Daily Archives: March 14, 2023
RCT | Intrapartum azithromycin fails to reduce neonatal sepsis and death
14 Mar, 2023 | 14:00h | UTCSummary: This randomized controlled trial aimed to evaluate the effectiveness of administering azithromycin during labor to reduce neonatal sepsis and mortality. The randomized trial involved 11,983 birthing parents and their infants in West Africa.
The study found no significant difference in the incidence of neonatal sepsis or mortality between the azithromycin and placebo groups. On the other hand, the rate of non-invasive infections, including skin infections in newborns, and mastitis and puerperal fever in parents, was lower in the azithromycin group in the following four weeks.
The authors concluded that these results do not support the routine introduction of oral intrapartum azithromycin to reduce neonatal sepsis or mortality. However, it is important to notice that a recent large study published in the New England Journal of Medicine showed conflicting results.
Article: Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentaries:
Azithromycin during labor doesn’t reduce sepsis, mortality in newborns – CIDRAP
Effect of antibiotics during pregnancy on neonatal sepsis and mortality – MedicalResearch.com
Related study with conflicting results: Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Single-dose antibiotic prevents maternal sepsis and death – NIH News
Commentaries:
In large study, a single antibiotic dose slashed rate of sepsis in childbirth – STAT
Dose of azithromycin found to cut risk of maternal death, sepsis in childbirth – CIDRAP
Commentary on Twitter
Study results do not support routine introduction of oral intrapartum azithromycin to reduce neonatal sepsis or mortality. https://t.co/yDpg1CCGa2 pic.twitter.com/5Oc4HqZ4sX
— JAMA (@JAMA_current) March 7, 2023
AHA Scientific Statement | Atrial fibrillation occurring during acute hospitalization
14 Mar, 2023 | 14:04h | UTC
RCT | Sotatercept improves exercise capacity in patients with pulmonary arterial hypertension
14 Mar, 2023 | 14:02h | UTCSummary: This multicenter, double-blind randomized trial involved 323 adults with Pulmonary Arterial Hypertension (PAH) who were randomized to receive either subcutaneous sotatercept or placebo every three weeks for 24 weeks.
The primary endpoint was the change from baseline in the 6-minute walk distance. Sotatercept demonstrated a greater improvement in exercise capacity compared to placebo and improved secondary endpoints, including pulmonary vascular resistance and WHO functional class.
Adverse events were more common in the sotatercept group and included epistaxis, dizziness, telangiectasia, increased hemoglobin levels, thrombocytopenia, and increased blood pressure.
Article: Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
STELLAR, ‘Impressive’ Results With Novel Drug Sotatercept in PAH – TCTMD
Scanxiety among adults with cancer: a scoping review to guide research and interventions
14 Mar, 2023 | 13:55h | UTCSummary: The article presents a scoping review of existing literature on scanxiety, which refers to the anxiety and distress experienced by cancer patients before and after medical imaging scans. The authors identified and synthesized findings from 36 articles on scanxiety among adults diagnosed with current or prior cancer.
The authors observed that scanxiety is a prevalent issue throughout the cancer continuum and may be linked to various factors related to the procedure itself or the uncertainty surrounding the possible outcomes of the scans.
The waiting period between the scan procedure and receipt of the results was described as particularly stressful, with participants reporting feeling overwhelmed by negative thoughts and fears about the potential outcomes of the scan. Some participants even found it difficult to focus on daily activities or responsibilities during this time.
The authors suggest that implementing supportive measures during scan experiences, including examining the waiting period between scans and scan results, could enhance the well-being for individuals with cancer who are going through different stages of treatment.
Article: Scanxiety among Adults with Cancer: A Scoping Review to Guide Research and Interventions – Cancers
SR | Environmental interventions can reduce falls in high-risk older adults
14 Mar, 2023 | 13:58h | UTCSummary: Falls and fall-related injuries are common among older adults and can have serious consequences, such as restricting activity or institutionalization. The Cochrane review aimed to assess the effects of environmental interventions, such as fall-hazard reduction, assistive technology, home modifications, and education, on preventing falls in older adults living in the community.
