Daily Archives: April 4, 2023

RCT | Mindfulness therapy proves more effective and affordable than cognitive behavioral therapy for depression

4 Apr, 2023 | 14:04h | UTC

Summary: The LIGHTMind Randomized Clinical Trial studied 410 adults with mild to moderate depression, comparing the clinical effectiveness and cost-effectiveness of practitioner-supported mindfulness-based cognitive therapy self-help (MBCT-SH) to practitioner-supported cognitive behavioral therapy self-help (CBT-SH). The trial provided participants with either an MBCT-SH or CBT-SH workbook and six support sessions with a trained practitioner. Depressive symptom severity was measured using the Patient Health Questionnaire (PHQ-9) score at 16 weeks after randomization.

Results showed that MBCT-SH led to significantly greater reductions in depressive symptoms and was more cost-effective than CBT-SH. The between-group difference was 1.5 PHQ-9 points, and MBCT-SH cost health services £526 ($631) less per participant over a 42-week follow-up period. A substantial portion of this cost difference was due to additional face-to-face individual psychological therapy accessed by CBT-SH participants outside of the study intervention.

The trial concluded that offering practitioner-supported MBCT-SH for mild to moderate depression could improve outcomes and save money compared to CBT-SH. To translate these findings into practice, proper training and supervision for practitioners delivering MBCT-SH are necessary. Future research should focus on corroborating and extending these findings, exploring factors contributing to MBCT-SH’s relative effectiveness, and examining potential barriers and facilitators for successful implementation in routine clinical practice.

Article: Clinical Effectiveness and Cost-Effectiveness of Supported Mindfulness-Based Cognitive Therapy Self-help Compared With Supported Cognitive Behavioral Therapy Self-help for Adults Experiencing Depression: The Low-Intensity Guided Help Through Mindfulness (LIGHTMind) Randomized Clinical Trial – JAMA Psychiatry

Commentary:

Mindfulness better than CBT for treating depression, study finds – The Guardian

Practitioner-Supported Mindfulness-Based Cognitive Therapy Aids Depression – HealthDay

Commentary on Twitter

Practitioner-supported mindfulness-based cognitive therapy self-help for mild-moderate depression is clinically- and cost-effective compared to currently recommended practitioner-support CBT self-help. https://t.co/H23AfwiO7X pic.twitter.com/xTHzYG4oqg

— JAMA Psychiatry (@JAMAPsych) March 22, 2023

What is acute kidney injury? A visual guide

4 Apr, 2023 | 14:02h | UTC

What is acute kidney injury? A visual guide – Nature

Opinion | AI-generated medical advice—GPT and beyond

4 Apr, 2023 | 14:00h | UTC

AI-Generated Medical Advice—GPT and Beyond – JAMA (free for a limited period)

The use of ChatGPT and other large language models in surgical science – BJS Open

ChatGPT vs. NCI: analyzing the quality of cancer information on myths and misconceptions

ChatGPT has many uses. Experts explore what this means for healthcare and medical research – The Conversation

Artificial Intelligence in Medicine & ChatGPT: De-Tether the Physician – Journal of Medical Systems (if the link is paywalled, try this one)

Can artificial intelligence help for scientific writing? – Critical Care

Artificial intelligence in academic writing: a paradigm-shifting technological advance

Performance of ChatGPT on USMLE: potential for AI-assisted medical education using large language models

Perspective | ChatGPT-assisted diagnosis: is the future suddenly here?

Perspective | Generating scholarly content with ChatGPT: ethical challenges for medical publishing

ChatGPT: Will It Transform the World of Health Care? – UCSF Department of Medicine

ChatGPT and the future of medical writing (ChatGPT itself wrote this paper)

ChatGPT: five priorities for research – Nature

The path forward for ChatGPT in academia – Lumo’s Newsletter

Nonhuman “Authors” and Implications for the Integrity of Scientific Publication and Medical Knowledge – JAMA

ChatGPT is fun, but not an author – Science

Tools such as ChatGPT threaten transparent science; here are our ground rules for their use – Nature

ChatGPT listed as author on research papers: many scientists disapprove – Nature

Abstracts written by ChatGPT fool scientists

RCT | No significant fracture reduction from monthly 60,000 IU vitamin D3 supplementation

4 Apr, 2023 | 13:58h | UTC

The effect of monthly vitamin D supplementation on fractures: a tertiary outcome from the population-based, double-blind, randomised, placebo-controlled D-Health trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)

RCT | Supplemental Vitamin D does not reduce incident fractures in midlife and older adults.

Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials – BMJ Open

Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis – JAMA

Contrary to prior studies, new research finds no heightened postoperative risk after a recent covid-19 infection

4 Apr, 2023 | 13:54h | UTC

Estimated Risk of Adverse Surgical Outcomes Among Patients With Recent COVID-19 Infection Using Target Trial Emulation Methods – JAMA Network Open

Commentaries:

COVID infection within 60 days not tied to adverse postsurgical outcomes – CIDRAP

Adverse Postoperative Outcomes Not Increased With Recent COVID-19 – HealthDay

ASA and APSF statement on perioperative testing for the COVID-19 virus.

Surgical Triage and Timing for Patients with COVID: A Guidance Statement from the Society of Thoracic Surgeons – Annals of Thoracic Surgery

When to operate after SARS-CoV-2 infection? A review on the recent consensus recommendation of the DGC/BDC and the DGAI/BDA – Langenbeck’s Archives of Surgery

Guideline Update: Timing of elective surgery and risk assessment after SARS-CoV-2 infection – “The guidance remains that patients should avoid elective surgery within 7 weeks of infection, unless the benefits of doing so exceed the risk of waiting”.

Perioperative cardiovascular considerations prior to elective noncardiac surgery in patients with a history of Covid-19.

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

BJS commission on surgery and perioperative care post-COVID-19.

The risk of postoperative complications following major elective surgery in active or resolved COVID-19 in the United States – Major, elective surgery 0–4 weeks after Covid-19 is associated with greatly increased risk of postoperative complications; surgery performed 4–8 weeks after infection is still associated with an increased risk of pneumonia.

ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.

Position statement: Perioperative management of post-COVID-19 surgical patients.

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

Bivalent Booster | Observational data suggests no increased cardiovascular risks compared to monovalent vaccine

4 Apr, 2023 | 13:55h | UTC

Stroke, Myocardial Infarction, and Pulmonary Embolism after Bivalent Booster – New England Journal of Medicine

Commentary: Similarly Low Risk of CV Events With Bivalent and Monovalent mRNA Boosters – TCTMD

Commentary on Twitter

In this French study, the risk of cardiovascular events was similar among recipients of the bivalent Pfizer–BioNTech vaccine and the original monovalent vaccine 21 days after the booster dose. https://t.co/FUZbbsn82I pic.twitter.com/ki0FPeutNm

— NEJM (@NEJM) March 29, 2023

M-A | Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2

4 Apr, 2023 | 13:52h | UTC

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

RCT | Vitamin D supplementation shows no significant impact on psoriasis severity

4 Apr, 2023 | 13:51h | UTC

Summary: In a randomized, double-blind, placebo-controlled clinical trial involving 122 participants with plaque psoriasis, researchers investigated the effects of vitamin D supplementation on psoriasis severity during winter. Participants received either vitamin D (cholecalciferol, 100,000 IU loading dose followed by 20,000 IU/week) or a placebo for four months. The primary outcome was Psoriasis Area Severity Index (PASI) scores, with secondary outcomes including Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores.

The study found no significant difference in PASI scores or secondary outcomes between the two groups. The results suggest that vitamin D supplementation does not affect psoriasis severity. However, low baseline severity scores and a lower than expected increase in 25-hydroxyvitamin D levels in the intervention group may have influenced the findings, indicating that further research may be needed to account for these factors.

