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December 2019 Briefing - Neurology

Here are what the editors at HealthDay consider to be the most important developments in Neurology for December 2019. 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.

Antiepileptic Drug Exposure Low in Breastfeeding Infants

TUESDAY, Dec. 31, 2019 (HealthDay News) -- Among infants breastfed by mothers who are receiving drug therapy for epilepsy, antiepileptic drug (AED) concentrations in infant blood samples are substantially lower than those in maternal blood samples, according to a study published online Dec. 30 in JAMA Neurology.

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Severity of Autism Symptoms May Vary in Monozygotic Twins

TUESDAY, Dec. 31, 2019 (HealthDay News) -- Autism spectrum disorder (ASD) is markedly heritable, with probandwise concordance of 96 percent, but there is variation in the severity of symptomatology above the diagnostic threshold, according to a study published online Dec. 18 in Behavior Genetics.

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fMRI Measures May Predict Psychiatric Symptoms in Children

TUESDAY, Dec. 31, 2019 (HealthDay News) -- Resting-state functional magnetic resonance imaging (fMRI) measures may be able to predict symptoms of attention-deficit/hyperactivity disorder or major depressive disorder in children, according to a study published online Dec. 26 in JAMA Psychiatry.

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Subtle Cognitive Difficulties May Predict Amyloidosis

TUESDAY, Dec. 31, 2019 (HealthDay News) -- Individuals with objectively-defined subtle cognitive difficulties (Obj-SCD) have faster amyloid accumulation and faster entorhinal cortical thinning compared with cognitively normal (CN) individuals, according to a study published online Dec. 30 in Neurology.

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Machine Learning System Makes More Alerts for Med Errors

TUESDAY, Dec. 31, 2019 (HealthDay News) -- A machine learning system can generate clinically valid alerts for medication errors that might be missed with existing clinical decision support (CDS) systems, according to a study published in the January issue of The Joint Commission Journal on Quality and Patient Safety.

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Multiple Health Benefits Reported for Intermittent Fasting

MONDAY, Dec. 30, 2019 (HealthDay News) -- Intermittent fasting has multiple health benefits, according to a review article published in the Dec. 26 issue of the New England Journal of Medicine.

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Yoga Has Positive Effect on Brain Structure, Function

MONDAY, Dec. 30, 2019 (HealthDay News) -- Yoga has a positive effect on the structure and/or function of various brain regions and networks, including the default mode network, according to research published online Dec. 26 in Brain Plasticity.

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Case Study: Methylmercury Toxicity Found From Skin-Lightening Cream

FRIDAY, Dec. 27, 2019 (HealthDay News) -- In a Notes from the Field report, published in the Dec. 20 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, doctors present the case of a California woman with significant central nervous system damage after using a skin-lightening cream from Mexico that contained toxic mercury.

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Marijuana Use for MS Tied to Legal Permissiveness

FRIDAY, Dec. 27, 2019 (HealthDay News) -- Cannabis use among patients with multiple sclerosis (MS) is more likely where cannabis laws are more permissive, according to a study published in the February issue of Multiple Sclerosis and Related Disorders.

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Many Hospitals Fail to Provide Instructions for Patient Portals

THURSDAY, Dec. 26, 2019 (HealthDay News) -- Many hospital patient portals fail to educate patients fully and set expectations for secure messaging, according to a study recently published in the Journal of General Internal Medicine.

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Palliative Care Services Lagging Worldwide

TUESDAY, Dec. 24, 2019 (HealthDay News) -- Greater palliative care development and implementation is needed worldwide, according to a study recently published in the Journal of Pain and Symptom Management.

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Patient Share of Out-of-Network Costs Rising

TUESDAY, Dec. 24, 2019 (HealthDay News) -- The out-of-pocket costs for out-of-network (OON) care grew rapidly for privately insured Americans from 2012 to 2017, according to a study published in the December issue of the American Journal of Managed Care.

