In the first six months of 1989, more than 7,000 cases of measles were reported to the US Centers for Disease Control (CDC), a sharp increase over previous years (Morbid Mortal Weekly Rep, 33:456, July 7, 1989). Many of these cases occurred in children and college students who had previously been vaccinated against the disease. Practitioners have asked, therefore, whether their previously immunized young patients should receive a second (or, in some cases, third) immunization against measles.

The Reflotron (Boehringer Mannheim), a desk-top colorimetric reflectance analyzer that weighs 12 pounds, can do clinical chemistry tests on 30 l of whole blood, plasma or serum, using multilayered strips containing dry chemicals. A single test takes two to three minutes.

High-dose chemotherapy, with or without total body radiation, followed by bone marrow transplantation to restore bone marrow function has been used widely in the treatment of malignant diseases in recent years (Medical Letter, 34:79, 1992; 37:25, 1995). Now, however, instead of using bone marrow itself to restore function destroyed by chemotherapy and radiation, many centers infuse hematopoietic stem cells harvested from peripheral blood. Most stem cell transplants have been autologous; allogeneic stem cells have been tried in a small number of patients (WI Bensinger et al, Blood,...

Spinal manipulation has been used to treat not only back and neck pain, but also many other conditions. A recent commentary questioned its safety.

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 mNEXSPIKE (Moderna), an mRNA vaccine, for prevention of COVID-19 in adults ≥65 years old and in persons 12-64 years old who have a condition that puts them at high risk for severe outcomes from COVID-19. Spikevax, the original Moderna mRNA COVID-19 vaccine, remains in production2; it is licensed for use in persons ≥12 years old and is available under an Emergency Use Authorization (EUA) for children 6 months to 11 years old.

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).