Article: Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels: A Randomized Clinical Trial – JAMA Dermatology (free for a limited period)

Commentary: Vitamin D Ineffective for Psoriasis Patients with Lower Serum 25-Hydroxyvitamin D Levels in Winter – HCP Live

Commentary on Twitter

This RCT, performed in North-Norway, found no measurable effect of vitamin D supplementation on psoriasis severity during winter. Low baseline severity, & lower-than-expected rise in 25(OH)D levels in intervention group, may have affected the results. https://t.co/ip17uFQsgM

— JAMA Dermatology (@JAMADerm) March 29, 2023

M-A | No significant health benefits found for low-volume alcohol intake

4 Apr, 2023 | 13:48h | UTC

Summary: This systematic review and meta-analysis aimed to investigate the association between alcohol use and all-cause mortality, taking into account potential sources of bias. The study analyzed data from 107 cohort studies published between January 1980 and July 2021, which included 4,838,825 participants and 425,564 deaths.

The study found no significant reductions in all-cause mortality risk for drinkers who consumed less than 25 grams of ethanol per day compared to lifetime nondrinkers. However, there was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams per day and male drinkers who drank 45 or more grams per day.

The analysis highlighted the importance of controlling for former drinker bias and misclassification errors and found sex differences in the risk of all-cause mortality.

In conclusion, the updated meta-analysis found no significantly reduced risk of all-cause mortality associated with low-volume alcohol consumption after adjusting for potential confounding factors. The study recommends that future longitudinal studies in this field should attempt to minimize lifetime selection biases by not including former and occasional drinkers in the reference group and by using younger cohorts at baseline.

Article: Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses – JAMA Network Open

Commentary: Drinking Alcohol Brings No Health Benefits, Study Finds – HealthDay

National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study – The Lancet Public Health

Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet

The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet Psychiatry

Prioritising action on alcohol for health and development – The BMJ

Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study – The Lancet Oncology

Cohort study | Younger stroke survivors show elevated cancer risk for up to 8 years

4 Apr, 2023 | 13:46h | UTC

Summary: In this cohort study, 390,398 patients aged 15 years or older in the Netherlands, without a history of cancer and with a first-ever ischemic stroke or intracerebral hemorrhage (ICH), were analyzed between January 1, 1998, and January 1, 2019. The primary outcome was the cumulative incidence of first-ever cancer after the index stroke, stratified by stroke subtype, age, and sex, compared with age-, sex-, and calendar year-matched peers from the general population.

The findings revealed that, in the first year after a stroke, patients aged 15 to 49 years had a 3- to 5-fold increased risk of cancer compared to individuals without a stroke. In contrast, the risk was only slightly elevated for patients aged 50 years or older. The cancer risk remained elevated for up to 8 years after an ischemic stroke and 6 years after an ICH in the younger age group, with the highest risks observed for lung cancer, gastrointestinal cancer, and hematologic cancer.

The findings may be confounded by shared risk factors, such as smoking. Alternatively, the increased cancer risk may have a causal mechanism between cancer and stroke, possibly related to the hypercoagulable state induced by cancer. However, the study design does not allow for conclusions about causal mechanisms, and the researchers called for further studies investigating the usefulness of cancer screening after a stroke.

Article: Association of Stroke at Young Age With New Cancer in the Years After Stroke Among Patients in the Netherlands – JAMA Network Open

RCT | Comparable results in endovascular therapy using general anesthesia vs. procedural sedation for stroke treatment

4 Apr, 2023 | 13:45h | UTC

Outcomes After Endovascular Therapy With Procedural Sedation vs General Anesthesia in Patients With Acute Ischemic Stroke: The AMETIS Randomized Clinical Trial – JAMA Neurology (free for a limited period)

See also: Visual Abstract

RCT | Pelvic intraoperative neuromonitoring prevents dysfunction in patients with rectal cancer

4 Apr, 2023 | 13:43h | UTC

Pelvic Intraoperative Neuromonitoring Prevents Dysfunction in Patients With Rectal Cancer: Results From a Multicenter, Randomized, Controlled Clinical Trial of a NEUROmonitoring System (NEUROS) – Annals of Surgery

RCT | Memantine outperforms placebo for hair-pulling and skin-picking behaviors

4 Apr, 2023 | 13:40h | UTC

Double-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder – American Journal of Psychiatry (link to abstract – $ for full-text)

