Approved? Not-approved? What is “tentative approval?” Clinical trial data on this novel “once nightly” sodium oxibate showed the drug to be acceptable for narcolepsy. But legal issues are holding up the FDA approval process.

If eponyms are avoided, Wernicke encephalopathy, commonly known as Wernicke-Korsakoff syndrome or alcoholic encephalopathy, is a kind of thiamine (vitamin B1) deficiency that is frequently observed in alcoholics. Imaging typically reveals mamillary bodies, dorsomedial thalami, tectal plate, periaqueductal area, and/or the area around the third ventricle as areas of symmetrical enhanced T2/FLAIR signal.

Although research exists on the impact of CNS stimulants used in pregnancy, only a few small studies have looked at atomoxetine and pregnancy outcomes. This large cohort study of 4.2 million pregnancies ending in live births in northern Europe and the US reviewed nearly 1,000 pregnancies exposed to atomoxetine in the first trimester. Compared with non-exposed pregnancies, there was no observed increase in major congenital abnormalities with atomoxetine use in the first trimester.

The literature on chronic pain and stigma was reviewed by a group of academics from Sapienza University of Rome, Italy, who published their findings in the journal Pain and Therapy. Perhaps most unexpectedly, they discovered that stigma surrounding pain persists even in clinical settings, resulting in clinicians’ inadequate evaluations of patients’ pain, doubt about the reality of their suffering, and lower pain ratings. These factors frequently result in inadequate treatment of pain and a propensity to believe that it is solely a psychological disorder.

Who is at fault when the patient is injured when only partially following the doctor’s orders regarding limiting activity? The doctor hadn’t discussed all the potential adverse effects (e.g. dizziness and fainting) from medical therapy but had warned the patient to strictly moderate their activity level. Read the case and the court ruling.

In his discussion of the subject, Adam M. Brufsky, MD, PhD, FACP, of the University of Pittsburgh School of Medicine notes that about 50% of breast cancers categorized as HER2-negative exhibit low HER2 expression, and preliminary data suggest that new antibody-drug conjugates may be effective in treating tumors with low HER2 expression; clinical trials are currently underway. Trastuzumab should not be added to treatment plans for women with low HER2 expression, according to Dr. Brufsky, because it does not assist those with IHC 3+ or ISH-amplified breast cancer or those without those conditions. Finally, compared to triple-negative tumors, hormone receptor-positive (HR+)/HER2-negative cancers seem to have low HER2 expression more commonly.