Daily Archives: February 27, 2023
Choosing Wisely internationally – 213 helpful recommendations for antimicrobial stewardship!
27 Feb, 2023 | 13:19h | UTCSummary: The article discusses the importance of antimicrobial stewardship (AMS) in the face of increasing antimicrobial resistance and the role of the Choosing Wisely campaign in promoting the rational use of antibiotics. The study evaluated 213 Choosing Wisely recommendations related to AMS practices in six countries (Australia/New Zealand, Canada, Italy, Switzerland, the USA, and Germany) and categorized them according to six categories: diagnostics, indication, choice of anti-infective drugs, dosing, application, and duration of therapy. Topics related to indication and diagnostics were most frequently addressed, and avoiding antibiotic treatment of asymptomatic bacteriuria and upper respiratory tract infections were central topics across all countries.
Article: Choosing Wisely internationally – helpful recommendations for antimicrobial stewardship! – Infection
See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Perspective | Beware of overdiagnosis harms from screening, lower diagnostic thresholds, and incidentalomas
27 Feb, 2023 | 13:18h | UTCSummary: This article discusses the concept of overdiagnosis and its relevance to clinical practice guidelines. Overdiagnosis is the diagnosis of a condition that, if unrecognized, would not result in symptoms or cause a patient harm during their lifetime, such as discovering a low-grade cancer that will never lead to symptoms at the end of life. But, unlike false positives, overdiagnosed individuals truly have the condition; they just don’t benefit from the diagnosis. Overdiagnosis can also result from lowering diagnostic thresholds for diagnosing a disease, which inflates diagnosis rates among patients and leads to recommendations for subsequent interventions without clear benefits. The article highlights the importance of providing accurate information to patients about the possibility and burden of overdiagnosis to inform shared decision-making and minimize the harms of screening interventions.
Related:
Overdiagnosis: it’s official – The BMJ
Overdiagnosis: what it is and what it isn’t – BMJ Evidence Based Medicine
Overdiagnosis across medical disciplines: a scoping review – The BMJ Open
Too much medical care: bad for you, bad for health care systems – STAT News
Overdiagnosis: causes and consequences in primary health care – Canadian Family Physician
Five warning signs of overdiagnosis – The Conversation
What is overdiagnosed cancer? And why does it matter? – Croakey
Blame rising cancer overdiagnosis on ‘irrational exuberance’ for early detection – STAT
A food allergy epidemic… or just another case of overdiagnosis?
An epidemic of overdiagnosis: Melanoma diagnoses sky rocket
RCT | Tight glycemic control did not preserve pancreatic beta cell function in newly diagnosed pediatric type 1 diabetes
27 Feb, 2023 | 13:16h | UTCSummary: The study aimed to determine if intensive diabetes management with an automated insulin delivery system could help preserve pancreatic beta cell function in youth with newly diagnosed type 1 diabetes. The randomized clinical trial included 113 youths aged 7 to 17 years and found that although the mean time in the target range of 70 to 180 mg/dL was 78% in the intensive management group vs. 64% in the standard care group, intensive diabetes management did not affect the decline in pancreatic C-peptide secretion at 52 weeks. The study concluded that near normalization of glucose levels instituted immediately after diagnosis of type 1 diabetes did not preserve pancreatic beta cell function in youth.
Article: Effect of Tight Glycemic Control on Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Preserving Pancreatic Beta Cell Function in Recent-Onset Type 1 Diabetes – JAMA (free for a limited period)
Commentary on Twitter
Intensive diabetes management with automated insulin delivery did not affect the decline in pancreatic C-peptide secretion at 52 weeks in youths with newly diagnosed type 1 diabetes. https://t.co/e1n5xagrtv #ATTD2023 pic.twitter.com/C6743BmqyH
— JAMA (@JAMA_current) February 24, 2023
Study links proton pump inhibitor use to increased risk of acquiring drug-resistant bacteria in hospitalized patients
27 Feb, 2023 | 13:13h | UTCSummary: This case-control study investigated whether proton pump inhibitors (PPIs) are associated with an increased risk of acquiring extended-spectrum β-lactamase (ESBL) or carbapenemase-producing Enterobacterales among hospitalized patients. The study involved 2239 adult hospitalized patients. After controlling for confounding factors, patients who received PPIs within the previous 30 days had a nearly 50% increased risk (aIRR, 1.48) of acquiring ESBL- or carbapenemase-producing Enterobacterales compared with those who did not receive PPIs. The study has the limitations of an observational study but points to the need for judicious use of PPIs to mitigate the risk of acquiring drug-resistant Enterobacterales among hospitalized patients.
