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Category: Emergency Medicine | Monthly Briefing

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January 2012 Briefing - Emergency Medicine

Last Updated: February 01, 2012.

 

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Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for January 2012. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Safety-Net Status Not Linked to ER Length of Stay

TUESDAY, Jan. 31 (HealthDay News) -- There is no significant difference in compliance with emergency department length-of-stay measures for admissions, discharges, observations, and transfers between safety-net and non-safety-net hospitals, according to a study published in the Feb. 1 issue of the Journal of the American Medical Association.

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Sixty Percent Burn Size Crucial Threshold in Children

TUESDAY, Jan. 31 (HealthDay News) -- Children with burns covering 60 percent of their body or more are at much higher risk for complications and death and should receive specialized care, according to a study published online Jan. 31 in The Lancet.

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Hemi-CC7 Transfer Poor Option for Brachial Plexus Injury

MONDAY, Jan. 30 (HealthDay News) -- The use of hemi-contralateral C7 (CC7) transfer alone for either restoration of shoulder function or transfer to the median nerve is not recommended in patients with posttraumatic brachial plexus injury, according to a study published in the Jan. 18 issue of The Journal of Bone & Joint Surgery.

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Booster Seat Use Inconsistent When Carpooling

MONDAY, Jan. 30 (HealthDay News) -- Booster seat use among children aged 4 to 8 years is inconsistent during carpooling, according to a study published online Jan. 30 in Pediatrics.

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More Research Needed on Weaning of Addicted Infants

MONDAY, Jan. 30 (HealthDay News) -- More research is necessary to identify the optimal treatment strategy for weaning infants with neonatal drug withdrawal, but updates for clinical identification and monitoring of opioid-exposed infants have been presented in a guidance statement from the American Academy of Pediatrics (AAP) published online Jan. 30 in Pediatrics.

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Self-Rated Health Status Predicts Mortality Among CVD Patients

FRIDAY, Jan. 27 (HealthDay News) -- Self-rated health status is a risk factor for future vascular events and mortality in patients with cardiovascular diseases, particularly in those with asymptomatic atherosclerotic disease, according to a study published online Jan. 18 in the Journal of Internal Medicine.

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COPD Assessment Test Predicts Exacerbation Severity

FRIDAY, Jan. 27 (HealthDay News) -- The COPD Assessment Test (CAT) provides a reliable score of exacerbation severity in patients with chronic obstructive pulmonary disease (COPD), according to a study published online Jan. 26 in the American Journal of Respiratory and Critical Care Medicine.

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Steroid-Sparing Renal Transplant Yields Successful Outcomes

FRIDAY, Jan. 27 (HealthDay News) -- Rapid discontinuation of prednisone (RDP) five days after renal transplantation from a living (LD) or deceased donor (DD) yields acceptable 10-year patient and graft outcomes, according to research published online Jan. 26 in the Clinical Journal of the American Society of Nephrology.

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No Complications From Using Stored Red Blood Cells

FRIDAY, Jan. 27 (HealthDay News) -- There is no significant difference in early complications, including measures of pulmonary function, immunologic status, or coagulation status, after using fresh versus standard issue red blood cell (RBC) transfusions, according to a study published online Jan. 26 in the American Journal of Respiratory and Critical Care Medicine.

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ACE Inhibitors Not Linked to Improved Outcomes After ACS

THURSDAY, Jan. 26 (HealthDay News) -- For patients with acute coronary syndrome (ACS), prior chronic use of an angiotensin-converting enzyme (ACE) inhibitor is not independently associated with improved in-hospital outcomes, according to a study published in the Feb. 1 issue of The American Journal of Cardiology.

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Anaphylactic Shock After Immunizations Is Rare

THURSDAY, Jan. 26 (HealthDay News) -- Anaphylactic shock following immunization is extremely rare in children, and in the few reported cases, some children have a delayed onset of symptoms, according to a study published online Jan. 23 in the Archives of Disease in Childhood.

