2 Minute Medicine ® - Public Health

1. Roughly 65% of the cancer medication budget is allocated to treatments that provide improvement in survival 2. Immune checkpoint inhibitors represent 17% of the cancer medication budget Evidence Rating Level : 2 (Good) Study Rundown: The incidence of cancer is increasing yearly, and many cancer medications are publicly funded in the most populous province of Canada, Ontario. The cost of these medications is roughly half of the total government spending on cancer care in this province. Many of these therapeutics have been shown to have marked improvement in progression-free survival or quality of life, but some covered medicines have a more modest effect...

1. Novel assay, NG-LFA, showed strong sensitivity and specificity compared to NG-PCR in both urine and vaginal specimens. 2. NG-MAST showed 93 different sequence types out of 156 LFA-positive specimens. Evidence Rating Level: 2 (Good) Study Rundown: To address the need for a rapid and cost-effective point-of-care test, a Neisseria gonorrhoeae novel lateral flow assay (NG-LFA) was developed to meet World Health Organization (WHO) and Foundation for Innovative New Diagnostics (FIND) criteria. This randomized controlled trial aimed to evaluate the NG-LFA’s performance in symptomatic male and female patients...

1. The R21/Matrix-M vaccine had a high 12-month efficacy across seasonal and standard sites. 2. The reduction in malarial infection rates was 4 times greater at seasonal sites compared to standard sites. Evidence Rating Level: 1 (Excellent) Study Rundown: The R21/Matrix-M vaccine is a novel vaccine for the prevention of Plasmodium falciparum infection in regions with moderate to high malaria transmission. In a recent phase 2b trial, the vaccine demonstrated high efficacy against clinical malaria with seasonal administration...

1. Children randomized to the MenA group rather than the Vi-TT group were more likely to be diagnosed with typhoid fever. 2. Overall Vi-TT vaccine efficacy was 78.3% with the highest efficacy seen for children aged 2-4 years. Evidence Rating Level: 1 (Excellent) Study Rundown: Typhoid conjugate vaccines in Africa and Asia have shown high short-term efficacy, but data on long-term protection are limited. This study presents the final analysis of a trial in Malawi, spanning over 4 years, to assess vaccine efficacy over time and by age group...

1. In this cohort study of female teenagers in Ontario, Canada, the risk of premature death was greater among females with one teen pregnancy, and even greater among those who experienced two or more teen pregnancies. Evidence Rating Level: 2 (Good) Deaths during teen pregnancy and childbirth, including those due to hemorrhage, hypertensive disorders, or sepsis, are rare events. However, researchers postulated that teen pregnancy may be a marker of adverse childhood experiences (ACEs) before or during formative teenage years, which may increase the risk for premature mortality...

1. In this retrospective, population-based cohort study, adherence to health surveillance guidelines among adult survivors of childhood cancer in Ontario, Canada was suboptimal.  Evidence Rating Level : 2 (Good) It is known that adherence to long-term health surveillance guidelines among adult cancer survivors is poor. In this retrospective, population-based cohort study, researchers aimed to assess the adherence to surveillance guidelines for high-yield tests among adult survivors of childhood cancer. Participants in this study included adults who were diagnosed with childhood cancer between 1986 and 2014 in Ontario, Canada...

1. In a cohort of US children aged 9-10, those who used tobacco products had a greater risk of suicide attempts (SAs) but not nonsuicidal self-injury (NSSI), or suicidal ideation (SI). Evidence Rating Level: 2 (Good) Tobacco use has been on the rise in adolescents and children, and it has become an increasing public health concern. Smoking has negative effects on the health of individuals, especially on mental health outcomes such as diminished neurocognition and increased risk of poor social behaviours. Specifically, previous studies have found that there is a 2-5 greater risk of self-injurious thoughts and behaviours (SITBs) activity in adolescent smokers than in adult smokers, although this association is poorly characterized...

1. In this randomized controlled trial, participants who received free e-cigarettes in addition to counseling had greater continuous abstinence from smoking at six months compared to those who received standard-of-care counseling alone. 2. Rates of nicotine use and adverse events were greater in the intervention group. Evidence Rating Level: 1 (Excellent) Study Rundown: E-cigarettes allow users to inhale nicotine while avoiding many of the toxic combustion products of tobacco cigarettes. However, e-cigarette aerosols are also hypothesized to contribute to adverse biological effects, and literature discussing the safety and efficacy of e-cigarette use for tobacco cessation is scarce...

1. In Ontario Canada, only 50% of home care clients received at least 1 or more palliative home care visits during their last 6 months of life. 2. The Risk Evaluation for Support: Predictions for Elder-life in their Communities Tool (RESPECT) served as a valuable prognostic model to provide early identification of palliative care needs.   Evidence Rating Level: 2 (Good) Palliative care is as essential service in the provision of holistic and patient-centred care for those diagnosed with life-limiting illnesses...

1. In this cohort study, patients with uncomplicated gram-negative bacteremia who were switched from intravenous (IV) to oral antibiotics demonstrated similar 90-day all-cause mortality to those receiving prolonged IV antibiotic treatment.  2. Patients in the early switch arm were no more likely to experience infection recurrence or complications related to antibiotic use at 30 and 90 day follow-up.  Evidence Rating Level: 2 (Good)         Study Rundown: Gram-negative bacteremia poses a significant health concern, and clinicians are tasked with assigning the proper antibiotic treatment and duration for these patients...

