Daily Archives: March 29, 2023
Study shows a slight breast cancer risk increase with progestogen-only birth control, comparable to combined oral methods
29 Mar, 2023 | 13:35h | UTCSummary: A UK study and meta-analysis examined breast cancer risk linked to hormonal contraceptives, emphasizing progestagen-only contraceptives in premenopausal women. Utilizing a nested case-control design with the Clinical Practice Research Datalink (CPRD), a primary care database, the study included 9,498 women under 50 diagnosed with invasive breast cancer between 1996 and 2017, and 18,171 closely matched controls. The meta-analysis merged CPRD findings with 12 observational studies on progestagen-only preparations.
The results revealed that current or recent use of combined oral contraceptives, oral progestagen-only contraceptives, injectable progestagen, and progestagen intrauterine devices all led to a similar increase in breast cancer risk. The 15-year absolute excess risk associated with five years of oral combined or progestagen-only contraceptive use ranged from 8 per 100,000 users aged 16-20 to 265 per 100,000 users aged 35-39. The study concluded that both contraceptive types were linked to a slight breast cancer risk increase, and these risks must be weighed against the benefits of contraceptive use during childbearing years.
News Release: Study finds similar association of progestogen-only and combined hormonal contraceptives with breast cancer risk – PLOS
M-A | Limited evidence for analgesic effectiveness in acute low back pain treatment
29 Mar, 2023 | 13:32h | UTCSummary: The objective of this systematic review and network meta-analysis was to assess the effectiveness and safety of various analgesic medicines for treating acute non-specific low back pain. After examining 98 randomized controlled trials with over 15,000 participants, the study found that the quality of evidence for the effectiveness and safety of these medications is low or very low.
Some analgesic medicines showed potential in reducing pain intensity, but the evidence was limited due to trial risk of bias and imprecision in effect estimates. Furthermore, certain medications might increase the risk of adverse events during treatment, with evidence ranging from moderate to very low confidence.
Given the lack of high-quality evidence, clinicians and patients are advised to be cautious when using analgesic medicines for acute non-specific low back pain. More robust head-to-head comparison trials are needed to provide clearer guidance on the best course of treatment.
News Release: Study finds “considerable uncertainty” around effectiveness and safety of analgesics for low back pain – BMJ Newsroom
Commentary from the author on Twitter (thread – click for more)
Out today in @bmj_latest.
We found “considerable uncertainty” around the effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain.
Available at https://t.co/PeOmEOeJyJ
Thread ? pic.twitter.com/T8YDNGhhME
— Michael Wewege (@mawewege) March 22, 2023
Review | Cerebrovascular manifestations of SARS-CoV-2
29 Mar, 2023 | 13:29h | UTC
Alcohol minimum unit pricing in Scotland led to substantial decrease in alcohol-attributable deaths and hospitalizations
29 Mar, 2023 | 13:28h | UTCNews Release: Minimum unit pricing for alcohol associated with a 13% decrease in deaths from alcohol consumption in Scotland – Lancet
Commentaries:
Minimum pricing averts alcohol deaths, study claims – BBC
Scotland’s minimum pricing linked to 13% drop in alcohol-related deaths, study finds – The Guardian
Commentary on Twitter (thread – click for more)
Minimum unit pricing for #alcohol was introduced in Scotland in 2018 (50p per unit) with the aim of reducing alcohol consumption in the heaviest drinkers.
A new study analyses the impact of the policy on alcohol-specific hospitalisations and deaths. https://t.co/ehoHjbc8lw
— The Lancet (@TheLancet) March 21, 2023
M-A | Aggressive IV hydration may increase mortality risk in severe acute pancreatitis
29 Mar, 2023 | 13:26h | UTCSummary: This systematic review and meta-analysis investigated the outcomes of aggressive and non-aggressive intravenous hydration in patients with severe and non-severe acute pancreatitis (AP). The study included nine randomized controlled trials with a total of 953 participants.
The findings revealed that aggressive intravenous hydration significantly increased mortality risk in severe AP cases, and fluid-related complication risk in both severe and non-severe AP cases. However, the study has some limitations, as only one study with 249 participants was judged to have a low risk of bias in all domains, while the remaining eight studies had non-low risk of bias, raising concerns about the reliability of the findings.
Despite these concerns, the findings still suggest that more conservative intravenous fluid resuscitation protocols for AP may be preferable. Further research with more rigorous study designs is needed to provide robust evidence on the effectiveness of different intravenous hydration strategies in treating acute pancreatitis.
