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Round Up Email February 2024

In this month's Round Up highlighted subjects includes updated evidence relating to exercise in the management of depression, an explanation of “breakthrough measles” and key facts summary of nitazenes.

Question 1
Nitazenes - are a group of compounds developed in the 1950s as opioid analgesics, but they were never approved to market. A characteristic of nitazenes is their high potency with Etonitazene is 500 x as potent as heroin (note for comparison fentanyl is 50 x as potent as heroin).: Nitazenes
With respect to nitazenes, which statement is false?
- chemical structures of nitazenes are distinct from the typical morphine-like phenanthrene motif and meperidine analogs like fentanyl
- Isotonitazene is 5x as potent as heroin
- nitazenes can cause fatal respiratory depression
Question 2
Lean mass hyper responder (LMHR) – this dyslipidaemic phenotype is summarised on GPnotebook.ge: Lean mass hyper-responder (LMHR)
With respect to the Lean Mass Hyper-Responder (LMHR) which statement is false?
- LMHRs characteristically have an LDL cholesterol > 5 mmol/l whilst on a low carbohydrate diet
- LMHRs characteristically have an HDL cholesterol >2 mmol/l whilst on a low carbohydrate diet
- LMHRs characteristically have triglycerides >5 mmol/l whilst on a low carbohydrate diet
Question 3
The glycaemic index of a food is the capacity of a portion of that food containing 50 g available carbohydrate to raise blood glucose compared with 50 g glucose in normal glucose-tolerant individuals; whereas the of a food is essentially a product of the glycaemic index of the food and the available carbohydrate: Glycaemic index (GI) and glycaemic load
With respect to glycaemic index (GI) and glycaemic load, which statement is false?
- a diet with a lower glycaemic load can be achieved by choosing foods with a low glycaemic index or by reducing the quantities of carbohydrate consumed, or both
- diets with a high glycaemic index have been associated with improvements in insulin sensitivity
- consumption of high glycaemic index food is linked to increased incidence of type 2 diabetes
Question 4
Smoking cessation and e-cigarettes – updated evidence regarding the use of e-cigarettes in smoking cessation: Smoking cessation and E-cigarettes
With respect to smoking cessation and e-cigarettes, which statement is false?
- evidence showed that addition of e-cigarettes to standard smoking-cessation counselling (SCC) resulted in greater abstinence from tobacco use among smokers than SCC alone
- evidence showed e-cigarettes were less effective than nicotine patches for abstinence at the end of pregnancy
- "dabbing" is the practice of inhaling heated butane hash oil
Question 5
Breakthrough measles – this condition is given the “key facts” GPnotebook treatment. Is “breakthrough measles” more infectious than “primary measles”?: Breakthrough measles
With respect to "breakthrough measles", which statement is false?
- "breakthrough measles" is more infectious than primary measles infection
- "breakthrough measles" is used to describe a confirmed case of measles in someone who developed immunity to measles, either from natural measles or from prior receipt of measles containing vaccine
- in measles endemic areas breakthrough cases represent fewer than 10% of total infections, but this will increase as vaccination coverage in the general population rises
Question 6
Exercise in the management of depression – this section of GPnotebook has been updated: Exercise in depression
With respect to exercise in the management of depression, which statement is false?
- NICE state that "patients of all ages with mild depression should be advised of the benefits of following a structured and supervised exercise programme of typically up to 10 sessions per week of moderate duration (45 minutes to 1 hour) for between 10 and 12 weeks"
- evidence shows that exercise seems to improve depressive symptoms in people with a diagnosis of depression
- exercise has been shown to help prevent depression and to be beneficial for adults with severe or treatment resistant depression

Round Up Email February 2024

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6