1. Elderly participants who consumed cannabis 30 minutes before driving in a simulator were found to have increased standard deviation in their lateral position (SDLP), which was used as a measure to determine the amount of swerving a driver experienced.  2.  Blood tetrahydrocannabinol (THC) levels were not significantly correlated with SDLP, though the study was limited by its smaller sample size.  Evidence Rating Level: 2 (good) Study Rundown:   Although prior literature suggests that cannabis consumption increases risks of motor vehicle collisions while under the influence, specifics surrounding the role of tetrahydrocannabinol (THC) levels remains unclear...

1. Having a greater number of unmet social needs was associated with lower utilization of screening mammography services, as well as a later stage of breast cancer at the time of diagnosis.  Evidence Rating Level: 1 (Excellent) Social determinants of health (SDOH) are important drivers of health inequities. Unmet social needs, such as housing and food insecurity, are known to be associated with worse health outcomes. In this study, researchers aimed to determine whether unmet social needs are associated with the use of screening mammography programs and the stage of breast cancer diagnosis...

1. In this cohort study, estimated glomerular filtration rate based on both creatinine and cystatin C (eGFRcr-cys   ) was more strongly associated with cardiovascular events than estimates based on creatinine alone (eGFRcr). 2. Nearly one-third of individuals were reclassified into a different severity category after recalculation. Evidence Rating Level: 2 (Good) Study Rundown: GFR is used to define chronic kidney disease (CKD) and is typically estimated using serum creatinine. However, loss of muscle mass in old age can depress circulating creatinine levels, creating the illusion of better renal function...

1. In this serial cross-sectional analysis, discharge rates for acute pulmonary embolism (PE) in emergency departments (EDs) in the United States (US) remained constant between 2012 and 2020. 2. No baseline characteristics in patients with acute PE were associated with an increased likelihood of discharge from the ED. Evidence Rating Level: 2 (Good) Study Rundown: Acute PE occurs when there is a disruption of blood flow in the pulmonary artery or its branches due to a thrombus, which often originates in the deep veins...

1. Implementation of smartphone-based walking programs in shopping malls resulted in a significant increase of daily steps amongst users during the pandemic.  Evidence Rating Level: 2 (Good) The benefits of physical activity are numerous, especially when it comes to preventing diseases. Walking is a simple exercise that most people can partake in, ultimately benefiting their physical activity levels while reducing disease risk. However, after the initiation of the pandemic, daily steps decreased dramatically...

1. In this cross-sectional study, community-dwelling adults over the age of sixty-five averaged nearly twenty-one “health care contact days” per year. 2. Approximately half of the visits for laboratory testing or imaging did not have an associated office visit. Evidence Rating Level: 2 (Good) Study Rundown: Utilization of healthcare services can present a significant physical and financial burden, especially to older adults. “Health care contact days” is a metric intended to reflect the totality of healthcare use outside the home, as well as offer insight into both cost and accessibility...

1. In this randomized controlled trial, infants who received a dose of azithromycin during their routine well visit had comparable mortality rates to placebo. 2. No differences were observed between the azithromycin and placebo groups with regard to rates of caregiver-reported hospitalization, sick-child clinic visits, or adverse events. Evidence Rating Level: 1 (Excellent) Study Rundown: Previous mass distribution of azithromycin in sub-Saharan regions has been shown to reduce childhood all-cause mortality, particularly among infants one to 11 months of age...

1. In this randomized controlled trial, the Butantan-Dengue Vaccine (Butantan-DV) was effective in the prevention of symptomatic, virologically confirmed dengue after two years, regardless of baseline serostatus. 2. Butantan-DV was effective against DENV-1 and DENV-2 serotypes across all age groups. Evidence Rating Level: 2 (Good) Study Rundown: Dengue is a mosquito-borne viral illness that can result in high fever and is commonly encountered in Southeast Asia and South and Central America. There are currently two licensed live, attenuated vaccines against dengue, including CYD-TDV and TAK-003, but both require multiple doses and serve a limited age group...

1. In this randomized controlled trial, patients experiencing symptomatic coronavirus disease 2019 (COVID-19) saw significant improvement in symptom resolution times compared to the placebo group. 2. Further investigation is needed to specifically delineate the impact of simnotrelvir on older COVID-19 patients.  Evidence Rating Level: 1 (Excellent) Study Rundown: COVID-19 has been a major public health concern since the initial pandemic occurrence in 2020. Though vaccinations are beneficial, they have not been completely effective at preventing the more recent strains of COVID-19...

1. In this cost analysis, compared to standard care, it was found that gene therapy for sickle cell disease (SCD) is cost-effective at a societal level based on two simulation models. 2. Acceptable value-based prices (VPBs) for SCD gene therapy ranged from $1 million to $2.5 million.  Evidence Rating Level: 2 (Good) Study Rundown: SCD is a genetic condition characterized by sickling red cells leading to recurrent vaso-occlusion and hemolysis and precipitating acute pain crises, ischemia, and progressive organ damage...