Vertebral fracture is the most common type of osteoporotic fracture. While thiazide diuretics, which are commonly prescribed for the treatment of hypertension, decrease calciuria, they may also induce hyponatremia, which has been associated with increased vertebral fracture risk. Loop diuretics increase calciuria, which would reduce bone mineral density and increase vertebral fracture risk, but they rarely cause hyponatremia. Recent studies on diuretics and fractures did not include or specifically examine vertebral fracture. The few studies of diuretics and vertebral fracture have been limited by cases defined by self-report or administrative data, relatively small number of cases, study design that was not prospective, and lack of long-term follow-up with updated information on diuretic use.

Proteinuria is a key indicator of kidney function. The gold standard for measuring proteinuria is to determine protein excretion rate, but this assigns patients with the cumbersome task of collecting urine for up to 24 hours. In an editorial in this month's AJKD, Rodby considers whether timed urine collections are really more informative than measures based on spot urine collections, such albumin-creatinine ratio and protein-creatinine ratio. Rodby weighs the advantages and disadvantages of each measure, and explains how fluctuations rooted in unknown biological factors can complicate the interpretation of urine protein levels.

This study used 2008-2011 national data to provide the first examination of pregnancy outcomes among women with hearing loss in the US. There were an estimated 17.9 million deliveries during this time frame, and 10,462 occurred in women with hearing loss. The analysis revealed birth outcomes for women with hearing loss were significantly more likely to include preterm birth and low birth weight than for women without hearing loss. Understanding and addressing the causes of these disparities is critical to improving pregnancy outcomes among women with hearing loss.

In light of the rapid rise of e-cigarette use among adolescents, Dean Krugman of the Department of Advertising and Public Relations at the University of Georgia discusses three articles in the current issue that examine the impact of e-cigarette marketing and advertising.

Inactivity among residents in nursing homes -- could it be improved with the help of professional educators? In a large Italian study (n=8,875) one-half of all residents were inactive. Factors involved included cognitive impairment, unsociable behavior, night restlessness, pressure sores, depression and clinical instability. However, for each hour of care by professional educators, there was a 1% decrease in inactivity. Some predictors of inactivity may not be modifiable, but some are and could benefit from programs designed to increase activity.

Two years after treatment, quality of life after uterine artery embolization or hysterectomy remains comparable.

Growth patterns in early life are predictors of adult cardiovascular disease (CVD) risk factors. In this cohort study, the authors used 2-way conditional growth analysis to study independent relationships of linear growth and weight gain during infancy, childhood, and adolescence, with adult CVD risk markers. Greater height and BMI after birth and through adolescence are associated with higher CVD risk factors in adulthood, which largely are attributable to adult height and BMI. Monitoring childhood weight and height and intervening to prevent accelerated weight gain may reduce later CVD risk.

A study in the Journal of the American College of Cardiology: Heart Failure found that people who reach 45 to 55 years of age without developing hypertension, diabetes or obesity have as much as an 86% reduced risk of heart failure in their lifetime. Researchers examined data from participants in the Framingham Heart Study and several other studies, and noted that data was not adjusted for risk factor changes before age 45 or after age 55.

Stroke rates among Americans at least 55 have dropped, while rates among younger groups increased, rising 68% among people age 45 to 54 and increasing twofold or more among those ages 35 to 44, researchers report in the Journal of the American Heart Association. The study examined stroke incidence in 1995-1999 and 2010-2014.

A UK study in the journal Heart found adults under age 50 who smoke had an almost 8.5 times higher risk of heart attack than their peers who used to smoke or never smoked. The findings, based on data for 1,727 individuals treated for ST-elevated myocardial infarction, also showed smokers aged 50 to 65 had a five times increased risk of heart attack and those older than 65 had a three times higher risk compared with nonsmokers and former smokers their age.

Survey results published in the journal Antimicrobial Resistance & Infection Control revealed that few hospitals around the world follow established guidelines intended to reduce cases of central line-associated bloodstream infections. According to the results, 80% of hospitals in middle-income countries and 81% in high-income countries have written clinical guidelines for CLABSI prevention, but only 23% and 60% comply with a bundle of recommended central line insertion practices, respectively.

A Medicare requirement that says patients' nursing home choices cannot be restricted by hospitals has meant that for years hospitals have given patients lists of all local facilities without sharing quality information, leading patients to unknowingly select substandard homes. A new rule drafted by the Obama administration but not yet finalized says hospitals should still provide patients with all options, but they also must share data about quality, and some hospitals are already doing so.

Racquet sports were associated with a 47% lower risk of death, cycling with a 15% lower risk, swimming a 28% lower risk and dance aerobics a 27% lower risk, compared with no form of physical activity, according to a study in the British Journal of Sports Medicine. UK researchers found that adults who engaged in racquet sports, aerobics and swimming also had a lower risk of death from heart disease and stroke than those who didn't participate in any of these sports.