Combined COVID-19, Flu Vaccine Candidate Headed to Phase 3 Trials: A new mRNA vaccine designed to protect against both flu and COVID-19 is beginning Phase 3 trials says Pfizer/BioNTech. The combination vaccine generated similar immunity to that generated by the individual vaccines with the same safety results in Phase 1 and 2 trials.
Reference: JAMA ONLINE 2023 November 15;doi:10.1001/JAMA.2023.22353
Most Young Adults Who Use E-Cigarettes Have Never Smoked: REALLY? In a behavioral study of 415,000 participants, people aged 18-24 years—18% used e-cigarettes, 72% of them had never smoked a regular cigarette. Southern and western states plus rural areas had higher numbers of e-cigarette users.
Reference: JAMA ONLINE 2023 November 15;doi.10.1001/JAMA.2023.22357
It’s Time to Switch to Primary HPV Screening for Cervical Cancer: Cervical cancer is a sexually transmitted disease caused by the Human Papilloma Virus (HPV). Screening for cervical cancer with HPV testing is as accurate as cytology (PAP Smear), but is done only once every five years. “Now is the right time for family physicians to shift our cervical cancer screening strategy from co-testing (PAP and HPV) to primary HPV testing for average risk and asymptomatic women.”
Reference: Harper DM, Bettcher CM, Young AP. EDITORIAL: It is time to switch to primary HPV screening for cervical cancer. Am Fam Phys 2024 January;109(1):8-10.
Norgestrel 0.075 mg (Opill) for Contraception: Norgertrel is a progestin-only (no estrogen) birth control option for women who can’t take estrogen. It is as much as 98% effective and available without a prescription. Taken once daily. There is a high rate of adverse effects—nausea, breast tenderness, headaches (in 15% to 35% of patients), and uterine bleeding (48%). The price is yet to be determined.
Reference: Torro JT, Bhayani A. NEW DRUG REVIEWS: Norgestrel 0.075 mg (Opill) for Contraception. Am Fam Phys 2024 January;109(1):90-91.
First-line Treatment for Chronic Nasal and Sinus Inflammation: Nasal saline irrigations and intanasal corticosteroids like fluticasone, nasonex, et al. combined improve sinonasal symptoms.
Reference: AFP Clinical Answers Am Fam Phys 2024 January;109(1):87.
Do Cortisone Shots into a Joint Raise Blood Sugar in Diabetics?: Joint injections with cortisone will raise a controlled diabetic’s blood sugar from 165 to 500mg/dL at 2 to 84 hours after the injection and return it to baseline in 18 hours to 21 days. For poorly controlled diabetes the risk of hyperglycemia is far higher.
Reference: Ditto above.
Do diuretics Rx’d for hypertension cause adverse cardiovascular events?: Chlorthalidone and Hydrochlorothiazide are both equally effective for BP lowering and CV events, but chlorthalidone causes low potassium more.
Reference: Ditto above
Are antihistamines safe during pregnancy? Yes, first and second generation antihistamines are safe to use throughout pregnancy.
Reference: Ditto above
Are local cortisone injections into the carpal tunnel safe and effective for treatment of carpal tunnel syndrome? Yes to both! They reduce symptoms, improve function and quality of life in patients with mild to moderate CTS for up to six months. They also have a reduced need for surgery at 12 months.
Reference: Clebek KT, Chambers ML, Nguyen KQ. Local corticosteroid Injection vs. Placebo for Carpal Tunnel Syndrome Am Fam Phys 2024 January;109(2):17-18.
Can tadalifil (Cialis) be used for lower urinary tract symptoms?: Cialis may be helpful in improving symptoms and quality of life in patients with benign prostatic enlargement. Tadafil is superior to tamsulosin (Flomax) when symptoms also include erectile dysfunction. Thus, since 2021, the American Urological Association has recommended 5 mg of tadafil daily for lower urinary tract symptoms from BPH when erectile dysfunction is also present.
Reference: Rohrbough CR, Colgan B, Gasser O. Tadalafil for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. Am Fam Phys 2024 January;109(1): 83-84.
