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In this trial, patients with three-vessel coronary artery disease, PCI guided by assessment of fractional flow reserve was not noninferior to CABG with respect to the composite end point of death, myocardial infarction, stroke, or repeat revascularization. https://t.co/uYZGZWub0T pic.twitter.com/zsghs2SlsA

— NEJM (@NEJM) November 4, 2021

Cluster RCT: In older adults with advanced cancer, a geriatric assessment program reduced the toxic effects of cancer treatment.

5 Nov, 2021 | 09:48h | UTC

Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised study – The Lancet

News Release: Less Chemotherapy, Personalized Care: Wilmot Study Reinforces Major Strides in Geriatric Oncology – University of Rochester Medical Center

RCT: A geriatric assessment–driven intervention can reduce chemotherapy-related toxic effects in older adults with cancer.

Perspective: A Cancer Care Approach Tailored to The Elderly May Have Better Results

Commentary from the author on Twitter (thread – click for more)

https://twitter.com/rochgerionc/status/1456046017766375425

Observational study showed J&J single shot vaccine had an effectiveness of 74% against symptomatic Covid-19.

4 Nov, 2021 | 10:08h | UTC

Analysis of the Effectiveness of the Ad26.COV2.S Adenoviral Vector Vaccine for Preventing COVID-19 – JAMA Network Open

Commentaries:

Single-Dose Ad26.COV2.S Vaccine—Room for Improvement – JAMA Network Open

Real-world study shows J&J COVID-19 vaccine 74% effective – CIDRAP

J&J COVID-19 Vaccine: FDA recommends booster shot for all adults aged 18 and older at least two months following initial vaccination with the single-shot vaccine.

[Press release – not published yet] J&J says booster shot at two months provided 75% protection against moderate to severe COVID-19 globally and 94% of such cases in the U.S.

CDC Report: Moderna’s vaccine associated with greater effectiveness (93%) against Covid-19 hospitalization compared to Pfizer (88%) and J&J (71%) vaccines.

[Preprint] Observational study finds single-dose Johnson & Johnson vaccine is 76.7% effective in preventing SARS-CoV-2 infection

RCT: Single-Dose Johnson & Johnson Vaccine has 85% efficacy against severe/critical Covid-19 and maintains efficacy against variant B.1.351

Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain.

5 Nov, 2021 | 09:44h | UTC

Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain – Journal of Hospital Medicine

Large observational study suggests Tramadol is associated with increased risk of adverse outcomes compared to Codeine.

Tramadol: Where do we go from here? – “Tramadol’s unpredictability, unique potential harms, and lack of advantage over other opioids or NSAIDs are now well recognized”.

Cohort Study: Chronic Use of Tramadol After Acute Pain Episode

WHO issues emergency use approval for India’s Covaxin.

4 Nov, 2021 | 10:11h | UTC

WHO issues emergency use listing for eighth COVID-19 vaccine – World Health Organization

Commentaries:

WHO Gives India’s Covaxin Approval, Opening the Door to COVAX distribution – Health Policy Watch

WHO green-lights India’s COVID vaccine as global cases rise – CIDRAP

Commentary on Twitter (thread – click for more)

🆕 WHO has granted emergency use listing (EUL) to #COVAXIN® (developed by Bharat Biotech), adding to a growing portfolio of vaccines validated by WHO for the prevention of #COVID19. pic.twitter.com/dp2A1knGtT

— World Health Organization (WHO) (@WHO) November 3, 2021

CDC Guidance: Immunocompromised may need a fourth Covid-19 shot.

4 Nov, 2021 | 10:06h | UTC

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States – Centers for Disease Control and Prevention

Commentaries:

Immunocompromised may need a fourth Covid-19 shot, CDC says – CNN

Some immunocompromised people can receive a 4th Covid shot, CDC says – NBC News

Ten Things to Know About Multisystem Inflammatory Syndrome in Children (MIS-C).

4 Nov, 2021 | 10:00h | UTC

Ten Things to Know About MIS-C – American College of Cardiology

Cohort study: long term follow-up showed most patients with post–COVID-19 Multisystem Inflammatory Syndrome in Children had good outcomes with no significant medium- or long-term sequelae.

Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: An Overview and Comparison.

