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Daily Archives: October 17, 2021

RCT supports the use of therapeutic heparin in moderately ill patients admitted to the hospital with Covid-19.

17 Oct, 2021 | 21:35h | UTC

Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial – The BMJ

Commentary: High-dose of readily available blood thinner reduces risk of death for moderately ill COVID-19 patients – St. Michael’s Hospital

Related studies (some conflicting results)

RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.

Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.

M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

RCT: In noncritically ill patients hospitalized with Covid-19, therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge compared with usual-care thromboprophylaxis.

RCT: In critically ill patients with Covid-19, therapeutic anticoagulation with heparin did not result in improved outcomes compared to usual-care pharmacologic thromboprophylaxis.

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

 

Commentary on Twitter

 

J&J COVID-19 Vaccine: FDA recommends booster shot for all adults aged 18 and older at least two months following initial vaccination with the single-shot vaccine.

17 Oct, 2021 | 21:32h | UTC

News release: Johnson & Johnson COVID-19 Vaccine Booster Shot Unanimously Recommended for Emergency Use Authorization by U.S. FDA Advisory Committee

Commentaries:

FDA panel endorses booster shot for J&J COVID-19 vaccine – Associated Press

The Johnson & Johnson one-dose vaccine offers good protection now. A booster shot will maximize that, experts say – CNN

FDA advisers recommend J&J Covid-19 vaccine boosters, talk mix and match boosters – CNN

Related: [Press release – not published yet] J&J says booster shot at two months provided 75% protection against moderate to severe COVID-19 globally and 94% of such cases in the U.S.

 

[Preprint] Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – “Vaccine protection declined by mid-August 2021, decreasing from 91.9% in March to 53.9%”.

17 Oct, 2021 | 21:29h | UTC

Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – medRxiv

Related:

Observational study in Qatar showed the effectiveness of Pfizer vaccine against any SARS-CoV-2 infection dropped to 20% in months 5 through 7 after the second dose, but effectiveness against severe Covid-19 remained high.

Cohort study: Pfizer vaccine effectiveness against any infections declined from 88% during the first month after full vaccination to 47% after 5 months. Vaccine effectiveness against hospital admissions remained high; 87% within 1 month, and 88% at 5 months after full vaccination, with no significant waning.

Editorial | Covid-19 vaccination: evidence of waning immunity is overstated.

COVID vaccine immunity is waning — how much does that matter? – “As debates about booster shots heat up, what’s known about the duration of vaccine-based immunity is still evolving”.

COVID vaccine effects wane over time but still prevent death and severe illness.

Perspective | What we actually know about waning immunity.

Another study shows Pfizer mRNA vaccine immunity is reduced over time.

[Press release – not published yet] Study shows vaccine protection wanes over time, but vaccines still offer good protection against severe disease.

Studies: COVID vaccine protection waning against infection but not hospitalization.

 

Commentary on Twitter

 

Review: SARS-CoV-2 Dose, Infection, and Disease Outcomes for COVID-19.

17 Oct, 2021 | 21:30h | UTC

SARS-CoV-2 Dose, Infection, and Disease Outcomes for COVID-19 – A Review – Clinical Infectious Diseases

Related: Seroconversion and fever are dose-dependent in a nonhuman primate model of inhalational COVID-19.

 

Commentary from the author on Twitter (thread – click for more)

 

Management of Diabetes Mellitus in patients with CKD: Core Curriculum 2022.

17 Oct, 2021 | 21:23h | UTC

Management of Diabetes Mellitus in Patients With CKD: Core Curriculum 2022 – American Journal of Kidney Diseases

 

What can masks do? Part 2: What makes for a good mask study — and why most fail.

17 Oct, 2021 | 21:25h | UTC

COMMENTARY: What can masks do? Part 2: What makes for a good mask study — and why most fail – CIDRAP

See also: COMMENTARY: What can masks do? Part 1: The science behind COVID-19 protection – CIDRAP

 

Guidelines for the surgical management of ulcerative colitis.

17 Oct, 2021 | 21:21h | UTC

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Ulcerative Colitis – Diseases of the Colon & Rectum

 

Commentary on Twitter

 

Eight months later: Researchers compare immune responses elicited by three COVID-19 vaccines.

17 Oct, 2021 | 21:27h | UTC

News release: Eight months later: Researchers compare immune responses elicited by three COVID-19 vaccines – Beth Israel Deaconess Medical Center

Original study: Differential Kinetics of Immune Responses Elicited by Covid-19 Vaccines – New England Journal of Medicine

 

Commentary on Twitter

 

Viewpoint: Surgical overtreatment and shared decision-making—the limits of choice. – “Payment models further incentivize surgical intervention. Fee-for-service payment plans reward surgeons for operating, not for ensuring that surgery is right for a patient”.

17 Oct, 2021 | 21:17h | UTC

Surgical Overtreatment and Shared Decision-making—The Limits of Choice – JAMA Surgery (free for a limited period)

 

Commentary on Twitter

 

Guidelines for anesthesiologists on patient blood management in cardiac surgery.

17 Oct, 2021 | 21:22h | UTC

2021 Clinical Practice Guidelines for Anesthesiologists on Patient Blood Management in Cardiac Surgery – Journal of Cardiothoracic and Vascular Anesthesia

 

Commentary on Twitter

 

M-A: Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis – although Etoricoxib 60 mg/day and diclofenac 150 mg/day seem to be most effective treatments, topical diclofenac 70-81 mg/day is safer and should be considered as first line treatment.

17 Oct, 2021 | 21:14h | UTC

Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis – The BMJ

News release: Topical pain-killers more effective, safer than opioids for knee osteoarthritis pain – St. Michael’s Hospital

Commentary: Network meta-analysis compares analgesic regimens for osteoarthritis – medwire News

 

Commentary on Twitter

 

RCT: After third molar surgery, Ibuprofen doses above 400 mg did not significantly increase the analgesic effect, and Paracetamol 1000/codeine 60 mg was not more effective than ibuprofen 400 mg.

17 Oct, 2021 | 21:16h | UTC

Analgesic effect of oral ibuprofen 400, 600, and 800 mg; paracetamol 500 and 1000 mg; and paracetamol 1000 mg plus 60 mg codeine in acute postoperative pain: a single-dose, randomized, placebo-controlled, and double-blind study – European Journal of Clinical Pharmacology

 

Review: Management of infectious emergencies for the inpatient dermatologist.

17 Oct, 2021 | 21:06h | UTC

Management of Infectious Emergencies for the Inpatient Dermatologist – Current Dermatology Reports (if this link is paywalled, try this one)

 

Serious injury risk higher for horse riding than for football, motor racing, or skiing – “Chest most common site of injury, but head and neck injuries most lethal”.

17 Oct, 2021 | 21:08h | UTC

News release: Serious injury risk higher for horse riding than for football, motor racing, or skiing – BMJ

Original study: Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA – Trauma Surgery & Acute Care Open

Commentary: Horse Riding More Dangerous Than Skiis And Motorcycles, Injury Data Reveal – Science Alert

 

M-A: Psychosocial and psychological interventions for relapse prevention in schizophrenia.

17 Oct, 2021 | 21:12h | UTC

Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis – The Lancet Psychiatry

 

Commentary on Twitter

 

Review: Timing of antibiotic therapy in the ICU.

17 Oct, 2021 | 21:05h | UTC

Timing of antibiotic therapy in the ICU – Critical Care

 

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