The review included 22 randomized controlled trials from 10 countries involving 8,463 community-residing older people. The study found that home fall-hazard interventions, which involve evaluating potential fall hazards and implementing safety adaptations or behavioral strategies, can reduce the rate of falls by 26% and the number of people who experience one or more falls by 11% in people at a higher risk of falling.
On the other hand, the study did not find any evidence of a decrease in the rate of falls when the interventions were not targeted toward individuals at higher risk. Additionally, the study suggests that these interventions are unlikely to have a significant impact on health-related quality of life, and there may be little or no difference in the risk of fall-related fractures, hospitalizations due to falls, or the rate of falls that require medical attention.
Summary: Reducing fall hazards within the environment – Cochrane Library
Commentary: Preventing falls in older people: new evidence on what helps – Evidently Cochrane
Video | Tutorial explores ways of analyzing data from RCTs, including intention-to-treat, per-protocol, and as-treated analyses
14 Mar, 2023 | 13:53h | UTCGood Intentions to Treat – NEJM Evidence
M-A | Ionizing radiation and cardiovascular disease
14 Mar, 2023 | 13:49h | UTCIonising radiation and cardiovascular disease: systematic review and meta-analysis – The BMJ
News Release: Low dose radiation linked to increased lifetime risk of heart disease – BMJ Newsroom
Review | Orthostatic tachycardia after covid-19
14 Mar, 2023 | 13:48h | UTCOrthostatic tachycardia after covid-19 – The BMJ
Commentary: Key steps for diagnosis and management of orthostatic tachycardia after COVID-19 – News Medical
RCT | Three-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients with aortic stenosis
14 Mar, 2023 | 13:47h | UTCThree-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis – Journal of the American College of Cardiology (link to abstract – $ for full-text)
News Release: Benefits of TAVR Remain Consistent in Patients at Low Surgical Risk at Three Years – American College of Cardiology
Commentary on Twitter
#ACC23/#WCCardio #JACC LBCT SimPub: Data from the Evolut Low Risk trial demonstrated that #TAVR at 3 years showed durable benefits compared with surgery with respect to all-cause mortality or disabling stroke. https://t.co/PtEEFI1P1t#vhdAS #SAVR #CardioTwitter @kashishgoelmd pic.twitter.com/x0milxBGxO
— JACC Journals (@JACCJournals) March 5, 2023
Mortality rates and clinical manifestations of severe hypothyroidism in the ICU: a French multicenter cohort study
14 Mar, 2023 | 13:44h | UTCSummary: This article presents the findings of a retrospective multicenter cohort study conducted over 18 years in 32 French ICUs to investigate severe hypothyroidism (SH) requiring ICU admission.
The study included 82 patients with SH, with thyroiditis and thyroidectomy being the primary causes, and levothyroxine discontinuation, sepsis, and amiodarone-related hypothyroidism being the most frequent triggers.
Patients with SH presented with various clinical symptoms, including hypothermia, hemodynamic failure, and coma, with in-ICU and 6-month mortality rates being 26% and 39%, respectively. The study also found that patients with hemodynamic and respiratory failure on admission to the ICU had a higher likelihood of mortality.
Levothyroxine replacement was provided to all patients, but the administration route and loading dose varied. The authors recommend early diagnosis, prompt levothyroxine administration, and close monitoring of cardiac and hemodynamic parameters for SH patients admitted to the ICU.
SR | Myocardial revascularization in patients with ischemic cardiomyopathy: for whom and how
14 Mar, 2023 | 13:46h | UTC
Risk factors for Carbapenem-Resistant Enterobacterales infections: a matched case-control study
14 Mar, 2023 | 13:43h | UTCSummary: The study aimed to investigate risk factors for infections caused by carbapenem-resistant Enterobacterales (CRE) and identify variables that increase the probability of CRE infection among admitted patients in hospitals with high CRE incidence.
