2 Minute Medicine ® - Public Health

1. Despite the decrease in colonoscopies performed at the start of the COVID-19 pandemic, there was no difference in the percentage of colorectal cancer (CRC) presentations at a later stage or with higher acuity, when comparing patients diagnosed with rectal adenocarcinoma pre-pandemic and during the pandemic. Evidence Rating Level: 2 (Good) Colonoscopies as part of colorectal cancer (CRC) screening are instrumental in the early diagnosis of CRC, and have been associated with a 75% reduction in mortality for those diagnosed with left-sided colon cancer, likely due to earlier detection...

1. In a survey study, transgender and gender-diverse adolescents reported barriers, inadequate psychosocial support, and discrimination when receiving gender-affirming care through primary care.  2. They also highlighted benefits, such as convenience, and called for greater care coordination between primary care providers and gender care specialists to improve their experiences. Evidence Rating Level:  4 (Below average) Study Rundown: While gender-affirming care is recommended as the standard of care by the American Academy of Pediatrics, transgender and gender diverse (TGD) adolescents still face many barriers to accessing it...

1. In this cross-sectional study, rates of statin use for primary prevention were lower among non-Hispanic Black men and non-Mexican Hispanic women compared to non-Hispanic White men. 2. Rates of statin use for secondary prevention were highest among non-Hispanic White men, after adjusting for patient and structural factors. Evidence Rating Level: 2 (Good) Study Rundown: Statins reduce low-density lipoprotein cholesterol and are often the first-line agent for primary and secondary prevention of cardiovascular disease...

1. In a long-term follow-up study of an earlier randomized control trial, participants demonstrated sustained immunity 10 years after receiving a 3-dose series of human papilloma virus (HPV) vaccination. 2. There were no HPV-related malignancies or vaccine-related serious adverse events during the follow-up period. Evidence Rating Level: 1 (Excellent) Study Rundown: The risk of HPV-related cancer is lifelong, and therefore any benefit from HPV vaccination needs to be durable across time. This extension study sought to determine the long-term immunogenicity and safety of the 9-valent HPV (9vHPV) vaccine at 10 years following vaccination...

1. In this randomized controlled trial, a maternally administered vaccine for infant group B streptococcus (GBS) demonstrated a reduced risk of invasive GBS. 2. There was no significant difference in number of adverse events seen in patients who received the vaccine. Evidence Rating Level: 1 (Excellent) Study Rundown: GBS can cause sepsis and meningitis in newborns, with the primary risk factor being exposure to maternal rectovaginal group B streptococcal colonization during delivery. Often, pregnant women receive intrapartum antibiotic prophylaxis if they test positive for the GBS screen...

1. In an underserved community, providing free iron-containing prenatal vitamins improved hematocrit, reduced the prevalence of anemia, and reduced the need for postpartum blood transfusions.  Evidence rating level: 2 (Good) Maternal anemia during pregnancy is associated with a greater need for postpartum blood transfusions, intrauterine growth restriction, and perinatal mortality. Researchers aimed to determine whether providing free iron supplements to an underserved patient population during prenatal visits would improve hematologic indices and reduce the need for postpartum blood transfusions...

1.  In this observational cohort study, recurrent injury was frequent among firearm injury survivors, especially patients from socially vulnerable areas. 2. Fatal firearm injuries also occurred more frequently in prior firearm injury survivors. Evidence Rating Level: 1 (Excellent) Study Rundown: Firearm injuries are the leading cause of death for United States youths aged 1 to 19 years old, with socially vulnerable groups such as Black children and young adults disproportionally affected. Additionally, structural racism and other social determinants of health have increased the risk of violent injury among these populations...

1. Children living in areas of North Carolina composed predominantly of non-Hispanic Black individuals had higher blood lead levels than children living in areas with fewer non-Hispanic Black individuals. 2. This relationship persisted from the early 1990s to 2015, despite the decline of blood lead levels over time in North Carolina. Evidence Rating Level:  2 (Good) Study Rundown: Racial residential segregation (RRS) — the geographic separation of racial or ethnic groups — has been linked to worse health outcomes and increased mortality...

1. Compared to non-Indigenous Canadians, Indigenous females of reproductive age living off of reserves had poorer access to primary care and greater unmet healthcare needs.  Evidence rating level: 3 (Average) Researchers aimed to assess health care disparities among Indigenous females in Canada living off of reserves. This cross-sectional study collected data on females aged 15 to 55 from the Canadian Community Health Survey from 2015 to 2020, including 2902 First Nations, 2345 Métis, 742 Inuit, and 74,760 non-Indigenous females...

1.  In this randomized controlled trial, among patients living with human immunodeficiency virus (HIV) at low-to-moderate risk of cardiovascular disease, pitavastatin calcium was superior to placebo in reducing the risk of a major adverse cardiovascular event (MACE). 2. The trial was stopped early due to evidence of the efficacy and safety of pitavastatin. Evidence Rating Level: 1 (Excellent) Study Rundown: Patients with HIV are living longer on anti-retroviral therapy (ART) and have a significantly higher risk of developing cardiovascular diseases, even under optimal ART and with undetectable HIV titers...

