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Daily Archives: April 3, 2023

Single-arm study | Transcatheter arterialization of deep veins may help avoid amputation in chronic limb-threatening ischemia

3 Apr, 2023 | 14:03h | UTC

Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

New procedure helps patients avoid leg amputation – Vanderbilt University

PROMISE II: Flow-Diverting Procedure May Save Limbs in CLTI – TCTMD

Transcatheter Arterialization Could Revolutionize Treatment of Limb-Threatening Ischemia – HCP Live

Transcatheter Arterialization for Limb Ischemia – American College of Cardiology

 

Commentary on Twitter

https://twitter.com/NEJM/status/1641192272539824128

 

AHA Scientific Statement | Pediatric primary hypertension: An underrecognized condition

3 Apr, 2023 | 14:05h | UTC

Pediatric Primary Hypertension: An Underrecognized Condition: A Scientific Statement From the American Heart Association – Hypertension

Top Things to Know: Pediatric Primary Hypertension: An Underrecognized Condition – American Heart Association

News Release: Children with high blood pressure often become adults with high blood pressure – American Heart Association

Commentaries:

The Birth of Pediatric Primary Hypertension – American Heart Association

AHA Highlights Pediatric Hypertension in Scientific Statement – HCP Live

 

RCT | Comparable efficacy of cefotaxime, ceftriaxone, and ciprofloxacin in treating spontaneous bacterial peritonitis

3 Apr, 2023 | 14:01h | UTC

Summary: This multicenter, prospective, open-label, randomized controlled trial compared the efficacy of cefotaxime, ceftriaxone, and ciprofloxacin as initial treatments for spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. The study included 261 patients aged 16 to 75, with liver cirrhosis, ascites, and a polymorphonuclear cell count of >250/mm3. Researchers performed follow-up paracentesis at 48 hours to evaluate the assigned antibiotics, and assessed resolution rates at 120 and 168 hours of treatment.

The primary endpoint, resolution rates at 120 hours, showed no statistically significant difference between the groups: 67.8% for cefotaxime, 77.0% for ceftriaxone, and 73.6% for ciprofloxacin. One-month mortality rates were also similar. The study concluded that these antibiotics are equally effective as initial treatments for SBP, particularly for community-acquired infections, when administered based on response-guided therapy.

Article: Response-Guided Therapy With Cefotaxime, Ceftriaxone, or Ciprofloxacin for Spontaneous Bacterial Peritonitis: A Randomized Trial: A Validation Study of 2021 AASLD Practice Guidance for SBP – American Journal of Gastroenterology (free for a limited period)

 

M-A | Mediterranean & low-fat diets may reduce mortality and non-fatal MI in patients with high cardiovascular risk

3 Apr, 2023 | 13:59h | UTC

Summary: This systematic review and network meta-analysis aimed to determine the relative efficacy of different diets for preventing mortality and major cardiovascular events in patients at increased risk of cardiovascular disease. The study identified 40 randomized trials with 35,548 participants across seven dietary programs.

Moderate certainty evidence showed that Mediterranean and low-fat diets, with or without physical activity or other interventions, reduced all-cause mortality and non-fatal myocardial infarction in patients with increased cardiovascular risk. Mediterranean diet programs were also likely to reduce stroke risk.

Other dietary programs generally were not superior to minimal intervention. When compared with one another, no convincing evidence was found that the Mediterranean diet was superior to the low-fat diets in preventing mortality or non-fatal myocardial infarction.

Article: Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis – The BMJ

News Release: Benefits of Mediterranean and low fat diet programmes in patients at risk of cardiovascular disease – BMJ Newsroom

Commentary: Mediterranean, Low-Fat Diets Both Good for Health: Network Meta-analysis – TCTMD

 

SR | Adding ultrasound to mammography increases breast cancer detection, but increases false-positives and biopsies

3 Apr, 2023 | 13:55h | UTC

Summary: The systematic review examined the effectiveness and safety of combining mammography with breast ultrasonography versus mammography alone for breast cancer screening in women at average risk. The research included one randomized controlled trial, two prospective cohort studies, and five retrospective cohort studies, involving a total of 209,207 women.