Cohort study: Six month follow-up of Multisystem Inflammatory Syndrome in Children.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, there was no evidence that recovery differed after primary treatment with intravenous immune globulin (IVIG) alone, IVIG plus glucocorticoids, or glucocorticoids alone.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, initial treatment with intravenous immune globulin (IVIG) plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone.

Cohort study showed that the incidence of Multisystem Inflammatory Syndrome in Children (MIS-C) was 316 persons per 1 000 000 SARS-CoV-2 infections in persons younger than 21 years. The incidence was higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons.

Cohort study showed good recovery for most children 6 months after Pediatric Inflammatory Multisystem Syndrome (PIMS-TS) associated with SARS-CoV-2.

Epidemiology of Multisystem Inflammatory Syndrome in Children: A Step Closer to Understanding Who, Where, and When

Neurologic involvement in children and adolescents with COVID-19 or Multisystem Inflammatory Syndrome

Clinical Update: Acute covid-19 and multisystem inflammatory syndrome in children

Differences in characteristics and outcomes of children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C) vs. severe acute COVID-19

Cutaneous findings in SARS-CoV-2-associated Multisystem Inflammatory Disease in Children (MIS-C)

SR: Multisystem inflammatory syndrome in children related to COVID-19

Observational study: The combination of Immunoglobulins + Methylprednisolone was associated with a better course of fever compared to Immunoglobulins alone in Multisystem Inflammatory Syndrome in children

ACR Guidance for pediatric patients with multisystem inflammatory syndrome in children associated with SARS‐CoV‐2

New systematic review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 infection summarizes the clinical features, management, and outcomes of the disease, showing favorable outcomes for the majority of children

The USPSTF draft statement recommends against screening for chronic obstructive pulmonary disease in asymptomatic adults.

4 Nov, 2021 | 09:56h | UTC

Chronic Obstructive Pulmonary Disease: Screening – U.S. Preventive Services Task Force

Commentary: USPSTF Still Advises Against COPD Screening for Asymptomatic Adults – HealthDay

ASH Guideline issued a conditional recommendation against routine use of outpatient anticoagulant prophylaxis in patients with COVID-19 being discharged from the hospital.

4 Nov, 2021 | 10:03h | UTC

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: July 2021 update on post-discharge thromboprophylaxis – Blood Advances

M-A: Zinc might help to stave off respiratory infection symptoms and cut illness duration – “But quality of evidence variable, and no clarity on optimal formulation or dose”.

4 Nov, 2021 | 09:53h | UTC

News Release: Zinc might help to stave off respiratory infection symptoms and cut illness duration – BMJ

Original Study: Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials – BMJ Open

Commentary on Twitter

A zinc supplement might help stave off the symptoms of respiratory tract infections, such as coughing, congestion, and sore throat, and cut illness duration, suggests a pooled analysis of the available evidence, published in @BMJ_Open https://t.co/Nq5KadAw5y

— BMJ Group (@bmj_company) November 2, 2021

Review: Lower carbohydrate diets for adults with type 2 diabetes.

4 Nov, 2021 | 09:55h | UTC

Lower carbohydrate diets for adults with type 2 diabetes – British Journal of Nutrition

Meta-analysis of randomized trials: patients adhering to a low carbohydrate diet for six months may experience remission of diabetes without adverse consequences

Low carbohydrate diet: Insights from a general practice service in patients with type 2 diabetes

Position Statement on Low-Carbohydrate Diets for Adults with Diabetes

Low Carbohydrate Diets for Diabetes: A Review of the Clinical Effectiveness and Guidelines

Systematic Review: Low‐carbohydrate Diets for Type 2 Diabetes Management

Practical Guide: Adapting Diabetes Medication for Low Carbohydrate Management of Type 2 Diabetes

Observational Study: Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet

Study: Dietary Carbohydrate Restriction Improves Metabolic Syndrome Independent of Weight Loss

Research: Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes

A national HPV vaccination program in England was associated with an estimated reduction in cervical cancer rates of 87% for those offered the vaccine at age 12–13 years.

4 Nov, 2021 | 09:58h | UTC

The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study – The Lancet

Nationwide cohort study in Sweden shows HPV vaccination linked to reduced risk of invasive cervical cancer

CDC: 92% of Human Papillomavirus–Attributable Cancers can be Targeted by HPV Vaccination

Meta-Analysis: Population-level Impact of HPV Vaccination Programs

Commentary on Twitter

NEW—Cervical cancer rates 87% lower in women offered vaccination against human papillomavirus (#HPV) between ages 12-13 than in previous generations, English study confirms.

