Neurology
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Colon Cancer Screening by Stool DNA Testing
Recent guidelines issued by the American Cancer Society and American Society of Gastroenterology recommend colonoscopy as the preferred screening method for colon cancer, but wisely include the philosophy, “The best colon cancer screening test is the test you can get done!” — reflecting the relative reticence shown by many Americans to undergo colonoscopy. CT colonography compares very favorably colonoscopy, yet many insurers are not willing to pay for it.
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Long-term Payoff of Bariatric Surgery
The benefits of bariatric surgery are gaining new levels of respect as long-term evidence of favorable outcomes — other than cosmetic — continue to accrue. Indeed, in the population of obese diabetics, bariatric surgery is one of the only interventions documented to improve all-cause mortality.
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Weighing the Harms and Benefits of E-cigarettes
So far, studies evaluating whether e-cigarettes are less harmful than traditional cigarettes remain mostly inconclusive.
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Hypoglycemia Increases Cardiovascular Risk in Patients With Type 1 and Type 2 Diabetes
This is a retrospective analysis of data from the UK Clinical Practice Research Datalink which includes 265,868 insulin-treated patients age > 30 years diagnosed with diabetes between 2001 and 2007. 3260 were diagnosed with T1DM and 10,422 had T2DM. During a median follow-up of 5 years for type 1 diabetes patients and 4.8 years for those with type 2 diabetes, hypoglycemia was experienced by 573 (18%) and 1463 (14%) of patients, respectively. Compared with patients who did not experience hypoglycemia, the hazard ratio (HR) for CV events among T1DM patients who experienced hypoglycemia was 1.51 (not significant) and 1.61 for those with and without a history of CVD. For T2DM patients, the respective HRs were 1.60 and 1.49. The median time interval between the first hypoglycemia event and the first CV event was 1.5 years for all diabetes patients. Thus, hypoglycemia increases the risk of both CV and all-cause mortality in patients with diabetes.
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Influenza, 2014-2015 — Something Old, Something New, and a Mismatch
By early January, influenza activity had reached epidemic proportions in large parts of the United States, despite prior vaccination.
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REM Behavior Disorder as a Predictor of Parkinson’s Disease
Here are the results of a carefully executed study of REM behavior disorder patients compared to controls and those with Parkinson’s disease.
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Empagliflozin Tablets (Jardiance ®)
A new sodium glucose co-transporter 2 (SGLT2) has been approved by the FDA. Empagliflozin follows canagliflozin (Invokana) and dapagliflozin (Farxiga)as the third entry in this group. These drugs reduce plasma glucose levels by reducing renal absorption of filtered glucose. Empagliflozin is marketed by Boehringer Ingelheim as Jardiance. -
Good Ol’ Vitamin C: Does It Deserve Another Look for Your Heart?
SYNOPSIS: A meta-analysis and systematic review found vitamin C supplementation improved endothelial function in patients with diabetes, atherosclerosis, and heart failure. -
Stopping Colonoscopy at Age 75 ¡ª Even With a History of Colon Cancer
SYNOPSIS: The incidence of colorectal cancer is much less in people > 75 years of age compared with ages 50-74, even in patients with a personal history of colon cancer or adenomatous polyps. Complication rates for colonoscopy are high in the elderly ¡Ý age 75 and in patients with comorbidities. Surveillance colonoscopy may be stopped in the advanced elderly and in comorbid elderly patients. -
Bring on the Butter and the Eggs
SYNOPSIS: People who were randomized to a low-carbohydrate diet lost more weight than those who were randomized to a low-fat diet over a year. They also had greater improvements in risk factors for cardiovascular disease.