geoffrey modest medical blogs

  A recent Danish study found that elderly patients given the high-dose influenza vaccine had reduced incidence of cardiorespiratory hospitalizations when compared to those given the standard-dose vaccine (see influenza vaccine high-dose helps in elderly JAMACardiol2025  in dropbox, or doi:10.1001/jamacardio.2025.3460) Details: --332,438 participants at least 65-year-old were assessed through a prespecified secondary analysis of the DANFLU-2 study, a pragmatic, open-label, individually randomized clinical trial using nationwide administrative health registries in Denmark during the 2022/2023 to 2024/2025 Influenza seasons -- patients were randomized to receiving a high-dose inactivated influenza vaccine (HD-IIV) versus the standard-dose IIV (SD-IIV) -- severe cardiovascular outcomes were prespecified secondary and exploratory endpoints in the DANFLU-2 trial, when occurring at least 14 days after vaccination and through May 31 of the following year -- there were no formal exclu...

  On November 4, the CDC released their clinical practice guideline for prescribing opioids for pain:   https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm?s_cid=rr7103a1_w   , or   DOI:  http://dx.doi.org/10.15585/mmwr.rr7103a1   .    A warning: this is a long blog, but hugely shorter than the MMWR article. will embed many of my comments in the Details and Recommendation sections in brackets   Details: -- pain is divided into acute pain (<1month), subacute (1 to 3 months), and chronic (>3 months) -- one in five adults had chronic pain in the US in 2019 and approximately one in 14 experienced “high impact” chronic pain, defined by high-frequency pain (at least "most days" as well as pain limiting life or work activities -- chronic pain is also associated with increased likelihood of behavioral health conditions, including mental and substance use disorders, and there is an increased risk for suicidal ideation and behaviors -- chronic pa...