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In older adults, antithrombotic drugs, antidiabetes drugs, and opioids accounted for three fourths of these visits.

Adverse drug events (ADEs) pose substantial risk for patients, including emergency department (ED) visits and hospitalizations (NEJM JW Hosp Med Jan 2012 and N Engl J Med 2011; 365:2002). In this new study, investigators used a U.S. national surveillance database to estimate that, each year, 4 in 1000 people (0.4%) visit EDs due to ADEs (1 in 4 such visits result in hospitalization). In older Americans, the annual ED visit rate click here due to ADEs is even higher (1%), with nearly half of such visits resulting in hospitalization.

Whereas ED visits among children usually were due to ADEs caused by antibiotics and antipsychotics, three fourths of ADEs among older adults were caused Danny Amendola by four drug classes — anticoagulants, antiplatelet agents, antidiabetic drugs, and opioid analgesics. Beers list medications (i.e., medications to avoid in older patients) were responsible for <4% of all ADE visits to EDs among elders.

Moderate-intensity exercise once or twice weekly is associated with lower risk for premature death.

Most guidelines on exercise to promote health and longevity recommend moderate-to-vigorous−intensity activity several days weekly. Benefits of exercise performed 1 or 2 days weekly (usually on weekends, the so-called weekend-warrior pattern) are less clear. In this study, researchers linked health-behavior survey data from nearly 64,000 English and Scottish adults (mean age, 57) with national mortality data. Participants were classified as inactive (63%), insufficiently active (22%), weekend warriors (4%), and regularly active (11%). Weekend warriors were defined as those who performed at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity weekly during one or two sessions; regularly active participants performed the same amount of activity in three or more sessions. Insufficiently active participants exercised at lower-than-recommended levels.

During mean follow-up of nearly 9 years, more than 8800 participants died. After adjusting for chronic diseases, health risk factors, and demographic variables, all-cause mortality was significantly lower among those who were insufficiently active (hazard ratio, 0.69), weekend warriors (HR, 0.70), or regularly active (HR, 0.65) than among inactive participants. Relative risk reductions for cardiovascular-related death were similar to those for all-cause mortality; relative risk for cancer-related death was lowered somewhat less, but with similar relations among groups.

Asthma was ruled out in about a third of patients with previously diagnosed adult-onset asthma.

National Asthma Education and Prevention Program (NAEPP) guidelines emphasize confirming an initial asthma diagnosis with reversible airflow obstruction on spirometry and following a patient to see if his or her medications can be stepped down (J Allerg Clin Immunol 2007; 120:S94). In this Canadian cohort study, researchers evaluated 613 patients who had received diagnoses of adult-onset asthma during the previous 5 years to determine whether they Jonathan Ericsson limited jersey truly had asthma and whether their medications could be discontinued safely. Participants underwent serial diagnostic evaluations based on symptoms, spirometry, and methacholine challenge. If results were normal, patients were weaned off their medications. Those who had no reversible airflow obstruction or airway hyper-reactivity after all medications were stopped were deemed not to have asthma.

Asthma was excluded in 33% of the patients, less than half of whom had spirometry performed as part of their initial diagnoses. The most common alternative diagnoses generally were benign, but 12 patients had serious cardiopulmonary conditions that required intervention

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