Pressure is the most critical factor in the development of pressure ulcers; high pressure applied constantly for two hours produces irreversible tissue ischemia and necrosis. Malnutrition, fecal and urinary incontinence, fractures, and a low serum albumin may be additional risk factors. Frequent turning and mobilization of patients, relieving pressure and allowing tissue reoxygenation, are the most effective means of prevention and treatment (PS Goode and RM Allman, Med Clin North Am, 73:1511, Nov 1989).

Oat bran, the ground inner husk of the grain, has recently become popular as a dietary means of lowering blood lipids. It is available both separately and as a constituent of oatmeal, which is the ground product of the whole grain. Oat bran and oatmeal are available in various breakfast cereals and can also be used in baked goods, such as muffins or bread. Some of these sources are listed in the table on page 112.

The FDA has approved a conjugate heptavalent pneumococcal vaccine for prevention of invasive pneumococcal disease in infants and children.

Diagnostic tests for human immunodeficiency virus (HIV) infection use four approaches: identification of antibodies to viral proteins, detection of viral antigens, detection of viral nucleic acids, and culturing the virus (CJ Schleupner in GL Mandell et al, eds, Principles and Practice of Infectious Diseases, 4th ed, New York:Churchill Livingstone, 1995, page 1253). In recent years, the FDA has approved the use of a 10- minute blood test, two home collection kits, and office tests that use urine and oral secretions to diagnose HIV infection. One home test, Confide (Johnson & Johnson), was...

Improved glucose meters and 2 sensing systems for continuous monitoring have become available for management of diabetes.

A 2024-2025 formulation of the Novavax adjuvanted protein subunit COVID-19 vaccine that more closely targets currently circulating SARS-CoV-2 variants is available now under an FDA Emergency Use Authorization (EUA) for use in persons ≥12 years old. The 2024-2025 formulations of the mRNA COVID-19 vaccines manufactured by Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax) were licensed by the FDA last month for use in persons ≥12 years old and made available under EUAs for use in persons 6 months to 11 years old.

The FDA has approved Shield (Guardant), a DNA blood test, for colorectal cancer (CRC) screening in average-risk adults ≥45 years old. Shield is the second blood-based DNA test to be approved for CRC screening; ColoHealth (formerly Epi proColon) was approved in 2016.

Since the last Medical Letter article on surgical correction of refractive errors (Volume 41, page 122, 1999), some new techniques have been tried and new results have been reported.

Pregnant women now often receive promotional material from private cord blood banks urging them to save and store their babies' cord blood.

View the Expanded Table: Some Vaccines for Travelers