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Oral HPV Infection Prevalence in U.S. Close to 7 Percent

THURSDAY, Jan. 26 (HealthDay News) -- In the United States, the prevalence of oral human papillomavirus (HPV) infection is 6.9 percent, with higher prevalence in men than women, according to a study published online Jan. 26 in the Journal of the American Medical Association.

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Deaths From Myocardial Infarction Halved in England

THURSDAY, Jan. 26 (HealthDay News) -- From 2002 to 2010 in England, there was a decrease of about half in the total mortality rate for acute myocardial infarction, according to a study published online Jan. 25 in BMJ.

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Exposure to Iodinated Contrast Media Affects Thyroid Function

THURSDAY, Jan. 26 (HealthDay News) -- Exposure to iodinated contrast media (ICM), which are frequently used during imaging procedures, is associated with changes in thyroid function, specifically an increased risk of developing incident hyperthyroidism and incident overt hypothyroidism, according to a study published in the Jan. 23 issue of the Archives of Internal Medicine.

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Neurologists Should Routinely Assess Patients for Abuse

WEDNESDAY, Jan. 25 (HealthDay News) -- Neurologists should evaluate patients for abuse and neglect, according to a position statement issued by the American Academy of Neurology published online Jan. 25 in Neurology.

Position Statement

Overuse of Health Care Services Understudied

WEDNESDAY, Jan. 25 (HealthDay News) -- Overuse of health care services in the United States is an understudied problem, with the majority of research limited to a few interventions, according to a review published in the Jan. 23 issue of the Archives of Internal Medicine.

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Unemployed Have Poorer Mental and Physical Health

TUESDAY, Jan. 24 (HealthDay News) -- Unemployed adults are about half as likely to have health insurance as employed individuals; have poorer mental and physical health, regardless of their insurance status; and are less likely to receive needed medical care and prescriptions, according to a January data brief issued by the National Center for Health Statistics.

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Lansoprazole Does Not Improve Asthma Control in Children

TUESDAY, Jan. 24 (HealthDay News) -- For children with asthma without overt gastroesophageal reflux (GER), treatment with the proton pump inhibitor (PPI) lansoprazole is not associated with improved asthma control, according to a study published in the Jan. 25 issue of the Journal of the American Medical Association.

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HealthGrades IDs Notable Hospitals for Clinical Excellence

TUESDAY, Jan. 24 (HealthDay News) -- The top 5 percent of U.S. hospitals has more than a 30 percent lower risk-adjusted mortality across 17 procedures and diagnoses, compared with other hospitals, according to the 10th annual HealthGrades Hospital Quality and Clinical Excellence study published online Jan. 24.

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Recent Shift in Indication for Total Elbow Arthroplasty

TUESDAY, Jan. 24 (HealthDay News) -- The most common indication for total elbow arthroplasty in New York State changed from inflammatory conditions in 1997 to trauma in 2006, with revision and complication rates remaining high, according to a study published in the Jan. 18 issue of The Journal of Bone & Joint Surgery.

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Effects of Severe, Childhood Brain Injury Long Lasting

MONDAY, Jan. 23 (HealthDay News) -- There is a high risk of persisting deficits following severe, childhood traumatic brain injury (TBI), according to a study published online Jan. 23 in Pediatrics.

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Dosing Errors Occur With IV Acetaminophen in Children

MONDAY, Jan. 23 (HealthDay News) -- Use of a new intravenous formulation of acetaminophen is associated with dosing errors in neonates, infants, and small children, and evaluation and management of these dosing errors are similar to oral overdose, according to a report published online Jan. 23 in Pediatrics.

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Inadequate Hep B Vaccinations for High-Risk Adults

MONDAY, Jan. 23 (HealthDay News) -- Approximately half of all adults at high risk of hepatitis B infection are vaccinated against hepatitis B, and more than half miss opportunities to be vaccinated, according to a study published online Jan. 12 in Infection.