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Healthy Sleep Pattern May Reduce Risk for Cardiovascular Disease

TUESDAY, Dec. 24, 2019 (HealthDay News) -- A healthy sleep pattern is associated with reduced risks for cardiovascular disease (CVD), coronary heart disease (CHD), and stroke, according to a study published online Dec. 18 in the European Heart Journal.

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Enrollment in Affordable Care Act Holds Steady for Third Straight Year

MONDAY, Dec. 23, 2019 (HealthDay News) -- Enrollment in Affordable Care Act coverage for next year has surpassed 8 million, a sign that many Americans still turn to the government health insurance program to help pay for their medical care.

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Standardized Screening for ASD Recommended at 18, 24 Months

MONDAY, Dec. 23, 2019 (HealthDay News) -- Standardized screening for autism spectrum disorder (ASD) is recommended at ages 18 and 24 months in primary care, according to a clinical report published online Dec. 16 in Pediatrics.

Executive Summary
Clinical Report

Sleep Fragmentation Linked to Odds of Migraine

MONDAY, Dec. 23, 2019 (HealthDay News) -- Sleep fragmentation, defined by low sleep efficiency, is associated with increased odds of migraine a day later, but there is no temporal association for short sleep duration and low sleep quality with migraine, according to a study published online Dec. 16 in Neurology.

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Aspirin May No Longer Have Effect in Primary CVD Prevention

MONDAY, Dec. 23, 2019 (HealthDay News) -- Aspirin may not be effective for primary prevention of cardiovascular disease and cancer mortality, according to research published online Nov. 21 in Family Practice.

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Cognitive Symptom Score From EHR Predicts Risk for Dementia

FRIDAY, Dec. 20, 2019 (HealthDay News) -- A cognitive symptom measure identified in discharge summaries can predict the risk for dementia, according to a study published online Dec. 17 in Alzheimer's & Dementia.

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Concussions More Common Among College Students Than Thought

FRIDAY, Dec. 20, 2019 (HealthDay News) -- Concussions are common among the U.S. collegiate population, with rates higher for non-sport-related concussion versus sport-related concussion, according to a study published online Dec. 18 in JAMA Network Open.

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Gabapentinoids, Opioids Combo Carries Risk for Breathing Problems

FRIDAY, Dec. 20, 2019 (HealthDay News) -- New warnings about the risk for dangerous breathing difficulties when gabapentinoids are used with opioids or by certain patients must now appear on product labels, the U.S. Food and Drug Administration announced Thursday.

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Private Care Program for U.S. Vets Gets $8.9 Billion in Budget Deal

THURSDAY, Dec. 19, 2019 (HealthDay News) -- A controversial program meant to get more U.S. veterans to use private health care received $8.9 billion as part of a government spending bill approved by the House.

AP News Article

FDA to Allow States to Import Prescription Drugs From Other Countries

WEDNESDAY, Dec. 18, 2019 (HealthDay News) -- Federal health officials have unveiled plans to allow prescription drug imports from Canada and other foreign nations.

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Midlife Obesity in Women May Increase Risk for Dementia Later

WEDNESDAY, Dec. 18, 2019 (HealthDay News) -- In women, midlife obesity is associated with increased risk for dementia later in life, while no clear associations are apparent for low body mass index (BMI), low caloric intake, or inactivity at baseline, according to a study published online Dec. 18 in Neurology.

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Fenfluramine Reduces Convulsive Seizures in Dravet Syndrome

WEDNESDAY, Dec. 18, 2019 (HealthDay News) -- Among patients with Dravet syndrome, the reduction in frequency of convulsive seizures is greater with fenfluramine than with placebo, according to a study published online Dec. 17 in The Lancet.

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Spine Surgery Safely Performed in Some Very Elderly Patients

WEDNESDAY, Dec. 18, 2019 (HealthDay News) -- In a carefully defined cohort of patients aged 80 years and older undergoing spine surgery, perioperative complications occurred in 20 percent, according to a study published online Dec. 17 in the Journal of Neurosurgery: Spine.