Review | Recompensation in cirrhosis: current evidence and future directions
29 Mar, 2023 | 13:24h | UTCRecompensation in Cirrhosis: Current Evidence and Future Directions – Journal of Clinical and Experimental Hepatology (free for a limited period)
SR | Diagnostic accuracy of heart auscultation for detecting valve disease
29 Mar, 2023 | 13:23h | UTC
SR | Effect of antenatal corticosteroid administration-to-birth interval on maternal and newborn outcomes
29 Mar, 2023 | 13:22h | UTC
FIGO Good Practice Recommendations on the use of progesterone in the management of recurrent first-trimester miscarriage
29 Mar, 2023 | 13:20h | UTC
Review | Supplemental oxygen and noninvasive ventilation
29 Mar, 2023 | 13:18h | UTCSupplemental oxygen and noninvasive ventilation – European Respiratory Review
M-A | Effects of dexmedetomidine on postoperative sleep quality
29 Mar, 2023 | 13:17h | UTC
SR | Anti‐vascular endothelial growth factor for proliferative diabetic retinopathy
29 Mar, 2023 | 13:15h | UTCAnti‐vascular endothelial growth factor for proliferative diabetic retinopathy – Cochrane Library
Phase 2b RCT | Liposomal irinotecan plus fluorouracil/leucovorin for patients with previously treated metastatic biliary tract cancer
29 Mar, 2023 | 13:14h | UTCTreatment With Liposomal Irinotecan Plus Fluorouracil and Leucovorin for Patients With Previously Treated Metastatic Biliary Tract Cancer: The Phase 2b NIFTY Randomized Clinical Trial – JAMA Oncology (link to abstract – $ for full-text)
Commentary on Twitter
Final analysis of NIFTY trial demonstrates significant improvement of PFS & OS with use of nal-IRI plus 5-FU/LV compared to 5-FU/LV in patients with previously treated advanced biliary tract cancer. https://t.co/WrZ3GtXYxP #GICSM pic.twitter.com/BqxSbBG9dv
— JAMA Oncology (@JAMAOnc) March 23, 2023
Podcast | Diabetes updates
29 Mar, 2023 | 13:09h | UTC#387: Diabetes Updates with Dr. Marie McDonnell: New Tools for the New Rules – The Curbsiders
Cohort Study | Evaluating 5 creatinine-based formulas for eGFR estimation in older patients
29 Mar, 2023 | 13:12h | UTC
Commentary on Twitter
5 commonly-used creatinine-based equations provided different eGFR estimates in older adults in Sweden. BIS equation outperformed others in predicting 15-year mortality, but its accuracy was reduced in subgroups of low muscle mass and high age. https://t.co/DOJmp4HzZn
— JAMA Network Open (@JAMANetworkOpen) March 23, 2023
A syndrome-specific antibiotic stewardship intervention reduced antipseudomonal antibiotic use in diabetic foot infections
29 Mar, 2023 | 13:10h | UTC
Podcast | Pears in primary aldosteronism, mineralocorticoid receptor antagonists, and renovascular hypertension
29 Mar, 2023 | 13:07h | UTC
RCT | Effects of Docetaxel as a radiosensitizer in patients with head and neck cancer, unsuitable for cisplatin-based chemoradiation
29 Mar, 2023 | 13:05h | UTCResults of Phase III Randomized Trial for Use of Docetaxel as a Radiosensitizer in Patients With Head and Neck Cancer, Unsuitable for Cisplatin-Based Chemoradiation – Journal of Clinical Oncology (link to abstract – $ for full-text)
Editorial: Good Radiosensitizer Hunting – Journal of Clinical Oncology
Commentaries:
Docetaxel Added to Radiation Provides DFS, OS Benefit in Cisplatin-Ineligible HNSCC – OncLive
Consensus Paper | Diagnosis and treatment of anticancer drug-induced interstitial lung disease
29 Mar, 2023 | 13:04h | UTC
Cohort Study | Risk of liver fibrosis associated with long-term methotrexate therapy may be overestimated
29 Mar, 2023 | 13:02h | UTC
SR | Local corticosteroid injection versus placebo for carpal tunnel syndrome
29 Mar, 2023 | 13:00h | UTCLocal corticosteroid injection versus placebo for carpal tunnel syndrome – Cochrane Library
Summary: Local steroid injection for carpal tunnel syndrome – Cochrane Library
Commentary on Twitter
Local steroid injection for #CarpalTunnel syndrome @CochraneNMD systematic review looks at the evidence from 9 studies involving 639 people.
'Probably improves symptoms & function for up to six months.'
Read the full @CochraneLibrary review: https://t.co/4z5euxpQqE pic.twitter.com/VEy0VUNxV8
— Cochrane UK (@CochraneUK) February 4, 2023
Cohort Study | Associations between betablockers and psychiatric and behavioral outcomes
29 Mar, 2023 | 12:57h | UTCNews Release: Use of β-blockers linked with reductions in violence – News Medical/PLOS
Commentaries:
Beta blockers: how these common heart medications may reduce the risk of violence – The Conversation
Expert reaction to study looking at beta-blockers and lower rates of violence – Science Media Centre
M-A | Factors associated with post-treatment control of viral load in HIV-infected patients
29 Mar, 2023 | 12:56h | UTC
Plasma D-Dimer may be useful in the diagnosis of periprosthetic joint infection
29 Mar, 2023 | 12:33h | UTCPlasma D-Dimer Is Noninferior to Serum C-Reactive Protein in the Diagnosis of Periprosthetic Joint Infection – The Journal of Bone and Joint Surgery (link to abstract – $ for full-text)
News Release: D-dimer blood test shows value in detecting prosthetic joint infections – Wolters Kluwer