News release: New research points to drug option for hair-pulling, skin-picking disorders – University of Chicago

Commentary: Memantine May Reduce Symptoms of Hair-Pulling, Skin-Picking Disorder – Psychiatric News Alert

Cross-sectional study | Association between sodium intake and coronary and carotid atherosclerosis

4 Apr, 2023 | 13:42h | UTC

The association between sodium intake and coronary and carotid atherosclerosis in the general Swedish population – European Heart Journal Open

Editorial: Dietary salt intake and atherosclerosis: an area not fully explored – European Heart Journal Open

News Release: High salt diet associated with hardened arteries even in people with normal blood pressure – European Society of Cardiology

RCT | Baricitinib + topical corticosteroids effective in kids with moderate-severe atopic dermatitis

4 Apr, 2023 | 13:39h | UTC

Efficacy and safety of baricitinib in combination with topical corticosteroids in pediatric patients with moderate-to-severe atopic dermatitis with inadequate response to topical corticosteroids: results from a phase 3, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS) – British Journal of Dermatology

News Release: New approach to nail bed injury surgery could significantly cut NHS costs – University of Oxford

Commentary on Twitter

? #ICU green teams: form or join now, no time to waste!!
? how common are environmental sustainability teams?
? how to create a successful green team
? what could teams be doing?
? evidence for effectiveness
Free to read #FOAMcc on @yourICM
?️ https://t.co/SPDVv3xSwd pic.twitter.com/xVD4I5pOoz

— Intensive Care Medicine (@yourICM) April 3, 2023

Cohort Study | Preoperative depression has minimal impact on 5-year bariatric surgery outcomes

4 Apr, 2023 | 13:23h | UTC

Preoperative Depression Status and 5 Year Metabolic and Bariatric Surgery Outcomes in the PCORnet Bariatric Study Cohort – Annals of Surgery

Applying AI to MRI | A promising approach for detecting severe mental illness risk

4 Apr, 2023 | 13:25h | UTC

Detecting individuals with severe mental illness using artificial intelligence applied to magnetic resonance imaging – eBioMedicine

RCT | Mindfulness therapy proves more effective and affordable than cognitive behavioral therapy for depression

What is acute kidney injury? A visual guide

Opinion | AI-generated medical advice—GPT and beyond

RCT | No significant fracture reduction from monthly 60,000 IU vitamin D3 supplementation

Contrary to prior studies, new research finds no heightened postoperative risk after a recent covid-19 infection

Bivalent Booster | Observational data suggests no increased cardiovascular risks compared to monovalent vaccine

M-A | Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2

RCT | Vitamin D supplementation shows no significant impact on psoriasis severity

M-A | No significant health benefits found for low-volume alcohol intake

Cohort study | Younger stroke survivors show elevated cancer risk for up to 8 years

RCT | Comparable results in endovascular therapy using general anesthesia vs. procedural sedation for stroke treatment

RCT | Pelvic intraoperative neuromonitoring prevents dysfunction in patients with rectal cancer

RCT | Memantine outperforms placebo for hair-pulling and skin-picking behaviors

Cross-sectional study | Association between sodium intake and coronary and carotid atherosclerosis

RCT | Baricitinib + topical corticosteroids effective in kids with moderate-severe atopic dermatitis

S1-guideline cutaneous and subcutaneous leiomyosarcoma

Cochrane Library | Hearing conditions: evidence, experience and resources

Perspective | Coping with anastomotic leaks: harder as one gets older?

RCT | Effectiveness of nail bed repair in children with vs. without replacing the fingernail

Two FITs better than one: enhancing diagnostic performance for colorectal cancer in symptomatic populations

Brief Review | What every gastroenterologist should know about gastrointestinal neuroendocrine tumors

M-A | Evolution and refinement of magnetically guided sentinel lymph node detection in breast cancer

Perspective | Create intensive care green teams, there is no time to waste

Cohort Study | Preoperative depression has minimal impact on 5-year bariatric surgery outcomes

Applying AI to MRI | A promising approach for detecting severe mental illness risk

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