The study was performed in 50 hospitals in Southern Europe from March 2016 to November 2018 and included patients with complicated urinary tract infection, complicated intraabdominal infection, pneumonia, or bacteremia from other sources due to CRE. Control groups were patients with infection caused by carbapenem-susceptible Enterobacterales and non-infected patients, matched according to the same criteria as the CRE group (type of infection, ward, and duration of hospital admission).
The results showed that the main risk factors for CRE infections were previous colonization with CRE, use of urinary catheters, and exposure to broad-spectrum antibiotics.
The study’s findings offer evidence to inform decisions about preventive measures and empirical treatment for patients with suspected CRE infections. Additionally, the study can guide the efficient design of future randomized trials focusing on high-risk patients.
Related:
RCT | Colistin monotherapy vs. combination therapy for carbapenem-resistant organisms
Ultrasound-guided nerve blocks | Suggested procedural guidelines for emergency physicians
14 Mar, 2023 | 13:41h | UTC
Review | Pathogenesis, epidemiology and control of Group A Streptococcus infection
14 Mar, 2023 | 13:38h | UTC
Commentary on Twitter
NEW??Pathogenesis, epidemiology and control of Group A Streptococcus infectionhttps://t.co/XFSKQrTe1P
Brouwer & co. summarize the epidemiological and clinical features of Group A Streptococcus infection, and the molecular mechanisms of GAS virulence and drug resistance. pic.twitter.com/qm23YgnKlg
— Nature Reviews Microbiology (@NatureRevMicro) March 10, 2023
International society of sports nutrition position stand: energy drinks and energy shots
14 Mar, 2023 | 13:39h | UTC
Burden, trends, and inequalities of heart failure globally, 1990 to 2019
14 Mar, 2023 | 13:35h | UTC
Podcast and Brief Review | TIA/Stroke pearls for the hospitalist
14 Mar, 2023 | 13:36h | UTC#385 TIA/Stroke for the Hospitalist featuring Dr. Karima Benameur – The Curbsiders
Adolescent substance use | Objective assessment with hair analysis nearly doubled the estimated prevalence based on self-reported data
14 Mar, 2023 | 13:34h | UTCNews Release: Hair analysis shows child drug use could be twice as high as we think – Taylor & Francis Group
Press release | New technique reduces postoperative complications in prostate cancer surgery
14 Mar, 2023 | 13:33h | UTC
Evidence for harmful cardiovascular effects of ambient ozone: Insights from a multi-city time-series study in China
14 Mar, 2023 | 13:32h | UTCOzone pollution and hospital admissions for cardiovascular events – European Heart Journal
News Release: Ozone pollution is linked with increased hospitalizations for cardiovascular disease – European Society of Cardiology
Perspective | Embracing complexity in sepsis
14 Mar, 2023 | 13:31h | UTCEmbracing complexity in sepsis – Critical Care
Feasibility and efficacy of microwave ablation in the treatment of papillary thyroid microcarcinoma: a prospective cohort study
14 Mar, 2023 | 13:30h | UTCMicrowave Ablation for Papillary Thyroid Microcarcinoma with and without US-detected Capsule Invasion: A Multicenter Prospective Cohort Study – Radiology (link to abstract – $ for full-text)
Retrospective Cohort | Arrhythmogenic cardiotoxicity associated with contemporary treatments of lymphoproliferative disorders
14 Mar, 2023 | 13:27h | UTC
Review | Role of precision medicine in obstructive sleep apnea
14 Mar, 2023 | 13:28h | UTCRole of precision medicine in obstructive sleep apnoea – BMJ Medicine
Commentary on Twitter
#Review: Role of precision medicine in obstructive sleep #apnoea ▶️https://t.co/OnxOHR2F6T#BMJMedicine pic.twitter.com/GUT3dKkfvL
— BMJMedicine (@BMJMedicine) March 9, 2023
Perspective | How I prescribe prolonged intermittent renal replacement therapy
14 Mar, 2023 | 13:26h | UTCHow I prescribe prolonged intermittent renal replacement therapy – Critical Care