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Neuromodulators Reduce Pain in Rheumatoid Arthritis

FRIDAY, Jan. 20 (HealthDay News) -- Neuromodulators are superior to placebo for reducing pain in patients with rheumatoid arthritis (RA), but treatment is associated with adverse events; whereas muscle relaxants show no benefit for improving pain in RA, according to two reviews published online Jan. 18 in the Cochrane Database of Systematic Reviews.

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SSRIs Increase Fall Risk in Elderly Dementia Patients

FRIDAY, Jan. 20 (HealthDay News) -- Even at low doses, selective serotonin reuptake inhibitors (SSRIs) increase the risk of injuries due to falls in elderly dementia patients, and the risk increases further at higher doses and when hypnotics and sedatives are added, according to a study published online Jan. 18 in the British Journal of Clinical Pharmacology.

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Warfarin Patients With Head Trauma Need Second CT Scan

FRIDAY, Jan. 20 (HealthDay News) -- For patients on warfarin with minor head trauma who have an initial negative computed tomography (CT) scan, 24-hour observation followed by an additional CT scan identifies the majority of cases of delayed bleeding, according to a study published online Jan. 16 in the Annals of Emergency Medicine.

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Taking Two or More Medications Increases Fall Rate

FRIDAY, Jan. 20 (HealthDay News) -- The use of two or more prescription medications is associated with an increased risk of falls and fall-related injuries at home among young and middle-aged adults, according to a study published online Jan. 16 in Injury Prevention.

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Sexual Activity Safe for Most Cardiovascular Disease Patients

THURSDAY, Jan. 19 (HealthDay News) -- For most individuals with stable cardiovascular disease (CVD), sexual activity is safe, according to a scientific statement from the American Heart Association published online Jan. 19 in Circulation.

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Worse Outcomes for Stroke Patients With Delirium

THURSDAY, Jan. 19 (HealthDay News) -- Stroke patients who develop delirium have worse outcomes, including higher mortality and longer hospitalizations, and are more likely to be discharged to a care facility, according to a review published online Jan. 19 in Stroke.

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Upper Normal BP Increases Risk for A-Fib in Men

THURSDAY, Jan. 19 (HealthDay News) -- Having blood pressure (BP) within the upper limits of normal can predict future atrial fibrillation (AF) in otherwise healthy, middle-aged men, according to a study published online Jan. 17 in Hypertension.

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Endovascular Graft Approved for Tears of Aorta

MONDAY, Jan. 16 (HealthDay News) -- The U.S. Food and Drug Administration has expanded approval of an endovascular graft to include ruptures of the aorta.

tears of the aorta

Access to Quality Primary Care Reduces Mortality Risk

MONDAY, Jan. 16 (HealthDay News) -- Greater access to high-quality primary medical care that includes features of comprehensiveness, patient-centeredness, and extended office hours is associated with a reduced risk of death, according to a study published in the January/February issue of the Annals of Family Medicine.

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Drowning Hospitalizations for Peds Down in Recent Years

MONDAY, Jan. 16 (HealthDay News) -- Hospitalization rates for pediatric drowning have decreased over the past 14 years among children of all ages, with males continuing to have higher hospitalization rates than females, according to a study published online Jan. 16 in Pediatrics.

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Fatal Case of Measles Without Rash Found in Young Woman

FRIDAY, Jan. 13 (HealthDay News) -- A fatality from measles with acute respiratory distress syndrome (ARDS), but without rash, has been reported, according to a study published online Jan. 11 in the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

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New Procedure Cuts Arrival-to-Triage Time in Pediatric ER

FRIDAY, Jan. 13 (HealthDay News) -- Implementation of a new pediatric emergency nursing triage procedure significantly reduces arrival-to-triage times to less than 10 minutes for most patients, according to a study published in the January issue of the Journal of Emergency Nursing.

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U.S. Health Care Expenditure Still Unevenly Distributed

FRIDAY, Jan. 13 (HealthDay News) -- Health care expenditure in the United States is still unevenly distributed, with 1 percent of the population accounting for approximately 20 percent of expenditure in 2008 and 2009, according to a January statistical brief published by the Agency for Healthcare Research and Quality (AHRQ).