Commentaries:
Study links acid suppressants to colonization with multidrug-resistant bacteria – CIDRAP
Proton Pump Inhibitors Associated With Increased Risk of Drug-Resistant Infections – HCP Live
RCT | Verapamil partially preserved pancreatic beta cell function in newly diagnosed pediatric type 1 diabetes
27 Feb, 2023 | 13:14h | UTCSummary: The study aimed to determine whether verapamil could preserve pancreatic beta cell function in children and adolescents with newly diagnosed type 1 diabetes. The randomized clinical trial involved 88 participants who were given either verapamil or placebo once daily for 52 weeks. The study found that C-peptide levels were 30% higher in the verapamil group compared to the placebo group at 52 weeks, and the percentage of participants with a 52-week peak C-peptide level of 0.2 pmol/mL or greater was 95% in the verapamil group compared to 71% in the placebo group. The study also found that verapamil was well tolerated with few adverse events. The results suggest that verapamil may partially preserve stimulated C-peptide secretion in children and adolescents with newly diagnosed type 1 diabetes. However, further studies with patient-relevant outcomes are needed to determine the long-term effectiveness and the optimal length of therapy.
Article: Effect of Verapamil on Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Preserving Pancreatic Beta Cell Function in Recent-Onset Type 1 Diabetes – JAMA (free for a limited period)
News Release: Verapamil shows beneficial effect on the pancreas in children with newly-diagnosed type 1 diabetes – University of Minnesota
Commentary on Twitter
In youth with newly diagnosed type 1 diabetes, verapamil partially preserved stimulated C-peptide secretion at 52 weeks from diagnosis compared with placebo. https://t.co/m4xbczf93C #ATTD2023 pic.twitter.com/teM0jjh1tT
— JAMA (@JAMA_current) February 24, 2023
Perspective | Can artificial intelligence help for scientific writing?
27 Feb, 2023 | 13:09h | UTCCan artificial intelligence help for scientific writing? – Critical Care
Related:
Perspective | ChatGPT-assisted diagnosis: is the future suddenly here?
Perspective | Generating scholarly content with ChatGPT: ethical challenges for medical publishing
ChatGPT: Will It Transform the World of Health Care? – UCSF Department of Medicine
ChatGPT and the future of medical writing (ChatGPT itself wrote this paper)
ChatGPT: five priorities for research – Nature
The path forward for ChatGPT in academia – Lumo’s Newsletter
ChatGPT is fun, but not an author – Science
Tools such as ChatGPT threaten transparent science; here are our ground rules for their use – Nature
ChatGPT listed as author on research papers: many scientists disapprove – Nature
Abstracts written by ChatGPT fool scientists
Cohort Study | Aggressive end-of-life care is still common among older adults with metastatic cancer in the US
27 Feb, 2023 | 13:11h | UTCSummary: The study aimed to compare the markers of aggressive end-of-life (EOL) care between older adults with metastatic cancer who are nursing home (NH) residents and those who live in community settings. The study analyzed data from 146,329 patients who died from metastatic breast, colorectal, lung, pancreas, or prostate cancer between 2013 and 2017, and found that aggressive EOL care was more common among NH residents than community-dwelling residents (63.6% vs. 58.3%). More than one hospital admission in the last 30 days of life and death in the hospital were the key markers associated with a higher prevalence of aggressive EOL care. The authors suggest that interventions targeting these factors could improve the quality of end-of-life care.
