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WHO Policy Brief: The urgent need to implement patient blood management.

20 Oct, 2021 | 10:15h | UTC

The urgent need to implement patient blood management: policy brief – World Health Organization

Covid-19: New mutation of Delta variant under close watch in UK.

20 Oct, 2021 | 10:21h | UTC

Covid-19: New mutation of Delta variant under close watch in UK – BBC

WHO’s 7 policy recommendations on building resilient health systems.

20 Oct, 2021 | 10:18h | UTC

News release: WHO’s 7 policy recommendations on building resilient health systems – World Health Organization

WHO Position Paper: Building health systems resilience for universal health coverage and health security during the COVID-19 pandemic and beyond

Commentary on Twitter (thread – click for more)

#COVID19 has shown that there can be no lasting economic development without #HealthForAll & protection against health emergencies. Here are WHO’s 7⃣ recommendations on building resilient health systems based on #PrimaryHealthCare & #HealthSecurity.

👉 https://t.co/pp5Gh9BTnz pic.twitter.com/0d021b5ylf

— World Health Organization (WHO) (@WHO) October 19, 2021

Systematic Review: anti-interleukin-13 or anti-interleukin-4 agents may be appropriate for adults with moderate-to-severe uncontrolled asthma who have not responded to other treatments.

20 Oct, 2021 | 10:19h | UTC

Anti‐interleukin‐13 and anti‐interleukin‐4 agents versus placebo, anti‐interleukin‐5 or anti‐immunoglobulin‐E agents, for people with asthma – Cochrane Library

Summary: Anti-interleukin-13 or anti-interleukin-4 agents versus placebo, anti-interleukin-5 or anti-immunoglobulin-E agents, for children and adults with asthma – Cochrane Library

Commentary on Twitter (thread – click for more)

Lead author David Evans said “Approximately five to ten percent of people with asthma experience symptoms that are severe or difficult-to-treat… [1/3] pic.twitter.com/Nw606oSrX0

— CochraneAirways (@CochraneAirways) October 19, 2021

Users’ guides to the medical literature: how to interpret and use a clinical practice guideline or recommendation.

20 Oct, 2021 | 10:09h | UTC

How to Interpret and Use a Clinical Practice Guideline or Recommendation: Users’ Guides to the Medical Literature – JAMA (free for a limited period)

Author Interview: How to Interpret and Use a Clinical Practice Guideline

RCT: In patients with Type 2 Diabetes, Tirzepatide is associated with reduced weight, improved glycemic control, and lower risk of hypoglycemia compared to insulin glargine.

20 Oct, 2021 | 10:13h | UTC

Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial – The Lancet (link to abstract – $ for full-text)

RCT: Once-weekly tirzepatide vs. once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes.

RCT: Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2.

RCT: Tirzepatide yielded greater glycated hemoglobin and body weight reductions compared to Semaglutide 1 mg.

Review: Athletes and Hypertension.

20 Oct, 2021 | 09:52h | UTC

Athletes and Hypertension – Current Cardiology Reports

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

20 Oct, 2021 | 10:11h | UTC

Association of Tramadol vs Codeine Prescription Dispensation With Mortality and Other Adverse Clinical Outcomes – JAMA (free for a limited period)

Editorial: Tramadol, Codeine, and Risk of Adverse Outcomes – JAMA (free for a limited period)

Choosing Wisely in Pediatric Hospital Medicine: 5 New Recommendations to Improve Value.

20 Oct, 2021 | 09:58h | UTC

Choosing Wisely in Pediatric Hospital Medicine: 5 New Recommendations to Improve Value – Hospital Pediatrics

See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada

Cohort study: Acute urinary retention may be a clinical marker of occult prostate cancer and other urogenital, colorectal, and neurological cancers.

20 Oct, 2021 | 09:50h | UTC

Acute urinary retention and risk of cancer: population based Danish cohort study – The BMJ

Commentary on Twitter

This study finds that a first diagnosis of acute urinary retention in patients aged 50 years or older was a clinical marker not only for prostate cancer but also for other urogenital cancers and colorectal and neurological cancershttps://t.co/0f1Z93cqR0 @dceaarhus

— The BMJ (@bmj_latest) October 19, 2021

Things We Do for No Reason: fluid restriction for the management of acute decompensated heart failure in patients with reduced ejection fraction.

