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Time trends of acute hepatitis C incidence by age groups: 2003-2016.

Hepatitis C Infection Screening and Management in Opioid Use Epidemics in the United States

Acute hepatitis C infection is on the rise in the United States, with a more than twofold increase in incidence rate from 2003 to 2016 overall and a threefold increase among young adults1, 2 (Figure). In 2016, a total of 2967 cases were reported from 42 states, and the Centers for Disease Control and Prevention estimates the […]

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Tramadol: Understanding the Risk of Serotonin Syndrome and Seizures

Tramadol is commonly prescribed for pain control because it presents a lower risk for addiction and respiratory depression compared to other opioids. However, tramadol’s serotonin and norepinephrine reuptake inhibitory effects result in a unique adverse effect profile. Two such adverse events are serotonin syndrome and seizures. The prevalence of tramadol-induced serotonin syndrome and seizures is […]

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elder woman in eye exam

Prescription of Statins to Women Poses New Clinical Challenges

In women and men, cardiovascular disease is and will remain the leading avoidable cause of premature death in the United States and is rapidly becoming so worldwide.1 Although many women fear breast cancer more than cardiovascular disease, 1 in 8 will develop and 1 in 25 will die of this disease, whereas more than 1 in […]

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2017 Is Banner Year for Drug Approvals by the Food and Drug Administration

In 2017, the US Food and Drug Administration (FDA) approved 46 novel drugs, a 21-year high,1, 2, 3 and an additional 29 previously approved drugs received newly approved indications. This record setting year was due, in part, to several new expedited review pathways at the FDA, including accelerated approval, priority review, and fast-track and breakthrough therapy, all of […]

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Actigraphy analysis methods and terms. Vertical lines represent the activity count in a 15-second epoch. Red markers at base of actigraphy bars represent epochs scored as awake by the software/algorithm. Light channel (yellow) removed from panels B and C in order to demonstrate activity patterns. (A) Hospitalized adult with long sleep bouts. Rest intervals (light blue background) are determined by the scorer, using decreased activity levels and light level changes, as periods where the subject is likely to be sleeping/trying to sleep. Sleep bouts within the rest interval are determined by the software's algorithm, which scores sleep or wake based on activity count thresholds in a particular epoch and multiple surrounding epochs; the sum total of these sleep bouts give the total duration of sleep within a particular interval. Please note the clear changes in activity level between daytime and nighttime, as well as the minimal amount of wrist activity during sleep for this individual. (B) Hospitalized adult with short sleep bouts. Here, sleep within the rest interval is characterized by multiple short sleep bouts (examples shown with arrows in this panel), suggesting substantial sleep fragmentation. (C) Acutely ill, hospitalized adult with Confusion Assessment Method–positive delirium. This individual was noted to become delirious overnight. Note the increased and prolonged activity during the night, as well as the lack of sleep. Daytime rest periods ≥30 minutes were designated as naptime rest intervals; naps were summed together with the nighttime sleep to determine the total sleep time for a 24-hour period. Gray area in this panel is time prior to the start of the device's recording.

Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial

Studies suggest that melatonin may prevent delirium, a condition of acute brain dysfunction occurring in 20%-30% of hospitalized older adults that is associated with increased morbidity and mortality. We examined the effect of melatonin on delirium prevention in hospitalized older adults while measuring sleep parameters as a possible underlying mechanism. Methods This was a randomized […]

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Sudden Creatine Kinase Elevation When an Athlete Starts Boxing: Looking Deeper Prior to Knocking the Statin Out

A 55-year-old Caucasian man with a prior computed tomography calcium score in the 75th percentile for age, sex, and race at age 39 years, and on long-term high-intensity statin therapy presented with episodic myalgia. He reported 3 episodes within the past year of sudden severe quadriceps pain that self-resolved within 2 days. His activities included biking […]

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