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Elevated PCSK9 levels associated with psoriasis suggest new treatment target
https://www.mdedge.com/dermatology/article/260931/psoriasis/elevated-pcsk9-levels-associated-psoriasis-suggest-new
Ted Bosworth

Jan 30th, 2023 - A Mendelian randomization study employing data from nearly 300,000 individuals has linked elevated levels of the PCSK9 enzyme with an increased risk of psoriasis, suggesting it might be targetable as an intervention. Independent of low-density lipoprotein cholesterol (LDL-C), which is reduced when PCSK9 is inhibited, a reduction in PCSK9 levels appears to have a direct impact on lowering psoria.

The ongoing search for answers
https://www.mdedge.com/neurology/article/260930/business-medicine/ongoing-search-answers
Allan M. Block, MD

Jan 30th, 2023 - Hidden in the Dec. 1, 2022, issue of the New England Journal of Medicine was a small article on using deferiprone for Parkinson’s disease.

Novel nomogram distinguishes pneumonias
https://www.mdedge.com/chestphysician/article/260924/infectious-diseases/novel-nomogram-distinguishes-pneumonias
Heidi Splete, MDedge News

Jan 30th, 2023 - A model incorporating factors such as lymphocytes and lung lesions differentiated adenovirus pneumonias from Chlamydia psittaci (CPP) in a multicenter study of nearly 200 individuals. Symptoms of pneumonia caused by CPP are often confused with other respiratory infections, particularly adenovirus pneumonia (AVP), which can delay correct diagnosis and impact treatment, Yi Li, MD, of Xiangya Hosp.

Dermatologists address cultural competence and unconscious biases in the specialty
https://www.mdedge.com/dermatology/article/260923/diversity-medicine/dermatologists-address-cultural-competence-and
Thomas R. Collins

Jan 30th, 2023 - ORLANDO – When he was applying for residency, Omar N. Qutub, MD, eagerly arrived at his first interview of the day.

Two AI optical diagnosis systems appear clinically comparable for small colorectal polyps
https://www.mdedge.com/internalmedicine/article/260922/gastroenterology/two-ai-optical-diagnosis-systems-appear-clinically
Carolyn Crist

Jan 30th, 2023 - In a head-to-head comparison, two commercially available computer-aided diagnosis systems appeared clinically equivalent for the optical diagnosis of small colorectal polyps, according to a research letter published in Gastroenterology. For the optical diagnosis of diminutive colorectal polyps, the comparable performances of both CAD-EYE (Fujifilm Co.

Rural Residence Tied to Higher Risk for Heart Failure for Women, Black Men
https://www.clinicaladvisor.com/home/topics/cardiovascular-disease-information-center/rural-residence-tied-higher-risk-heart-failure-women-black-men/
Clinical Advisor

Jan 30th, 2023 - HealthDay News — Rural residence is associated with an increased risk for heart failure among women and Black men, according to a study published online in JAMA Cardiology. Sarah E. Turecamo, from the US National Institutes of Health in Bethesda, Maryland, and colleagues assessed whether rurality is associated with an increased risk for heart failure. The analysis included data from 27,115 part...

Noninvasive liver test may help select asymptomatic candidates for heart failure tests
https://www.mdedge.com/internalmedicine/article/260919/cardiology/noninvasive-liver-test-may-help-select-asymptomatic
Carolyn Crist

Jan 30th, 2023 - A noninvasive test for liver disease may be a useful, low-cost screening tool to select asymptomatic candidates for a detailed examination of heart failure with preserved ejection fraction (HFpEF), say authors of a report published in Gastro Hep Advances. The fibrosis-4 (FIB-4) index was a significant predictor of high HFpEF risk, wrote Chisato Okamoto, MD, of the department of medical biochemi.

Polypill Tested for Cognitive, Functional Benefits
https://www.medpagetoday.com/neurology/dementia/102884

Jan 30th, 2023 - Reducing blood pressure and cholesterol in the TIPS-3 trial with a polypill, with or without aspirin, showed no protective effect on cognition in older adults with cardiovascular disease risk factors, a secondary analysis showed. During a 5-year follow-up, about the same number of trial participants in TIPS-3 experienced substantive cognitive decline in both the treatment and placebo groups, ac...

