Daily Archives: March 1, 2023
RCT | Endovascular ultrasound renal denervation is modestly effective in the treatment of hypertension
1 Mar, 2023 | 14:11h | UTCSummary: The RADIANCE II randomized clinical trial investigated the efficacy and safety of endovascular ultrasound renal denervation in patients with hypertension without the influence of antihypertensive medications. The trial enrolled 224 patients who were withdrawn from such medications and randomly assigned to receive either ultrasound renal denervation or a sham procedure. Results showed that ultrasound renal denervation reduced ambulatory systolic blood pressure by 6.3 mmHg on average at 2 months, compared to the sham procedure, without any reported adverse events. While these findings suggest that ultrasound renal denervation may be modestly effective in the treatment of hypertension, the short-term follow-up period limits the generalizability of these results to daily practice. Additionally, the clinical relevance of a procedure that reduces blood pressure only after withdrawing blood pressure medications should be considered.
Article: Endovascular Ultrasound Renal Denervation to Treat Hypertension: The RADIANCE II Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Is There a Role for Renal Denervation in the Treatment of Hypertension? – JAMA Cardiology (free for a limited period)
RCT | Long-term effects of early antiretroviral therapy initiation in HIV infection highlight the importance of early treatment
1 Mar, 2023 | 14:12h | UTCSummary: The article discusses the long-term results of the Strategic Timing of AntiRetroviral Treatment (START) trial, which aimed to determine the effects of early initiation of antiretroviral therapy (ART) for individuals with HIV and CD4+ counts above 500 cells/mm3 compared to those who deferred treatment until their CD4+ count was below 350 cells/mm3. The trial found that immediate ART initiation reduced the risk of AIDS and serious non-AIDS (SNA) conditions compared to deferred treatment. The study’s long-term results also found that a persistent excess risk of AIDS and SNA conditions remained even after ART was initiated in those who initially deferred treatment. The study highlights the importance of early diagnosis and prompt initiation of ART for individuals with HIV.
Article: Long-Term Benefits from Early Antiretroviral Therapy Initiation in HIV Infection – NEJM Evidence
Original Study: Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection – New England Journal of Medicine
Pooled analysis of 3 sham-controlled trials on ultrasound renal denervation for patients with hypertension
1 Mar, 2023 | 14:10h | UTCSummary: The article reports a patient-level pooled analysis of 3 randomized clinical trials that aimed to determine the effectiveness and safety of ultrasound renal denervation (uRDN) in reducing blood pressure (BP) compared to a sham procedure. The analysis included 506 patients with varying severities of hypertension and found that uRDN was modestly effective in reducing daytime ambulatory systolic BP at 2 months compared to the sham procedure, with a mean difference of 5.9 mmHg. One of the limitations of this analysis is that its findings are restricted to a 2-month follow-up. Additional follow-up from the included trials will be required to examine the durability of the effect and safety data.
Editorial: Is There a Role for Renal Denervation in the Treatment of Hypertension? – JAMA Cardiology (free for a limited period)
Artificial sweetener erythritol possibly implicated in increased cardiovascular risk
1 Mar, 2023 | 14:08h | UTCSummary: A recent study published in Nature Medicine found that erythritol, a popular artificial sweetener, is possibly implicated with an increased risk of major adverse cardiovascular events (MACE) such as heart attack and stroke. Analyzing data from over 4,000 people in the US and Europe, the researchers found that those with higher blood erythritol levels were at a greater risk of MACE. The researchers also examined the effects of adding erythritol to whole blood or isolated platelets and found that it made platelets easier to activate and form clots. In addition, a pilot intervention study with healthy volunteers showed that erythritol ingestion led to a marked and sustained increase in plasma erythritol levels above those associated with heightened platelet reactivity and thrombosis potential. The authors note that further studies are needed to confirm their findings and assess the long-term safety of erythritol.
