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A study published in JAMA Internal Medicine found that patients who received preexposure prophylaxis (PrEP) prescriptions from primary care clinicians were less likely to reverse or abandon their prescriptions compared to those who received prescriptions from other non-infectious disease clinicians. The study analyzed data from approximately 37,000 individuals who received new insurer-approved PrEP prescriptions between 2015 and 2019. The researchers also noted that a diverse range of clinicians, regardless of specialty, should be equipped to prescribe PrEP and offer counseling. The study suggests that supporting primary care providers in prescribing PrEP can help increase adherence to the medication. [Extracted from the article]

A systematic review of over 5,000 individuals suggests that the prophylactic placement of balloon catheters or sheaths before planned cesarean delivery may reduce blood loss in women with placenta accreta spectrum disorder. Placenta accreta spectrum disorder occurs when the uterus is damaged, causing the placenta to fail to detach after birth and potentially leading to life-threatening postpartum hemorrhage. The review analyzed data from 50 studies and found that blood loss was significantly lower in the intervention groups compared to the control groups. However, more research is needed to examine the efficacy and safety of these interventions. [Extracted from the article]

New studies presented at the Society of Gynecologic Oncology's Annual Meeting on Women's Cancer suggest that many women with cancer experience sexual dysfunction, but this issue often goes unaddressed. Patients want to discuss sexuality and intimacy, but not necessarily at the time of diagnosis. Oncologists are becoming more aware of sexual side effects, but patients may not have opportunities to talk about their concerns. It is important for clinicians to open the door to these conversations and refer patients to specialized services as needed. Barriers to discussing sexual issues include limited time, lack of training, and discomfort. Researchers are exploring the impact of different cancer prevention treatments on sexual side effects, and more research is needed to address the needs of diverse patient populations. [Extracted from the article]

A study published in The Lancet found that a combination of individualized walking programs and education significantly reduced the recurrence of low back pain in adults. The study involved 700 participants and randomized them into an intervention group and a control group. The intervention group received education and progressive walking sessions with a physiotherapist over 6 months, while the control group received no intervention. The intervention group had a longer time to recurrence of low back pain and a reduced risk of recurrence compared to the control group. However, there were more adverse events related to lower extremities in the intervention group. The study suggests that walking and education interventions can be cost-effective and accessible for preventing low back pain recurrence. However, the findings should be interpreted with caution, as the study had limitations and the participants were predominantly of high socioeconomic status. Further research is needed to assess the implementation of walking interventions in different contexts and to compare the effectiveness of interventions involving different healthcare providers. [Extracted from the article]

Two studies presented at the annual clinical and scientific meeting of the American College of Obstetricians and Gynecologists (ACOG) found that the use of combined contraceptive vaginal rings (CCVRs) was associated with an increased risk for several types of sexually transmitted infections (STIs). The studies analyzed data from patient databases and found that CCVR use was significantly associated with an increased risk for herpes simplex virus 2, vaginitis, vulvitis, candidiasis, trichomoniasis, and pelvic inflammatory disease. However, CCVR use was associated with a decreased risk for chlamydia. The researchers noted that further study is needed to understand the effects of local hormone delivery on the vaginal mucosa. The studies highlight the need for condoms to protect against STIs and HIV, as CCVRs are indicated only for contraception or birth control. The findings also have potential implications for the development of multi-purpose prevention technologies (MPTs) that could provide protection against both HIV and pregnancy. [Extracted from the article]

The U.S. Preventive Services Task Force (USPSTF) has recommended exercise interventions to prevent falls in older adults who are at increased risk. Falls are a leading cause of injury-related morbidity and mortality among older adults in the United States. The task force found that exercise interventions yielded a moderate benefit in reducing falls among at-risk older adults. The recommendation is based on a systematic review of 83 randomized trials involving 48,839 individuals. Exercise components such as gait training, balance training, and functional training were associated with reduced risk of falls. However, multifactorial interventions were not significantly associated with reductions in fall risk. The task force emphasized the need for more research on factors that drive exercise initiation and adherence in older adults. [Extracted from the article]

The US Food and Drug Administration (FDA) has approved lifileucel, a new treatment for melanoma, making it the first cellular therapy to be marketed for a solid tumor cancer. Lifileucel is made from a patient's surgically removed tumor and has a price tag of $515,000 for a one-time treatment. The cost and insurance coverage for lifileucel are still being worked out, and patients' out-of-pocket costs will vary based on their insurance. Clinicians hope to see improvements in the efficacy and toxicity of lifileucel through further research and dose adjustments. [Extracted from the article]

