Daily Archives: March 20, 2023
RCT | Closed-loop insulin delivery system enhances blood sugar control in young children with type 1 diabetes
20 Mar, 2023 | 13:54h | UTCSummary: The study enrolled 102 young children between ages 2 and 5, randomized in a 2:1 ratio to either a closed-loop control system of insulin delivery (“artificial pancreas”) or a standard care comparison group. During the 13 weeks of study follow-up, participants in the artificial pancreas group spent 12% more time within their target blood glucose range compared to the standard care group.
The closed-loop group experienced two cases of severe hypoglycemia, while the standard-care group had one case. In the closed-loop group, one case of diabetic ketoacidosis occurred due to a problem with the insulin pump.
Article: Trial of Hybrid Closed-Loop Control in Young Children with Type 1 Diabetes – New England Journal of Medicine (link to abstract – $ for full-text)
News Releases:
Commentary on Twitter
In children 2 to younger than 6 years of age with type 1 diabetes, a closed-loop control system was associated with a greater percentage of time in the target glycemic range than standard care. https://t.co/rAOLXRNuub#pediatrics #T1D pic.twitter.com/Nzwl3aFr1w
— NEJM (@NEJM) March 17, 2023
Cohort Study | Early childhood respiratory infections linked to increased risk of premature respiratory disease mortality in adulthood
20 Mar, 2023 | 13:52h | UTCSummary: The study aimed to determine the link between lower respiratory tract infections (LRTIs) in early childhood and premature adult death from respiratory disease. The study used data from a nationally representative cohort recruited at birth in Great Britain in 1946 and followed participants across eight decades.
After adjusting for multiple markers of childhood social disadvantage and adult smoking, the study found that individuals who had an LRTI by age 2 years were 93% more likely to die prematurely from respiratory disease as adults than those who did not have early childhood LRTI, accounting for one-fifth of these deaths and an estimated 179,188 excess deaths across England and Wales between 1972 and 2019.
However, it is important to note that this observational study cannot establish causality, but rather suggests that early childhood LRTI is a marker of increased risk of respiratory-cause deaths later in life.
News Release: Respiratory disease in early childhood linked to higher risk of death for adults – Imperial College London
Commentaries:
Childhood bronchitis, pneumonia tied to premature respiratory death in adults – CIDRAP
Early childhood lower respiratory tract infection: a key determinant of premature adult respiratory mortality – The Lancet (free registration required)
Commentary from the author on Twitter (thread – click for more)
1/ Great to see the interest in our @TheLancet paper linking lower respiratory tract infections in early childhood to the risk of premature adult death from respiratory disease across Great Britain.
A🧵exploring our study (1/21)
Full paper link below:https://t.co/LlGQJC1wAP
— James P Allinson (@JPAllinson) March 11, 2023
COVID-19 pandemic measures may have caused reduced cognitive abilities among German students, study shows
20 Mar, 2023 | 13:50h | UTCSummary: This study investigated the impact of the COVID-19 pandemic on the cognitive abilities of secondary school students in Germany. The study compared the intelligence test performance of 424 students in Grades 7 to 9, tested after the first six months of the pandemic, to the results of two highly comparable student samples tested in 2002 and 2012.
The study found that the 2020 sample had substantially lower intelligence test scores than both the 2002 and 2012 samples. The study also retested the 2020 sample after another full school year of COVID-19-affected schooling in 2021 and found no signs of catching up to previous cohorts or further declines in cognitive performance.
It can be inferred from the article that the lower intelligence test scores of the 2020 sample may have been caused by the prolonged disruption of regular schooling due to the COVID-19 pandemic, including lockdowns and school closures.
The study highlights the potential negative impact of the COVID-19 pandemic on the cognitive abilities of secondary school students and suggests that these consequences should be taken into account when conducting intelligence assessments in the post-pandemic era. It also recommends that appropriate compensatory measures be implemented to address any learning loss or cognitive deficits that may have resulted from the disruption of regular schooling during the pandemic.
