geoffrey modest medical blogs

  A recent study found that a brief motivational intervention in the emergency department decreased subsequent heavy alcohol drinking days at one year (see  alcohol motiv intervention jama2022  in dropbox, or doi:10.1001/jamanetworkopen.2022.37563 )    Details :  -- 344 adults aged 18 to 35 who presented to the emergency department in a single tertiary care facility in Laussanne, Switzerland for any cause but had alcohol intoxication were randomized to a brief motivational interviewing session versus brief advice counseling, from December 2016 to August 2019       -- alcohol intoxication was determined by either a blood alcohol concentration of at least 0.5 g/L, breathalyzer test suggesting a similar concentration, or clinical indication of intoxication       -- there were a total of 2108 such identified individuals, but only 344 consented to participation and 306 provided at least one follow-up (89% ha...

  A really huge database assessment found no benefit of giving adults tetanus/diphtheria vaccine boosters if they completed their childhood vaccines (see   tetanus booster adults CID2021  in dropbox, or DOI: 10.1093/cid/ciaa017   ).    Details :  -- observational cohort study using secondary sources from the World Health Organization (WHO) and World Bank, from 2001-17 -- main outcomes assessed: differences in reported tetanus and diphtheria clinical infections globally, stratified by whether adult booster vaccines were given or not as recommended by the individual country's vaccine schedule Results :  Tetanus -- for 11.6 billion person-years of data from 31 North American and European countries, the tetanus incidence range per 1 million person-years:      -- for those countries recommending adult vaccination (Group 1):           -- North America (3 countries): 0.09-0.42   ...