High certainty evidence from one trial indicated that combining mammography with ultrasonography led to the detection of more breast cancer cases than mammography alone (5 vs. 3 per 1000 women). However, this combination also led to a higher number of false-positive results and biopsies. For every 1000 women screened with the combined approach, 37 more received a false-positive result, and 27 more women underwent a biopsy.

Secondary analysis of the trial data revealed that in women with dense breasts, the combined screening detected more cancer cases than mammography alone, while cohort studies for women with non-dense breasts showed no statistically significant difference between the two screening methods.

The included studies did not analyze whether the higher number of detected cancers with the combined screening method resulted in lower mortality rates compared to mammography alone. Further research, including randomized controlled trials or prospective cohort studies with longer observation periods, is needed to assess the impact of the two screening interventions on morbidity and mortality.

Article: Mammography in combination with breast ultrasonography versus mammography for breast cancer screening in women at average risk – Cochrane Database of Systematic Reviews

Summary: Mammography followed by ultrasonography compared to mammography alone for breast cancer screening in women at average risk of breast cancer – Cochrane Database of Systematic Reviews

 

Cohort Study | Infections requiring hospitalization linked to increased short- and long-term cardiovascular risks

3 Apr, 2023 | 13:57h | UTC

Summary: The study examined the association between severe infections and the risk of cardiovascular disease in people without prior cardiovascular issues. Data from 331,683 UK Biobank participants and 271,533 Finnish participants were analyzed. Cardiovascular risk factors were measured at baseline, and infectious diseases and subsequent cardiovascular events were diagnosed through the linkage of participants to hospital and mortality registers.

Results showed that hospitalization for infection was associated with an increased risk of major cardiovascular events, regardless of the type of infection. The risk was highest during the first month after infection, with hazard ratios of 7.87 and 7.64 in the UK Biobank and Finnish cohorts, respectively. However, the risk remained elevated throughout the follow-up period, with hazard ratios of 1.47 in the UK Biobank and 1.41 in the Finnish cohort.

The study suggests that severe infections requiring hospital treatment are associated with increased risks for major cardiovascular disease events both immediately after hospitalization and in the long-term. However, it is important to note that residual confounding cannot be excluded, and further research is needed to establish causality.

Article: Severe Infection and Risk of Cardiovascular Disease: A Multicohort Study – Circulation

Commentary: Severe Infections Linked to a Variety of CV Events, Both Acute and Long-term – TCTMD

 

Commentary on Twitter

 

Lateral flow devices maintain detection sensitivity across Alpha, Delta, and Omicron waves

3 Apr, 2023 | 13:53h | UTC

Summary: The study assessed the performance of antigen lateral flow devices (LFDs) during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic in the UK. Researchers aimed to understand LFD performance concerning changes in variant infections, vaccination, viral load, and LFD use, as well as the devices’ ability to detect infectious individuals. Paired LFD and RT-PCR test results were collected from both asymptomatic and symptomatic participants between November 2020 and March 2022.

When compared to RT-PCR testing, the overall LFD sensitivity was 63.2%, and specificity was 99.71%. The sensitivity was higher in symptomatic participants (68.7%) than in asymptomatic participants (52.8%). The study found that increased viral load was independently associated with a higher likelihood of being LFD positive. There was no evidence of a significant difference in LFD sensitivity between the alpha and delta variants, but sensitivity increased during the omicron wave. Vaccination status did not show an independent association with LFD sensitivity.

The study concluded that LFDs can detect most SARS-CoV-2 infections across different viral variants and during vaccine roll-out, contributing to reduced transmission risk. However, LFD performance is lower in asymptomatic individuals, which should be taken into account when designing testing programs.

