Round Up Email February 2026

Question 1

Indoor tanning and melanoma – the melanoma risk associated with use of indoor tanning is detailed in this page on GPnotebook.: Indoor tanning and melanoma

With respect to indoor tanning and melanoma, which statement is true?

a study showed that, after adjusting for age, sex, sunburn history, and family history, tanning bed use remained associated with a nearly 3-fold increased risk of melanoma compared to non-tanning bed users
a study showed that, after adjusting for age, sex, sunburn history, and family history, tanning bed use remained associated with a nearly 1.5-fold increased risk of melanoma compared to non-tanning bed users
a study showed that, after adjusting for age, sex, sunburn history, and family history, tanning bed use remained associated with a nearly 8-fold increased risk of melanoma compared to non-tanning bed users

Question 2

Kidney stones and kidney cancer risk – there is an increased risk of renal cell carcinoma associated with kidney stones; but is there an increased risk of transitional cell carcinoma associated with kidney stones?: Kidney stones and kidney cancer risk

With respect to risk of kidney cancer and kidney stones, which statement is false?

evidence shows an an increased risk of RCC (renal cell carcinoma) in patients with a history of prior kidney stones; but no increased risk of TCC (transitional cell carcinoma)
a meta-analysis demonstrates a significant association between kidney stones and increased risk of kidney cancer, with affected individuals having approximately twice the risk of developing kidney cancer
transitional cell carcinoma accounts for about 5% of all primary renal tumours, and often presents late

Question 3

Anticholinergic burden (ACB) and cognitive decline – this subject is summarised on GPnotebook.: Anticholinergic burden (ACB) and cognitive decline

With respect to anticholinergic burden (ACB) and cognitive decline, which statement is false?

long-term use of medications with anticholinergic properties has been associated with cognitive and functional decline among older adults
a study showed that anticholinergic burden (ACB) was associated with cognitive decline, particularly in the memory and executive function domains
diazepam has a higher anticholinergic burden (ACB) score than hydroxyzine

Question 4

Semaglutide and non-arteritic anterior ischemic optic neuropathy (NAION) – the risk of NAOIN associated with semaglutide is summarised on GPnotebook.: Semaglutide and non-arteritic anterior ischemic optic neuropathy (NAION)

With respect to semaglutide and non-arteritic anterior ischemic optic neuropathy (NAION), which statement is false?

non-arteritic anterior ischemic optic neuropathy (NAION) typically causes sudden, painless vision loss, usually in one eye that is often described as a blurring or cloudiness of vision
the European Medicines Agency (EMA) has reviewed all available data on NAION with semaglutide, including data from non-clinical studies, clinical trials, post-marketing surveillance and the medical literature, and has concluded that NAION is a very rare side effect of semaglutide (meaning it may affect up to 1 in 1,000 people taking semaglutide)
hypertension, diabetes, and nocturnal hypotension are risk factors for development of non-arteritic anterior ischemic optic neuropathy (NAION)

Question 5

Oxybutynin to reduce hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer - Oxybutynin is an anticholinergic agent available in oral and transdermal formulations that is commonly used for treating overactive bladder symptoms. However, there is also evidence that oxybutynin may be a therapeutic option for the management of hot flashes. This section of GPnotebook describes the use of oxybutynin in men receiving ADT for prostate cancer.: Oxybutynin to reduce hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer

With respect to oxybutynin to reduce hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer, which statement is false?

a 6 week, double-blind, placebo-controlled trial found that more than 70% of patients taking 5 mg of oxybutynin twice daily experienced at least a 50% reduction in hot flash scores
study evidence found that 2.5 mg and 5 mg doses of oxybutynin had equivalent effects in terms of reducing hot flashes in men receiving androgen-deprivation therapy (ADT) for prostate cancer
in patients receiving oxybutynin on this study showed no significant change in IPSS scores related to incomplete emptying or straining

Question 6

Melatonin in paediatric sleep disorders – When does the physiological increase in melatonin secretion during the night reach it’s peak? In general, are night-time melatonin levels 3x, 5x or 10x daytime levels? Is there evidence of long-term effectiveness of melatonin in the management of sleep disorders in children with typical development?: Melatonin in paediatric sleep disorders

With respect to melatonin in paediatric sleep disorders, which statement is false?

physiological increase in melatonin secretion during the night has a peak around 2 am and night-time values usually at least three times greater than daytime values
a review concluded that melatonin use was generally effective for sleep outcomes for specific populations in the short term; however, longer-term data in children with typical development were lacking
pititutary melatonin production is powerfully suppressed by light acting through the retino-hypothalamic tract