After a fragility fracture, one woman in five fractured again within two years — and fewer than one in five started treatment

The edition in brief

In a US claims cohort of 467,721 women aged 50 or over with a new clinical fracture (median age 76), 19.4% had a further fracture within 24 months — 27.8% after a spine fracture and 24.2% after a pelvic fracture — yet only 17.5% began osteoporosis treatment, most within six months. A pragmatic factorial trial of 1,837 people due for repeat lung cancer screening found that pending the scan order for the primary care physician and reminding the patient raised on-time screening from 47.4% to 75.5% (RR 1.59), while print and video education alone slightly lowered it. A survey and focus-group study of 33 US hospitalists found benzodiazepines still dominate alcohol withdrawal treatment, phenobarbital is used in about two-thirds of emergency departments and under half of medical wards, and practice varies widely. The American College of Physicians now recommends hormone therapy first for menopausal vasomotor symptoms (strong recommendation, high-certainty evidence), venlafaxine or desvenlafaxine second, and SSRIs, gabapentin or a neurokinin receptor antagonist third, chosen through shared decision-making.