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tetanus resurgence: vaccine hesitancy

  A recent article reviewed the resurgence of tetanus in the US that is associated with inadequate tetanus vaccine administration: see tetanus resurgence JAMA2026 in dropbox, or doi:10.1001/jama.2026.9347 A few background issues: -- tetanus is ubiquitous in nature -- clinical tetanus develops in humans when the spores of the Clostridium tetani bacteria germinate in anaerobic environments; the spores release the tetanus toxin tetanospasmin     -- the typical scenario is having a contaminated or deep wound providing anaerobic conditions     -- the diagnosis of tetanus is a clinical one: there are no diagnostic tests that support or rule out tetanus -- this toxin affects the sympathetic nervous system by interfering with the release of neurotransmitters, resulting in sustained muscular contraction and spasms -- this effect involves many different muscles, leading to respiratory failure from chest wall spasms, diaphragmatic dysfunction, laryngospasm and airway obs...
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  stop colonoscopy age 75??  Summarize this email  Modest, Geoffrey (HMFP - Medicine) ​ Modest, Geoffrey (HMFP - Medicine) ​   A recent article assessed people who had had adenomas on prior colonoscopy but then had their follow-up colonoscopy after age 75, finding that there was very small benefit for doing a follow-up colonoscopy: see colon ca stop at age 75 JAMA2026 or doi:10.1001/jama.2026.3414. Though there is a reasonable argument to the contrary!!! Details : -- 91,952 individuals underwent colonoscopy between January 1,2006, and December 31,2019 on or after age 65, with 25,538 individuals (28%) having had an adenoma resected, compared with 66,414 individuals (72%) who were without adenomas -- this study was done to estimate retrospectively the cumulative colorectal cancer (CRC) risks, non-CRC mortality, and all-cause mortality comparing these two groups -- the researchers accessed the VA oncology domain cancer registry data, the CRC deaths form the National Death Inde...
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