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Site of Blood Collection From IV Does Not Affect Hemolysis Rate

THURSDAY, Jan. 12 (HealthDay News) -- No statistically significant difference in the rate of hemolysis is observed when emergency department nurses collect coagulation blood samples directly via catheter hub or via extension tubing connected to the intravenous (IV) catheter hub, according to a study published in the January issue of the Journal of Emergency Nursing.

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Physical Activity in Work or Leisure Tied to Lower MI Risk

THURSDAY, Jan. 12 (HealthDay News) -- Physical activity during work or leisure time is associated with a significantly lower risk of myocardial infarction (MI), according to a multinational study published online Jan. 11 in the European Heart Journal.

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Low Risk of Cardiac Arrest in Marathon Runners

THURSDAY, Jan. 12 (HealthDay News) -- While the overall risk of cardiac arrest during a marathon or half-marathon is low, the risk is higher for those participating in marathons than half-marathons and for men than women, particularly for men with underlying hypertrophic cardiomyopathy or atherosclerotic coronary disease, according to a study published in the Jan. 12 issue of the New England Journal of Medicine.

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Subclinical Tachyarrhythmias Tied to Increased Risk of Stroke

WEDNESDAY, Jan. 11 (HealthDay News) -- Subclinical atrial tachyarrhythmias, which occur in approximately 10 percent of patients in the first three months after pacemaker or defibrillator implantation, are associated with an increased risk of clinical atrial fibrillation, stroke, and systemic embolism, according to a study published in the Jan. 12 issue of the New England Journal of Medicine.

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CDC: 2010 Saw Decrease in Age-Adjusted Death Rates

WEDNESDAY, Jan. 11 (HealthDay News) -- From 2009 to 2010, age-adjusted death rates decreased and life expectancy increased, according to a Jan. 11 report published by the U.S. Centers for Disease Control and Prevention.

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Rx Provides Fast Relief of Pain, Urgency of Interstitial Cystitis

WEDNESDAY, Jan. 11 (HealthDay News) -- Alkalinized lidocaine plus heparin provides significant and immediate relief from the pain and urgency symptoms of interstitial cystitis (IC) for 12 hours after treatment, according to a study published in the January issue of the Journal of Sexual Medicine.

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Too High, Too Low Serum Potassium Linked to Mortality

TUESDAY, Jan. 10 (HealthDay News) -- Patients hospitalized after an acute myocardial infarction (AMI) with post-admission serum potassium levels between 3.5 and 4.5 mEq/L (milliEquivalents per liter) have a lower risk of death than those with higher or lower levels, according to a study published in the Jan. 11 issue of the Journal of the American Medical Association.

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CDC: Binge Drinking Prevalence High in United States

TUESDAY, Jan. 10 (HealthDay News) -- About one in six adults in the United States regularly engages in binge drinking, which accounts for more than 40,000 alcohol-related deaths every year, according to research published in the Jan. 10 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Dementia Associated With More Hospital Admissions

TUESDAY, Jan. 10 (HealthDay News) -- Hospital admission rates for all causes, and for ambulatory care-sensitive conditions (ACSCs), are significantly higher among patients with dementia compared to older patients without dementia, according to a study published in the Jan. 11 issue of the Journal of the American Medical Association.

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Long-Term Prognostic Value of Dobutamine Stress Echo Limited

TUESDAY, Jan. 10 (HealthDay News) -- Dobutamine stress echocardiography (DSE) has limited long-term predictive value for patients with diabetes who are unable to perform an exercise stress test, particularly during the first seven years after initial testing, according to a study published online Jan. 6 in Diabetes Care.

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A Broken Heart Does Increase Heart Attack Risk

TUESDAY, Jan. 10 (HealthDay News) -- The death of a significant person in someone's life is associated with a significantly increased risk of acute myocardial infarction (MI) for the grieving individual in the days following the death, according to a study published online Jan. 9 in Circulation.