Article: Performance of antigen lateral flow devices in the UK during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic: a diagnostic and observational study – The Lancet Infectious Diseases

Invited Commentary: The performance of rapid antigen tests against SARS-CoV-2 variants – The Lancet Infectious Diseases

Related:

Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2: a rapid review with network meta-analysis of diagnostic test accuracy studies – BMC Medicine

Accuracy of rapid point-of-care antigen-based diagnostics for SARS-CoV-2: An updated systematic review and meta-analysis with meta-regression analyzing influencing factors – PLOS Medicine

Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ

Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection – Cochrane Library

 

Gastric Cancer: the combined impact of H. pylori infection and pathogenic gene variants

3 Apr, 2023 | 13:51h | UTC

Helicobacter pylori, Homologous-Recombination Genes, and Gastric Cancer – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Helicobacter Pylori Infection Modifies the Risk of Gastric Cancer Associated with Germline Pathogenic Variants in Homologous Recombination Genes – ESMO

Commentary: H. Pylori Infection Negatively Modifies Genetically Increased Risk for Gastric Cancer – Physician’s Weekly

 

Commentary on Twitter

 

RCT | Vedolizumab for the treatment of chronic pouchitis

3 Apr, 2023 | 13:49h | UTC

Vedolizumab for the Treatment of Chronic Pouchitis – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: New hope for patients after vedolizumab found effective to treat Chronic Pouchitis – University of Oxford

 

Commentary on Twitter

 

RCT | Pembrolizumab plus chemotherapy in advanced endometrial cancer

3 Apr, 2023 | 13:48h | UTC

Pembrolizumab plus Chemotherapy in Advanced Endometrial Cancer – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Adding Pembrolizumab to Standard Chemotherapy, Followed by Pembrolizumab Maintenance, Results in Longer PFS in Patients with Advanced or Recurrent Endometrial Cancer – ESMO

 

Commentary on Twitter

 

RCT | Dostarlimab for primary advanced or recurrent endometrial cancer

3 Apr, 2023 | 13:46h | UTC

Dostarlimab for Primary Advanced or Recurrent Endometrial Cancer – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary:

RUBY Trial: Dostarlimab Plus Carboplatin and Paclitaxel in Advanced Endometrial Cancer – The ASCO Post

Dostarlimab Plus Chemotherapy Elicits PFS Benefit in Recurrent Endometrial Cancer – OncLive

 

ICU Delirium | Bayesian analysis suggests high probabilities of benefits and low probabilities of harm with the use of haloperidol

3 Apr, 2023 | 13:43h | UTC

Haloperidol vs. placebo for the treatment of delirium in ICU patients: a pre-planned, secondary Bayesian analysis of the AID–ICU trial – Intensive Care Medicine (free for a limited period)

Original article: RCT | Haloperidol for the treatment of delirium in ICU patients did not significantly improve outcomes.

 

Commentary on Twitter

 

RCTs | Fitusiran prophylaxis reduces bleeding in people with hemophilia A or hemophilia B

3 Apr, 2023 | 13:44h | UTC

Efficacy and safety of fitusiran prophylaxis in people with haemophilia A or haemophilia B with inhibitors (ATLAS-INH): a multicentre, open-label, randomised phase 3 trial – The Lancet (link to abstract – $ for full-text)

Fitusiran prophylaxis in people with severe haemophilia A or haemophilia B without inhibitors (ATLAS-A/B): a multicentre, open-label, randomised, phase 3 trial – The Lancet Haematology (link to abstract – $ for full-text)

News Release: Monthly injections of fitusiran reduces bleeds in patients with haemophilia A and B – The Lancet

 

Overcoming size disparity in liver transplant access: prioritizing smaller donors for smaller candidates

3 Apr, 2023 | 13:41h | UTC

Association of Body Surface Area With Access to Deceased Donor Liver Transplant and Novel Allocation Policies – JAMA Surgery (free for a limited period)