Sulfites have been named the "Allergen of the Year" for 2024 by the American Contact Dermatitis Society (ACDS). Sulfites are found in various products such as food, drinks, pharmaceuticals, and personal care items. They can cause type IV hypersensitivity reactions, which present as red, itchy patches on the skin. Sulfites are not commonly included in patch test series, so they may be missed as a relevant allergen. It is important to correctly label products containing sulfites and to be aware of potential sources of exposure, both in nonoccupational and occupational settings. [Extracted from the article]

A new study has found that adults with persistent metabolic syndrome that worsens over time are at an increased risk for any type of cancer. Metabolic syndrome, which includes conditions such as high blood pressure, high blood sugar, increased abdominal fat, and high cholesterol and triglycerides, has been associated with an increased risk of diseases like heart disease, stroke, and type 2 diabetes. Previous studies have shown an association between metabolic syndrome and an increased risk of various cancers, but the reasons for this association remain unclear. The study suggests that proactive and continuous management of metabolic syndrome may be an essential strategy in preventing cancer. However, more research is needed to assess the impact of interventions on cancer risk and to better define metabolic dysfunction. [Extracted from the article]

A study published in The Lancet Gastroenterology & Hepatology found that linaclotide, a medication approved for adults with chronic constipation, was effective in treating functional constipation in children and adolescents. The study involved 330 individuals and showed that those who took linaclotide had significantly more spontaneous bowel movements compared to those who took a placebo. The medication was well-tolerated overall, with diarrhea being the most frequently reported side effect. However, further research is needed to address limitations in the study and determine the long-term safety and efficacy of linaclotide in pediatric patients. [Extracted from the article]

A standardized induction of labor protocol did not significantly reduce the rates of cesarean delivery in patients with obesity, according to a study presented at a conference. Previous research has shown that the risk of cesarean delivery increases with higher body mass index (BMI) among nulliparous patients. The study found that despite implementing a standardized protocol, differences in cesarean delivery rates persisted, suggesting that factors other than variations in care contribute to the increased risk of cesarean delivery in patients with obesity. The study highlights the need for further research to understand the physiological differences that may drive this relationship and the potential need for different protocols for obese patients. [Extracted from the article]

Back to basics to improve women's health Some clinicians may be disappointed by the Evidence Report's primary finding that no alternative screening strategies outperformed routine blood pressure measurement, wrote Anne E. Denoble, MD, and Christian M. Pettker, MD, both of Yale University, New Haven, Conn., in an accompanying editorial. A positive result for new-onset hypertension was defined as systolic blood pressure of 140 mm Hg or diastolic blood pressure 90 mm Hg in the absence of chronic hypertension, based on two measurements at least 4 hours apart. All pregnant women should undergo screening for hypertensive disorders, with evidence-based management for those screening positive, according to a new recommendation from the U.S. Preventive Services Task Force. [Extracted from the article]

For patients with uterine prolapse, a traditional technique showed superiority, while vaginal estrogen cream failed to improve outcomes for vaginal apical prolapse repair in two new studies published in JAMA. "About 13% of women will specifically undergo surgery to repair pelvic organ prolapse", said Dr. Rahn, of the department of obstetrics and gynecology, University of Texas Southwestern Medical Center, Dallas. [Extracted from the article]

"This study builds on prior research from the same SAFE study cohort that established self-managed medication abortion in the first 9 weeks of pregnancy as safe and effective, and noninferior to clinician-managed abortion", Dr. Moseson said. Data support self-management medication abortion later in pregnancy "Many people are not aware that there is a robust randomized clinical trial literature that demonstrates that both medication abortion regimens remain highly effective up to 24-28 weeks of pregnancy", as well as a Cochrane review, Dr. Moseson said. According to a recent report, "more than half the abortions in the U.S. were done using medication in 2020, and protocols developed during the pandemic helped us see how safe medication abortion can be without in-person clinic visits", Dr. Owens said. [Extracted from the article]

Strength training has been found to lower the risk of knee pain and osteoarthritis, contrary to previous assumptions. Researchers reviewed data from 2,607 adults and found that strength training at any point in life was associated with a lower incidence of knee pain and osteoarthritis. The study also found a dose-response relationship, with the highest exposure to strength training resulting in the lowest odds of knee pain and osteoarthritis. The researchers suggest that the medical community should encourage more people to participate in strength training to reduce their risk of chronic conditions. However, the study's observational design and self-selected study population may have biased the results, and further research is needed to explore the associations between strength training and knee osteoarthritis. [Extracted from the article]