Daily Archives: February 28, 2023
WHO Report | A woman dies every two minutes due to pregnancy or childbirth
28 Feb, 2023 | 14:04h | UTCSummary: This new report by United Nations agencies shows that a woman dies every two minutes due to pregnancy or childbirth. The report covers maternal deaths from 2000 to 2020 and reveals that maternal deaths either increased or stagnated in nearly all regions of the world, with some regions experiencing major setbacks. The poorest parts of the world and countries affected by conflict continue to have the highest rates of maternal deaths. Severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions aggravated by pregnancy are the leading causes of maternal deaths, which are largely preventable and treatable with access to high-quality healthcare. The COVID-19 pandemic may have further held back progress on maternal health. The report calls for urgent action to ensure every woman and girl has access to critical health services before, during, and after childbirth, so they can fully exercise their reproductive rights.
News Release: A woman dies every two minutes due to pregnancy or childbirth: UN agencies – World Health Organization
Commentaries:
Ambitious goal to slash maternal deaths in jeopardy – Nature
U.N.: Progress on reducing global maternal mortality has stalled since 2015 – STAT
Eight Hundred Women Die Every Day During Pregnancy or Childbirth – Health Policy Watch
Choosing Wisely in Cardiology | New ACC list of five things physicians and patients should question
28 Feb, 2023 | 14:03h | UTCSummary: The American College of Cardiology (ACC) has released a list of “Five Things Physicians and Patients Should Question” in cardiology as part of the Choosing Wisely campaign, which encourages conversations between clinicians and patients about potentially unnecessary tests, treatments, and procedures. The list includes recommendations to:
- Avoid the routine use of invasive hemodynamic monitoring with pulmonary artery catheters in patients with uncomplicated acute decompensated heart failure.
- Avoid performing atrial fibrillation ablation for the sole purpose of discontinuing chronic anticoagulation.
- Avoid routine imaging stress tests or coronary CT angiography for the workup of palpitations or presyncope.
- Avoid obtaining a coronary artery calcium score in patients with known clinical atherosclerotic cardiovascular disease.
- Avoid obtaining routine serial echocardiograms for chronic heart failure if there has been no change in signs, symptoms, or management.
The recommendations are based on published national guidelines and aim to broadly represent the field of cardiology.
Commentary: ACC Releases New List of Choosing Wisely Recommendations – American College of Cardiology
See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Review | Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management
28 Feb, 2023 | 14:00h | UTCAntiphospholipid syndrome: advances in diagnosis, pathogenesis, and management – The BMJ
Physicians are more burned out than ever — here’s what can be done about it
28 Feb, 2023 | 13:57h | UTCPhysicians Are More Burned Out Than Ever—Here’s What Can Be Done About It – JAMA (free for a limited period)
Related Report: Addressing Health Worker Burnout – The U.S. Surgeon General’s Advisory on Building a Thriving Health Workforce
Related:
AAP Clinical Report | Physician health and wellness.
M-A | Physicians suffering burnout are twice as likely to be involved in patient safety incidents.
Systematic Review | Predictors of burnout among healthcare providers.
Physician Well-being 2.0: Where Are We and Where Are We Going? – Mayo Clinic Proceedings
Assessment of Risk Factors for Suicide Among US Health Care Professionals
Beyond Burnout: Docs Decry ‘Moral Injury’ From Financial Pressures of Health Care
Hospital administration response to physician stress and burnout – Journal of Hospital Practice
Opinion: It’s Time to Talk About Physician Burnout and Moral Injury
Systematic Review: Effect of Organization-Directed Workplace Interventions on Physician Burnout
The 3 Causes Of Physician Burnout (And Why There’s No Simple Solution) – Forbes
Physician Burnout: A Global Crisis
The Burnout Crisis in American Medicine – The Atlantic
Physician burnout costs up to $17B a year, task force says – HealthcareDive
Systematic Review: Prevalence of Burnout Among Physicians
Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction
M-A | Which adverse events and which drugs are implicated in drug-related hospital admissions
28 Feb, 2023 | 13:59h | UTCSummary: This systematic review and meta-analysis aimed to provide an updated estimation of drug-related hospital admissions, the types and frequency of drug-induced harm, and the drugs involved. The review included 17 studies that examined acute admissions to emergency departments or inpatient wards resulting from drug-induced harm in the general population. These studies were published between January 2012 and December 2021. The estimated rates of admissions resulting from adverse drug reactions* (ADRs) and adverse drug events* (ADEs) were 8.3% and 13.9%, respectively. Almost half of the admissions related to ADRs and over two-thirds of those related to ADEs were possibly preventable. Gastrointestinal disorders, electrolyte disturbances, bleeding events, and renal and urinary disorders were the most frequently involved categories of drug-induced harm. The most frequently involved drug groups were nervous system drugs, followed by cardiovascular and antithrombotic agents.
