Daily Archives: May 15, 2023
Practice Guidance | Differential diagnosis of suspected COPD exacerbations in the acute care setting
15 May, 2023 | 13:26h | UTC
Commentary on Twitter
Differential Diagnosis of Suspected Chronic Obstructive Pulmonary Disease Exacerbations in the Acute Care Setting: Best Practice
? Open Access
? https://t.co/aPiT06E2g4 pic.twitter.com/kF40aSS7Oo— ATS Blue Journal (@ATSBlueEditor) May 12, 2023
Canadian Task Force advises fragility fracture screening for women over 65, but not for men or younger women
15 May, 2023 | 13:23h | UTCRelated USPSTF Statement: Screening Osteoporosis to Prevent Fractures
Guideline | Acute dizziness and vertigo in the emergency department
15 May, 2023 | 13:25h | UTC
RCT | Rivaroxaban doesn’t reduce thrombotic events, hospitalization, or death in outpatients with COVID-19
15 May, 2023 | 13:19h | UTCSummary: The PREVENT-HD trial, a double-blind, placebo-controlled randomized study, was conducted to evaluate the effectiveness of prophylactic anticoagulation in reducing venous and arterial thrombosis, hospitalization, and death in nonhospitalized patients with symptomatic COVID-19 and at least one thrombosis risk factor. The trial took place between August 2020 and April 2022 across 14 US integrated healthcare delivery networks, with 1,284 patients enrolled and randomly assigned to receive either 10 mg of oral rivaroxaban or placebo daily for 35 days.
However, the study was terminated prematurely due to enrollment challenges and lower-than-expected event rates. The primary efficacy outcome, a composite of various hazardous events, occurred in 3.4% of the rivaroxaban group and 3.0% of the placebo group, with no significant difference between the two groups (hazard ratio, 1.16 [95% CI, 0.63–2.15]; P=0.63). No critical-site or fatal bleeding was observed, and only one patient in the rivaroxaban group experienced a major bleed.
In conclusion, rivaroxaban prescribed for 35 days in nonhospitalized patients with symptomatic COVID-19 at risk for thrombosis does not appear to reduce the composite end point of venous and arterial thrombotic events, hospitalization, and death. The study’s premature termination and lower-than-expected event rates may limit the generalizability of these findings.
Commentary on Twitter
#OriginalArticle: In this #RCT, Rivaroxaban did not appear to reduce a composite endpoint of venous and arterial thrombotic events, hospitalization, and death among non‐hospitalized patients with symptomatic COVID‐19 #AHAJournals https://t.co/PhdXnTJ0V9 pic.twitter.com/f04uYu2M5f
— Circulation (@CircAHA) May 10, 2023
RCT | Prophylactic antibiotics show no statistically significant survival improvement in severe alcohol-related hepatitis
15 May, 2023 | 13:21h | UTCSummary: This multicenter, randomized, double-blind clinical trial aimed to determine the efficacy of amoxicillin-clavulanate combined with prednisolone compared to placebo combined with prednisolone on mortality in patients hospitalized with severe alcohol-related hepatitis. The study involved 284 patients from 25 centers in France and Belgium with biopsy-proven severe alcohol-related hepatitis, who were followed up for 180 days.
The primary outcome was all-cause mortality at 60 days, while secondary outcomes included mortality at 90 and 180 days, infection rates, hepatorenal syndrome, and changes in Model for End-stage Liver Disease (MELD) and Lille scores. The results showed no statistically significant difference in 60-day mortality between the two groups, with 17.3% in the amoxicillin-clavulanate group and 21.3% in the placebo group. However, infection rates at 60 days were significantly lower in the amoxicillin-clavulanate group compared to the placebo group.
It is worth noting that the study may have been underpowered, as the absolute risk difference of 4% did not achieve statistical significance. In conclusion, the combination of amoxicillin-clavulanate and prednisolone did not show a statistically significant improvement in 2-month survival in patients hospitalized with severe alcohol-related hepatitis compared to prednisolone alone. These findings do not support the use of prophylactic antibiotics to improve survival in this patient population, but the potential underpowered nature of the study should be considered.
