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Daily Archives: March 3, 2023

ACG Guideline | Diagnosis and management of biliary strictures

3 Mar, 2023 | 14:13h | UTC

ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures – The American Journal of Gastroenterology

 


Estimates and projections of the global economic cost of 29 cancers in 204 countries and territories from 2020 to 2050

3 Mar, 2023 | 14:09h | UTC

Summary: The study aimed to estimate the global economic cost and distribution of 29 cancers in 204 countries and territories from 2020 to 2050. The study’s findings suggest that the global economic cost of cancers from 2020 to 2050 is estimated at $25.2 trillion. The five cancers with the highest financial costs are tracheal, bronchus, and lung cancer; colon and rectum cancer; breast cancer; liver cancer; and leukemia. China and the US face the highest economic costs, and the financial and health burdens are distributed unequally across countries, world regions, and country income groups.

Article: Estimates and Projections of the Global Economic Cost of 29 Cancers in 204 Countries and Territories From 2020 to 2050 – JAMA Oncology

News Release: The price of cancer – International Institute for Applied Systems Analysis

 

Commentary on Twitter

 


Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews

3 Mar, 2023 | 14:11h | UTC

Summary: This umbrella review summarized the evidence on the effects of physical activity interventions on symptoms of depression, anxiety, and psychological distress in adult populations. The study included 97 systematic reviews comprising 1039 randomized controlled trials and 128,119 participants. The results showed that physical activity had medium effects on depression, anxiety, and psychological distress compared to usual care across all populations. Higher-intensity physical activity was associated with greater improvements in symptoms, and the effectiveness of physical activity interventions diminished with longer-duration interventions. The authors concluded that physical activity is highly beneficial for improving symptoms of depression, anxiety, and distress in a wide range of adult populations, including those with mental health disorders and chronic diseases, and should be a mainstay approach in their management.

Article: Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews – British Journal of Sports Medicine (link to abstract – $ for full-text)

News Release: Exercise more effective than medicines to manage mental health – University of South Australia

Commentary from the authors: Exercise is even more effective than counselling or medication for depression. But how much do you need? – The Conversation

 

Commentary on Twitter

 


An overview of systematic reviews and meta-analyses on the effect of medication interventions targeting polypharmacy for frail older adults

3 Mar, 2023 | 14:07h | UTC

Summary: This overview of published systematic reviews examined the effectiveness of medication reviews on managing polypharmacy in frail older adults. The overview identified 10 systematic reviews, which included 154 studies. Medication reviews were the most common intervention, and the evidence suggests that they help reduce inappropriate medication use in frail older adults, but their impact on frailty scores and hospital admission is unclear. Pharmacist-led medication interventions were the most common, reducing inappropriate prescriptions in various settings. Tools, such as clinical decision-making computer support tools, were also found to be effective. The evidence quality ranged from moderate to critically low, highlighting the need for further research to establish if interventions directed at polypharmacy could have an impact on frailty syndromes.

Article: An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults – Journal of Clinical Medicine

Related:

Physician-led medication reviews in polypharmacy patients treated with at least 12 medications in a type 2 diabetes outpatient clinic: a randomised trial – Diabetic Medicine

RCT | A deprescribing intervention reduced medication burden among older adults in post-acute care

Achieving sustainable healthcare through deprescribing of unnecessary medications: making sense of the evidence – Cochrane Library

Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis – Health Technology Assessment

Barriers and facilitators to deprescribing of cardiovascular medications: a systematic review – BMJ Open

A National Modified Delphi Consensus Process to Prioritize Experiences and Interventions for Antipsychotic Medication Deprescribing Among Adult Patients With Critical Illness – Critical Care Explorations

Deprescribing proton pump inhibitors – Australian Journal of General Practice

Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis – Age and Ageing

Optimizing Medication Use in Older Adults With Rheumatic Musculoskeletal Diseases: Deprescribing as an Approach When Less May Be More – ACP Open Rheumatology

Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy – European Heart Journal – Cardiovascular Pharmacotherapy

Deprescribing in Older Adults with Cardiovascular Disease – Journal of the American College of Cardiology

Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology

Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports

How-to guide for medication reviews in older adults with cancer: A Young International Society of Geriatric Oncology and Nursing & Allied Health Interest Group initiative – Journal of Geriatric Oncology