*Adverse drug events (ADEs) and adverse drug reactions (ADRs) are two terms that are often used interchangeably, but they actually have different meanings. Adverse drug events (ADEs) refer to any negative effect that results from medication exposure and can be caused by a variety of factors, including medication errors, overdose, drug interactions, or allergic reactions. In contrast, adverse drug reactions (ADRs) are a specific type of ADE that occur as unintended effects of medication at normal therapeutic doses.
Perspective | Gender dysphoria in young people is rising — and so is professional disagreement
28 Feb, 2023 | 13:55h | UTCGender dysphoria in young people is rising—and so is professional disagreement – The BMJ
News Release: Gender dysphoria is rising—and so is professional disagreement – BMJ Newsroom
Commentary on Twitter
More children and adolescents are identifying as transgender and are being offered medical treatment, especially in the US—but some providers and European authorities are urging caution because of a lack of strong evidence. @writingblock reports https://t.co/24aDMo7rb0
— The BMJ (@bmj_latest) February 26, 2023
RCT | 2-y outcomes confirm the harms caused by high prophylactic platelet transfusion thresholds in preterm infants
28 Feb, 2023 | 13:53h | UTCSummary: The study investigated the long-term outcomes of preterm infants who participated in a randomized trial of platelet transfusions at different threshold levels. Infants with platelet counts below 50×109/L were enrolled and randomized to either a higher threshold of 50×109/L or a lower threshold of 25×109/L. The study found that infants randomized to the higher threshold had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years compared to the lower threshold group. The study further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. The mechanisms by which platelet transfusions could mediate harmful effects remain unknown, but the study identified increased rates of intraventricular hemorrhage and bronchopulmonary dysplasia in the higher threshold group, which may contribute to the adverse outcomes observed.
Original Study: Randomized Trial: Platelet-Transfusion Thresholds in Neonates
Commentary from the author on Twitter (thread – click for more)
We already knew from the @PlaNeT2_trial that a higher prophylactic platelet transfusion threshold (<50) in preterm babies is associated with significantly increased mortality or major bleeding compared with a lower one (<25)… https://t.co/pJrE44BIIx
— Carmel Moore (@carmelmoore) February 22, 2023
AAP Policy Statement | Crowding in the emergency department: challenges and recommendations for the care of children
28 Feb, 2023 | 13:50h | UTCTechnical Report: Crowding in the Emergency Department: Challenges and Best Practices for the Care of Children – Pediatrics
News Release: Crowding in the ED: AAP guidance offers solutions to complex problem – American Academy of Pediatrics
Perspective | The inertia of clinical trials and unethical control arms in oncology
28 Feb, 2023 | 13:51h | UTCThe inertia of clinical trials and unethical control arms – Sensible Medicine
Guidelines | Efficacy and safety of non-steroidal anti-inflammatory drugs for the treatment of acute pain after orthopedic trauma
28 Feb, 2023 | 13:48h | UTC
M-A | Application of enhanced recovery after surgery in partial nephrectomy for renal tumors
28 Feb, 2023 | 13:46h | UTCRelated:
Complete List of Enhanced Recovery After Surgery (ERAS) Society Guidelines
Unique considerations for patient retention in decentralized clinical trials
28 Feb, 2023 | 13:43h | UTC
Fatal accident calls MRI safety standards into question—are more regulations needed?
