Although metabolic surgery was originally performed to treat hypercholesterolemia, the effects of contemporary bariatric surgery on serum lipids have not been systematically characterized.

After the recent consensus by professional medical organizations around long-acting reversible contraceptives (LARCs) as first-line contraception for adolescents, the authors of this review consolidated the literature on existing access barriers to LARCs for adolescents, with the aim of fostering thoughtful interventions to ensure the shift in guidelines leads to increased use of LARCs.

Asymptomatic microscopic hematuria (AMH) is defined as three or greater red blood cells (RBC) per high-powered field (HPF) on a properly collected urinary specimen. The initial evaluation for AMH should include a radiologic evaluation with computed tomography (CT) urogram without and with intravenous contrast. CT is the imaging procedure of choice because it has the highest sensitivity and specificity for imaging the upper tracts. A cystoscopy to evaluate the lower urinary tract should be performed on all patients who present with risk factors for urinary tract malignancies (e.g., irritative voiding symptoms, current or past tobacco use, chemical exposures) regardless of age. 

Some parents believe human papillomavirus (HPV) vaccination increases the chance of risky sexual behaviors among adolescents. This paper summarizes the evidence available on adolescent girls and women engaging in risky sexual activity following HPV vaccination. Studies measured changes in sexual behaviors, including age at sexual debut, risky sexual behaviors, use of condoms and contraception, sexually transmitted infection rates, HIV rates, and pregnancy terminations. The available data showed either no association between vaccination status and the outcomes of interest or a positive association with safer sexual behaviors.

Nearly 40% of women with a medical contraindication to estrogen use were using a combined hormonal contraceptive method.

A large increase in geriatricians and nurse practitioners will be needed in the next decade to handle dementia care. But who is currently taking care of elderly people with dementia? In a Baltimore study of Medicare recipients with dementia, researchers wanted to learn where the focus should be for educating key specialists. Cardiologists, neurologists, hematologists/oncologists, and urologists were the most predominant providers of care (PPCs). Future research should investigate whether primary care or specialists should be PPCs for dementia care.

While use of inhaled corticosteroid (ICS) in asthma is known to be overall erratic, the long-term use of ICS by patients selected during an episode of regular use is poorly documented. Among a historical cohort of 5,096 patients with regular use (≥3 ICS refills within 120 days), only 24.0% had a percentage of days covered ≥80% over the 12 months following the selection period. Achieving CMA ≥ 80% was associated with factors such as more severe/less controlled asthma and more frequent GP visits. A majority of asthma patients selected during an episode of regular ICS use did not maintain therapy over the following months. Adherence should be repeatedly monitored, and the reasons for discontinuation should be investigated, at prescriber and patient levels.

The US Preventive Services Task Force issued guidelines that call for latent tuberculosis infection screening of high-risk, asymptomatic adults, according to a statement published in the Journal of the American Medical Association. Patients at risk include adults born in or who previously lived in countries with a high prevalence of tuberculosis, as well as adults living in group settings such as homeless shelters and long-term care facilities.

Researchers found that adults whose thyroid hormone levels fall within the upper end of normal ranges have 2.5 times greater odds of sudden cardiac death than those whose thyroid levels were in the low-normal range and four times the risk of sudden cardiac death over 10 years. The study was published in the journal Circulation.

A study in JAMA Surgery found gastric bypass surgery patients had lost 31% of initial weight after one year, compared with 1% weight loss among nonsurgical patients. Researchers found people who had gastric bypass lost more weight at four years than those having other types of weight-loss surgery, and at the 10-year mark, only 19 of the almost 1,800 gastric bypass patients studied had regained pounds to near their initial weight.

Hospitals are using transition-to-home programs, which help ensure discharged patients can care for themselves and have sufficient support, to reduce readmission rates and penalties. Data showed a San Diego County post-discharge program saved Medicare an estimated $13.8 million over two years, mainly due to fewer readmissions.

The American Academy of Pediatrics released a policy statement in Pediatrics recommending that all children ages 6 months and older receive inactivated influenza vaccines instead of the FluMist quadrivalent live attenuated influenza vaccine this flu season, following interim guidance from the CDC's Advisory Committee on Immunization Practices warning against FluMist due to its poor effectiveness during the last three flu seasons. The statement also urged that all pregnant women and health care personnel receive flu shots.

A video-based telehealth platform in the ICU may improve communication between physicians and families on medical decisions, making it easier for families who cannot be there in person without disrupting workflows, according to a study in the American Journal of Clinical Care. However, such a platform should be "reliable, easy to use, and compliant with health information and patient privacy regulations" to maximize its efficacy, said study lead author Dr. Daniel Holena.