In an analysis of 19 studies across 12 countries involving more than 25,000 participants, individuals in highest 20% bracket for omega 3 levels had 13% less risk for developing CKD compared with participants in the lowest 20% bracket. Results were consistent and independent of subgroup variables of age, GFR, hypertension, CAD, and diabetes.

Updated recommendations include EGD with multiple duodenal biopsies, setting intestinal healing as the goal for gluten-free diet, and use of gluten-free oats in some populations. There wasn’t evidence to support routine use of probiotics or use of gluten detection devices.

On exam, this 19-year-old woman has malar rash characterized by pink-violet papules and plaques with no other physical finding. ANA is positive and urinalysis is remarkable for 3+ blood and protein. What test is the most appropriate next step?

Reports on the Vaccine Safety Datalink flagged the need to investigate a potential increased risk those 65 years of age and older, for ischemic stroke in the first 21 days after receiving the bivalent Pfizer-BioNTech booster. FDA has parallel monitoring systems to confirm or fail to validate a safety signal. In this case, those other systems did not confirm the Vaccine Safety Datalink flag.

Among more than 3,000 patients taking hydroxychloroquine, overall cumulative incidence for developing retinopathy were 2.5% and 8.6% at 10 and 15 years respectively. Incidence was strongly dose-related and most cases were mild.

In comparing PTSD to PTSD plus sexual abuse, minors with PTSD following sexual abuse are more likely to suffer MDD, substance use disorder, and suicidal behavior.