Clinical Publication
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Sulopenem Etzadroxil and Probenecid (Orlynvah)
The U.S. Food and Drug Administration has approved a combination of sulopenem and probenecid for the treatment of uncomplicated urinary tract infections.
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Epilepsy and Cardiovascular Events
This large prospective cohort study found that older adults with a lifetime history of epilepsy were more likely to experience cardiovascular events (CVEs), and that enzyme-inducing antiseizure medications (EIASMs) may account for a significant portion of this risk. The findings suggest a potential causal link between epilepsy treated with EIASMs and CVE, highlighting the need for careful medication selection in epilepsy management.
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DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke
In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), resulted in no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.
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Migraines: Which Came First, the Chocolate or the Craving?
Knowledge of the differentiation between the triggers for a potential migraine attack and the prodromal symptoms of an initiated migraine attack reveals strategies that decrease migraine disability. Recognition of migraine triggers allows for a modification of behavior to avoid precipitating an attack. Recognition of common migraine prodromal symptoms creates an early time window when rapid treatment enhances the therapeutic intervention’s efficacy.
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Osteoporosis: An Update for Primary Care Providers
Bones, as reservoirs of calcium and phosphorus, continuously remodel to maintain strength and function. However, suboptimal peak bone mass in young adulthood, excessive resorption of bone, or impaired bone formation during remodeling can result in osteoporosis. Among Caucasian adults ages 50 years and older in the United States, about 50% of women and 20% of men will experience an osteoporotic fracture in their remaining lifetime; however, fracture rates differ by ethnic/racial population and skeletal site. Annual fracture-related costs are expected to increase from $57 billion to more than $95 billion by 2040. Therefore, it is imperative that primary care providers address this challenge by implementing practices to screen patients for osteoporosis to prevent and/or treat the disorder and subsequent comorbidities.
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Exploring the Benefits of Time-Restricted Eating and Nutritional Counseling
In a randomized trial, adding time-restricted eating (limiting eating to an eight- to 10-hour window) to standard nutritional counseling improved hemoglobin A1c, glycemic control, and other markers of cardiometabolic health when compared to standard treatment alone.
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Twice-Yearly Subcutaneous Lenacapavir Injection Prevents HIV Infection
Subcutaneous injection of lenacapavir every 26 weeks had 100% efficacy in preventing human immunodeficiency virus (HIV) infection in a high-risk population.
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Validation of the New American Heart Association’s PREVENT Equations
An analysis of the accuracy of the new American Heart Association PREVENT Equations for predicting 10-year cardiovascular disease mortality in the National Health and Nutrition Examination Survey population has shown excellent discrimination with only modest underprediction and supports its use vs. the pooled cohort equation, which is the current standard.
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Combatting the Resurgence of Syphilis
Syphilis has continued its upward trend, reaching the highest number of cases in the United States in 2023 since the 1950s. There was a brief dip in cases during the first few months of social isolation with COVID, but, overall, cases have doubled since 2015. It is obvious the current approach of testing those who present with symptoms or other sexually transmitted infections is not sufficient.
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Preventing Recurrent UTI with Probiotics
About half of women experience urinary tract infection (UTI) during their lifetime, and around 20% to 25% will experience recurrent UTI (defined as three or more UTIs in a 12-month period or two UTIs in a six-month period). Those with two UTIs in a six-month period have a 50% chance of a third UTI. Repeated courses of antibacterials distort both intestinal and vaginal flora, further increasing the risk of urinary infection.