JAK Inhibitor Improves Symptoms, Anemia in Myelofibrosis
https://www.medpagetoday.com/hematologyoncology/othercancers/102883

Jan 30th, 2023 - Myelofibrosis treatment with the Janus kinase (JAK) inhibitor momelotinib resulted in clinically significant improvements in symptoms and spleen response compared with danazol for symptomatic, JAK inhibitor-exposed patients with anemia and intermediate- or high-risk disease, the phase III MOMENTUM trial showed. A significantly greater proportion of patients in the momelotinib group reported a ≥...

Commentary: Early Diagnosis of PsA, February 2023
https://www.mdedge.com/rheumatology/article/260916/psoriatic-arthritis/commentary-early-diagnosis-psa-february-2023
Vinod Chandran, MBBS, MD, DM, PhD

Jan 30th, 2023 - Vinod Chandran, MBBS, MD, DM, PhD Most patients develop psoriatic arthritis (PsA) after the onset of cutaneous psoriasis. The path toward long-term remission of PsA may be by early diagnosis and effective treatment prior to the onset of joint damage.

Dermatopathologist reflects on the early history of melanoma
https://www.mdedge.com/dermatology/article/260915/melanoma/dermatopathologist-reflects-early-history-melanoma
Doug Brunk

Jan 30th, 2023 - SAN DIEGO – Evidence of melanoma in the ancient past is rare, but according to James W. Patterson, MD, signs of melanoma with cutaneous lesions and diffuse bony metastases have been discovered in Peruvian Inca mummies.

Cardiometabolic Risk With Autism: Vigilance Urged
https://www.medpagetoday.com/neurology/autism/102882

Jan 30th, 2023 - People with autism had an elevated risk of cardiometabolic conditions across several dozen studies, researchers confirmed in a meta-analysis. Among children and adults in the analyzed studies, autism was associated with greater likelihood of concomitant: Yet, there was no significantly associated increased risk of hypertension and stroke with autism across all age groups, according to investiga...

High School Alcohol Use Can Quickly Escalate
https://www.medpagetoday.com/pediatrics/generalpediatrics/102881

Jan 30th, 2023 - Heavy binge drinking isn't just a college problem, researchers affirmed, finding that most teen alcohol use that escalated to having 10 or more drinks in a row reached that level rapidly during the high school years. Among a sample of youth who reported drinking in the prior 30 days when surveyed in the 12th grade and who said they engaged in high-intensity drinking (HID, 10 or more in a row) w...

14-year-old boy • aching midsternal pain following a basketball injury • worsening pain with direct pressure and when the patient sneezed • Dx?
https://www.mdedge.com/familymedicine/article/260914/pediatrics
MDedge Family Medicine; Catherine Romaine, BS, Alyssa Heinrich, MD et. al.

Jan 30th, 2023 - THE CASE A 14-year-old boy sought care at our clinic for persistent chest pain after being hit in the chest with a teammate’s shoulder during a basketball game 3 weeks earlier. He had aching midsternal chest pain that worsened with direct pressure and when he sneezed, twisted, or bent forward.

Consider this tool to reduce antibiotic-associated adverse events in patients with sepsis
https://www.mdedge.com/familymedicine/article/260913/infectious-diseases/consider-tool-reduce-antibiotic-associated-adverse
MDedge Family Medicine; Timothy Mott, MD, FAAFP, Zachary Orme, DO

Jan 30th, 2023 - ILLUSTRATIVE CASE A 52-year-old woman presents to the emergency department complaining of dysuria and a fever. Her work-up yields a diagnosis of sepsis secondary to pyelonephritis and bacteremia.

Does regular walking improve lipid levels in adults?
https://www.mdedge.com/familymedicine/article/260912/cardiology/does-regular-walking-improve-lipid-levels-adults
MDedge Family Medicine; Kayla Hatchell, MD, Emily Chin, DO et. al.

