgeTweets.

Medical boards change or consider amending mental health-related licensing questions

By Kerry Dooley Young

@KDooleyYoung

State medical boards across the nation are mulling changes in questioning for mental health history among physicians.

Other news:

Panel releases guidelines for red meat, processed meat consumption

"This assessment may be excessively pessimistic; indeed, we hope that is the case," the panel said.

Cannabis-using MS patients improve cognition with 28 days of abstinence

Memory, executive function, and information processing speed improved significantly.

TKI preserved lung function in patients with fibrosing interstitial disease

Nintedanib substantially reduced the rate of decline in lung function.

Apple cider vinegar soaks fall short in atopic dermatitis

Acetic acid, particularly apple cider vinegar, has become prominent among emerging natural remedies for atopic dermatitis.

You can contact the MDedge Daily Medical News by emailing us at [email protected] or following us on Twitter at @MDedgeTweets.

AF risk is elevated after early-stage breast cancer diagnosis

By Susan London

Risk for atrial fibrillation was higher for women who had received chemotherapy but was not tied to specific cardiotoxic drugs or drug classes.

Other news:

Universal ASD screening is feasible, but M-CHAT/F underperforms

The current screening tool for autism spectrum disorder underperformed, especially in children of color and in children from lower-income households.

FDA adds diabetic kidney disease, heart failure indications to canagliflozin

The approval makes canagliflozin the first drug indicated for diabetic kidney disease treatment in 20 years.

Heart disease raises risk of severe cutaneous adverse reactions to allopurinol

Chronic kidney disease and high initial dosage add to the risk of hospitalization, researchers found.

NICUs admitting more normal-weight newborns

As the number of NICU beds has increased, more lower-risk newborns are headed to the NICU.

You can contact the MDedge Daily Medical News by emailing us at [email protected] or following us on Twitter at @MDedgeTweets.

CDC reports most vaping lung disease linked to THC-containing cartridges

By Michele G. Sullivan

The CDC says more than 75% of patients with vaping-related lung injuries used at least one THC-containing product before developing symptoms.

Other stories:

Legislators disagree on new drug-pricing proposal

Legislation introduced by House Speaker Nancy Pelosi would compel Medicare to make deals with drug manufacturers on maximum, reasonable prices for certain high-cost drugs.

How does alcohol intake affect dementia risk in older adults?

Alcohol dose and frequency of drinking are correlated with cognitive decline and risk of dementia.

Palliative care programs continue growth in U.S. hospitals

While the growth of palliative care programs continues, access often depends on where you live.

Judge dismisses doctors’ lawsuit against ABIM

A district court dismissed a lawsuit against the American Board of Internal Medicine over its maintenance of certification program, calling the legal challenge “flawed.”

You can contact the MDedge Daily Medical News by emailing us at [email protected] or following us on Twitter at @MDedgeTweets.