Deprescribing in Palliative Cancer Care – Life

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360

Process evaluation of implementation strategies to reduce potentially inappropriate medication prescribing in older population: A scoping review – Research in Social and Administrative Pharmacy

AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review – Gastroenterology

Development of a Metric to Detect and Decrease Low-Value Prescribing in Older Adults – JAMA Network Open

The MedSafer Study—Electronic Decision Support for Deprescribing in Hospitalized Older Adults: A Cluster Randomized Clinical Trial – JAMA Internal Medicine

Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models – Drugs & Aging

Deprescribing in palliative patients with cancer: a concise review of tools and guidelines – Supportive Care in Cancer

Prescribing practices, patterns, and potential harms in patients receiving palliative care: A systematic scoping review – Exploratory Research in Clinical and Social Pharmacy

A narrative review of evidence to guide deprescribing among older adults – Journal of General and Family Medicine

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens – The Lancet Health Longevity

Polypharmacy Management in Older Patients – Mayo Clinic Proceedings

Psychopharmacological Treatment in Older People: Avoiding Drug Interactions and Polypharmacy – Deutsches Ärzteblatt international

Eliminating Medication Overload: A National Action Plan – Lown Institute

International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): Position Statement and 10 Recommendations for Action – Drugs & Aging

Common ED Medication Errors: Polypharmacy – emDocs

Current and future perspectives on the management of polypharmacy – BMC Family Practice

Routine deprescribing of chronic medications to combat polypharmacy – Therapeutic Advances in Drug Safety

Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international

Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety

 


Perspective | The other long Covid: the pandemic took young people’s present. What will it do to their future?

3 Mar, 2023 | 14:05h | UTC

The other long Covid: The pandemic took young people’s present. What will it do to their future? – Vox

 


Nitrous oxide-induced subacute combined degeneration of the cord: diagnosis and treatment

3 Mar, 2023 | 14:01h | UTC

Nitrous oxide-induced subacute combined degeneration of the cord: diagnosis and treatment – Practical Neurology

News Release: Surge in nitrous oxide abuse: New guidelines to help clinicians recognise cases and prevent spinal cord damage – Queen Mary University of London

 


Drug allergy | A 2022 practice parameter update

3 Mar, 2023 | 13:59h | UTC

Drug allergy: A 2022 practice parameter update – The Journal of Allergy and Clinical Immunology

 


RCT | Reducing social media use improves appearance and weight esteem in youth with emotional distress

3 Mar, 2023 | 14:04h | UTC

Summary: The article discusses a randomized controlled trial conducted on 220 participants aged 17-25 to examine the effects of reducing smartphone social media use (SMU) on appearance and weight esteem in youth with emotional distress. The participants were divided into an intervention group (limited to 1 hr/day SMU) and a control group (unrestricted SMU). The study found that reducing SMU improved appearance and weight esteem in the intervention group, while the control group showed no significant change. The authors concluded that reducing SMU may be a feasible and effective method of improving body image in a vulnerable youth population and should be evaluated as a potential component in treating body image-related disturbances. It is worth noting, however, that the impossibility of blinding participants and the subjective nature of the endpoints make it difficult to draw definitive conclusions on the subject.

Article: Reducing Social Media Use Improves Appearance and Weight Esteem in Youth With Emotional Distress – American Psychological Association

News Release: Reducing social media use significantly improves body image in teens, young adults – American Psychological Association

Commentary: How to help young people limit screen time — and feel better about how they look – NPR

 


Severity and impact of accidental bowel leakage two decades after no, one, or two obstetrical sphincter injuries

3 Mar, 2023 | 13:56h | UTC

Summary: This study investigated the long-term severity and subjective impact of anal incontinence among women who had experienced 1 or 2 consecutive obstetrical anal sphincter injuries compared with those without injuries. The study used prospectively registered data and a questionnaire to analyze outcomes, including the frequency of fecal and gas incontinence, the impact on daily life, and the effect on other pelvic floor disorders. The results showed that the severity and impact of anal incontinence doubled and quadrupled in women with 1 or 2 consecutive sphincter injuries, respectively, compared with those without injury. The second sphincter injury had an equally large additive effect compared to the first injury. However, the study found that 1 or 2 sphincter injuries did not affect other pelvic floor disorders or lower urinary tract symptoms compared to women without injury.

