1) nurses commit more suicide and average population (doctors don't) 2) AK will turn in to SCC at a rate of about 2% per year 3) STOP SMOKING (even if you gain weight) 4) zofran is about equal to the rest for pregnant patients and the outcomes we care about 5) Tubes in the ear for children with acute otitis media?? It works about the same as medical management Association of US Nurse and Physician Occupation With Risk of Suicide | Nursing | JAMA Psychiatry | JAMA Network This retrospective cohort study used US data from 159 372 suicides reported in the National Violent Death Reporting System from 2007 to 2018. Researchers found that suicide was more common among nurses compared with the general population (sex-adjusted incidence, 23.8 per 100,000 vs 20.1 per 100,000; RR, 1.18). By sex, the physician suicide rate was not different from that of the general population Ten-Year Follow-up of Persons With Sun-Damaged Skin Associated With Subsequent Development of Cutaneous Squamous Cell Carcinoma | Dermatology | JAMA Dermatology | JAMA Network authors use Kaiser Permanente Northern California data to investigate a patient’s risk of SCC after an AK in more than 200,000 patients with AKs ( they give a bunch of fancy results but I am just going to tell you exactly what you need to know or want to know and that is what is the risk of AK turning into SCC and the answer is about 2% per year. An absolute risk is straightforward to use when thinking about patients: these results suggest that, if you see 10 patients with AKs on a given clinic day, one of them will have an SCC in the next 5 years. People don’t want to quit smoking, usually because it is addictive but some of the things they tell themselves is they smoke to stay skinny Sahle BW et al. Weight gain after smoking cessation and risk of major chronic diseases and mortality. JAMA Netw Open 2021 Apr 1; 4:e217044. (https://doi.org/10.1001/jamanetworkopen.2021.7044) prospective cohort study, looked at weight gain and associated mortality in about 17,000 adults over 8 years, during the 8 years of follow up 47% never smoked, 22% continued to smoke, and 31% quit smoking. participants who quit smoking gained on average 3.1 kg or almost 7 pounds compared with those who continued to smoke those who quit and gained weight had a hazard ratio for all-cause mortality around 0.30 compared to those who continued to smoke. This means if your risk of dying is 1 if you continue to smoke then if you stop smoking your risk of dying goes down to 0.3! This is insanely large, we have no drugs that give this big of a benefit and certainly not for mortality. That is a 70% decrease in mortality It just goes to show that although treatment is good, prevention, and discontinuing cigarette smoking is better. Comparison of Pregnancy Outcomes of Patients Treated With Ondansetron vs Alternative Antiemetic Medications in a Multinational, Population-Based Cohort | Clinical Pharmacy and Pharmacology | JAMA Network Open | JAMA Network Ondansetron is frequently used to treat nausea and vomiting during pregnancy. Although some studies reported important safety signals, few studies have been sufficiently large to assess rare pregnancy outcomes. Data from 456 963 pregnancies were included to evaluate exposure to ondansetron during pregnancy was compared with exposure to other commonly used antiemetics to minimize confounding by indication. primary outcome was fetal death, defined as either spontaneous abortion or stillbirth. there was no association between ondansetron exposure during pregnancy and increased risk of fetal death, spontaneous abortion, stillbirth, or major congenital malformations compared with exposure to other antiemetic drugs. Somethings we do in medicine we do because no one really questions it— Tympanostomy Tubes or Medical Management for Recurrent Acute Otitis Media | NEJM pe(continued)