Jan 30th, 2023 - Evidence summary Walking’s impact on cholesterol levels is modest, inconsistent A 2022 systematic review and meta-analysis of 21 studies (n = 1129) evaluated the effects of walking on lipids and lipoproteins in women older than 18 years who were overweight or obese and were not taking any lipid-lowering medications. Median TC was 206 mg/dL and median LDL was 126 mg/dL.

Acute hepatic porphyrias no longer as rare as previously thought
https://www.mdedge.com/internalmedicine/article/260911/gastroenterology/acute-hepatic-porphyrias-no-longer-rare-previously
Carolyn Crist

Jan 30th, 2023 - Although rare, acute hepatic porphyrias (AHPs) may be more common than previously thought, particularly among women between ages 15 and 50, according to a new clinical practice update from the American Gastroenterological Association. For acute attacks, treatment should include intravenous hemin, and for patients with recurrent attacks, a newly-approved therapy called givosiran should be consid.

FDA Greenlights First Drug for ESR1-Mutated Breast Cancer
https://www.medpagetoday.com/hematologyoncology/breastcancer/102880

Jan 30th, 2023 - The FDA approved the selective estrogen receptor (ER) degrader elacestrant (Orserdu) for the treatment of postmenopausal women or adult men with ER-positive, HER2-negative, ESR1-mutated advanced or metastatic breast cancer with disease progression following at least one line of endocrine therapy. The FDA also approved the Guardant360 CDx assay as a companion diagnostic test to identify patients...

Early Return to School After Concussion Linked to Lower Symptom Burden
https://www.clinicaladvisor.com/home/topics/neurology-information-center/early-return-school-after-concussion-linked-lower-symptom-burden/
Clinical Advisor

Jan 30th, 2023 - Children with a concussion may no longer have to sit quietly in a dark room for days. New research suggests that prolonged absence from school and other activities may hinder recovery from a concussion. Returning to school earlier than previously recommended may be associated with lower symptom burden, leading to a faster recovery, according to an published online in JAMA Network Open. The anal...

Physician group issues 31 treatment recommendations for early-onset colorectal cancer
https://www.mdedge.com/internalmedicine/article/260906/oncology/physician-group-issues-31-treatment-recommendations-early
Jim Kling

Jan 30th, 2023 - An international group of physicians has issued consensus recommendations for the diagnosis and management of patients with early-onset colorectal cancer (eoCRC). Led by Giulia Martina Cavestro, MD, PhD, a gastroenterologist with the University Vita Salute San Raffaele Hospital, Milan, the Delphi Initiative for Early-Onset Colorectal Cancer group penned 31 recommendations for treating patients.

Study: Diminished COVID Vaccine Response in Lupus
https://www.medpagetoday.com/rheumatology/lupus/102876

Jan 30th, 2023 - Patients with systemic lupus erythematosus (SLE) showed reduced antibody responses following COVID-19 vaccination, with drugs for the condition such as belimumab (Benlysta) and mycophenolate mofetil (MMF) likely to blame, researchers said. Immunoglobulin G (IgG) titers measured 2 weeks after the second dose of mRNA COVID vaccines were lower by about 20% among 342 lupus patients compared with th...

Reversible BTK Inhibitor Gets FDA Nod for Mantle Cell Lymphoma
https://www.medpagetoday.com/hematologyoncology/lymphoma/102874

Jan 30th, 2023 - The FDA has granted accelerated approval to pirtobrutinib (Jaypirca), a non-covalent or reversible Bruton's tyrosine kinase (BTK) inhibitor, for the treatment of relapsed or refractory mantle cell lymphoma (MCL) after at least two prior lines of systemic therapy, including a BTK inhibitor. Pirtobrutinib is the first BTK inhibitor of any kind specifically approved for patients with MCL that has ...