Article: Severity and impact of accidental bowel leakage two decades after no, one, or two sphincter injuries – American Journal of Obstetrics & Gynecology

News Release: Decades-long suffering from obstetric injuries – University of Gothenburg

 


Consensus Statement on the definition and classification of metabolic hyperferritinemia

3 Mar, 2023 | 13:58h | UTC

Consensus Statement on the definition and classification of metabolic hyperferritinaemia – Nature Reviews Endocrinology (if the link is paywalled, try this one)

 


RCT | Immediate vs. delayed urinary catheter removal following non-hysterectomy benign gynecological laparoscopy

3 Mar, 2023 | 13:55h | UTC

Summary: This randomized clinical trial compared the rates of urinary retention and postoperative urinary tract infection between women with immediate vs. delayed removal of the indwelling catheter following benign gynecological laparoscopic surgery, excluding hysterectomy, pelvic floor, or surgeries with concomitant bowel procedures. A total of 693 women aged 18 years or older were randomized to immediate or delayed urinary catheter removal. The results showed an increased risk of urinary retention with immediate vs. delayed removal of the urinary catheter (8.2% vs. 4.2%), highlighting the need to ensure patients report normal voiding and emptying before discharge to reduce the need for readmission for management of urinary retention.

Article: Immediate versus delayed urinary catheter removal following non-hysterectomy benign gynecological laparoscopy: a randomised trial – BJOG (link to abstract – $ for full-text)

Related: Feasibility of immediate removal of urinary catheter after laparoscopic gynecological surgery for benign diseases: A meta-analysis of randomized controlled trials – Obstetrics & Gynecology (link to abstract – $ for full-text)

 


Perspective | MRI for all: portable low-field scanners could revolutionize medical imaging in nations rich and poor — if doctors embrace them

3 Mar, 2023 | 13:53h | UTC

MRI FOR ALL: Portable low-field scanners could revolutionize medical imaging in nations rich and poor—if doctors embrace them – Science (a few articles per month are free)

 


Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland

3 Mar, 2023 | 13:51h | UTC

Summary: The study aimed to determine the association between maternal diabetes and overweight/obesity and the risk of congenital heart defects (CHDs) in offspring. The study analyzed data from all children born in Finland between 2006 and 2016 and their mothers. Maternal type 1 diabetes (T1DM) was found to be associated with a significantly increased risk for any CHD, with an odds ratio of 3.71, whereas maternal overweight and obesity were associated with only a slightly increased risk for complex defects and left ventricular outflow tract obstruction. Maternal diabetes was responsible for 3.0% of offspring’s CHD, while maternal overweight and obesity were responsible for 0.7%, indicating weaker associations between maternal overweight and obesity and CHD in the offspring than previously reported.

[Preprint] Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland – medRxiv

 

Commentary from the author on Twitter

 


SR | Interventions for preventing and treating kidney disease in IgA vasculitis

3 Mar, 2023 | 13:47h | UTC

Interventions for preventing and treating kidney disease in IgA vasculitis – Cochrane Library

Summary: Interventions for preventing and treating kidney disease in IgA vasculitis (Henoch-Schönlein Purpura) – Cochrane Library

 


Cohort Study | Long-term changes in the size of pituitary microadenomas

3 Mar, 2023 | 13:49h | UTC

Summary: The prevalence of pituitary lesions in radiologic studies is estimated to be 10% to 38.5%. However, it is unclear how frequently incidental lesions should be monitored by serial pituitary MRI. A retrospective longitudinal cohort study was conducted to evaluate changes in pituitary microadenomas over time. During the study period (from 2003 to 2021), 414 patients with pituitary microadenomas were identified, and 177 patients had more than 1 MRI. Approximately two-thirds of the microadenomas demonstrated no change or a decrease in size, while the rest exhibited a slow growth rate, indicating that less frequent monitoring could be considered safe.