20 Oct, 2021 | 10:00h | UTC

Things We Do for No Reason™: Fluid Restriction for the Management of Acute Decompensated Heart Failure in Patients With Reduced Ejection Fraction – Journal of Hospital Medicine (free for a limited period)

Commentary on Twitter

🚨 Today’s Things We Do for No Reason ™️ from @JHospMedicine: Why do we think fluid restriction is important in managing ADHF? What’s the alternative? 💓

📢 Sound off in the replies why you do or don’t follow this practice. 👀#HeartFailure #ADHF https://t.co/QayZdqqNSd

— Society of Hospital Medicine (@SocietyHospMed) October 19, 2021

Long-term consequences of the misuse of ivermectin data.

19 Oct, 2021 | 09:56h | UTC

Long-term consequences of the misuse of ivermectin data – The Lancet Infectious Diseases

Ivermectin: How false science created a Covid ‘miracle’ drug.

Fraudulent ivermectin studies open up new battleground between science and misinformation.

The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable.

Ivermectin: Cochrane’s most talked about review so far, ever. Why?

Flawed ivermectin preprint highlights challenges of COVID drug studies.

Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.

Why was a major study on ivermectin for covid-19 just retracted?

RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – “IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease”.

Ivermectin is the new hydroxychloroquine, take 2 – “Ivermectin shouldn’t be used to treat COVID-19 outside of the context of a well-designed clinical trial”.

Therapeutics and COVID-19 | WHO guideline update advises Ivermectin should only be used to treat COVID-19 within clinical trials

RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19

Commentary on Twitter

Ivermectin's data for Covid, checkered with inconsistencies, small/low quality clinical trials, and fraud, have long-term consequences for the drug's established and essential useshttps://t.co/NG6vpej8GP @TheLancetInfDis pic.twitter.com/Oz0FxUJetK

— Eric Topol (@EricTopol) October 18, 2021

RECOVERY Trial: In patients admitted to hospital with COVID-19, Colchicine did not reduce 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death.

19 Oct, 2021 | 10:14h | UTC

Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial – The Lancet Respiratory Medicine

[Preprint] PRINCIPLE RCT: Colchicine does not improve time to recovery in outpatients with Covid-19 at higher risk of complications.

COLCORONA RCT: Colchicine for community-treated patients with COVID-19 – findings suggest it may lower death and hospital admission rates, but further studies are required.

[Preprint] RECOVERY Trial: Colchicine does not improve outcomes in patients admitted to hospital with COVID-19.

Systematic Review: Colchicine for the treatment of COVID‐19 – not beneficial for hospitalized patients; inconclusive evidence for the treatment of non-hospitalized patients, “probably slightly reduces the need for hospitalization or death within 28 days compared to placebo”.

19 Oct, 2021 | 10:13h | UTC

Colchicine for the treatment of COVID‐19 – Cochrane Library

[Preprint] PRINCIPLE RCT: Colchicine does not improve time to recovery in outpatients with Covid-19 at higher risk of complications.

COLCORONA RCT: Colchicine for community-treated patients with COVID-19 – findings suggest it may lower death and hospital admission rates, but further studies are required.

[Preprint] RECOVERY Trial: Colchicine does not improve outcomes in patients admitted to hospital with COVID-19.

Commentary on Twitter

JUST PUBLISHED – Is #colchicine (often used to treat #gout) an effective treatment for people with #COVID19? ➡️ https://t.co/IF1enksFpn New @CochraneHaem systematic review includes evidence from 4 RCTS with 11,525 hospitalised & 4488 non‐hospitalised people.

— The Cochrane Library (@CochraneLibrary) October 18, 2021

China’s COVID vaccines have been crucial — now immunity is waning.

19 Oct, 2021 | 09:53h | UTC

China’s COVID vaccines have been crucial — now immunity is waning – Nature

[Preprint] Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – “Vaccine protection declined by mid-August 2021, decreasing from 91.9% in March to 53.9%”.

Observational study in Qatar showed the effectiveness of Pfizer vaccine against any SARS-CoV-2 infection dropped to 20% in months 5 through 7 after the second dose, but effectiveness against severe Covid-19 remained high.

Cohort study: Pfizer vaccine effectiveness against any infections declined from 88% during the first month after full vaccination to 47% after 5 months. Vaccine effectiveness against hospital admissions remained high; 87% within 1 month, and 88% at 5 months after full vaccination, with no significant waning.

Editorial | Covid-19 vaccination: evidence of waning immunity is overstated.

