Publication: JAMA Oncology Objective: With NSCLC having relatively poor outcomes and the significant data supporting the use of metformin as an antineoplastic agent, the researchers wanted to compare overall or progression-free survival in chemoradiation alone vs. chemoradiation + metformin stage III NSCLC patients. Design: Randomized clinical trial, open-label, phase 2 study; 167 eligible patients

Expecting perfection when it comes to charting? Are you overly self-critical, telling yourself you’ll never get the charts done or you’re just not good at it? Do you go too big, watching your “identity-forming” charting spiral out of control? Keep calm and listen to this KevinMD.com podcast from Dr. Gail Gazelle, an internal medicine physician and the author of the book Everyday Resilience, who shares helpful advice for doctors struggling with these three mistakes.

Findings: Primary outcomes included AMI, HF, stroke, and CVEs; 51 secondary and safety outcomes included angioedema, cough, syncope, and electrolyte abnormalities. ACE inhibitors were associated with a significantly increased risk of four secondary and safety outcomes compared with ARBs.Design: Multinational cohort study; Patients: ~2.3M ACE, ~674K ARB 

The additional approval expands immunization coverage to the most at-risk group for acquiring shingles – the immunocompromised. It also shortens the time to the second dose in the 2-dose Shingrix schedule.  Decision support based on the Zoster Efficacy Study in Patients Undergoing HSCT (ZOE-HSCT) phase III trial (JAMA).

According to the SUSTAIN FORTE study presented online in The Lancet Diabetes & Endocrinology, doubling the dose of semaglutide (Ozempic) might be a helpful option for people not achieving glycemic goals. Still, some researchers aren’t convinced this is a sound strategy – “statistically significant but barely clinically relevant” — suggesting opting for another agent when faced with a patient struggling to control HbA1c.

According to the interim guidance, “remote-learning highlighted inequities in education, was detrimental to the educational attainment of students of all ages, and exacerbated the mental health crisis among children and adolescents.” The AAP continues to recommend that all staff and students who are 2 years or older wear face masks unless medical or developmental conditions prohibit their use, urging everyone who is eligible to get vaccinated against COVID-19.