Lipoprotein associated phospholipase A₂ (Lp-PLA₂), an enzyme involved in the repair of oxidative damage to lipoproteins, causes release of inflammatory mediators associated with atherosclerosis. A new assay, PLAC (diaDexus, Inc.), is now available to measure Lp-PLA₂ levels. C-reactive protein (CRP), another inflammatory mediator, appears to be a biomarker for coronary disease (MH Shishehbor et al, Cleve Clin J Med 2003; 70:634). The role of Lp-PLA₂ testing in determining cardiovascular risk is less clear.

The FDA has licensed Penbraya (Pfizer), a pentavalent polysaccharide conjugate meningococcal vaccine, for prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, B, C, W, or Y (MenABCWY) in persons 10-25 years old. Penbraya is the only meningococcal vaccine that contains all five of these serogroups. Two quadrivalent polysaccharide conjugate meningococcal vaccines containing serogroups A, C, W, and Y (MenACWY; Menveo, MenQuadfi) and two meningococcal serogroup B vaccines (MenB; Bexsero, Trumenba) are available in the US (see Table...

The FDA has licensed the pentavalent vaccine Penmenvy (GSK) for prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, B, C, W, or Y (MenABCWY) in persons 10-25 years old. Penmenvy is the second pentavalent meningococcal vaccine to become available in the US; Penbraya was licensed in 2023.

Liquid diets for weight reduction, once discredited because of their adverse effects, are becoming popular again. Now, formula diets are available through physicians or hospitals as part of a packaged weight-reduction program that includes nutrition education and modification of eating and exercise habits. Three widely used programs are Optifast (Sandoz), Medifast (Nutrition Institute of Maryland, 1840 York Road, Timonium, MD 21093) and HMR (Health Management Resources, 59 Temple Place, Boston, MA 02111).

Systemic allergic reactions to insect stings can include generalized urticaria, bronchospasm, laryngeal edema, hypotension and death. About 1% to 3% of adults in the USA have had a systemic allergic reaction to an insect sting (RE Reisman, Med Clin North Am, 76:883, 1992; UR M ller, Monogr Allergy, 31:131, 1993).

Interest in surgical treatment of Parkinson's disease has increased as the limitations of medical treatment have become apparent (Medical Letter, 35:31, 1993). Two approaches have been used. The first is transplantation of dopamine-producing cells into the patient's brain. The second is stereotactic surgery in areas of the brain that modify movement.

Dalteparin (Fragmin - Pharmacia), the second low-molecular-weight heparin to be marketed in the USA, is now available for prevention of deep vein thrombosis in high-risk patients after abdominal surgery. Enoxaparin (Lovenox -Rh ne-Poulenc Rorer) was approved in 1993 for prevention of deep vein thrombosis after hip replacement (Medical Letter, 35:75, 1993) and later approved for use in knee replacement. Five other low-molecular-weight heparins and one heparinoid are under investigation in the USA (MJ Cziraky and SA Spinler, Clin Pharm, 12:892, 1993).

PC Spes, a dietary supplement sold for "prostate health", is being used increasingly to treat prostate cancer.

An automatic, noninvasive, glucose-monitoring device (GlucoWatch Biographer) has been approved for marketing by the FDA. The manufacturer states that it is not meant to replace a regular blood glucose meter.

A transdermal contraceptive patch (Ortho Evra — Ortho-McNeil) has been approved by the FDA. Each 20 cm² patch contains 6 mg of the progestin norelgestromin (the active metabolite of norgestimate) and 0.75 mg of ethinyl estradiol.