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SAE Rate Higher With Nilotinib Versus Placebo in Parkinson Disease

TUESDAY, Dec. 17, 2019 (HealthDay News) -- Among patients with moderately severe Parkinson disease, exploratory biomarkers are altered in response to nilotinib, but the rate of serious adverse events (SAEs) is significantly higher in those receiving nilotinib versus placebo, according to a study published online Dec. 16 in JAMA Neurology.

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Frailty May Worsen Outcomes in Traumatic Spinal Cord Injury

TUESDAY, Dec. 17, 2019 (HealthDay News) -- Frailty is an important predictor of worse outcome after traumatic spinal cord injury (tSCI) in patients <75 years of age, according to a study recently published in the Journal of Neurotrauma.

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Outcomes Worse for Rural Residents With Chronic Conditions

MONDAY, Dec. 16, 2019 (HealthDay News) -- Rural Medicare beneficiaries with complex chronic conditions have higher preventable hospitalization and mortality rates than their urban peers, which is partially explained by reduced access to specialists, according to a report published in the December issue of Health Affairs, a theme issue on rural health.

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Many Long-Term Breast Cancer Survivors Die From Other Causes

MONDAY, Dec. 16, 2019 (HealthDay News) -- Non-breast cancer (non-BC) causes of death represent a considerable proportion of deaths among patients diagnosed with BC, according to a study published online Dec. 16 in Cancer.

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Five-Year Mortality Up in Older Adults With Unplanned Admission

MONDAY, Dec. 16, 2019 (HealthDay News) -- Death within five years of first unplanned hospital admission is common among older adults, according to a study published in the Dec. 16 issue of CMAJ, the journal of the Canadian Medical Association.

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Domestic Abuse Increases Risk for Fibromyalgia, Chronic Fatigue

MONDAY, Dec. 16, 2019 (HealthDay News) -- There is an association between a history of intimate partner violence (IPV) and the development of functional syndromes, including fibromyalgia and chronic fatigue syndrome (CFS), in women, according to a study published online Dec. 6 in the Journal of Interpersonal Violence.

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Hahn Confirmed as New FDA Chief

FRIDAY, Dec. 13, 2019 (HealthDay News) -- Stephen Hahn, M.D., was confirmed as commissioner of the U.S. Food and Drug Administration in a 72-18 Senate vote on Thursday.

The New York Times Article

Antibiotic Exposure May Be Tied to Risk for Parkinson Disease

FRIDAY, Dec. 13, 2019 (HealthDay News) -- Exposure to certain types of oral antibiotics may be associated with an elevated risk for Parkinson disease (PD), according to a study published online Nov. 18 in Movement Disorders.

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Evidence Supports Use of High-Dose Aspirin for Migraine

FRIDAY, Dec. 13, 2019 (HealthDay News) -- Evidence supports the use of high-dose aspirin for treating acute migraine and low-dose aspirin for prevention of recurrent attacks, according to a review recently published in the American Journal of Medicine.

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Exposure to PM2.5 Linked to Decline in Episodic Memory

THURSDAY, Dec. 12, 2019 (HealthDay News) -- Long-term exposure to particulate matter with aerodynamic diameter <2.5 µm (PM2.5) contributes to decline in free recall/new learning among older women, according to a study published online Nov. 20 in Brain.

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Shortage of Applied Behavior Analysts Found for Children With Autism

WEDNESDAY, Dec. 11, 2019 (HealthDay News) -- The supply of applied behavior analysis (ABA) providers for children with autism spectrum disorder (ASD) falls short of the benchmark in 49 states and Washington, D.C., according to a study published online Dec. 11 in Psychiatric Services.