First direct evidence of cervical cancer prevention using bivalent vaccine: https://t.co/HdQbGIKxZp pic.twitter.com/PMFermHGOv

— The Lancet (@TheLancet) November 3, 2021

Spontaneous coronary artery dissection: Principles of management.

4 Nov, 2021 | 09:52h | UTC

Spontaneous coronary artery dissection: Principles of management – Cleveland Clinic Journal of Medicine

Spontaneous Coronary Artery Dissection: Pitfalls of Angiographic Diagnosis and an Approach to Ambiguous Cases.

Spontaneous Coronary Artery Dissection: Clinical Considerations in Diagnosis and Treatment

Review: Spontaneous Coronary Artery Dissections and Associated Predisposing Factors

Study: Natural History of Spontaneous Coronary Artery Dissection

Spontaneous Coronary Artery Dissection: An Often Unrecognized Cause of Acute Coronary Syndrome

ESC position paper on spontaneous coronary artery dissection

Guideline: Spontaneous Coronary Artery Dissection

Study: Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence

COVID-19 vaccination in pregnancy—number needed to vaccinate to avoid harm.

3 Nov, 2021 | 10:09h | UTC

COVID-19 vaccination in pregnancy—number needed to vaccinate to avoid harm – The Lancet Infectious Diseases

A case-controlled study showed Covid-19 vaccination during early pregnancy was not associated with increased risk of first-trimester miscarriage.

Editorial: Covid-19 treatments and vaccines must be evaluated in pregnancy.

AstraZeneca vaccination not linked to reduced fertility rates and adverse birth outcomes.

Cohort study: Vaccinated pregnant patients had 90% lower risk of severe or critical Covid-19 compared with unvaccinated pregnant patients.

Two observational studies suggest spontaneous abortion is not increased following COVID-19 mRNA vaccination during pregnancy.

Study shows high effectiveness of the Pfizer mRNA COVID-19 vaccine in pregnancy.

5 Crucial Things to Know About COVID-19 Vaccines and Pregnancy.

CDC Guidance: Pregnant people should be vaccinated against COVID-19.

ACOG and SMFM Recommend COVID-19 Vaccination for Pregnant Individuals – “ACOG encourages its members to enthusiastically recommend vaccination to their patients.”

Cohort study: Pfizer/BioNTech COVID vaccine associated with 78% lower risk of Covid-19 in pregnancy.

CDC advisers endorse Pfizer’s Covid-19 vaccine for kids 5-11.

3 Nov, 2021 | 10:11h | UTC

ACIP Presentation Slides: November 2-3, 2021 Meeting – Centers for Disease Control and Prevention

Commentaries:

CDC advisors give go-ahead to COVID-19 vaccines for young kids – CIDRAP

CDC advisers endorse Pfizer’s Covid-19 vaccine for kids 5-11 – STAT

American Academy of Pediatrics Applauds CDC Advisory Committee’s Approval of Safe, Effective COVID-19 Vaccine for Children Ages 5-11

Adolescents’ recreational screen time doubled during pandemic, affecting mental health.

3 Nov, 2021 | 10:06h | UTC

News release: Adolescents’ recreational screen time doubled during pandemic, affecting mental health – University of California, San Francisco

Original Study: Screen Time Use Among US Adolescents During the COVID-19 Pandemic: Findings From the Adolescent Brain Cognitive Development (ABCD) Study – JAMA Pediatrics

Commentary: Kids nearly doubled screen time during the pandemic, but there is something you can do about it – CNN

Commentary from the author on Twitter

🚨 New @UCSF study in @JAMAPediatrics 🚨

Recreational #ScreenTime in teens doubled to nearly 8⃣ hours per day during the #COVID19 #pandemic, excluding screen time for school.

⬆️ screen time linked to
⬇️ mental health
⬆️ stress
⬇️ social support

🔗 https://t.co/04RhNIAh4r 📺 pic.twitter.com/f2PvETdFbF

— Jason Nagata, MD (@jasonmnagata) November 1, 2021

Short Review: Cardiac injury in Covid-19.

