A study in the Annals of Internal Medicine looked at the association between cardiovascular outcomes and the coprescription of nitrates with PDE5 inhibitors in more than 42,000 men over a 10-year period. Two composite outcomes were measured: 1) cardiac arrest, shock, myocardial infarction, ischemic stroke, or acute coronary arteriography; and 2) syncope, angina pectoris, or drug-related adverse event. The authors found no statistically significant increase in measured cardiovascular AEs.

Primary hyperparathyroidism (PHPT) is associated with increased risk for fractures, cardiovascular disease, kidney disease, and cancer, along with increased mortality. In mild PHPT with modest hypercalcemia and without known morbidities, parathyroidectomy is debated because no long-term randomized trials have been performed related to it.

Drinking beer and spirits is linked to elevated levels of visceral fat, which is associated with increased risk of cardiovascular disease, metabolic syndrome, and other health complications. Moderate wine consumption shows no such association with levels of this harmful fat and may even protect against it.

Hyperglycemia is associated with poor clinical outcomes in critically ill patients. Most medical societies recommend less stringent glucose control, in the range of 140 to 180 mg/dL, for critically ill patients. In this population, although glucose management is essential, hypoglycemia is associated with increased mortality. Enhancing the amount of time glucose levels are in the target range and minimizing glycemic variability have been associated with improved outcomes in critically ill patients.

In a study of parenteral cancer drug pricing at 61 NCI-designated cancer centers, median price markups on 25 commonly used drugs ranged from approximately 120% to 630% over acquisition cost. The paper’s authors recommend public policy prohibiting excessive markup on parenteral chemotherapies as a means to reduce unnecessary financial burden on patients.

“For patients with T1cN1-2 or T2-4N0 (stage II or III), early-stage TNBC, the Panel recommends use of pembrolizumab (200 mg once every 3 weeks or 400 mg once every 6 weeks) in combination with neoadjuvant chemotherapy, followed by adjuvant pembrolizumab after surgery.”