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Cancer Among Younger Americans is Increasing

   A study published on JAMA Network Open using data from the National Cancer Institute Surveillance program reported a mere 0.74 % increase among all age groups for “early onset cancers,” but they rose 4.35% in women and dropped 4.9% in men. Women saw the fastest increases in gastrointestinal, endocrine, and breast cancers. Asian and Pacific Island people increased 32%, Hispanics increased 28%, while rates decreased 5% for Blacks and 12% for Whites.

Inflation Reduction Act Provisions Reduce Prescription Drug Costs

   The Washington Post reports the Inflation Reduction Act set a $35 cap on the cost of insulin and mandates Medicare to negotiate the price of some drugs for seniors and those with disabilities. 

Sugar Substitutes Don’t Help Weight Control and May Increase Risk of Heart Disease and Diabetes

   The World Health Organization (WHO) warns against using artificial sweeteners for weight control. They have no nutritional value. Short term use (3 months or less) will lower weight and body mass index (BMI), but will not improve glucose or insulin levels. Higher use of nonsugar sweeteners (over a decade) correlated with increased risk of obesity, cardiovascular diseases (stroke, in particular), and death from any cause. Sugar substitutes were NOT associated with a higher risk of cancer, but saccharin was linked to bladder cancer in a few cases. Children on sugar substitutes lost weight, but BMI scores were unaffected. Bottom line: use unsweetened foods and drinks rather than substitute sweeteners and focus on reducing consumption of sugar and substitutes in children still forming food preferences.

Daily Aspirin Linked with Anemia in Older People

   Taking 100mg of aspirin per day was associated with a 20% higher risk of anemia. Anemia in older folks is caused by aspirin-induced bleeding in the GI tract. Aspirin is recommended for prevention of recurrent episodes after a first occurrence. The Annals of Internal Medicine reported on 19,114 people in the Aspirin Reducing Events in the Elderly trial. 51 people per 1000 person-years who took aspirin were anemic. Of those on placebo only 43/1000 were anemic. Monitoring hemoglobin is important.

Social Isolation, Loneliness Tied to Higher Mortality

   In Nature Human Behavior a report says social isolation and loneliness were associated with a 32% higher risk of all-cause mortality and 14% higher risk of cancer mortality. Social isolation from other people was also linked to a higher risk of death from cardiovascular disease. Those who live isolated lives are more likely to engage in unhealthy behaviors—smoking, sedentary lifestyle, less likely to seek medical care.

More Than 80% of the World’s Morphine goes to North America, Europe

   In 2021, 80% of the world’s morphine was distributed to high-income countries in Europe and North America. These countries consume 63 times as much as low-income countries (WHO report). 

First U.S. Malaria Cases in 20 Years Prompt CDC Advisory

   4 Floridians and 1 Texan were recently diagnosed with malaria caused by Plasmodium vivax. They were all treated and improved. Theses cases prompted the CDC to put labs and hospitals on alert for more cases and upgrade treatment methods and protocols. 

Fasting No Better Than Calorie Counting for Weight Loss

   Time-restricted eating (within an 8-hour period each day) lost just as much weight after one top year as those who reduced their daily calorie consumption by 25%. Both groups lost 5% of their original weight. Time-restricted eating is a new concept that reduces calorie intake without realizing it. 

What is First Line Treatment of Hay Fever?

   Intranasal corticosteroids are the most effective treatment. OTC sprays are ineffective if not aggravating. Non-sedating oral antihistamines are somewhat effective, but are second-line.

How Should Neonatal Hyperbilirubinemia Be Diagnosed?

   All newborns should be checked for jaundice every 12 hours from birth to hospital discharge. Those who appear jaundiced should have serum bilirubin measurements done and treatment begun per results-based protocols.

How to Evaluate a Young Child With a Limp?

   Children under 5 years don’t fake a limp—there is always a pathologic reason. If physical exam fails to determine a cause, x-rays of the entire affected extremity must be done. Tibia, fibula, femur, hip joint, and pelvis should be done.

How to Treat Benign Paroxysmal Positional Vertigo?

   Repositioning maneuvers (Epley Maneuver)—see your doctor—works very well. Antihistamines (Antivert) and benzodiapines (Valium/diazepam) provide some help.

Pandemic Tied to Greater Increases in BMI in 10-12 Year Olds

   JAMA Pediatrics reports over time, 10-12 year olds had increases in Body Mass Index greater than in the prepandemic time period. 

Isometric Exercises Most Effective for Improving Resting Blood Pressure

   Several exercise modes improved resting BP, but isometric exercise was most effective.

References: AAFP Family Medicine Today: Cancer Among Younger Americans Increasing

2923 August 17.

Suran M. Sugar Substitutes Don’t Help Weight Control and May Increase Risk of Heart Disease and Diabetes, WHO Says. JAMA 2023 July 3;330(1):9-10.

Medical News in Brief: Daily Dose of Aspirin Linked with Anemia in a Older People JAMA 2023 July 18;330(3):210.

Medical News in Brief: Social Isolation, Loneliness Tied to Higher Mortality JAMA 2023 July 18;330(3):211.

Medical News Briefs: Dirst US Malaria Cases in 20 years Prompt CDC Advisory JAMA 2023 July 25;330(4):306.

Medical News Briefs: Fasting No Better Than Calorie Counting for Weight Loss JAMA 2023 July 25;330(4):306.

AFP Clinical Answers: Allergic Rhinitis Am Fam Phys 2023 August;108(2):134.

AFP Clinical Answers: Neonatal Hyperbilirubinemia Am Fam Phys 2023 August;108(2):134.

AFP Clinical Answers: Young Child with an Acute Limp Am Fam Phys 2023 August;108(2):134.

AFP Clinical Answers: Benign Paroxysmal Positional Vertigo Am Fam Phys 2023 August;108(2):134.

AAFP Family Medicine Today: Pandemic Tied to Greater Increases in BMI in 10-12 Year Olds 2023 August 18. 

AAFP Family Medicine Today: Isometric Exercises are Most Effective For Improving Resting BP 2023 August 18.  

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