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Stroke Risk Up With Long Sleep Duration, Long Midday Napping

WEDNESDAY, Dec. 11, 2019 (HealthDay News) -- The risks for incident stroke are increased with long sleep duration, long midday napping, and poor sleep quality, according to a study published online Dec. 11 in Neurology.

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2003 to 2017 Saw Increase in Deaths at Home, Hospice Facility

WEDNESDAY, Dec. 11, 2019 (HealthDay News) -- From 2003 to 2017, there was a decrease in deaths occurring in hospitals and nursing facilities and an increase in deaths at home and at hospice facilities, according to a research letter published in the Dec. 12 issue of the New England Journal of Medicine.

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Aerobic Exercise May Slow Cognitive Decline in Older Adults

WEDNESDAY, Dec. 11, 2019 (HealthDay News) -- Among older adults who have cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND), cognitive function was better at one-year follow-up in participants compared with controls after a six-month exercise intervention, with or without the Dietary Approaches to Stop Hypertension (DASH) diet, according to a study published online Nov. 22 in the Journal of the American Geriatrics Society.

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U.S. Primary Care Doctors Face Challenges in Coordinating Care

TUESDAY, Dec. 10, 2019 (HealthDay News) -- Physicians from the United States and other high-income countries report difficulties with care coordination, with a substantial proportion of U.S. physicians not receiving timely notification or the information needed from specialists or other sites of care, according to a study published online Dec. 10 in Health Affairs.

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Breastfeeding May Protect Against Postpartum Relapses in MS

TUESDAY, Dec. 10, 2019 (HealthDay News) -- Breastfeeding may be protective against postpartum relapses in multiple sclerosis (MS), according to a review and meta-analysis published online Dec. 9 in JAMA Neurology.

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Low-Dose Aspirin May Cut Dementia Risk in Women With Diabetes

TUESDAY, Dec. 10, 2019 (HealthDay News) -- Long-term use of low-dose aspirin may reduce the risk for dementia in women with type 2 diabetes, according to a study published online Dec. 4 in Diabetes Care.

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U.S. Health Care Spending Up 4.6 Percent in 2018

TUESDAY, Dec. 10, 2019 (HealthDay News) -- In 2018, U.S. health care spending increased 4.6 percent, a faster rate than that seen in 2017, according to a report published online Dec. 5 in Health Affairs.

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2016 to 2019 Saw Increase in Medical Students With Disabilities

MONDAY, Dec. 9, 2019 (HealthDay News) -- From 2016 to 2019, there was an increase in the proportion of medical students reporting disabilities, according to a research letter published in the Nov. 26 issue of the Journal of the American Medical Association.

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Half of U.S. Physicians Recommend Complementary Health Approaches

MONDAY, Dec. 9, 2019 (HealthDay News) -- More than half of office-based physicians recommend complementary health approaches (CHAs) to their patients, according to a study published online Dec. 2 in the Journal of Alternative and Complementary Medicine.

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Effects of Omega-3 Fish Oil Mixed for ADHD Symptoms in Youth

MONDAY, Dec. 9, 2019 (HealthDay News) -- The effect of omega-3 fish oil supplements on cognitive symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) may vary according to endogenous levels of eicosapentaenoic acid (EPA), according to a study published online Nov. 20 in Translational Psychiatry.

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Retail Prescription Drug Prices Fall for First Time in 45 Years

FRIDAY, Dec. 6, 2019 (HealthDay News) -- Retail prescription drug prices in the United States fell by 1 percent last year, a new government report shows.

AP News Article

Rural Population Underrepresented Among Medical Students

FRIDAY, Dec. 6, 2019 (HealthDay News) -- In 2017, less than 5 percent of all incoming medical students were rural students, according to a study published in the December issue of Health Affairs, a theme issue on rural health.

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More Girls Admitted With Pediatric Multiple Sclerosis

FRIDAY, Dec. 6, 2019 (HealthDay News) -- For pediatric patients with multiple sclerosis, there are more admissions among girls and among white children, according to a research letter published in the February 2020 issue of Multiple Sclerosis and Related Disorders.