Viruses Tied to Subsequent Dementia, Other Neurodegenerative Diseases
https://www.medpagetoday.com/neurology/generalneurology/102872

Jan 30th, 2023 - At least 22 viral illnesses were linked with an increased risk of subsequent neurodegenerative disease, NIH researchers found. Using data from the U.K. and Finland, Mike Nalls, PhD, of the NIH Center for Alzheimer's and Related Dementias, and co-authors identified 45 viral exposures that were tied to an increased risk of dementia or other neurodegenerative diseases and replicated 22 of these as...

Supervised Exercise Keeps Diabetes at Bay a Decade Later
https://www.medpagetoday.com/endocrinology/diabetes/102871

Jan 30th, 2023 - Supervised moderate and vigorous aerobic activity helped stave off type 2 diabetes in at-risk individuals with central obesity and nonalcoholic fatty liver disease, according to 10-year follow-up of a randomized trial from China. Compared with adults who did not exercise, the risk of diabetes was reduced by 49% in the vigorous exercise group (relative risk [RR] 0.51, 95% CI 0.27-0.94, P=0.01) a...

EMTs After Tyre Nichols Beating Suspended; Long COVID Declining; Damar Hamlin Speaks
https://www.medpagetoday.com/emergencymedicine/emergencymedicine/102870

Jan 30th, 2023 - Note that some links may require subscriptions. The medical response following the beating of Tyre Nichols by Memphis police is being questioned; now two emergency medical technicians (EMTs) have been suspended pending an investigation. (New York Times) COVID-19 is still a global health emergency, the World Health Organization said, though it may be reaching a turning point. (AP) Meanwhile, the...

Enriched ICU Nutrition Strategy Spoiled in Randomized Trial
https://www.medpagetoday.com/criticalcare/generalcriticalcare/102875

Jan 30th, 2023 - Higher protein doses did not improve critically ill patient outcomes, and may even be detrimental to patients with high organ failure and acute kidney injury, the EFFORT trial found. In nutritionally high-risk adults undergoing mechanical ventilation, alive hospital discharge for those who received higher doses of protein reached 46.1% by 60 days after randomization, compared with the 50.2% rat...

Woman Seeks Answers After 3 Years of Painful Genital Ulcers
https://www.medpagetoday.com/dermatology/generaldermatology/102873

Jan 30th, 2023 - A woman in her late 40s presented with painful ulcers in her groin and armpits that hadn't healed in 3 years, an Indian group reported in JAMA Dermatology. The woman explained that when the sores first appeared, they were just itchy, oozing, reddish bumps; over time, they worsened to form painful, pus-filled oozing ulcers. She had been treated with numerous courses of antibiotics, antifungals, ...

Sovos Brands Intermediate, Inc. Issues Allergy Alert on Undeclared Egg in Rao's Slow Simmered Soup, Labeled as Chicken & Gnocchi but Containing Vegetable Minestrone
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733665

Sovos Brands Intermediate, Inc. ("Sovos") is voluntarily recalling a limited number of 16-ounce jars of Rao's Made for Home Slow Simmered Soup, Chicken & Gnocchi, because the affected jars may contain undeclared egg.

Ameripack Foods LLC Announces Allergy Alert for Undeclared Soy and Egg in H-E-B Meal Simple Chocolate Chunk Brownie
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733429

Ameripack Foods LLC of Hughes Springs, TX is issuing a recall for 976lbs. of brownies for H-E-B Meal Simple Chocolate Chunk Brownie 13 Oz due to an undeclared - Soy & Egg. People who have an allergy or severe sensitivity to soy or egg run the risk of serious or life-threatening allergic reaction if

Daiso Issues Allergy Alert on Undeclared Milk in Tohato Nagewa Snack
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733304

Daiso California LLC of La Mirada, CA is recalling Tohato Nagewa Snack (skus 4901940112036 & 4901940112005) because it contains an undeclared milk derivative ingredient. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they co

Caesar's Pasta, LLC Recalls Frozen Manicotti Because of Possible Health Risk
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733291

Caesar's Pasta, LLC of Blackwood, NJ is recalling 5,610 lbs. of frozen manicotti, because it has the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immun

Perineal leiomyoma after 4th degree laceration
https://www.mdedge.com/obgyn/article/260905/perineal-leiomyoma-after-4th-degree-laceration
Mary K. Collins, DO, G. William Stone, MD et. al.

