Revisiting 2012

Revisiting 2012

• A large randomized trial (14k men) of multivitamins has shown a small, statistically-significant reduction in total cancer risk (JAMA 2012;308(18):1871-1880).
• Vitamin D does not prevent cold (JAMA 2012;308(13):1333-1339).
• A large randomized trial in patients at increased risk for heart disease because of dysglycemia found no effect of fish oil supplements in reducing the rate of cardiovascular events (N Engl J Med 2012;367:309-318). 
• A systematic review and meta-analysis of 9 randomized trials evaluating supplementation with beta-carotene, vitamin C, and vitamin E for one year found no evidence that vitamin supplementation reduced the risk of cataract or of cataract extraction (Cochrane Database Syst Rev 2012;6:CD004567).
• Portable monitoring is a reasonable alternative to in-laboratory sleep study in patients with a high pre-test probability of moderate to severe obstructive sleep apnea.
• Systemic high BP is more common among individuals who have untreated obstructive sleep apnea (snoring) than among those who do not.
• Antiretroviral therapy is now recommended in all HIV-infected patients, regardless of CD4 cell counts.
• Prolongation of the QT interval and torsades de pointes in ECG is associated with antibiotics, such as erythromycin and clarithromycin.
• After a heart attack, beta-blockers may not be required for more than 4 years unless specifically indicated.
• Anti-depression drugs SSRIs may lead to one additional brain hemorrhage for every 10,000 patients treated for one year.
• All pregnant women should receive tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine in each pregnancy
• Tdap should be administered after 20 weeks and optimally between 27 and 36 weeks of pregnancy.
• Previously, Tdap was recommended only for women who had never received the acellular pertussis vaccine.
• Tenofovir-emtricitabine is now used for pre-exposure prophylaxis among confirmed HIV-negative individuals at high risk for sexually-acquired HIV infection
• In areas of high HIV prevalence, the daily use of tenofovir-emtricitabine reduced risk of HIV by 48 to 75%.