COVID vaccine immunity is waning — how much does that matter? – “As debates about booster shots heat up, what’s known about the duration of vaccine-based immunity is still evolving”.

COVID vaccine effects wane over time but still prevent death and severe illness.

Perspective | What we actually know about waning immunity.

Another study shows Pfizer mRNA vaccine immunity is reduced over time.

[Press release – not published yet] Study shows vaccine protection wanes over time, but vaccines still offer good protection against severe disease.

Studies: COVID vaccine protection waning against infection but not hospitalization.

Systematic Review: Restricting access to poisons is associated with decreases in suicide by poisoning without an equivalent shift toward other methods.

20 Oct, 2021 | 09:48h | UTC

Association Between Means Restriction of Poison and Method-Specific Suicide Rates: A Systematic Review – JAMA Network Open

Commentary on Twitter

Important new study on suicide in @JAMAHealthForum. Restricting access to poisons is associated with reductions in suicide without an equivalent shift toward other methods. https://t.co/dINq3oIxvd pic.twitter.com/vEn9wOlprN

— David Juurlink (@DavidJuurlink) October 18, 2021

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

19 Oct, 2021 | 09:52h | UTC

BJS commission on surgery and perioperative care post-COVID-19 – British Journal of Surgery

Commentary on Twitter

The @BJSurgery commission on surgery and perioperative care post #Covid_19

🌐 Global surgical community involved

😱 Pandemic uncovers problems in healthcare systems

🧑‍🎓 Training severely damaged

🧿 Ethics committee needed at surgical oncology centreshttps://t.co/CfNk9vBPjV pic.twitter.com/vomtZ3zcql

— Giovanni Marchegiani (@Gio_Marchegiani) October 16, 2021

Editorial: Preparing for “Disease X”.

19 Oct, 2021 | 09:54h | UTC

Preparing for “Disease X” – Science

Another observational study suggests Rivaroxaban is associated with higher rates of gastrointestinal bleeding than other direct oral anticoagulants.

19 Oct, 2021 | 09:47h | UTC

Rivaroxaban Is Associated with Higher Rates of Gastrointestinal Bleeding Than Other Direct Oral Anticoagulants: A Nationwide Propensity Score–Weighted Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentary: Rivaroxaban Again Linked to More Bleeding vs Other DOACs – TCTMD

Commentary on Twitter

A new study from @uni_iceland and @Landspitali finds that #Rivaroxaban is associated with a higher risk of GI bleeding compared to other direct oral anticoagulants. https://t.co/2J451CN5dD #afib #bleedingrisk #DOAC pic.twitter.com/Q6VSv5Taqg

— Annals of Int Med (@AnnalsofIM) October 13, 2021

Cluster RCT: An exercise intervention may improve academic achievement among children.

19 Oct, 2021 | 09:45h | UTC

Exercise Intervention for Academic Achievement Among Children: A Randomized Controlled Trial – Pediatrics

Commentary on Twitter

Physical inactivity is an important health concern worldwide. This study examined the effects of an exercise intervention on children’s academic achievement, cognitive function, physical fitness, and other health-related outcomes: https://t.co/Pdd0qZqYNN #Pediatrics pic.twitter.com/VkyPba3Sv2

— AAP CME Journals (@AAPJournals) October 18, 2021

Guideline: Management of anticoagulants and antiplatelet agents in cutaneous surgery.

19 Oct, 2021 | 09:50h | UTC

S3 guideline: Management of anticoagulants and antiplatelet agents in cutaneous surgery – Journal of the German Society of Dermatology

Systematic Review: Calcium channel blockers versus other classes of drugs for hypertension – “there is moderate certainty evidence that diuretics reduce major cardiovascular events and congestive heart failure more than CCBs”.

19 Oct, 2021 | 08:56h | UTC

Summary: Calcium channel blockers versus other classes of drugs for hypertension – Cochrane Library

Original Study: Calcium channel blockers versus other classes of drugs for hypertension – Cochrane Library

Commentary on Twitter

How do calcium channel blockers compare to other #antihypertensive drugs for #hypertension?💊

Our @CochraneLibrary systematic review looks at evidence from 23 RCTs involving 153,849 participants with #highbloodpressure

👉🏾https://t.co/dDLCY1RoOT #SystematicReviews #SysRev pic.twitter.com/zJ4JNRRf0L

— Cochrane Hypertension (@CochraneHTN) October 17, 2021