Jan 29th, 2023 - Additional videos from SGS are available here, including these recent offerings: Tips and tricks for a successful rollerball endometrial ablation Resection of infected sacrohysteropexy mesh Surgical techniques for excision of juvenile cystic adenomyoma.

Volume 29, Number 2-February 2023
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733530

Table of Contents for Volume 29, Number 2-February 2023

Research Letter - Orthopoxvirus Infections in Rodents, Nigeria, 2018-2019
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733531

Research Letter — Orthopoxvirus Infections in Rodents, Nigeria, 2018–2019

Dispatch - Nipah Virus Exposure in Domestic and Peridomestic Animals Living in Human Outbreak Sites, Bangladesh, 2013-2015
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733533

Dispatch — Nipah Virus Exposure in Domestic and Peridomestic Animals Living in Human Outbreak Sites, Bangladesh, 2013–2015

Dispatch - (Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733532

Dispatch — (Mis)perception and Use of Unsterile Water in Home Medical Devices, PN View 360+ Survey, United States, August 2021

Synopsis - Infant Botulism, Israel, 2007-2021
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733534

cases indicate a stronger link to soil transmission, possible seasonal variation, and a milder course of disease.

ASL - 10 Things You Can do to Manage COVID-19 at Home
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733599

10 Things You Can do to Manage COVID-19 at Home presented in American Sign Language This video can also be viewed at https://www.cdc.gov/video/socialmedia/316025_10ThingstoManageCOVIDatHome-low-res.wmv

Sovos Brands Intermediate, Inc. Issues Allergy Alert on Undeclared Egg in Rao's Slow Simmered Soup, Labeled as Chicken & Gnocchi but Containing Vegetable Minestrone
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733666

Sovos Brands Intermediate, Inc. ("Sovos") is voluntarily recalling a limited number of 16-ounce jars of Rao's Made for Home Slow Simmered Soup, Chicken & Gnocchi, because the affected jars may contain undeclared egg.

People with Certain Medical Conditions
https://tools.cdc.gov/medialibrary/index.aspx#/media/id/733663

People with Certain Medical Conditions

Commentary: HER2+-targeted therapy, ovarian suppression, and adjuvant therapy in breast cancer, February 2023
https://www.mdedge.com/hematology-oncology/article/260902/breast-cancer/commentary-her2-targeted-therapy-ovarian
Erin Roesch, MD

Jan 27th, 2023 - Erin Roesch, MD Standard first-line therapy for human epidermal growth factor receptor 2 positive (HER2+, ERBB2+) metastatic breast cancer (MBC) includes dual-HER2 blockade (trastuzumab + pertuzumab) in combination with a taxane. 1,2 Differences according to hormone receptor status within HER2+ MBC have been demonstrated in clinicopathologic features, survival, and treatment response.

Commentary: A New Drug, and Pediatric Concerns, February 2023
https://www.mdedge.com/dermatology/article/260900/atopic-dermatitis/commentary-new-drug-and-pediatric-concerns-february
Steven R. Feldman, MD, PhD

Jan 27th, 2023 - Steven R. Feldman, MD, PhD I suspect lebrikizumab is going to be another excellent atopic dermatitis (AD) treatment option.

Fluorescence-optical imaging may detect preclinical PsA
https://www.mdedge.com/rheumatology/article/260899/psoriatic-arthritis/fluorescence-optical-imaging-may-detect-preclinical
Heidi Splete

Jan 27th, 2023 - Fluorescence-optical imaging (FOI) identified early signs of psoriatic arthritis, based on data from 2 years of follow-up of a cohort of 389 adults at 14 rheumatology centers. Approximately 25% of individuals with psoriasis go on to develop psoriatic arthritis (PsA), but there are no validated biomarkers to identify patients at risk for progression to PsA, Michaela Koehm, MD, of Goethe Universi.