Guideline | Acute mechanical circulatory support
27 Feb, 2023 | 13:04h | UTC
Artificial intelligence in academic writing: a paradigm-shifting technological advance
27 Feb, 2023 | 13:07h | UTCArtificial intelligence in academic writing: a paradigm-shifting technological advance – Nature Reviews Urology (free for a limited period)
Commentary on Twitter
Artificial Intelligence will not replace academics, but academics who use AI will replace those who do not.
-We should discuss boundaries/ethical issues!@NatRevUrol @OncoAlert @Roei_Golan7 @AkhilMuthigi @ranjithramamd @VincentRK @VPrasadMDMPH #ChatGPT https://t.co/neAtxrRXI8 pic.twitter.com/gOpzbdg1mO— Yüksel Ürün (@DrYukselUrun) February 26, 2023
Related:
Perspective | ChatGPT-assisted diagnosis: is the future suddenly here?
Perspective | Generating scholarly content with ChatGPT: ethical challenges for medical publishing
ChatGPT: Will It Transform the World of Health Care? – UCSF Department of Medicine
ChatGPT and the future of medical writing (ChatGPT itself wrote this paper)
ChatGPT: five priorities for research – Nature
The path forward for ChatGPT in academia – Lumo’s Newsletter
ChatGPT is fun, but not an author – Science
Tools such as ChatGPT threaten transparent science; here are our ground rules for their use – Nature
ChatGPT listed as author on research papers: many scientists disapprove – Nature
Abstracts written by ChatGPT fool scientists
RCT | Effects of globus pallidus focused ultrasound ablation in Parkinson’s disease
27 Feb, 2023 | 13:02h | UTCSummary: The study evaluated the efficacy and safety of unilateral focused ultrasound ablation of the internal segment of globus pallidus in patients with Parkinson’s disease and dyskinesias or motor fluctuations. The randomized controlled trial involved 94 patients who were either assigned to undergo ultrasound ablation or a sham procedure. The study found that unilateral pallidal ultrasound ablation resulted in a higher percentage of patients who improved motor function or reduced dyskinesia than a sham procedure over a period of 3 months but was associated with adverse events. The study suggests the need for longer and larger trials to determine the effect and safety of this technique in persons with Parkinson’s disease.
Article: Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Focused ultrasound reduces physical symptoms of Parkinson’s disease – Health Imaging
Video Summary: Focused Ultrasound Ablation for Parkinson’s Disease | NEJM
Consensus Report | Sepsis-associated acute kidney injury
27 Feb, 2023 | 13:05h | UTCSepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup – Nature Reviews Nephrology (if the link is paywalled, try this one)
Commentary on Twitter
A Primer in @DiseasePrimers summarizes the epidemiology, mechanisms, diagnosis and treatment of pre-eclampsia, and discusses patient quality of life and open research questions for this condition. https://t.co/IO3uchSl8b pic.twitter.com/Y7Ij6jmy5a
— Nature Portfolio (@NaturePortfolio) February 25, 2023
Parkinson disease primer for the general practitioner
27 Feb, 2023 | 13:00h | UTCPart 1: Diagnosis – Canadian Family Physician
Part 2: Management of motor and nonmotor symptoms – Canadian Family Physician
Related:
Management of psychiatric and cognitive complications in Parkinson’s disease – The BMJ
Podcast | Parkinson’s Disease for primary care.
Onconephrology 2022: an update
27 Feb, 2023 | 12:58h | UTCOnconephrology 2022: An Update – Kidney360
Related:
Treatment of acute kidney injury in cancer patients – Clinical Kidney Journal
Onconephrology: Update in Anticancer Drug-Related Nephrotoxicity – Nephron
Cohort Study | Could regular laxative use be associated with an increased risk of dementia?
