Archive for January 20, 2020

REVIEW – Human papillomavirus in 2019: An update on cervical cancer prevention and screening guidelines

Cleveland Clinic Journal of Medicine December 2019 V.86 N.12 P.173-178

ABSTRACT

The human papillomavirus (HPV) causes most cases of cervical cancer. Healthcare providers can help prevent this cancer by recommending HPV vaccination when appropriate, regularly screening women for cervical cancer, and following up on abnormal test results.

KEY POINTS

-Immunization against HPV can prevent up to 70% of HPV-related cervical cancer cases.

-Gardasil 9 is the only HPV vaccine currently available in the United States and is now approved for use in males and females between the ages of 9 and 45.

-In girls and boys younger than 15, a 2-dose schedule is recommended; patients ages 15 through 45 require 3 doses.

-Vaccine acceptance rates are highest when primary care providers announce that the vaccine is due rather than invite open-ended discussions.

-Regular cervical cancer screening is an important preventive tool and should be performed using the Papanicolaou (Pap) test, the high-risk HPV-only test, or the Pap-HPV cotest.

FULL TEXT

https://www.ccjm.org/content/86/3/173

PDF

https://www.ccjm.org/sites/default/files/additional-assets/PDFs/86_3_173.pdf

January 20, 2020 at 10:54 am

EDITORIAL – The return of measles—an unnecessary sequel

Cleveland Clinic Journal of Medicine December 2019 V.86 N.12 P.365-366

Concerns over fake news and alternative facts have permeated the fabric of our daily life. Trust in entrenched establishments seems to be at an all-time low. I grew up in the 1960s; I grew up with “don’t trust the man.” I grew up with the Vietnam War, Watergate, and the military-industrial complex, and I have read and heard enough since then to know that a good amount of our distrust was well founded. More recently, there has been increased public scrutiny of the “pharmaceutical-medical complex,” with concerns being raised in the media and by legislators regarding drug pricing, seemingly inappropriate physician prescribing of medications encouraged by drug manufacturers, and the overall costs of medical care. And yes, there is …

FULL TEXT

https://www.ccjm.org/content/86/6/365

PDF

https://www.ccjm.org/content/ccjom/86/6/365.full.pdf

January 20, 2020 at 10:52 am

Review – Measles: A dangerous vaccine-preventable disease returns

Cleveland Clinic Journal of Medicine December 2019 V.86 N.12 P.393-398

ABSTRACT

Although a safe and effective vaccine has been available for over 6 decades, vaccine hesitancy in the United States and social and political unrest globally have led to under-vaccination. As a result, in recent months, vaccine control of measles has been threatened with an alarming upswing in measles cases nationally and internationally. Here, we review the disease and its management in view of recent outbreaks.

KEY POINTS

-Measles is highly contagious and can have serious complications, including death.

-Measles vaccine is given in a 2-dose series. People who have received only 1 dose should receive either 1 or 2 more doses, depending on the situation, so that they are protected.

-The diagnosis of measles is straightforward when classic signs and symptoms are present—fever, cough, conjunctivitis, runny nose, and rash—especially after a known exposure or in the setting of outbreak. On the other hand, in partially vaccinated or immunosuppressed people, the illness presents atypically, and confirmation of diagnosis requires laboratory testing.

-Management is mostly supportive. Children—and probably also adults—should receive vitamin A.

-Since disease can be severe in the unvaccinated, immune globulin and vaccine are given to the normal host with an exposure and no history of vaccine or immunity.

FULL TEXT

https://www.ccjm.org/content/86/6/393

PDF

https://www.ccjm.org/sites/default/files/additional-assets/PDFs/86_6_393.pdf

January 20, 2020 at 10:50 am

How to respond to flu vaccine doubters

Cleveland Clinic Journal of Medicine December 2019 V.86 N.12 P.782-788

The benefits of influenza vaccination are clear to those in the medical community. Yet misinformation and unfounded fears continue to discourage some people from getting a flu shot. During the 2018–2019 influenza season, only 45% of US adults and 63% of children were vaccinated.

What should we tell patients who say no to the flu shot?

Here are 12 reasons people give for not wanting to receive the inactivated influenza vaccine, along with some potential responses and comments about the nasal live-attenuated vaccine

FULL TEXT

https://www.ccjm.org/content/86/12/782

PDF

https://www.ccjm.org/content/ccjom/86/12/782.full.pdf

January 20, 2020 at 10:48 am


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