geoffrey modest medical blogs

the recent REPRIEVE trial found that the use of the new statin pitavastatin was very effective in decreasing cardiovascular events in those with controlled HIV infection and otherwise very low cardiovasc risk, as well as documenting its safety (see hiv pitavastatin dec cardiovasc dz NEJM2023 in dropbox, orDOI: 10.1056/NEJMoa2304146)   Details : -- 7769 patients aged 40 to 75 and with HIV infection on a stable antiretroviral therapy and a low-to-moderate risk of cardiovascular disease based on the 2013 AHA/ACC risk calculator were randomized to pitavastatin 4mg versus placebo -- median age 50, 65% nonwhite, 31% women; international study with 53% from high-income countries, 18% from Latin America/Caribbean, 15% sub-Saharan Africa, rest from Southeast/East/South Asia -- median CD4 count was 621 and the HIV viral load was below quantification (<20 copies/mL) in 88% of the participants and <400 in   98% (no comment on the HIV meds used) -- median screening LDL was 108 mg

Just when you thought that Covid was over (and blogs on covid would stop):   Older adults with a prior Omicron infection may have an increased likelihood of reinfection, more than those without a prior infection (see covid omicron infection in elderly assoc with inc risk of reinfection Lancet2023 in dropbox, or https://doi.org/10.1016/j.eclinm.2023.102148   Details: -- 750 vaccinated residents of long-term care and retirement homes in the observational cohort COVID In Longer-Term Care Study in Ontario, Canada. The observation period for this study was from July to September 2022     -- patients were in 27 long-term care and retirement homes in Ontario -- median age 87, 64% female, 57% in long-term care residence -- all received 4 mRNA monovalent vaccines (36% had only mRNA-1273, 18% had only BNT162b2, and 46% a mixture), none received a bivalent vaccine; time since 4th vaccination was mean of 138 days, 60% living in residence with <6 outbreaks, clinical frailty score 7 (>6= “livi

Here are 2 pretty convincing articles suggesting that GLP-1 receptor agonists  (GLP-1RAs) might be important medications to treat alcohol use disorder (AUD)     ---------------------------------------------------------   1. a rat study:  alcohol dec with semaglutide rats lancet2023  in dropbox, or doi.org/10.1016/j.ebiom.2023.104642 -- male and female rats were studied, rats that were bred to have a voluntary high and stable alcohol consumption that created pharmacologically relevant blood alcohol concentrations   -- acute and repeated semaglutide administration led to significant reductions in alcohol intake and prevented relapse-like drinking in both male and female rats (relapses being simulated by withdrawing semaglutide after it had led to decreased alcohol consumption, rats then resuming drinking, then reinitiating semaglutide with good effect)       -- there was no decrease in drinking water or total liquid intake (there actually was a little increase in female rats)       -- th