Human alpha1-proteinase inhibitor (Prolastin Cutter), possibly better known as alpha1-antitypsin (ATT), is now available in the USA for replacement therapy in patients with emphysema who have a congential deficiency of the protein.

Now that US Secretary of Defense has decided to vaccinate more than 2 million memebers of the US armed forces against anthrax, US physicians may be asked to answer some questions about the vaccine and the disease.

Some readers have asked whether the widespread practice of taking aspirin to prevent first heart attacks is justifiable and, if so, what the dose should be. Only one large well-designed study has tested the use of aspirin for this purpose.

Patients may be asking about Airborne, a dietary supplement that is being heavily promoted for prevention and treatment of colds. It contains 7 herbal extracts, 3 vitamins, 2 amino acids, selenium, zinc and many other ingredients. Airborne Jr is available for children. There are some concerns. First, there is no conclusive evidence that this product or any of its ingredients prevents colds or shortens their duration. Second, the adult tablet contains 1 g of vitamin C, and the directions for use advise taking 1 tablet at the first sign of a cold and repeating the dose every 3 hours as...

The labeling of dabigatran etexilate (Pradaxa – Boehringer Ingelheim), an oral direct thrombin inhibitor, has recently been updated to include new dosing and monitoring recommendations and a warning on the risk of bleeding. Dabigatran etexilate was approved in the US in 2010 for the prevention of thromboembolic stroke in patients with non-valvular atrial fibrillation. It has been shown to be more effective than warfarin (Coumadin, and others) for this indication.

Electronic cigarettes, also called e-cigarettes, are advertised as a safer, more convenient, and socially acceptable alternative to smoking tobacco cigarettes. Widely available in retail stores and on the Internet, their use has been increasing over recent years, primarily among smokers, but also among non-smokers.

The FDA has approved the use of subcutaneous injections of deoxycholic acid (Kybella – Kythera/Allergan) to improve the appearance of moderate to severe convexity or fullness associated with submental fat (double chin) in adults. It is the first drug approved for this indication.

The FDA has approved Yosprala (Aralez), a fixed-dose combination of delayed-release aspirin and immediate-release omeprazole, for secondary prevention of cardiovascular and cerebrovascular events in patients who are at risk of developing aspirin-associated gastric ulcers (≥55 years old or history of gastric ulcers). Yosprala is the first product to become available in the US that combines aspirin and a proton pump inhibitor (PPI).

The FDA has expanded its Emergency Use Authorization for the adjuvanted protein subunit COVID-19 vaccine manufactured by Novavax to include its use as a first booster dose in adults who completed a primary series with any COVID-19 vaccine ≥6 months previously and are unable or unwilling to receive a booster dose of a bivalent mRNA vaccine. The Novavax vaccine is not authorized for use in persons who have received a booster dose of any other COVID-19 vaccine.

Human rabies continues to be rare in the USA, but animal rabies is becoming more common. An animal epizootic in the mid-Atlantic states, involving especially raccoons, has recently spread into the northeastern states.