Article: The artificial sweetener erythritol and cardiovascular event risk – Nature Medicine (free for a limited period)
News Release: Cleveland Clinic study finds common artificial sweetener linked to higher rates of heart attack and stroke
Commentaries:
Zero-calorie sweetener linked to heart attack and stroke, study finds – CNN
Could a Common Sweetener Raise Heart Risks? – HealthDay
Commentary on Twitter
A study in @NatureMedicine suggests that a commonly used artificial sweetener—erythritol—may be linked to cardiovascular disease events. https://t.co/QrbtvCFDJ4 pic.twitter.com/WpM9cLnXh7
— Nature Portfolio (@NaturePortfolio) February 27, 2023
M-A | Combination of multiple low-risk lifestyle behaviors and incident type 2 diabetes
1 Mar, 2023 | 14:06h | UTCSummary: This systematic review and meta-analysis assessed the association between multiple low-risk lifestyle behaviors (LRLBs) and the incidence of type 2 diabetes. The study examined 30 cohort comparisons involving 1,693,753 participants and 75,669 cases of type 2 diabetes. The LRLBs evaluated in the study were maintaining a healthy body weight, healthy diet, regular exercise, smoking abstinence or cessation, and light alcohol consumption. Results showed that the highest adherence to these LRLBs was associated with an 80% lower risk of type 2 diabetes compared to the lowest adherence group. Thus, targeting these LRLBs could be an effective strategy for the primary prevention of type 2 diabetes. However, the authors recommend promoting only four LRLBs, excluding alcohol intake, due to its association with increased harm. The potential benefits of small alcohol intake remain a controversial issue since most studies on the subject are observational and subject to residual confounding.
Article: Combination of Multiple Low-Risk Lifestyle Behaviors and Incident Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies – Diabetes Care (free for a limited period)
Commentary from the author on Twitter (thread – click for more)
Our research shows that adherence to multiple low-risk lifestyle behaviours including healthy diet and exercise can significantly reduce the risk of type 2 diabetes https://t.co/mWEEw9xYtQ #healthylifestyle #lowriskhabits #healthresearch
— Tauseef Khan (@tauseefkhan) February 22, 2023
Review | Borderline personality disorder
1 Mar, 2023 | 14:04h | UTCBorderline Personality Disorder: A Review – JAMA (free for a limited period)
JAMA Patient Page: Borderline Personality Disorder
Review | Platelet aggregation inhibitors and anticoagulants in gastroenterological and visceral surgical procedures
1 Mar, 2023 | 14:03h | UTC
Pediatric clinical practice adapted guidelines for management of nephrotic syndrome
1 Mar, 2023 | 14:01h | UTCPart 1: Steroid sensitive nephrotic syndrome
Part 2: Steroid-resistant nephrotic syndrome
IPNA Recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome
1 Mar, 2023 | 13:59h | UTCRelated:
WSES position paper | Training curriculum in minimally invasive emergency digestive surgery
1 Mar, 2023 | 13:58h | UTC
Opinion | There is no such thing as a validated prediction model
1 Mar, 2023 | 13:57h | UTCThere is no such thing as a validated prediction model – BMC Medicine
Definition of age-dependent reference values for the diameter of the common bile duct and pancreatic duct on MRCP
1 Mar, 2023 | 13:56h | UTC
Commentary on Twitter
Setting the standards ? of common bile duct and pancreatic duct
? CBD up to 8 mm < 65 y/o and up to 11 mm in ≥65 y/o
? PD diameters up to 3 mm in <65 y/o and up to 4 mm in ≥65 y/o
Landmark open access @Gut_BMJ paper ? kudos to authors ! ?https://t.co/hGEkfeVeRc pic.twitter.com/E4IXU50EZi
— Giovanni Marchegiani (@Gio_Marchegiani) February 28, 2023
M-A | Efficacy of brief behavioral therapy for insomnia in older adults with chronic insomnia
1 Mar, 2023 | 13:55h | UTC
M-A | Comparison of suture button and syndesmotic screw for ankle syndesmotic injuries
1 Mar, 2023 | 13:50h | UTC
Cohort Study | Elevated uric acid linked to increased risk of new‐onset atrial fibrillation
1 Mar, 2023 | 13:54h | UTCNews Release: Uric acid linked to later risk for irregular heart rhythm – American Heart Association
Commentary: Elevated uric acid levels linked to new-onset AFib – Cardiovascular Business
Commentary on Twitter
Elevated Uric Acid Is Associated With New‐Onset Atrial Fibrillation: Results From the Swedish AMORIS Cohort #AHAJournals https://t.co/P4ydRLTBrH pic.twitter.com/XT3ifw0YEH
— JAHA (@JAHA_AHA) January 12, 2023
Virtual wards: a rapid evidence synthesis and implications for the care of older people
1 Mar, 2023 | 13:52h | UTC
M-A | Catheter directed thrombolysis for not immediately threatened acute limb ischemia
1 Mar, 2023 | 13:49h | UTC
Is a one-size-fits-all ‘12-month rule’ appropriate when it comes to the last search date in systematic reviews?
