Biologics beyond anti-TNF therapies show promise for ulcerative colitis

By Doug Brunk

Long-term rates of colectomy for ulcerative colitis have not declined over a 10-year period.

Other stories:

Older black women on Medicare have worse outcomes after fragility fracture

Black women had a significantly higher mortality rate after a fracture, compared with their white counterparts.

Serum testosterone and estradiol levels associated with current asthma in women

The overall prevalence of current asthma in the sample was 9% (6% in men and 13% in women).

FDA approves first live vaccine for smallpox, monkeypox prevention

Jynneos is a live, nonreplicating vaccine based on the vaccinia virus, for smallpox and monkeypox.

Prevalence of developmental disabilities up significantly since 2009

Increase among children aged 3-17 years may be related to improved awareness and access to care.

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CONCLUDE data inconclusive on hypoglycemia risk for degludec vs. glargine

By Sara Freeman

The primary endpoint of the study was not met, thus differences between the long-acting insulins could not be confirmed.

Other news:

U.S. adults eating fewer carbs, more protein and fat

Trends suggest improved macronutrient consumption, but low-quality carbs and saturated fat remain a large part of U.S. diets.

Beta-blockers effective, safe for heart failure with renal dysfunction

They were as effective as they were in patients with normal renal function.

USPSTF: Screening pregnant women for asymptomatic bacteriuria cuts pyelonephritis risk

But the new recommendations urge clinicians to refrain from testing asymptomatic nonpregnant women and adult men.

Parent survey sheds light on suboptimal compliance with eczema medications

Parents may be willing to use therapies with concerning side effects if they can see a clear benefit for their child’s eczema.

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Many institutions exceed recommended radiation doses during lung cancer screening

By Erik Greb

A significant proportion of institutions that perform low-dose CT for lung cancer screening exceed the recommended radiation dose levels.

Other news:

Vitamin D does not improve bone density, structure in healthy patients

Supplemental vitamin D did not significantly affect bone mineral density in the whole body, femoral neck, total hip, or spine after 2 years of daily use.

Automatic reenrollment helps keep people insured

The research comes as the Centers for Medicare & Medicaid Services is contemplating the elimination of automatic reenrollment in marketplace plans.

Women’s residency and subspecialty choices diverging

Women increased their representation in internal medicine residency over the last 25 years, but the percentage of women in subspecialty fellowships declined.

Sensitive, responsive parenting improves child language skills

Sensitive and responsive parenting appears more effective than warmth in building language skills among children.

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Closure of women’s health clinics may negatively impact cervical cancer outcomes

By Will Pass

Mortality risk among women with cervical cancer was 36% higher in states that had a decreased number of women’s clinics.

Other news:

Machine learning–derived risk score predicts heart failure risk in diabetes patients

Highest WATCH-DM scores linked to 5-year heart failure risk approaching 20%.

Hyponatremia almost as common with spironolactone as chlorthalidone

Spironolactone risk increased by prior chlorthalidone hyponatremia.

Semaglutide beats canagliflozin as second-line therapy for type 2 diabetes

SUSTAIN 8 trial data show greater reductions in HbA1c and body weight with semaglutide.

Business case for interoperability remains elusive

Bringing ownership of health data to the individual and setting a clearer definition of health IT standards are important drivers of interoperability.

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First data VERIFY value of early combination therapy in type 2 diabetes

By Sara Freeman

Vildagliptin plus metformin provided greater and durable long-term benefits than metformin alone.

Other stories:

Increased levels of a bacterial strain may cause nonalcoholic fatty liver disease

Of the patients in the study with NAFLD, 61% carried high alcohol- and medium alcohol-producing Klebsiella pneumoniae.

Secondary prevention of osteoporotic fractures lacking

Osteoporotic fractures contribute significant health costs to the United States, yet secondary prevention efforts are lagging.

No link found between sleep position, pregnancy outcomes

A new prospective analysis casts doubt on findings from retrospective studies.

Baby beverage 101: New recommendations on what young children should drink

Hold the chocolate milk and ‘toddler milk,’ new report says, and watch the fruit juice.