28 Feb, 2023 | 13:44h | UTC
Review | Embracing complexity: making sense of diet, nutrition, obesity and type 2 diabetes
28 Feb, 2023 | 13:42h | UTCEmbracing complexity: making sense of diet, nutrition, obesity and type 2 diabetes – Diabetologia
Commentary on Twitter
Comprehensive Review @DiabetologiaJnl by my very talented friend Prof Nita Forouhi
Embracing complexity: making sense of diet, nutrition, obesity & T2 diabeteshttps://t.co/PxGOZL0XkB pic.twitter.com/x2GaDPClfi
— Prof Kamlesh Khunti (@kamleshkhunti) February 24, 2023
Under a http://creativecommons.org/licenses/by/4.0/ license
RCT | Ligation of intersphincteric fistulous tract vs. endorectal advancement flap for high-type fistula in ano
28 Feb, 2023 | 13:40h | UTCLigation of Intersphincteric Fistulous Tract vs Endorectal Advancement Flap for High-Type Fistula in Ano: A Randomized Controlled Trial – Journal of the American College of Surgeons (link to abstract – $ for full-text)
Commentary on Twitter
The FRAIL trial randomized patients into 2 arms: LIFT (Ligation of Intersphincteric Fistula tract) and ERAF (Endorectal Advancement Flap). At 2 years, LIFT had no incontinence and a healing rate that was higher than ERAF.https://t.co/EnlYQXsjg6@kumar_surg pic.twitter.com/AVIXnvPmwY
— JACS (@acsJACS) December 21, 2022
RCT | Effects of an exercise and physical activity program in patients with atrial fibrillation
28 Feb, 2023 | 13:38h | UTCAn Exercise and Physical Activity Program in Patients With Atrial Fibrillation: The ACTIVE-AF Randomized Controlled Trial – JACC: Clinical Electrophysiology (link to abstract – $ for full-text)
Commentary: ACTIVE-AF Suggests Physical Activity May Reduce Atrial Fibrillation Risk – HCP Live
SR | Insufficient evidence to recommend Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia
28 Feb, 2023 | 13:39h | UTC
Cardiovascular disease related to immune therapy: JACC: CardioOncology special focus issue
28 Feb, 2023 | 13:37h | UTCCardiovascular Disease Related to Immune Therapy: JACC: CardioOncology Special Focus Issue – JACC: CardioOncology
Homepage: Special Focus Issue: Immune Therapy
Cancer Immunotherapy Beyond Checkpoint Blockade: JACC: CardioOncology State-of-the-Art Review
Cardiotoxicity of T-Cell Antineoplastic Therapies: JACC: CardioOncology Primer
Related:
Cardiovascular complications of immune checkpoint inhibitors for cancer – European Heart Journal
Cardiotoxicity of immune checkpoint inhibitors – ESMO Open
Cardiotoxicity from immune checkpoint inhibitors – IJC Heart & Vasculature
Review | Morbidity and mortality after surgery for retroperitoneal sarcoma
28 Feb, 2023 | 13:35h | UTCMorbidity and Mortality after Surgery for Retroperitoneal Sarcoma – Current Oncology
The adult and pediatric palliative care: differences and shared issues
28 Feb, 2023 | 13:30h | UTC
M-A | Effect of posterior pericardiotomy in cardiac surgery
28 Feb, 2023 | 13:34h | UTC
Review | (Mal)nutrition in critical illness and beyond
28 Feb, 2023 | 13:28h | UTC(Mal)nutrition in critical illness and beyond: a narrative review – Anaesthesia
Cluster RCT | Effectiveness of an intensive care telehealth program to improve process quality
28 Feb, 2023 | 13:31h | UTC
Commentary on Twitter
? A structured, bundled telemedical quality improvement implemented in a local network of?? hospitals improved quality of acute #ICU care vs to standard of care, increasing adherence to evidence-based performance indicators.
Open #FOAMc on @yourICM
? https://t.co/WV56tXoiHM pic.twitter.com/YQQvm2HUO5— Intensive Care Medicine (@yourICM) January 16, 2023
Cohort Study | Risk of second primary malignancies in patients with chronic lymphocytic leukemia
28 Feb, 2023 | 13:27h | UTC
Commentary on Twitter
Our recent population-based study shows that patients with chronic lymphocytic leukemia (CLL) have an increased risk of developing second primary malignancies (SPMs) in the long term. 1/3#CLLsm #OpenAccess #NKRdata #IKNL @BloodCancerJnl @IKNL https://t.co/epgVnnwv2W
— Dr. Avinash Dinmohamed (@ADinmohamed) January 19, 2023
RCT | Single-dose psilocybin-assisted therapy in major depressive disorder
28 Feb, 2023 | 13:26h | UTCRelated:
Phase 2 RCT | Single-dose Psilocybin for a treatment-resistant episode of major depression.
Research: “Magic mushrooms” for treatment-resistant depression
Commentary on Twitter
?New placebo-controlled, double-blind, RCT: Single-dose #psilocybin-assisted therapy in #majordepressivedisorder
Results suggest that a single dose of psilocybin significantly reduces depressive symptoms compared to placebo for at least 2 weekshttps://t.co/Ps43rxHv6r pic.twitter.com/Qc8xSgnalw
— eClinicalMedicine – The Lancet Discovery Science (@eClinicalMed) January 18, 2023