Infant with red eyelid lesion
https://www.mdedge.com/familymedicine/article/260897/pediatrics/infant-red-eyelid-lesion
MDedge Family Medicine; Jimena G. Cervantes, MD, Richard P. Usatine, MD

Jan 27th, 2023 - A 4-MONTH-OLD HISPANIC INFANT was brought to her pediatrician by her parents for evaluation of a dark red lesion over her right eyelid. The mother said that the lesion appeared when the child was 4 weeks old and started as a small red dot.

Metabolic syndromes worsen outcomes in BC patients treated with neoadjuvant chemotherapy
https://www.mdedge.com/breast-cancer-icymi/article/260893/breast-cancer/metabolic-syndromes-worsen-outcomes-bc-patients

Jan 27th, 2023 - Key clinical point: The presence of metabolic syndromes (MetS) worsened survival outcomes and increased disease recurrence risk in patients with breast cancer (BC) who received neoadjuvant chemotherapy (NAC). Major finding: The MetS group had a significantly lower likelihood of achieving pathological complete response than the non-MetS group (odds ratio [ OR] 0.

Metastatic BC: Not worth changing the 4-weekly schedule of pegylated liposomal doxorubicin
https://www.mdedge.com/breast-cancer-icymi/article/260892/breast-cancer/metastatic-bc-not-worth-changing-4-weekly-schedule

Jan 27th, 2023 - Key clinical point: Recent phase 2 trials have recommended a 2-weekly schedule of pegylated liposomal doxorubicin (PLD) in patients with heavily treated metastatic breast cancer (BC); however, it failed to demonstrate any advantage in terms of efficacy or safety over the registered 4-weekly regimen of PLD. Major finding: The median progression-free survival was 3.

Early autologous fat grafting associated with increased BC recurrence risk
https://www.mdedge.com/breast-cancer-icymi/article/260891/breast-cancer/early-autologous-fat-grafting-associated-increased

Jan 27th, 2023 - Key clinical point: Autologous fat grafting (AFG) in the second stage of a 2-stage prosthetic breast reconstruction was linked to a higher risk for breast cancer (BC) recurrence when performed within a year after mastectomy. Major finding: Patients who did vs did not undergo AFG within 1 year after the primary operation had a significantly increased risk for disease recurrence (hazard ratio 5.

Meta-analysis compares adjuvant chemotherapy regimens for resected early-stage TNBC
https://www.mdedge.com/breast-cancer-icymi/article/260890/breast-cancer/meta-analysis-compares-adjuvant-chemotherapy

Jan 27th, 2023 - Key clinical point: In patients with early-stage triple-negative breast cancer (TNBC), adding capecitabine to classic anthracycline/taxane-based adjuvant chemotherapy improved overall survival (OS) and carboplatin/paclitaxel was the most effective regimen for improving disease-free survival (DFS). Major finding: Adjuvant chemotherapy with anthracyclines/taxanes plus capecitabine vs anthracyclin.

Overall survival improved with chemotherapy in ER-negative/HER2-negative, T1abN0 BC
https://www.mdedge.com/breast-cancer-icymi/article/260889/breast-cancer/overall-survival-improved-chemotherapy-er-negative

Jan 27th, 2023 - Key clinical point: Treatment with adjuvant chemotherapy significantly improved overall survival (OS) outcomes in patients with estrogen receptor-negative (ER−)/human epidermal growth factor receptor 2-negative (HER2−), T1abN0 breast cancer (BC). Major finding: After a median follow-up of 7.

ERBB2 mRNA expression predicts prognosis in trastuzumab emtansine-treated advanced HER2+ BC patients
https://www.mdedge.com/breast-cancer-icymi/article/260888/breast-cancer/erbb2-mrna-expression-predicts-prognosis

Jan 27th, 2023 - Key clinical point: In patients with advanced human epidermal growth factor receptor 2-positive ( HER2+ or ERBB2+) breast cancer (BC) treated with trastuzumab emtansine, the pre-established levels of ERBB2 mRNA expression according to the HER2DX standardized assay served as an important prognostic biomarker in predicting survival outcomes. Major finding: High, medium, and low levels of ERBB2 mR.