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In this month's Round Up highlights include comparing the evidence base for SGLT2 inhibitors and GLP-1 agonists, and the risk of prostate cancer and coffee consumption.
SSRIs use in pregnancy – new evidence highlights the risk of postpartum haemorrhage associated with use of SSRIs and SNRIs in pregnancy – this is summarised on GPnotebook: SSRIs and postpartum haemorrhage
1) Which statement regarding antidepressants and risk of postpartum haemorrhage is false?
There is evidence relating use of mirtazapine and increase risk of postpartum haemorrhage
There is evidence relating to the use of sertraline and increase risk of postpartum haemorrhage
There is evidence regarding the use of vortioxetine and increase risk of postpartum haemorrhage
Coffee consumption and prostate cancer – new evidence suggests a reduction in risk of development of prostate cancer associated with coffee consumption. What is the evidence and what may be the mechanism? These queries are answered on GPnotebook: Coffee consumption and prostate cancer
2) Which statement regarding prostate cancer risk and coffee consumption is true?
Coffee consumption is associated with reduced risk of prostate cancer
Coffee consumption is associated with increased risk of prostate cancer
Coffee consumption is associated with a neutral effect on risk of prostate cancer
Weight loss and CV risk in type 2 diabetes. Intuitively it might be thought that weight loss in a patient with type 2 diabetes would lower cardiovascular risk. This is not, at present, borne out by the evidence base. This conundrum is considered on this page of GPnotebook.: How do changes in weight (weight loss or weight gain) affect cardiovascular (CV) risk in type 2 diabetes
3) Which statement relating to changes to weight in type 2 diabetes is true?
The ORIGIN study gives evidence that a reduction weight reduction reduces cardiovascular risk in diabetes
the LOOKAHEAD trial showed that weight reduction did not improve any of the outcome variables on mortality or morbidity
The DCGP trial showed that weight loss in obese patients was an independent risk factor for reduced all-cause mortality
Ewing's sarcoma – an update of this sarcoma on GPnotebook: Ewing's sarcoma
4) Which statement regarding Ewing's sarcoma is true?
Is the most common bone cancer in children
Metastasis occurs late in the course of Ewing's sarcoma
Occurs more commonly in people of European ancestry than African ancestry
Use of antiepileptic medication in pregnancy – an update based on latest guidance: Antiepileptic drugs in pregnancy
5) Which statement regarding the use of antiepileptics in pregnancy is true?
risk of major congenital malformations with carbamazepine, phenobarbital, and topiramate is dose-independent
Levetiracetam – Studies involving more than 1,800 pregnancies exposed to levetiracetam suggest an increased risk of major congenital malformations
Lamotrigine at maintenance doses is not associated with an increased risk of major congenital malformations
SGLT2 inhibitors and GLP-1 agonists – a study comparing the non-glycaemic benefits of these agents is summarised in GPnotebook.: SGLT2 inhibitors in comparison with (or in addition to) GLP1 agonists - cardiovascular and renal benefits
6) Which statement is true?
SGLT2 inhibitor use is associated with a reduction in stroke risk more than GLP-1 agonist use
GLP-1 agonists have a greater protective renal effect than SGLT2 inhibitors
SGLT-2 inhibitors reduced mortality and admission to hospital for heart failure more than GLP-1 receptor agonists