1 Mar, 2023 | 13:48h | UTC
Commentary on Twitter
Is a one-size-fits-all ‘12-month rule’ appropriate when it comes to the last search date in systematic reviews?
Analysis by @gillianstokesm @EPPICentre @KatySutcliffe @UCLSocRes @James_M_Thomas #OpenAccess
Link: https://t.co/aNAdDXgphn pic.twitter.com/f2JZiaVDtz
— BMJ Evidence-Based Medicine (@BMJ_EBM) January 17, 2023
Review | The golden grapes of wrath – Staphylococcus aureus bacteremia
1 Mar, 2023 | 13:46h | UTC
SR | Surgical versus non‐surgical interventions for treating patellar dislocation
1 Mar, 2023 | 13:45h | UTCSurgical versus non‐surgical interventions for treating patellar dislocation – Cochrane Library
RCT | Single CT colonography vs. three rounds of fecal immunochemical test for screening of colorectal cancer
1 Mar, 2023 | 13:43h | UTCSingle CT colonography versus three rounds of faecal immunochemical test for population-based screening of colorectal cancer (SAVE): a randomised controlled trial – The Lancet Gastroenterology & Hepatology (link to abstract – $ for full-text)
Commentary on Twitter
New research – Sali et al – Single CT colonography versus three rounds of faecal immunochemical test for population-based screening of #colorectalcancer (SAVE): a randomised controlled trialhttps://t.co/RBxgAm0xJA#gitwitter #crcsm #colorectalcancerscreening #colonography pic.twitter.com/XSeJHxuO7c
— The Lancet Gastroenterology & Hepatology (@LancetGastroHep) September 16, 2022
RCT | US-assisted carbon nanoparticle suspension mapping vs. dual tracer-guided sentinel lymph node biopsy in patients with early breast cancer
1 Mar, 2023 | 13:42h | UTC
RCT | Momelotinib vs. danazol in symptomatic patients with anemia and myelofibrosis
1 Mar, 2023 | 13:39h | UTCMomelotinib versus danazol in symptomatic patients with anaemia and myelofibrosis (MOMENTUM): results from an international, double-blind, randomised, controlled, phase 3 study – The Lancet (link to abstract – $ for full-text)
RCT | Caffeine did not reduce time to first bowel movement after laparoscopic colectomy
1 Mar, 2023 | 13:41h | UTCCaffeine for intestinal transit after laparoscopic colectomy: randomized clinical trial (CaCo trial) – British Journal of Surgery (link to abstract – $ for full-text)
Commentary on Twitter
In BJS' December issue: Caffeine for intestinal transit after laparoscopic colectomy: randomized clinical trial (CaCo trial) https://t.co/6z1cboAxi0 @bplwijn @des_winter @ksoreide @MalinASund @evanscolorectal @nfmkok @paulo_sutt @robhinchliffe1 @young_bjs pic.twitter.com/yGtXiIwgq0
— BJS (@BJSurgery) December 28, 2022
RCT | Efficacy of oral vs. long-acting antipsychotic treatment in patients with early-phase schizophrenia
1 Mar, 2023 | 13:38h | UTCEfficacy of oral versus long-acting antipsychotic treatment in patients with early-phase schizophrenia in Europe and Israel: a large-scale, open-label, randomised trial (EULAST) – The Lancet Psychiatry (link to abstract – $ for full-text)
Commentary: No benefit of long-acting antipsychotics in schizophrenia? – MDedge