EULAR recommendations for the management of ANCA-associated vasculitis
20 Mar, 2023 | 13:47h | UTC
Review | Diseases affecting middle-aged and elderly individuals with trisomy 21
20 Mar, 2023 | 13:44h | UTC
Opinion | Irreconcilable differences: the divorce between response rates, progression-free survival, and overall survival
20 Mar, 2023 | 13:45h | UTC
COVID-19-associated mucormycosis | A systematic review and meta-analysis of 958 cases
20 Mar, 2023 | 13:43h | UTC
RCT | A 10-y comparison of paclitaxel-coated balloon, paclitaxel-eluting stent, and plain balloon angioplasty for DES in-stent restenosis
20 Mar, 2023 | 13:42h | UTCSummary: The ISAR-DESIRE 3 trial aimed to compare the 10-year efficacy and safety of plain balloon (PB), paclitaxel-coated balloon (PCB), and paclitaxel-eluting stent (PES) for percutaneous coronary intervention (PCI) of drug-eluting stent (DES) in-stent restenosis (ISR).
A total of 402 patients with DES-ISR were randomized to the different treatment groups: 134 patients to PB angioplasty (160 lesions), 137 patients to PCB angioplasty (172 lesions), and 131 patients to PES implantation (168 lesions).
PCB angioplasty and PES implantation had comparable 10-year results in the device-oriented composite endpoint including cardiac death, target vessel myocardial infarction, target lesion thrombosis, or target lesion revascularization, and significantly reduced the incidence of repeat target lesion revascularization compared to PB angioplasty alone. However, an excess of mortality within 5 years associated with PES warrants further investigation.
Article: Coronary artery restenosis treatment with plain balloon, drug-coated balloon, or drug-eluting stent: 10-year outcomes of the ISAR-DESIRE 3 trial – European Heart Journal (free for a limited period)
Commentary on Twitter
Coronary artery restenosis treatment with plain balloon, drug-coated balloon, or drug-eluting stent: 10-year outcomes of the ISAR-DESIRE 3 trial 👉https://t.co/NHQpCIaNod #EHJ #ESCYoung @ehj_ed @rladeiraslopes
— European Society of Cardiology Journals (@ESC_Journals) March 8, 2023
SR | Oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation
20 Mar, 2023 | 13:41h | UTCSummary: This systematic review and meta-analysis assessed the efficacy of Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation (AF). The review included nine randomized controlled trials involving 3,269 participants.
The analysis found that Class I and/or III antiarrhythmic drugs may reduce the recurrence of atrial tachyarrhythmias at 0 to 3 months and likely reduce recurrence at > 3 to 6 months. However, beyond six months, the evidence is uncertain, and the benefit of antiarrhythmic drugs may not persist. Additionally, the use of these drugs post-ablation likely reduces hospitalizations for atrial tachyarrhythmias by approximately 57% at 0 to 3 months.
The use of Class I and/or III antiarrhythmic drugs did not increase the risk of thromboembolic events, myocardial infarction, all-cause mortality, or the need for repeat ablation.
RCT | Intermittent IV ibuprofen reduces morphine consumption and provides pain relief after surgery
20 Mar, 2023 | 13:39h | UTCSummary: The article describes a randomized, placebo-controlled, double-blind clinical trial to evaluate the efficacy and safety of different doses of intravenous ibuprofen (IVIB) in treating acute postoperative pain. The trial involved patients who underwent abdominal or orthopedic surgery and were randomized to placebo, IVIB 400 mg, or IVIB 800 mg. The first dose was given intravenously 30 minutes before surgery ended, followed by IV administration every 6 hours for a total of 8 doses.
The study found that IV administration of ibuprofen 400 mg or 800 mg significantly reduced morphine consumption and relieved pain without increasing the incidence of adverse events.
The study’s strengths were its multicenter, randomized, controlled, and prospective design. However, the extensive list of exclusion criteria suggests that the study was made in a relatively healthy population, making it difficult to extrapolate the safety results for more fragile patients.
