Post-op pain management for kids: Hold the morphine

Clinical Brief – October, 12th

The Brief

To manage pain after a kid gets surgery for something like implant removal or joint repair, would you pick morphine or a non-prescription painkiller?

A Canadian trial reported that over-the-counter painkillers may manage pain after an orthopedic surgery just as well as morphine, but comes with fewer side effects. Continue reading “Post-op pain management for kids: Hold the morphine”

Notes on ESMO17: Palliative oncology

Clinical Brief – September 21st

ESMO, or the European Society of Medical Oncology Congress, is an annual gathering of cancer experts and patient advocates. Here are some studies from this year’s ESMO that may be of use.


Chemo is often dosed based on a person’s body-surface area. However, giving someone chemo based on how much drug the body actually gets instead, or pharmacokinetic-guided dosing, may help optimize the dose and reduce severe toxicities. Continue reading “Notes on ESMO17: Palliative oncology”

The week in brief

September 11th – 15th

Hi there, hope you had a great week! Here are your recent updates in the world of medical research and policy.


Lazy eye is a childhood condition where vision in one eye doesn’t develop properly.

The USPSTF now recommends screening kids between 3 to 5 years old at least once for lazy eye or its risk factors (USPSTF = US Preventive Services Task Force).


Researchers at the Mayo Clinic published a report on how they managed 10 patients who experienced immune-mediated neurological side effects after treatments with nivolumab (Opdivo) or pembrolizumab (Keytruda).

Reports like these teach us more about the possible harms of immunotherapies and balances the studies that are designed to show their efficacies.


ESMO, or the European Society of Medical Oncology Congress, is an annual gathering of cancer experts and patient advocates. Here are some studies from this year’s ESMO that may be of use.

Hematology

  • Treatment with radioactive iodine may be linked to the risk of developing acute myeloid leukemia, or AML.
  • Benefits of relatively modern treatments may benefit both younger and older patients with relapsed and refractory multiple myeloma.
  • Infusion-related reactions to daratumumab (Darzalex) may be managed with pre- and post-infusion meds.
  • Autologous stem cell transplantation may be considered for patients with non-Hodgkin lymphoma who are over 65.
  • Screening patients for multi-drug resistant bacteria may help predict sepsis involving such bacteria after chemotherapy.

Cancer prevention and screening

  • A social experiment looked at how citizen’s jury may handle decisions on policy about breast cancer screening.
  • A report summarized clinical features and outcomes of a serious but rare neurological side effect linked to treatment with bevacizumab (Avastin).
  • Cervical cancer screening is on the decline in France.
  • H. pylori infection may be linked to increased risk of stomach cancer in Japan.
  • Colorectal cancer is the 3rd most common cancer in Iran, but public awareness may be lagging behind.

Head and neck cancer

  • EBV viral load may be used to assess the risk of relapse and worse disease outcomes for non-metastatic nasopharyngeal carcinoma (a rare type of head and neck cancer).
  • Researchers from two cancer centers in Spain looked at their patients on immunotherapies in search for signs of hyper progression.
  • Collaboration between oncologists and geriatricians may help optimize treatment for elderly patients with head and neck cancer.
  • Radiation with high-dose chemo isn’t necessarily better than with low-dose chemo for head and neck cancer.

 

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The week in brief

September 5th – 8th

Congratulations for making it through another week! Here are your recent updates in the world of medical research and policy.


In a study, researchers found that routine hormonal treatment for early prostate cancer may be linked to an increased risk of heart disease.

The cause of this is not clear. Researchers suggest closer monitoring for at-risk men who are receiving treatment.


People living with rheumatoid arthritis (RA) are at increased risk of shingles.

For those on biologics, a shingles vaccine followed by a 2-week delay is generally recommended. Less is known about how to give shingles shots if a patient is on tofacitinib (Xeljanz) for RA.

A study found that people over 50 should wait 2-3 weeks after their shingles shot before starting tofacitinib.


Canakinumab (Ilaris) is an anti-inflammatory biologic. Studies published recently showed that canakinumab may offer protection against some heart diseases and was tied to significantly lower risk of lung cancer.

Sounds impressive, but did you know that Aspirin might give the same degree of protection against heart disease and cancer? Albeit colorectal cancer and not lung cancer, but still.


In a large analysis of trials, cognitive behavioral therapy (CBT) and meds (SSRI only) were both effective at reducing anxiety symptoms.

CBT was safer than meds, and outperformed fluoxetine (Prozac) for symptom reduction; and sertraline (Zoloft) for improved remission.


 

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CBT vs meds for childhood anxiety disorder

Clinical Brief – September, 8th

The Brief

In a large analysis of trials, cognitive behavioral therapy (CBT) and meds (SSRI only) were both effective at reducing anxiety symptoms.

CBT was safer than meds, and outperformed fluoxetine (Prozac) for symptom reduction; and sertraline (Zoloft) for improved remission. Continue reading “CBT vs meds for childhood anxiety disorder”

The week in brief

August 28th – September 1st

Congratulations for making it through another week! Here are your recent updates in the world of medical research and policy.


A trial published last weekend during the 2017 European Society of Cardiology congress found that a blood thinner, rivaroxaban (Xarelto), failed to outperform aspirin at preventing cardiovascular death, stroke, or heart attack for patients who had hardened arteries.

The combination of rivaroxaban + aspirin did do better than aspirin alone, but also came at higher risk for uncontrolled bleeding.


In July 2017, the Trump Administration announced funding cuts and an end to its Teen Pregnancy Prevention Program.

In a commentary, the potential consequences of these cuts are laid bare: Lowering the age of first intercourse, increasing the rate of premarital sex among teens, increasing the number of unintended pregnancies, and increasing the number of abortions.


A new study found that taking excessive amounts of vitamins B6 and B12 is linked to significantly elevated risk of lung cancer in men.

It doesn’t mean B6 and B12 causes cancer, but the data showed signs that men who intentionally seek B6 and B12 supplementation may be at increased risk of lung cancer.


Graft-vs-host disease (aka GVHD) is where the stem cell transplant develops into white blood cells that “rejects” the recipient.

To help predict what happens after an acute GVHD, a new study turned to some common biomarkers which are simple to test. Their risk score, EASIX, also came with an online calculator.


TB (or tuberculosis) is a potentially lethal infection which is particularly serious for patients living with HIV.

To circumvent the high cost of genetic tests used to screen for active TB, a new study showed that a simple finger-prick test for CRP may do the job at less than a fifth the cost.


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The upper cut: Teen pregnancy prevention

Clinical Brief – August 29th

The Brief

In July 2017, the DHHS in the US announced funding cuts and an end to its Teen Pregnancy Prevention Program.

In a commentary, the potential consequences of these cuts are laid bare: Lowering the age of first intercourse, increasing the rate of premarital sex among teens, increasing the number of unintended pregnancies, and increasing the number of abortions. Continue reading “The upper cut: Teen pregnancy prevention”

Take with caution, if we must

Clinical Brief – August 16th

The Brief

Dietary supplements, including homeopathic agents: Are they generally harmless? The latest stats suggest that poison center calls related to supplements are on the rise in the US.

In a related note, the FDA recently warned of possible bacterial contamination in supplements and a commonly prescribed stool softener made by PharmaTech. Their brands are listed below. Continue reading “Take with caution, if we must”