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Cancer Tied to Higher Risk for Deadly Stroke

FRIDAY, Dec. 6, 2019 (HealthDay News) -- The risk for a deadly stroke is higher in cancer patients and cancer survivors than the general public, according to a study published online Nov. 15 in Nature Communications.

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2007 to 2014 Saw Decrease in U.S. Incidence of Alzheimer Disease

FRIDAY, Dec. 6, 2019 (HealthDay News) -- From 2007 to 2014, there was a decrease in the diagnosed incidence of Alzheimer disease (AD), according to a study published online Dec. 4 in the Journal of the American Geriatrics Society.

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Evidence Uncertain Whether Interventions Prevent Falls in MS

THURSDAY, Dec. 5, 2019 (HealthDay News) -- There is uncertainty regarding the effect of exercise and other interventions on the prevention of falls in patients with multiple sclerosis (MS), according to a review published online Nov. 28 in the Cochrane Database of Systematic Reviews.

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Playing Analog Games Tied to Less Relative Cognitive Decline

THURSDAY, Dec. 5, 2019 (HealthDay News) -- Playing analog games is associated with less relative cognitive decline, according to a study published online Nov. 18 in the Journals of Gerontology: Series B.

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Review: Teleneurology Feasible for Several Neurologic Disorders

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- Teleneurology is feasible for several neurological disorders, according to a review published online Dec. 4 in Neurology.

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Ubrogepant Relieves Pain, Symptoms of Acute Migraine

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- The percentage of patients with migraine reporting freedom from pain is higher for those receiving ubrogepant than those receiving placebo, according to a study published in the Dec. 5 issue of the New England Journal of Medicine.

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Services Affected by Rural Hospitals Joining Health Systems

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- While affiliating with health systems may boost a rural hospital's financial viability, the affiliation is often associated with reductions in critical services, according to a study published in the December issue of Health Affairs, a theme issue on rural health.

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Mobile Stroke Unit Care May Reduce Time to Thrombolysis

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- Mobile stroke unit (MSU) care is associated with quicker time to thrombolysis in acute ischemic stroke compared with conventional ambulance care in a densely populated urban area, according to a study published online Dec. 4 in the Journal of the American Heart Association.

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Adults Not Living in Metro Areas Have Reduced Access to Care

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- Adults not living in metropolitan statistical areas (MSAs) are more likely to have reduced access to or use of health care services, according to a study published online Dec. 4 in the National Health Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.

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Physician Depressive Symptoms Tied to Higher Risk for Medical Errors

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- Physicians showing depressive symptoms are at higher risk for medical errors, according to a review published Nov. 27 in JAMA Network Open.

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Concussion May Up Risk for Suicide in High School Students

TUESDAY, Dec. 3, 2019 (HealthDay News) -- High school students with a history of sports-related concussions might be at an increased risk for suicide, according to a study published online Nov. 11 in the Journal of Affective Disorders.

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Inhaled Cannabis Cuts Headache, Migraine Severity

TUESDAY, Dec. 3, 2019 (HealthDay News) -- Inhaled cannabis reduces self-reported headache and migraine severity, according to a study published online Nov. 9 in the Journal of Pain.

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Risk for Hospital Admission Up With Short-Term PM2.5 Exposure

MONDAY, Dec. 2, 2019 (HealthDay News) -- Short-term exposure to fine particulate matter with diameter less than 2.5 µm (PM2.5) is associated with increased hospital admission risks and costs, according to a study published online Nov. 27 in The BMJ.

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End-Stage Renal Disease Patients at Higher Risk for Syphilis

MONDAY, Dec. 2, 2019 (HealthDay News) -- End-stage renal disease (ESRD) patients are at a higher risk for contracting syphilis, according to a study recently published in the Clinical Kidney Journal.

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