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Remember that preeclampsia has a ‘fourth trimester’
By M. Alexander Otto

Delivering the baby doesn’t always cure the hypertension. 

Other news:

Daily polypill lowers BP, cholesterol in underserved population
The regimen’s simplicity and low cost may overcome barriers to treatment.

Esketamine nasal spray may get expanded indication
The primary endpoint was met in two phase 3 pivotal trials in patients with major depressive disorder symptoms at imminent risk for suicide.

Most practices not screening for five social needs
The majority of the overall screening activity was driven by interpersonal violence screenings.

Growing vaping habit may lead to nicotine addiction in adolescents
Almost 12% of 12th graders report using e-cigarettes every day.

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Post-MI angina in stable patients flags high risk

By Mitchel L. Zoler

Patients more than 3 months out from a myocardial infarction with angina had an increased risk for subsequent cardiovascular death or a new MI.

Other news:

Drug abuse–linked infective endocarditis spiking in U.S.

New cases doubled from 2002 to 2016, and those affected tended to be younger white males living in poverty.

U.S. increases in RA burden outpace global averages

The incidence of rheumatoid arthritis rose by almost 21% from 1990 to 2017 in the United States.

Rivaroxaban bests combo therapy in post-PCI AFib

Though dosing questions remain, the Japanese AFIRE study affirms current U.S. and European practice.

Meta-analysis finds platelet-rich plasma may improve hair growth

Five studies reported statistically significant increases in hair density in favor of PRP over placebo.

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Wildfire smoke has acute cardiorespiratory impact, but long-term effects still under study

By Doug Brunk

While research advances, the unforgiving wildfire season looms, assuring more destruction of property and threats to cardiorespiratory health.

Other News: 

Pulegone levels in e-liquids, smokeless tobacco products exceed FDA limits

Daily exposure to pulegone was 44-1,608 times higher than that from menthol cigarettes.

FDA gives dapagliflozin Fast Track status for heart failure therapy

The designation is for reduction of cardiovascular death risk or disease progression in patients with reduced or preserved ejection fraction.

Benefits of peanut desensitization may not last

Previous studies have shown that desensitization to peanuts can be successful, but sustained response to oral immunotherapy after treatment reduction has not been well studied.

Most patients with RIS develop MS within 10 years

The conversion rate jumps to 87% in the presence of four risk factors at baseline.

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States pass record number of laws to reel in drug prices

By Steven Findlay, Kaiser Health News

Measures include authorizing imported prescription drugs, screening for excessive price increases by drug companies, and establishing oversight boards to set drug prices.

Other news: 

European cholesterol guidelines lower LDL targets, expand PCSK9 inhibitor use

Revised ESC dyslipidemia guidelines set an LDL-cholesterol goal below 55 mg/dL for the first time, and broaden PCSK9 inhibitor use.

Hospital-acquired C. diff. tied to four ‘high-risk’ antibiotic classes

High-risk antibiotics included second-, third-, and fourth-generation cephalosporins, fluoroquinolones, carbapenems, and lincosamides.

Rates of off-label prescribing for children continue to increase

Off-label ordering increased over 10 years, especially for antihistamines and psychotropic drugs.

Presumptive style of conversation boosts HPV vaccination rates in adolescents

The two-dose HPV vaccine schedule also seemed to improve completion rates.

Drug doses for heart failure could possibly be halved for women

By Randy Dotinga

Women reached the highest level of drug efficacy at half the doses of ACE inhibitors or ARBs and beta-blockers needed by men to reach the same level.

Other news:

'Peanut pill' gets thumbs-up from FDA advisory panel

An FDA panel recommended approval -- under conditions including a black box warning -- for AR101 peanut protein capsules as oral immunotherapy for children and teens with a confirmed peanut allergy.

High-dose teriparatide tops standard dose in boosting BMD in postmenopausal women with osteoporosis

The findings suggest that high-dose teriparatide stimulates even greater separation between bone resorption and formation.

BP load predicts cardiovascular damage in children

The amount of time spent above the 95th blood pressure percentile is an emerging metric of pediatric hypertension control.

FDA: NDMA found in samples of ranitidine

The agency is not calling for individuals to stop taking ranitidine at this time.

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