White Paper | Best practices in the communication and management of actionable incidental findings in ED imaging
20 Mar, 2023 | 13:34h | UTC
Study | Public health policies should recommend introducing peanut products to infants at 4-6 months of age to prevent peanut allergy
20 Mar, 2023 | 13:33h | UTCCommentary: Expert reaction to research on giving peanut products to babies – Science Media Centre
Related study: Early Introduction of Allergenic Foods Can Prevent Food Allergies in High Risk Infants
Related Guidelines:
AAP Updated Recommendations for Dietary Interventions to Prevent Atopic Disease
Timing of introduction of allergenic solids for infants at high risk – Canadian Paediatric Society
Commentary from the author on Twitter
Latest paper from #LEAPStudy is now published in @JACIonline. We have looked at what happens if peanut products are introduced into the infant diet at different ages across the whole population. https://t.co/zpOlrNHOSihttps://t.co/xDIgYjezyS
More details below. @GoAllergy 1/12 pic.twitter.com/jY5MvdJ2AZ— Graham Roberts (@ProfGRoberts) January 12, 2023
Review | The latent phase of labor
20 Mar, 2023 | 13:28h | UTCThe latent phase of labor – American Journal of Obstetrics & Gynecology
Commentary on Twitter
AJOG Expert Review in Labor: The latent phase of labor- Management of a prolonged latent phase of labor https://t.co/ep0rPrldAn @acog @RCObsGyn @SOGCorg @ranzcog @ISUOG pic.twitter.com/fm7cUaQsOr
— AJOG (@AJOG_thegray) March 17, 2023
Study shows inflammation is a stronger predictor of CV events than cholesterol in patients receiving statin therapy
20 Mar, 2023 | 13:31h | UTCInflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials – The Lancet (link to abstract – $ for full-text)
Commentaries:
CRP More Predictive of Future Events Than LDL in Statin-Treated Patients – TCTMD
Critical care outreach teams: a service without walls
20 Mar, 2023 | 13:27h | UTCCritical care outreach teams: a service without walls – Intensive Care Medicine
Commentary on Twitter
Critical care outreach teams
🏥 unanswered questions
🏥 future directions
Early recognizing deterioration/implementing time-critical interventions save lives! CCOTs offer holistic, supportive approach pre/post #ICU, beyond clinical assessment.#FOAMcc
🖇️ https://t.co/s9F9v25cNO pic.twitter.com/5uwPvZ04Ye— Intensive Care Medicine (@yourICM) March 18, 2023
Perspective | Trials on oxygen targets in the critically ill patients: do they change our knowledge and practice?
20 Mar, 2023 | 13:26h | UTCTrials on oxygen targets in the critically ill patients: do they change our knowledge and practice? – Intensive Care Medicine (if the link is paywalled, try this one)
Commentary on Twitter
💨 Trials on liberal/conservative O2 targets in #ICU: conflicting results! Many studies in progress. Waiting for evidence, consider O2 as powerful drug to be carefully titrated, for most of critically ill pts in normoxia-mild hyperoxaemia range. #FOAMcc
🖇️ https://t.co/ECWgmQkmAZ pic.twitter.com/gIwB9ax0k1— Intensive Care Medicine (@yourICM) March 15, 2023
Brief Review | High-risk pulmonary embolism in the ICU
20 Mar, 2023 | 13:24h | UTCHigh-risk pulmonary embolism in the intensive care unit – Intensive Care Medicine (free for a limited period)
Review | Choosing the best endoscopic approach for post-bariatric surgical leaks and fistulas
20 Mar, 2023 | 13:23h | UTC
Review | Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis
20 Mar, 2023 | 13:21h | UTCCardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis – European Heart Journal
Review | Neuromonitoring in critically ill patients
20 Mar, 2023 | 13:18h | UTCNeuromonitoring in Critically Ill Patients – Critical Care Medicine (free for a limited period)
Related: The importance of neuromonitoring in non-brain injured patients – Critical Care
M-A | Primary prevention of cardiovascular disease in women with a Mediterranean diet
20 Mar, 2023 | 13:20h | UTCNews Release: Mediterranean diet may cut women’s CVD and death risk by nearly 25% – BMJ Newsroom
Commentary:
Expert reaction to study looking at Mediterranean diet and women’s cardiovascular disease and death risk – Science Media Centre (Recommended reading – “Observational studies of nutrition have been notoriously misleading… Nutritional measures are strongly patterned by social factors and behavioral dispositions, leading to very substantial confounding”)
Review | Surviving sepsis campaign
20 Mar, 2023 | 13:17h | UTCSurviving Sepsis Campaign – Critical Care Medicine
Cross-sectional study | Impact of different alcoholic beverages on serum urate levels
20 Mar, 2023 | 13:16h | UTC
Commentary on Twitter
Beer and wine was associated with high and moderate increases in serum urate levels, respectively; sake was associated with a modest increase in serum urate levels, in patients getting routine checkups in Japan. https://t.co/J8OqKJI9fQ
— JAMA Network Open (@JAMANetworkOpen) March 17, 2023
M-A | Artificial intelligence for hip fracture detection and outcome prediction
20 Mar, 2023 | 13:13h | UTC
M-A | Global prevalence of diabetic retinopathy in pediatric type 2 diabetes
20 Mar, 2023 | 13:12h | UTC