Invited Commentary: Addressing Size-Based Disparities in Liver Transplant – JAMA Surgery (free for a limited period)

 

Commentary on Twitter

 

Review | Prolonged intermittent kidney replacement therapy

3 Apr, 2023 | 13:39h | UTC

Prolonged Intermittent Kidney Replacement Therapy – Clinical Journal of the American Society of Nephrology (free for a limited period)

 

Commentary on Twitter

 

Review | Acute respiratory distress syndrome, mechanical ventilation, and inhalation injury in burn patients

3 Apr, 2023 | 13:38h | UTC

Acute Respiratory Distress Syndrome, Mechanical Ventilation, and Inhalation Injury in Burn Patients – Surgical Clinics

 

Review | Dysfunctional labor and delivery: adverse effects on offspring

3 Apr, 2023 | 13:36h | UTC

Dysfunctional labor and delivery: adverse effects on offspring – American Journal of Obstetrics & Gynecology (free for a limited period)

 

RCT | Sparsentan reduces proteinuria in patients with IgA nephropathy

3 Apr, 2023 | 13:35h | UTC

Sparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial – The Lancet (link to abstract – $ for full-text)

 

Commentary on Twitter

 

Perspective | Teen girls are faring worse than boys on nearly all mental health measures—here’s why

3 Apr, 2023 | 13:33h | UTC

Teen Girls Are Faring Worse Than Boys on Nearly All Mental Health Measures—Here’s Why – JAMA (free for a limited period)

 

Commentary on Twitter

 

Glomerular diseases in pregnancy: pragmatic recommendations for clinical management

3 Apr, 2023 | 13:29h | UTC

Glomerular diseases in pregnancy: pragmatic recommendations for clinical management – Kidney International

 

Cohort Study | Long-term quality of life and functional outcome of patients with rectal cancer following a watch-and-wait approach

3 Apr, 2023 | 13:31h | UTC

Long-term Quality of Life and Functional Outcome of Patients With Rectal Cancer Following a Watch-and-Wait Approach – JAMA Surgery (free for a limited period)

Invited Commentary: Guiding Patients Through a “Watch-and-Wait” Approach for Rectal Cancer—Understanding the Functional Outcomes – JAMA Surgery (free for a limited period)

Related:

Cohort Study | A clinical calculator for rectal cancer can estimate recurrence after neoadjuvant therapy with or without surgery.

Guidelines for the surveillance and survivorship care of patients after curative treatment of colon and rectal cancer.

Study: Assessment of a Watch-and-Wait Strategy for Rectal Cancer in Patients With a Complete Response After Neoadjuvant Therapy

Study suggests the intensity of active surveillance in patients with rectal cancer managed by a watch-and-wait approach could be reduced if they maintain a complete clinical response within the first 3 years

 

Commentary on Twitter

 

Assessment of childhood short stature: a GP guide

3 Apr, 2023 | 13:28h | UTC

Assessment of childhood short stature: a GP guide – British Journal of General Practice (free for a limited period)

 

SR | Risk factors for length of NICU stay of newborns

3 Apr, 2023 | 13:23h | UTC

Risk factors for length of NICU stay of newborns: A systematic review – Frontiers in Pediatrics

 

Cohort Study | Associations between fetal or infancy pet exposure and food allergies

3 Apr, 2023 | 13:26h | UTC

Associations between fetal or infancy pet exposure and food allergies: The Japan Environment and Children’s Study – PLOS One

 

Postoperative delirium’s linked to long-term cognitive decline in elderly patients

3 Apr, 2023 | 13:20h | UTC

Postoperative Delirium’s linked to Long-term Cognitive Decline in Elderly Patients – JAMA Internal Medicine (link to abstract – $ for full-text)

News Release: Developing postoperative delirium associated with a faster rate of cognitive decline, says study – EurekAlert

Commentary: Postoperative Delirium Associated With Accelerated Cognitive Decline, Study Finds – Psychiatric News Alert

 

Commentary on Twitter

 

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