Article: Effect of Prophylactic Antibiotics on Mortality in Severe Alcohol-Related Hepatitis: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentary on Twitter
Among patients with severe alcohol-related #hepatitis receiving prednisolone, amoxicillin-clavulanate did not improve survival at 60-day follow-up compared with placebo. https://t.co/4XkVL2CTsP #DDW pic.twitter.com/9sh5vennkK
— JAMA (@JAMA_current) May 9, 2023
RCT | Cognitive behavioral therapy proves effective for severe post-COVID-19 fatigue
15 May, 2023 | 13:16h | UTCNews Release: Cognitive behavioral therapy lessens post-viral fatigue after COVID-19 – Amsterdam UMC
Commentary on Twitter
Efficacy of Cognitive Behavioral Therapy Targeting Severe Fatigue Following COVID-19: Results of a Randomized Controlled Trial
✅ Just Accepted
? Open Access@amsterdamUMChttps://t.co/P1jwLOcfvw— Clinical Infectious Diseases (@CIDJournal) May 13, 2023
Therapeutic plasma exchange: Core curriculum 2023
15 May, 2023 | 13:14h | UTCTherapeutic Plasma Exchange: Core Curriculum 2023 – American Journal of Kidney Diseases
Commentary on Twitter
Therapeutic Plasma Exchange: Core Curriculum 2023 https://t.co/6IoHXeAzyO (FREE)@Elena_Cervants @JohnSperati pic.twitter.com/3OVgAhXjCv
— AJKD (@AJKDonline) May 7, 2023
Review | Intensive care unit–acquired weakness in patients with acute kidney injury
15 May, 2023 | 13:12h | UTC
Commentary on Twitter
Intensive Care Unit–Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review https://t.co/I7JXcb11VY (FREE) @NephCrit_NM @KirbyMayerDPT @Ben_Griffin_MD @NRG3000 @njenkinsphd @FGonzalezSeguel @javo_neyra #AKI pic.twitter.com/8nDSSQFMwa
— AJKD (@AJKDonline) May 13, 2023
RCT | Peanut patch therapy is effective in desensitizing young children with allergies, but raises risk of serious adverse events
15 May, 2023 | 13:10h | UTCPhase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In the phase 3 EPITOPE trial involving children 1 to 3 years of age with peanut allergy, epicutaneous immunotherapy by means of a peanut patch was superior to placebo in desensitizing children to peanut. https://t.co/USk6HBI9Qh#pediatrics
— NEJM (@NEJM) May 10, 2023
RCT | Novel autotaxin inhibitor Ziritaxestat shows no benefit for idiopathic pulmonary fibrosis
15 May, 2023 | 13:08h | UTCZiritaxestat, a Novel Autotaxin Inhibitor, and Lung Function in Idiopathic Pulmonary Fibrosis: The ISABELA 1 and 2 Randomized Clinical Trials – JAMA (free for a limited period)
RCT | Statins do not prevent early cardiac dysfunction in anthracycline-treated cancer patients
15 May, 2023 | 13:07h | UTCStatins to prevent early cardiac dysfunction in cancer patients at increased cardiotoxicity risk receiving anthracyclines – European Heart Journal – Cardiovascular Pharmacotherapy (link to abstract – $ for full-text)
Commentary on Twitter
Primary prevention with atorvastatin during anthracycline therapy did not prevent cardiac dysfunction and myocardial tissue changes: SPARE-HF randomized trial https://t.co/9s2p9JSSq4 #echofirst #HF #LVEF #CMR #ESCYoung #EHJPharmacotherapy @FeliceGragnano @AgewallStefan pic.twitter.com/7tKG4tdpcD
— European Society of Cardiology Journals (@ESC_Journals) May 13, 2023
Review | Heart failure and liver disease: cardiohepatic interactions
15 May, 2023 | 13:06h | UTCHeart Failure and Liver Disease: Cardiohepatic Interactions – JACC: Heart Failure
M-A | Postoperative clinical outcomes for kinematically, restricted kinematically, or mechanically aligned total knee arthroplasty
15 May, 2023 | 13:04h | UTC
An update on the role of immunohistochemistry in the evaluation of pancreatic/liver/gastrointestinal luminal tract disorders
15 May, 2023 | 13:02h | UTC
Brief Review | Coagulation support during perioperative bleeding management
15 May, 2023 | 13:01h | UTCCoagulation support during perioperative bleeding management – Intensive Care Medicine
Commentary on Twitter
Coagulation & perioperative bleeding
?fibrinogen source/dose/time
?Ca++: just vs citrated blood products?
?PCCs/factor concentrates
?TXA
?plasma: volume or coagulation?
?PLTs as primary components
?RBCs not just DO2
?targeted coagulation support
?️ https://t.co/lv1i5GoHBg pic.twitter.com/8BtuAE6gt8— Intensive Care Medicine (@yourICM) May 13, 2023
RCT | Neck–shoulder region training for chronic headache in women
15 May, 2023 | 12:59h | UTC
Commentary on Twitter
Neck-Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial
????
"The progressive exercise program almost halved headache frequency"https://t.co/HQN2yppF27 pic.twitter.com/3ZFltwJTWl
— Physio Meets Science (@PhysioMeScience) April 26, 2023
Review | Nonalcoholic fatty liver disease from a primary care perspective
15 May, 2023 | 12:57h | UTCNonalcoholic fatty liver disease from a primary care perspective – Diabetes, Obesity and Metabolism
Review | Awake prone positioning in acute hypoxemic respiratory failure
15 May, 2023 | 12:56h | UTCAwake prone positioning in acute hypoxaemic respiratory failure – European Respiratory Review
RCT | Transvenous occlusion of incompetent pelvic veins to treat chronic pelvic pain in women
15 May, 2023 | 12:54h | UTC
M-A | Adding exercise to hypocaloric diet doesn’t enhance weight loss or glycemic control in T2D patients
15 May, 2023 | 12:52h | UTC
2023 Rectal cancer lexicon update | Revised consensus on terminology and staging
15 May, 2023 | 12:50h | UTC
Cohort Study | Following lifestyle recommendations linked to lower recurrence in high-risk breast cancer
15 May, 2023 | 12:48h | UTCCommentary: Adherence to healthy lifestyle found to cut breast cancer recurrence, mortality – HealthDay
Commentary on Twitter
Adherence to the @AmericanCancer and the @aicrtweets lifestyle recommendations before and after high-risk breast cancer treatment was associated with a 37% reduced risk of disease recurrence and a 58% reduction in mortality. https://t.co/sy6b8CGgr1
— JAMA Network Open (@JAMANetworkOpen) May 4, 2023
M-A | Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation
15 May, 2023 | 12:46h | UTC
Post-pneumonectomy syndrome: a systematic review of the current evidence and treatment options
15 May, 2023 | 12:45h | UTC
Clinical Trial Update | Lenvatinib plus pembrolizumab in previously treated advanced endometrial cancer
15 May, 2023 | 12:43h | UTCOriginal Article: Lenvatinib plus Pembrolizumab for Advanced Endometrial Cancer – New England Journal of Medicine