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Ask the doctors

Q. I heard that there is a new medication that you can take for the flu. Is this a vaccine?

A. In October 2018, for the first time in 20 years, the FDA approved a new medication to treat the flu. Baloxavir marboxil, sold as Xofluza, is not a vaccine, but rather an antiviral drug that can help your body fight off influenza more quickly. Antivirals work by stopping viruses from reproducing, lessening both the severity of your symptoms and their duration. Xofluza joins two antiviral drugs commonly prescribed for flu, oseltamivir (Tamiflu) and zanamivir inhaler (Relenza). (A third flu drug 鈥� peramivir, trade name Rapivab 鈥� is administered as an intravenous infusion.)

Because addiction to pain pills often starts with an operation, surgeons are shifting to non-opioid approaches for pain control.

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Many people who are struggling with opioid addiction didn't start taking the drugs at a party or at a friend's house. They were introduced to these painkilling medications by their doctor after a surgical procedure.

In the 1990s, the number of opioid prescriptions written for people undergoing surgery or experiencing pain conditions grew 鈥� and so did related problems. As a result, "we are in a current opioid epidemic, with 91 substance-related deaths each day, according to the CDC," says Dr. Elizabeth Matzkin, an orthopedic surgeon and assistant professor at Harvard Medical School.

Occasionally these heart rhythm disruptions signal a more serious condition.

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Lately you've felt like a flipping fish is stuck inside your chest. You feel fine otherwise, but there it is again 鈥� flip, flop. It's gone as fast as it appears. But you're starting to worry: is it a sign of a serious heart problem?

Chances are what you're feeling is a condition called heart palpitations, which are usually harmless blips in the heart rhythm, explains Dr. Peter Zimetbaum, a professor of cardiovascular medicine at Harvard Medical School. Only occasionally are these rhythm disturbances the sign of a more serious heart problem that should be checked out.

Research we're watching

A long-used vaccine is showing promise in helping to restore near-normal blood sugar levels in people with advanced type 1 diabetes. Researchers from Harvard Medical School injected adults who had type 1 diabetes with two doses of the bacillus Calmette-Gu茅rin (BCG) vaccine, which is traditionally used to prevent tuberculosis.

Participants in the study, all of whom had type 1 diabetes for many years, all showed significant improvements in their average blood sugar levels after the vaccination. The improvements lasted for the next five years. Researchers said that it appears the vaccine affected a metabolic mechanism that increases consumption of glucose by cells.

Ask the doctor

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Q. A friend has melanoma, and his doctor wants to use a new kind of treatment that boosts the immune system. Can you tell me more?

A. The immune system exists to attack foreign things that enter the body, such as germs. Certain cells of the immune system recognize and attack foreign things. Cancerous cells make chemicals that are not made by normal cells, chemicals the immune system should recognize as foreign. Unfortunately, eight million people around the globe die of cancer each year after their immune systems fail to destroy the cancer. Why do their immune systems fail?

Remove expired medications to avoid hazards such as accidental poisoning or ineffective treatment.

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Like any cupboard in your house, the medicine cabinet can easily become overstuffed with pills, potions, and creams that have expired or are no longer needed. But holding on to them can be dangerous. That's why experts recommend weeding through your medicine cabinet regularly. "Check it every six months or when you change your clocks," recommends Joanne Doyle Petrongolo, a pharmacist with Harvard-affiliated Massachusetts General Hospital. "Make it a regular habit to protect your family."

Medicine cabinet risks

For all their value, the substances in your medicine cabinet pose some risks beyond the side effects of the drugs:

Are you sabotaging your heart health without realizing it?

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As many as one in seven people being treated for high blood pressure doesn't have the condition under control, according to a recent scientific statement from the American Heart Association. The problem 鈥� known as resistant hypertension 鈥� is defined as having high blood pressure despite taking three or more blood pressure medications, including a diuretic.

For most people, high blood pressure means a reading of 130/80 millimeters of mercury (mm Hg) or higher. Staying below that threshold can dramatically lower a person's odds of having a stroke or heart attack. That's why it's so important to address the barriers that prevent people from reaching their blood pressure targets, says Dr. Randall Zusman, a cardiologist at Harvard-affiliated Massachusetts General Hospital.

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In the journals

It is often assumed that appendicitis means automatic surgery to relieve the pain and avoid complications. Yet, a study published online Sept. 25, 2018, by JAMA found that many people with uncomplicated acute appendicitis may be safely treated with antibiotics and avoid an appendectomy.

About 70% to 80% of acute appendicitis cases are uncomplicated, which means the appendix hasn't ruptured or formed an abscess. In the study, researchers had 530 people with uncomplicated acute appendicitis either undergo an appendectomy or receive 10 days of antibiotic therapy. After five years, 61% of the antibiotic group had no recurrences of appendicitis and no appendectomies.

Research we're watching

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Anti-inflammatory medications may play a role in ovarian cancer risk. A study by researchers at the Harvard T.H. Chan School of Public Health found that taking low-dose aspirin regularly appears to reduce the risk of ovarian cancer by 23%. However, long-term heavy use of ibuprofen (Advil), naproxen (Aleve), and other nonsteroidal anti-inflammatory drugs (NSAIDs) seems to increase risk.

The study, published online October 4 by JAMA Oncology, looked at data on more than 200,000 women who participated in the Nurses' Health Study and Nurses' Health Study II. Among the group studied, 1,054 women went on to develop ovarian cancer. Researchers then looked at what type of medications the women took on a regular basis. They found that women who took at least 10 doses of NSAIDs a week for multiple years had an increased risk of ovarian cancer. Women who took low-dose aspirin regularly seemed to have a reduced risk 鈥� but the same was not true among women who took a standard-dose aspirin.

On call

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Q. I have lost some of my sense of taste. I take medicine for high blood pressure. Could that be the reason?

A. The ability to enjoy food's flavor requires both your sense of taste and your sense of smell, which are triggered by the stimulation of nerve endings in the mouth and nose. As we age, our senses of smell and taste diminish. We lose taste buds, and those that remain shrink; and our tongue and nose become less discerning.