Article: Long-Term Changes in the Size of Pituitary Microadenomas – Annals of Internal Medicine (link to abstract – $ for full-text)

News Release: Fewer surveillance MRIs may be appropriate for patients with incidental pituitary lesions – American College of Physicians

 

Commentary on Twitter

 


Cohort Study | Association between a healthy lifestyle and memory decline in older adults

3 Mar, 2023 | 13:44h | UTC

Summary: This study examined the association between a healthy lifestyle and memory decline in older adults over a 10-year period. The study included 29,072 participants aged 60 or older with normal cognition and apolipoprotein E (APOE) genotyping at baseline. Six healthy lifestyle factors were assessed: a healthy diet, regular physical exercise, active social contact, active cognitive activity, never or former smoker, and never drinking alcohol. Participants were categorized into three groups based on their lifestyle factors: favorable, average, and unfavorable. The results showed that participants in the favorable group had slower memory decline than those in the unfavorable group, even in the presence of the APOE ε4 allele. These findings have important implications for public health initiatives to protect older adults against memory decline.

Article: Association between healthy lifestyle and memory decline in older adults: 10 year, population based, prospective cohort study – The BMJ

Editorial: Healthy lifestyles for dementia prevention – The BMJ

News Release: Healthy lifestyle linked to slower memory decline in older adults – BMJ Newsroom

Commentary: Healthful Lifestyle May Slow Memory Loss, Even for APOE Gene Carriers – JAMA

 

Commentary on Twitter

Under a http://creativecommons.org/licenses/by-nc/4.0/ license

 


Review | Practical guide for anticoagulant and antiplatelet reversal in clinical practice

3 Mar, 2023 | 13:42h | UTC

Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice – Pharmacy

 


RCT | Effects of a vibrating capsule for chronic constipation

3 Mar, 2023 | 13:41h | UTC

Randomized Placebo-Controlled Phase 3 Trial of Vibrating Capsule for Chronic Constipation – Gastroenterology (link to abstract – $ for full-text)

Commentary: Researchers reveal the impact of vibrating capsules in chronic constipation patients – News Medical

 


RCT | Baricitinib vs. placebo for systemic lupus erythematosus

3 Mar, 2023 | 13:39h | UTC

Baricitinib for systemic lupus erythematosus: a double-blind, randomised, placebo-controlled, phase 3 trial (SLE-BRAVE-I) – The Lancet (link to abstract – $ for full-text)

See also: Baricitinib for systemic lupus erythematosus: a double-blind, randomised, placebo-controlled, phase 3 trial (SLE-BRAVE-II) – The Lancet (link to abstract – $ for full-text)

Commentary: Benefit of baricitinib for treatment of patients with moderately to severely active SLE is unclear – Monash University

 

Commentary on Twitter

 


SR | Interventions for acute non‐arteritic central retinal artery occlusion

3 Mar, 2023 | 13:36h | UTC

Interventions for acute non‐arteritic central retinal artery occlusion – Cochrane Library

Summary: Treatments for acute central retinal artery occlusion (blockage of the blood supply to the retina of the eye) – Cochrane Library

 

Commentary on Twitter

 


Study shows sudden cardiac arrest during sports activity is rare among older adults

3 Mar, 2023 | 13:38h | UTC

Sudden Cardiac Arrest During Sports Activity in Older Adults – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentaries:

Sports-related sudden cardiac arrest is rare in older adults – Cedars-Sinai Medical Center

Risk of Sports-Related Sudden Cardiac Arrest Low in Older Adults – TCTMD

 


SR | Erythromycin prior to endoscopy for acute upper gastrointestinal hemorrhage

3 Mar, 2023 | 13:33h | UTC

Erythromycin prior to endoscopy for acute upper gastrointestinal haemorrhage – Cochrane Library

Summary: What are the benefits and risks of erythromycin given before endoscopy for people with intestinal bleeding? – Cochrane Library

 


SR | Endovascular therapy vs. medical treatment for symptomatic intracranial artery stenosis

3 Mar, 2023 | 13:35h | UTC

Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis – Cochrane Library

 


SR | Neoadjuvant treatment for stage III and IV cutaneous melanoma

3 Mar, 2023 | 13:32h | UTC

Neoadjuvant treatment for stage III and IV cutaneous melanoma – Cochrane Library

Summary: What are the benefits and risks of neoadjuvant treatment (drug treatment prior to surgery to remove a tumour) for melanoma, a type of skin cancer? – Cochrane Library

 


RCT | Efficacy of Fezolinetant in moderate-to-severe vasomotor symptoms associated with menopause

3 Mar, 2023 | 13:28h | UTC

Efficacy and Safety of Fezolinetant in Moderate-to-Severe Vasomotor Symptoms Associated With Menopause: A Phase 3 RCT – The Journal of Clinical Endocrinology & Metabolism

 


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