Daily Archives: May 24, 2023
Consensus Statement | Pre-discharge and early post-discharge management of patients hospitalized for acute heart failure
24 May, 2023 | 13:39h | UTC
Consensus Statement | Worsening of chronic heart failure: definition, epidemiology, management and prevention
24 May, 2023 | 13:38h | UTC
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes
24 May, 2023 | 13:30h | UTC
RCT | Spironolactone enhances acne outcomes and offers a viable alternative to oral antibiotics
24 May, 2023 | 13:27h | UTCSummary: The SAFA (Spironolactone for Adult Female Acne) trial was a multicenter, phase 3, double-blind, randomized controlled trial in England and Wales and evaluated the efficacy of spironolactone for treating adult women with acne vulgaris. A total of 410 women, aged ≥18 years and suffering from facial acne for a minimum of six months, were randomly assigned to receive either 50 mg/day of spironolactone or a placebo, increasing to 100 mg/day until week 24.
The primary outcome was measured by the Acne-Specific Quality of Life (Acne-QoL) symptom subscale score at week 12 and 24. The trial demonstrated that spironolactone improved Acne-QoL scores more effectively than the placebo, particularly at week 24. Additionally, more participants in the spironolactone group reported acne improvement, and treatment success was significantly higher in this group at week 12. Mild side effects, notably headaches, were more common in the spironolactone group.
The findings from the SAFA trial highlight spironolactone’s effectiveness, safety, and tolerability in treating adult women with acne vulgaris, suggesting it is a viable alternative to long-term antibiotic treatments. Future research is proposed on higher initial dosages of spironolactone, and its effects on different subgroups like patients with different ages, body mass index, and ethnicity.
Editorial: What do we know about prescribing spironolactone for acne? – The BMJ
News Release: Non-antibiotic treatment for women with persistent acne shown to be effective – University of Southhampton
Cohort Study | Ambulatory blood pressure more predictive of mortality than clinic blood pressure
24 May, 2023 | 13:19h | UTCSummary: This cohort study analyzed the relationship between clinic and ambulatory blood pressure with mortality. The study utilized data from March 2004 to December 2014, sourced from the Spanish Ambulatory Blood Pressure Registry, which included 59,124 patients from 223 primary care centers across all regions of Spain. Patients were monitored until their date of death or until December 31, 2019.
During a median follow-up of 9.7 years, 7174 (12.1%) patients died, including 2361 (4.0%) due to cardiovascular causes. Findings revealed J-shaped associations for several blood pressure measures. Notably, 24-hour systolic blood pressure had a stronger association with all-cause death (HR 1.41 per 1 SD increment [95% CI 1.36–1.47]) than clinic systolic blood pressure. When adjusted for clinic blood pressure, the association between 24-hour blood pressure and all-cause death remained strong (HR 1.43 [95% CI 1.37–1.49]). Night-time systolic blood pressure was found to be the most predictive of all-cause and cardiovascular death.
The findings imply that ambulatory blood pressure, particularly night-time blood pressure, is more informative about the risk of all-cause death and cardiovascular death than clinic blood pressure. Masked hypertension and sustained hypertension were associated with increased mortality risks, but not white-coat hypertension. These results emphasize the importance of ambulatory blood pressure monitoring in hypertension management and risk prediction. Future research should focus on potential causes and strategies to control night-time blood pressure effectively, considering its substantial association with death risk.
Commentary: Tight Link Between Ambulatory BP and Mortality Affirmed in Revamped Analysis – TCTMD
Perspective | Fake scientific papers are alarmingly common
24 May, 2023 | 13:18h | UTCFake scientific papers are alarmingly common – Science
Guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis
24 May, 2023 | 13:16h | UTCEvidence-Based Guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis – Nature Reviews Rheumatology (if the link is paywalled, try this one)
Related: 2022 ACR/EULAR Classification Criteria for Eosinophilic Granulomatosis with Polyangiitis.
Commentary on Twitter
New content online! Evidence-Based Guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis https://t.co/iBNSi55JfK pic.twitter.com/Wh71oHGXOL
— NatRevRheumatol (@NatRevRheumatol) May 9, 2023
Consensus Statement | Rationale and clinical application of antimicrobial stewardship principles in the intensive care unit
24 May, 2023 | 13:15h | UTC
M-A | Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients
24 May, 2023 | 13:13h | UTC
SR | Videolaryngoscopy vs. direct laryngoscopy for tracheal intubation in neonates
24 May, 2023 | 13:11h | UTCVideolaryngoscopy versus direct laryngoscopy for tracheal intubation in neonates – Cochrane Library
Commentary on Twitter
Videolaryngoscopy:
– may increase the success of intubation on 1st attempt and result in fewer intubation attempts, but may not reduce the time required for successful intubation
– likely results in a reduced incidence of airway‐related adverse effectshttps://t.co/ney0pt8PnH pic.twitter.com/lc6bbDME7e— Cochrane Neonatal (@CochraneNeonate) May 12, 2023
Review | Update in musculoskeletal pain in older adults with a focus on osteoarthritis-related pain
24 May, 2023 | 13:09h | UTC
Phase 2 RCT | Peresolimab outperforms placebo in patients with moderate-to-severe rheumatoid arthritis
24 May, 2023 | 13:07h | UTCA Phase 2 Trial of Peresolimab for Adults with Rheumatoid Arthritis – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Peresolimab Demonstrates Efficacy in Treating Patients With Rheumatoid Arthritis – HCP Live
Commentary on Twitter
Peresolimab showed efficacy in a phase 2a trial in patients with rheumatoid arthritis. These results provide evidence that stimulation of the PD-1 receptor has potential efficacy in the treatment of rheumatoid arthritis. https://t.co/2MkxLBrKTf
— NEJM (@NEJM) May 20, 2023
SR | High-dose olanzapine in treatment-resistant schizophrenia
24 May, 2023 | 13:06h | UTC
Review | Glycemic management in people with diabetes on peritoneal dialysis
24 May, 2023 | 13:04h | UTC
Commentary on Twitter (thread – click for more)
1/Hey #Nephtwitter #Medtwitter
Today, we are discussing
Clinical considerations while managing diabetes on Peritoneal dialysis (PD)#Tweetorial alert ?@KIReports
Full text link: https://t.co/sOEIa6AuNh pic.twitter.com/kVn4XDYylU— KIReports (@KIReports) May 20, 2023
Digital mental health: challenges and next steps
24 May, 2023 | 13:01h | UTCDigital mental health: challenges and next steps – BMJ Mental Health
SR | Management of lymph node–positive penile cancer
24 May, 2023 | 13:03h | UTCManagement of Lymph Node–positive Penile Cancer: A Systematic Review – European Urology