27 Feb, 2023 | 12:59h | UTCAssociation Between Regular Laxative Use and Incident Dementia in UK Biobank Participants – Neurology (link to abstract – $ for full-text)
News Release: Study: People Who Regularly Use Laxatives May Have an Increased Risk of Dementia – American Academy of Neurology
Commentary: Regular Use of Laxatives Linked to Risk for All-Cause Dementia – HealthDay
SR | Clinicopathological features of kidney injury related to immune checkpoint inhibitors
27 Feb, 2023 | 12:56h | UTCRelated:
Onconephrology 2022: An Update – Kidney360
Treatment of acute kidney injury in cancer patients – Clinical Kidney Journal
Onconephrology: Update in Anticancer Drug-Related Nephrotoxicity – Nephron
RCT | Epirubicin + Paclitaxel vs Epirubicin and Cyclophosphamide followed by Paclitaxel in operable ERBB2-negative and lymph node–positive BC
27 Feb, 2023 | 12:55h | UTC
Commentary on Twitter
RCT: Epirubicin + paclitaxel was non-inferior to the standard epirubicin + cyclophosphamide followed by paclitaxel in patients with operable HRBB2 negative and lymph nodes-positive breast cancer. https://t.co/Z672x44dQL pic.twitter.com/WdNJDtktLX
— JAMA Network Open (@JAMANetworkOpen) February 24, 2023
Single-arm study | Two-year outcomes of Valoctocogene Roxaparvovec therapy for Hemophilia A
27 Feb, 2023 | 12:51h | UTCTwo-Year Outcomes of Valoctocogene Roxaparvovec Therapy for Hemophilia A – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In the GENEr8-1 trial, participants with hemophilia A received B-domain–deleted factor VIII gene therapy delivered in an AAV5 vector. A decrease in annualized bleeding rates was maintained for 2 years despite declining factor VIII levels. https://t.co/hYy3pT8ssa#hematology pic.twitter.com/HuJQa0HiTR
— NEJM (@NEJM) February 23, 2023
RCT | Single chest tube superior to double chest tube post decortication in trauma/TB patients
27 Feb, 2023 | 12:53h | UTC
M-A | Adverse perinatal outcomes associated with antiretroviral therapy in women living with HIV
27 Feb, 2023 | 12:48h | UTC
Review | Diagnostic workup of childhood interstitial lung disease
27 Feb, 2023 | 12:50h | UTCDiagnostic workup of childhood interstitial lung disease – European Respiratory Review
Commentary on Twitter
ERR: Childhood interstitial lung diseases are rare and severe diseases. A stepwise approach to an aetiological diagnosis includes specific investigations performed in expert centres. The term “undefined chILD” must be regularly reassessed. https://t.co/C32b8QgS8I pic.twitter.com/Wq7iatPtTu
— ERS publications (@ERSpublications) February 26, 2023
Review | Pre-eclampsia
27 Feb, 2023 | 12:47h | UTCPre-eclampsia – Nature Reviews Disease Primers (if the link is paywalled, try this one)
Chronic low back pain: a narrative review of recent international guidelines for diagnosis and conservative treatment
27 Feb, 2023 | 12:46h | UTC
Cohort Study | Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein
27 Feb, 2023 | 12:44h | UTCLipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein – European Heart Journal (link to abstract – $ for full-text)
Commentary: Lp(a) Is Linked to Atherothrombosis Independent of CRP – American College of Cardiology
RCT | Isolated ambulatory phlebectomy vs. saphenous thermal ablation with concomitant phlebectomy in saphenous trunk and tributary incompetence
27 Feb, 2023 | 12:39h | UTC
SR | Nonopioid pharmacological management of acute low back pain
27 Feb, 2023 | 12:42h | UTCCommentary: Which Meds are Best for Acute Low Back Pain? – RheumNow
Related:
M-A: Effectiveness of treatments for acute and subacute mechanical non-specific low back pain
Guideline Interventions for the management of acute and chronic low back pain.
M-A: Little benefit from muscle relaxants for adults with non-specific low back pain.