3 Nov, 2021 | 10:04h | UTC

Cardiac injury in COVID-19 – Intensive Care Medicine

Commentary on Twitter

Myocardial injury in #COVID19, many potential mechanisms:
🫀myocardial DO2/VO2 imbalance
🫀ARDS & MV
🫀cytokine storm
🫀direct viral lesion.
Variable clinical presentations, with high complications rates, mortality & risk of long-term cardiac impairment.https://t.co/wxPDDrtEoY pic.twitter.com/vOx1B4cwY2

— Intensive Care Medicine (@yourICM) November 2, 2021

Review: The role of chest imaging in the diagnosis, management, and monitoring of Covid-19.

3 Nov, 2021 | 10:05h | UTC

The role of chest imaging in the diagnosis, management, and monitoring of coronavirus disease 2019 (COVID-19) – Insights into Imaging

RCT: Among children with community-acquired pneumonia discharged within 48 hours from the ED or hospital, lower-dose outpatient oral amoxicillin was noninferior to a higher dose, and a 3-day duration course was noninferior to 7 days.

3 Nov, 2021 | 09:56h | UTC

Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial – JAMA (free for a limited period)

RCT: 5 days of high-dose amoxicillin therapy noninferior to 10 days for the treatment of pediatric community-acquired pneumonia

Randomized Trial: Amoxicillin for 3 Days Noninferior to Amoxicillin for 5 Days for Chest-Indrawing Pneumonia in Children

ACP Guidance: Appropriate Use of Short-Course Antibiotics in Common Infections

RCT: 7 days of antibiotic therapy as good as 14 days for afebrile men with urinary tract infection.

RCT: A Seven-days course of antibiotics for the treatment of bloodstream infections by Enterobacterales was noninferior to a 14-days course.

RCT: Among patients with prosthetic joint infection, antibiotic therapy for 6 weeks was NOT shown to be noninferior to antibiotic therapy for 12 weeks and resulted in a higher percentage of patients with unfavorable outcomes.

Randomized Trial: Seven vs. Fourteen Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia

Commentary on Twitter

🔥Just published🔥
CAP-IT RCT
Children w CAP discharged from ED or hospital (w/in48 hrs)
lower-dose outpatient oral amoxicillin was noninferior to higher dose& 3d was noninferior to 7 d, w regard to need for Abx re-treatment @BradSpellberg table update 🤔 https://t.co/VkxBmJaEeW pic.twitter.com/fKzpGp1XM7

— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) November 2, 2021

AAP Policy Statement: Preventing Home Medication Administration Errors.

3 Nov, 2021 | 09:58h | UTC

Preventing Home Medication Administration Errors – Pediatrics

Commentary: Ways to Prevent Children’s Medication Errors at Home – American Academy of Pediatrics

Commentary on Twitter

This policy statement recommends strategies to reduce the incidence of pediatric medication administration errors at home, including those involving prescription and over-the-counter medications, as well as vitamins/supplements: https://t.co/vgqGNqw5NJ #Pediatrics pic.twitter.com/ar4EeZSxs0

— AAP CME Journals (@AAPJournals) November 2, 2021

AHA Scientific Statement: 2021 Dietary Guidance to Improve Cardiovascular Health.

3 Nov, 2021 | 10:00h | UTC

2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association – Circulation

News release: New look at nutrition research identifies 10 features of a heart-healthy eating pattern – American Heart Association

Top Things to Know: 2021 Dietary Guidance to Improve Cardiovascular Health – American Heart Association

Commentaries:

‘Balance’ is the key word in new dietary guidance for heart health – American Heart Association

The new American Heart Association dietary guidance to improve population-level cardiometabolic health: moving toward a heart-healthy food environment – American Heart Association

Commentary on Twitter

CHOOSE MINIMALLY PROCESSED FOODS INSTEAD OF ULTRA-PROCESSED FOODS is one of the 10 evidence-based dietary pattern recommendations in the new excellent 2021 American Heart Association Scientific Statement on Dietary Guidance to Improve Cardiovascular Healthhttps://t.co/YgtDKz05EP

— Carlos A. Monteiro (@CMonteiro_USP) November 2, 2021

Review: Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation.

3 Nov, 2021 | 09:45h | UTC

Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation – Nature Reviews Gastroenterology & Hepatology

Commentary on Twitter

New content online: Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation https://t.co/sWd1Vs6N2c pic.twitter.com/XZo8ETzhEl

— Nature Reviews Gastroenterology & Hepatology (@NatRevGastroHep) November 2, 2021

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