Not much longer than a decade ago, the approach to the treatment of estrogen receptor (ER)–positive, human epidermal growth factor receptor 2-negative, metastatic breast cancer focused primarily on the sequential use of a limited number of endocrine agents, continuing until progressively shorter durations of progression-free intervals were observed, suggesting the emergence of endocrine-refractory disease. Although data were emerging to suggest molecular mechanisms of endocrine resistance, including deregulation of the ER pathway, alterations in cell survival signals, and activation of escape pathways, therapeutic strategies that could leverage these insights were not available.¹ Thus, the approach was to pivot to chemotherapy for the remainder of a patient’s journey through metastatic disease.

In a cluster-randomized trial in 82 community hospitals where half of the hospitals used automated statistical surveillance of microbiology data to alert infection prevention programs to respond to outbreaks, real-time alerts did not significantly reduce additional outbreak cases (intervention period vs. baseline: statistical surveillance relative rate [RR]=1.41, control RR=1.81; difference-in-differences, 0.78; 95% confidence interval, 0.40 to 1.52; P=0.46) in the context of an ongoing pandemic.

Health care–associated infections (HAIs) are a pervasive problem, and although decreased rates of HAIs have been clearly achieved during the past decades, most recent estimates by the Centers for Disease Control and Prevention show the prevalence of HAIs in U.S. hospitals to be about 3%.¹ Many HAIs are preventable events and pose undue burdens on both patients and health care facilities. Hospitals’ infection prevention teams are responsible for working to prevent HAIs, which includes identifying and managing outbreaks. Although there is no consensus on how to define an outbreak, outbreaks of infectious diseases are most efficiently controlled when they are identified early, so rapid identification is a key strategy.

This randomized, placebo-controlled trial tested the use of intranasal oxytocin to reduce body weight in adults with obesity. Intranasal oxytocin, administered four times daily over 8 weeks, did not result in body weight change from baseline compared with placebo and was not associated with beneficial effects on body composition or resting energy expenditure from baseline to week 8. Oxytocin compared with placebo was associated with reduced caloric intake at an experimental test meal from baseline to week 6.

A growing number of patients are prescribed buprenorphine, a mixed agonist–antagonist of opioid receptors, for opioid use disorder (OUD), and clinicians are often faced with the question of how to adequately manage acute pain among hospitalized patients receiving buprenorphine for OUD. This article reviews the pharmacology of buprenorphine and provides pain management recommendations for patients prescribed buprenorphine in the setting of acute surgical and nonsurgical pain.