1. In this prospective cohort study, 1 out of 500 newborns were diagnosed with a medical condition that was detected via genetic sequencing but was missed by more commonly used biochemical screening tests.  Evidence rating level: 1 (Excellent) Newborn screening (NBS) is routinely performed across the world using biochemical testing methods. The effectiveness of genetic sequencing as an alternative method for NBS has not previously been studied. Researchers aimed to compare the ability of biochemical and genetic sequencing methods to detect disorders in newborns...

1. In this synthetic control analysis, changes in medical cannabis laws were not found to have made a significant difference in the proportion of patients receiving prescriptions for opioids for noncancerous pain. 2. Medical cannabis laws were also not found to impact the proportion of patients receiving procedures to address their chronic pain. Evidence Rating Level: 1 (Excellent) Study Rundown: Despite changes to medical laws that permit the use of cannabis for treating chronic noncancerous pain, evidence for its effectiveness in the literature is mixed...

1. In this surveillance study, the prevalence of markers of artemisinin resistance has increased to over 20% between 2016 and 2021 within 11 sampled districts in Uganda.  2. The prevalence of 469V and 675V mutations has increased by approximately 54% in northern Uganda. Evidence Rating Level: 1 (Excellent) Study Rundown: Malaria remains a significant public health challenge in certain global regions. The majority of global malaria cases and related deaths occur in Africa where control of malaria is primarily achieved through insecticides and artemisinin-based combination therapy...

1. Compared to those consuming below the maximum tolerable daily intake of the mycotoxin deoxynivalenol, those consuming above this threshold were at a greater risk of giving birth to small-for gestational age infants.  Evidence rating level: 1 (Excellent) Deoxynivalenol (DON) is a mycotoxin found in certain agricultural products, such as wheat and corn. It has been found to cause fetal growth retardation in animals, but its effects have not previously been studied in humans. Researchers aimed to assess the effect of DON consumption on fetal growth...

1. For postpartum pain management, there is no overall increased risk of persistent opioid use in patients prescribed oxycodone versus codeine upon hospital discharge. 2. For patients with vaginal deliveries, there is an increased risk of persistent opioid use for oxycodone compared to codeine. 3. For patients with C-section deliveries, there is a slightly decreased risk of persistent opioid use for oxycodone compared to codeine. Evidence Rating Level: 2 (Good) Study Rundown: There has been a recent shift away from codeine and towards other opioids for management of pain immediately postpartum...

1.  In a retrospective analysis of a cohort of general internal medicine physicians, it was found that antimicrobial prescribing was 30% higher in the 4th quartile compared to the 1st quartile, indicating considerable variability in physician prescribing. 2. Variation in antimicrobial prescribing did not predict clinical outcomes after discharge, but in-hospital mortality was associated with higher intensity prescribing for antimicrobials.  Evidence Rating Level: 2 (Good) The concept of antimicrobial stewardship among medical professionals is well-established, and preventing overuse is widely recognized as the most feasible way to prevent increasing levels of antimicrobial resistance on a global scale...

1. The prevalence of Hepatitis C infection during pregnancy increased between 1998 and 2018, coinciding with the opioid epidemic.  2. Individuals of White race, lower socioeconomic status, and a history of substance use were more likely to be infected with Hepatitis C during pregnancy.  3. Hepatitis C Infection was associated with a greater risk of gestational hypertension, cesarean delivery, preterm labour, poor fetal growth, and fetal distress . Evidence Rating Level: 2 (Good) Study Rundown: Hepatitis C virus (HCV) is the most prevalent chronic bloodborne infection in the United States...

1. In a cross-sectional study, adolescent survivors of childhood cancers were more sedentary than age-matched controls. 2. Age, gender, BMI, cancer relapse, and central nervous system tumors were all associated with less physical activity and more sedentary time. Evidence rating: 2 (Good) Study Rundown: Childhood cancer survivors are at increased risk for chronic medical conditions such as cardiovascular disease and diabetes mellitus.  Higher levels of physical activity are associated with a variety of long-term health benefits and an improved quality of life in the general population...

1. In this systematic review and meta-analysis, the intention-behavior gap in physical activity was 47.6%. 2. Furthermore, a very low proportion of non-intenders engaged in physical activity, indicating that intention is an important first step toward the behavior. Evidence Rating Level: 1 (Excellent) Physical activity has several important health benefits. However, a large percentage of the population worldwide does not meet recommended physical activity guidelines. Promoting physical activity is an essential step in improving these statistics...

1. The risk of mortality from solid cancer, lagged by 10 years, is estimated to be increased by 52% per Gy of radiation exposure, an association that is doubled when limiting to the low cumulative dose range of 0-100 mGy. 2. There is an approximate relationship between cumulative dose radiation exposure and mortality from solid cancer. 3. Excluding cancers commonly associated with smoking and asbestos exposure did not alter the association between radiation exposure and solid cancer mortality substantially...