December 17, 2020
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Infection may be an acute precipitant of cardiovascular events. However, the relationships between different types of infection and cardiovascular events are less known. Does exposure to infections of different organ systems increase risk of myocardial infarction or venous thromboembolism? Potential interventions, such as vaccination or antibiotic regimens, or cardiovascular disease prophylaxis, may be useful to not only treat the infection but also potentially reduce both thromboses and infarctions.
Full Story: The American Journal of Medicine (12/2020) 
Clinical Updates
Intrapartum hypoxic brain injury accounts for approximately 30% of severe cerebral palsy cases; focusing on Hon's fetal heart rate pattern may help prevent cerebral palsy.
Full Story: American Journal of Obstetrics & Gynecology (12/2020) 
Authors examined the circumstances of fire deaths among 1,479 children who died in fires from 2004 to 2016 to better understand the contribution of fireplay to child fire deaths. Fireplay led to 12 percent of the deaths. Children who died in fireplay fires were more likely to be younger, male, unsupervised, and involved in an open Child Protective Services case than children who died in fires without fireplay.
Full Story: American Journal of Preventive Medicine (12/2020) 
Using National Birth Defects Prevention Study data from 1997-2011, this study estimated associations between asthma medication use and 52 specific birth defects in 28,481 birth defect cases and 10,894 non-malformed controls. Early pregnancy bronchodilator only use was associated with cleft palate, cleft lip, longitudinal limb deficiency, and truncus arteriosus. Early pregnancy anti-inflammatory only use was not associated with the birth defects studied, but use of both medications was associated with biliary atresia and pulmonary atresia. Asthma medication use was not associated with most birth defects examined, but modest risks were observed for bronchodilator use and several birth defects. These findings support maintaining adequate asthma treatment during pregnancy, as early pregnancy asthma exacerbations have been associated with adverse birth outcomes.
Full Story: The Journal of Allergy and Clinical Immunology: In Practice (12/2020) 
Handgrip strength (HGS) asymmetry and weakness may be utilized as a prognostic assessment tool. This longitudinal study looked to see if an association exists between HGS asymmetry and weakness on time to mortality. Nearly 20,000 Americans with identified hand dominance and a measure of HGS were included. Ultimately, HGS asymmetry and weakness were found as markers of impaired strength capacity that independently accelerate time to mortality, but the magnitude of these associations was more prominent for weakness. Nevertheless, assessments of asymmetric HGS are a simple adjunct analysis that may show promise for increasing the prognostic value of handgrip dynamometers.
Full Story: Journal of the American Medical Directors Association (12/2020) 
Both small and large for gestational age infants may be at an increased risk of obesity later in life. What may be more important, however, is the rate of weight gain in infancy and early childhood. In this Commentary, Lyons-Reid et al discuss the importance of understanding body composition both at birth and its evolution during infancy on later health among infants born small and large for gestational age.
Full Story: The Journal of Pediatrics (12/2020) 
Medical News
Research published in the journal Hypertension found faster decreases in global cognitive scores for middle-age and older adults with hypertension or pre-hypertension, compared with those who did not have either condition. Treating hypertension at any age may reduce or prevent accelerated decreases in cognition, researchers said.
Full Story: MedPage Today (free registration) (12/14) 
The risk for being overweight, not eating a healthy diet and having high blood pressure was greater for women who were stressed with their jobs or in their roles as mother, spouse and caregiver, compared with women who were less stressed, according to a study published in the Journal of the American Heart Association. Women who felt their roles were rewarding had a 58% higher likelihood of engaging in at least two hours of moderate to vigorous physical activity a week and a 30% higher likelihood of not smoking.
Full Story: HealthDay News/American Heart Association News (12/11) 
A new statement published by the US Preventive Services Task Force backs its 2014 recommendation that adolescents and adults who are at increased risk for hepatitis B virus infection be screened. Experts suggest the US may need to shift to universal HBV screening, particularly when more effective treatments become available.
Full Story: Healio (free registration) (12/15) 
Business Practice News
Physicians can use electronic methods besides telehealth to develop relationships with their patients, according to Josh Weiner, CEO of SR Health by Solutionreach. Options include text messages, email updates, billing reminders and automated calls.
Full Story: Medical Economics (12/12) 
A study in JAMA Network Open found the odds of reporting a clinically significant medical error was 53% higher among physicians who reported moderate levels of sleep deprivation and 97% greater among those with the highest sleep deprivation levels, after adjusting for factors such as practice specialty and training status. Researchers surveyed over 11,300 clinicians and found the rates of sleep-related impairments were higher among residents than attending physicians.
Full Story: Becker's Hospital Review (12/14) 
Patient's Perspective
Convincing some older adults, including those living in nursing homes, and caregivers that a COVID-19 vaccine is safe to get is a challenge as the US begins a nationwide vaccination campaign. Timothy Farrell, a geriatrician at the University of Utah, recommends his patients ages 65 to 106 get vaccinated, saying there is a clear danger of COVID-19 and social isolation, which is a risk factor for mortality.
Full Story: The New York Times (tiered subscription model) (12/14),  The Associated Press (12/14) 
What's in front of you is a whole world of experiences beyond your imagination.
Phylicia Rashad,
actor, singer, stage director
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