Vulvar Melanoma Is Increasing in Older Women

Vulvar Melanoma Is Increasing in Older Women

The national incidence of vulvar melanoma is on the rise in women aged over 60 years, climbing by an average of 2.2% per year during 2000–2016, Maia K. Erickson reported in a poster at the virtual annual meeting of the American Academy of Dermatology.

These are often aggressive malignancies. The 5-year survival following diagnosis of vulvar melanoma in women aged 60 years or older was 39.7%, compared with 61.9% in younger women, according to Ms. Erickson, a visiting research fellow in the department of dermatology at Northwestern University, Chicago.

NEJM Journal Watch – 06.05.20

Prevalence of asymptomatic disease: An estimated 40–45% of people who test positive for SARS-CoV-2 do not have symptoms at the time of testing, according to a narrative review of 16 cohorts in the Annals of Internal Medicine. In four cohorts with longitudinal data, few of the asymptomatic patients (0–10%) went on to develop symptoms. But in one skilled nursing facility, 89% of initially asymptomatic patients became sick. The researchers say, “It is imperative that testing programs include those without symptoms.” They add, “The early data that we have assembled on the prevalence of asymptomatic SARS-CoV-2 infection suggest that this is a significant factor in the rapid progression of the COVID-19 pandemic.”

COVID-19: Asymptomatic Disease Prevalence / N95 Mask Reuse / Oxygen Management Strategies / Anti-Racism Demonstrations / Studies Retracted

Smoking cigarettes — even one or less per day — is associated with increased mortality risk, a JAMA Network Open study shows.  Researchers combined data from several federal smoking surveys performed between 1992 and 2011. In those surveys, some 500,000 adults reported their smoking histories. National mortality data showed that, compared with never-smokers, daily smokers (averaging 600 cigarettes per month) bore a 2.3-fold higher all-cause mortality risk, with non-daily smokers (averaging 40 per month) sustaining a 1.8-fold higher risk.  Heightened mortality risks became apparent even at levels of 6 to 10 cigarettes per month.  The researchers conclude: “Thus, all smokers should quit, regardless of how infrequently they smoke.”

Infrequent Smoking Carries Heightened Mortality Risk

Anorexia Nervosa – More Dangerous Than You Think

This article is written by an Emergency Medicine doctor for other Emergency Medicine doctors as a quick primer on recognizing and diagnosing anorexia.  While those of us in the life insurance business are not diagnosticians  you will definitely benefit from this short ten minute article on the next case you encounter where Momma Bear is applying for $2,000,000 on her skinny 15 year old daughter who can’t seem to gain weight no matter how much the kid eats.

AN is a common, severe psychiatric illness. It is often present with co-morbid psychiatric illnesses. There is a high mortality rate, 5.6% per decade. It is notoriously difficult to treat with psychotherapy and pharmacotherapy.

Anorexia Nervosa – More Dangerous Than You Think

Paediatric Multisystem Inflammatory Syndrome – (PIM-TS)

Citation:
DFTB, T. Paediatric Multisystem Inflammatory Syndrome, Don’t Forget the Bubbles, 2020. Available at:
http://doi.org/10.31440/DFTB.25760

There has clearly been a lot of media interest in PIMS-TS but it is still an extremely uncommon disease entity in the context of all children presenting to emergency and acute care services. The vast majority of children, including those who were critically ill, have made a good recovery.

 

Alcohol Abuse and Covid-19

The binging population is of particular concern. “This is a huge problem, driven by people in their 30s and 40s,” Saab told Medscape Medical News. “It’s fascinating; with each subsequent generation, risk behavior increases. Nobody seems to know why that is. Different parenting, different life stressors, social media? Things have changed.”

In the 25- to 34-year age group, death from liver cirrhosis increased 10.5% from 2009 to 2016, according to data from the ACCELERATE-AH consortium, which is looking at alcohol use by patients before and after liver transplantation, as reported by Medscape Medical News.

Alcohol Abuse Agitated by COVID-19 Stirring Liver Concerns

Read the entire article at the link above.

 

Meat Intake and Colorectal Polyps

Meat Intake and Colorectal Polyps

Research professor of medicine Martha Shrubsole, Ph.D., and colleagues at Vanderbilt University Medical Center have published the first study to evaluate intakes of meat, cooking methods and meat mutagens and risk of developing sessile serrated polyps (SSPs, also called sessile serrated lesions). Shrubsole previously reported that consuming high levels of red meat increased the risk of developing all types of polyps, but that the likelihood of developing SSPs was two times greater than the risk of developing adenomas and hyperplastic polyps (HP).

Conventional colorectal adenomas are the precursor lesions for most colorectal cancers. SSPs, however, represent an alternative pathway to carcinogenesis that may account for up to 35 percent of colorectal cancers. Because a diagnostic consensus for SSPs was not reached until 2010, few epidemiologic studies have evaluated risk factors.

 

Step It Up!

Previous studies have been done on step counts and mortality. However, they were conducted primarily with older adults or among people with debilitating chronic conditions. This study tracked a representative sample of U.S. adults aged 40 and over; approximately 4,800 participants wore accelerometers for up to seven days between 2003 and 2006. The participants were then followed for mortality through 2015 via the National Death Index. The researchers calculated associations between mortality and step number and intensity after adjustment for demographic and behavioral risk factors, body mass index, and health status at the start of the study.

They found that, compared with taking 4,000 steps per day, a number considered to be low for adults, taking 8,000 steps per day was associated with a 51% lower risk for all-cause mortality (or death from all causes). Taking 12,000 steps per day was associated with a 65% lower risk compared with taking 4,000 steps. In contrast, the authors saw no association between step intensity and risk of death after accounting for the total number of steps taken per day.

Higher daily step count linked with lower all-cause mortality

I am so screwed.

Community Factors and Life Expectancy

“When we controlled for historical life expectancy, we found three additional community factors that each exert a significant negative effect — a greater number of fast food restaurants, higher population density, and a greater share of jobs in mining, quarrying, and oil and gas extraction,” Dobis said. “For example, for every one percentage point increase in the number of fast food restaurants in a county, life expectancy declined by .004 years for men and .006 years for women.”

Community factors influence how long you’ll live

Journal Reference:     Elizabeth A. Dobis, Heather M. Stephens, Mark Skidmore, Stephan J. Goetz. Explaining the spatial variation in American life expectancy. Social Science & Medicine, 2020; 246: 112759 DOI: 10.1016/j.socscimed.2019.112759