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Benefit of Aspirin in Primary Prevention Questioned

TUESDAY, Jan. 10 (HealthDay News) -- For individuals without prior cardiovascular disease (CVD), aspirin prophylaxis does not reduce cardiovascular death or cancer mortality, although it is associated with reductions in nonfatal myocardial infarction (MI), according to a meta-analysis published online Jan. 9 in the Archives of Internal Medicine.

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No Rise in Intussusception After Rotavirus Shot Revival

TUESDAY, Jan. 10 (HealthDay News) -- The reintroduction of the rotavirus vaccination in the United States has not resulted in an increase in the rate of infant hospital discharges for intussusception, according to a study published online Jan. 2 in the Archives of Pediatrics & Adolescent Medicine.

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Ped Heart Surgery Deaths Higher at Low Volume Centers

MONDAY, Jan. 9 (HealthDay News) -- Postoperative mortality rates from complications after pediatric heart surgery are higher at centers with a lower volume of cases, according to a study published online Jan. 9 in Pediatrics.

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Rilonacept Reduces Gout Flares During Acute Urate Lowering Rx

MONDAY, Jan. 9 (HealthDay News) -- The use of rilonacept significantly reduces gout flare-ups in the first few months following initiation of urate-lowering therapy (ULT), according to research published online Jan. 4 in Arthritis & Rheumatism.

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Hypoglycemia in Intensive Diabetes Control May Up Survival

FRIDAY, Jan. 6 (HealthDay News) -- For adults with type 2 diabetes, recognized and unrecognized hypoglycemia is more common in those with intensive blood sugar control, and is associated with a small but significant reduction in the risk of mortality, according to a study published online Dec. 16 in Diabetes Care.

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In-Hospital, 30-Day Standardized Mortality Measures Differ

THURSDAY, Jan. 5 (HealthDay News) -- The mean risk-standardized mortality rates (RSMRs) differ for in-hospital and 30-day models, with wide variability across U.S. hospitals, according to a study published in the Jan. 3 issue of the Annals of Internal Medicine.

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Intrapartum Antibiotics Reduce Infant Strep B Infection Globally

THURSDAY, Jan. 5 (HealthDay News) -- Intrapartum prophylactic antibiotics substantially reduce infant streptococcus B infection worldwide, but the practice should be more widely adopted in low-income settings, according to research published online Jan. 5 in The Lancet.

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Most Type 2 Diabetes, CAD Patients Present With Angina

WEDNESDAY, Jan. 4 (HealthDay News) -- A large proportion of patients with type 2 diabetes mellitus and documented stable coronary artery disease have symptoms of angina, and the nature of symptom presentation may be associated with the type of previous revascularization, according to a study published in the Jan. 1 issue of The American Journal of Cardiology.

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Montelukast Doesn't Cut Upper Respiratory Infection Incidence

WEDNESDAY, Jan. 4 (HealthDay News) -- For young children, 12-week prophylactic treatment with montelukast does not reduce the incidence of upper respiratory tract infections (URIs), according to a study published online Jan. 4 in Pediatrics.

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Multiple Blockages, U.S. Heart Attack Care Ups Readmissions

TUESDAY, Jan. 3 (HealthDay News) -- Patients treated for heart attacks in the United States have shorter initial hospital stays but significantly higher rates of 30-day readmission compared with patients in other countries, according to a study published in the Jan. 4 issue of the Journal of the American Medical Association.

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CDC: Lean Response Ups Lab Surge Capacity During Pandemic

TUESDAY, Jan. 3 (HealthDay News) -- Implementation of Lean methods can improve the surge capacity of a laboratory, according to a study published in the January issue of the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

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Traditional, Disease Risk Factors ID'd in SLE Osteoporosis

TUESDAY, Jan. 3 (HealthDay News) -- For patients with systemic lupus erythematosus (SLE), the etiology of osteoporosis is multifactorial, encompassing traditional risk factors and SLE-related factors; and there is an increased fracture risk, according to a review published in the January issue of Arthritis Care & Research.

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