Respiratory Syncytial Virus Infection

Health authorities are warning of a looming triad this winter: COVID-19, influenza, and respiratory syncytial virus infections. Their emphasis has been on encouraging vaccination against COVID-19 and influenza. No vaccine is available for prevention of RSV infection, but one monoclonal antibody is available, and several vaccines and more monoclonal antibodies are in development.1 Most children […]

USPSTF Indications for Statins for Primary Prevention of CV Disease

Statins are recommended for virtually all patients who have atherosclerotic cardiovascular disease (ASCVD), but the indications for prevention of ASCVD are less clear. The US Preventive Services Task Force (USPSTF) recommendation statement on statin use for primary prevention of cardiovascular disease was recently published in the Journal of the American Medical Association.1 The USPSTF lists […]

Vitamin D Supplements

The July 28th issue of The New England Journal of Medicine included results from a large, randomized, placebo-controlled trial of vitamin D supplementation to lower the risk of fractures in middle-aged and older adults who were not selected based on gender, vitamin D deficiency, low bone mass, or osteoporosis. Supplementation with vitamin D3 2000IU/day did […]

Mifepristone

The recent Supreme Court decision overturning Roe v. Wade has heightened interest in the use of the oral antiprogestin mifepristone (Mifeprex) for termination of intrauterine pregnancies. Mifepristone binds to progesterone receptors and increases prostaglandin levels by inhibiting prostaglandin dehydrogenase; both actions stimulate uterine contractility. It is generally used with the prostaglandin analog misoprostol (Cytotec, and […]

Overdose-Prevention Centers

The May 26 issue of The New England Journal of Medicine includes 2 articles on a subject that deserves more attention than it has received from us.1,2 Drug overdose deaths rose above 100,000 annually during the Covid-19 pandemic in the US, fueled at least partly by purposeful fentanyl contamination of illicit drugs. Naloxone is widely […]

Whither COVID-19?

Or, in modern English, where is this pandemic going? The answer is clear: we don’t know. In Shanghai 26 million people have been locked down in their homes, while in Florida the governor is imploring children to take off their masks. CDC.gov tells us that more than 982,000 Americans have died from COVID-19, more than […]

Oral Antivirals for COVID-19: Supply and Demand

In December, the FDA granted Emergency Use Authorizations (EUAs) to 2 oral antiviral drugs for treatment of mild to moderate COVID-19 in outpatients at high risk of progressing to severe disease, including hospitalization or death. The long list of conditions that qualifies infected patients for a prescription for one of these agents includes age >65 […]