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Bioethics | The Reluctant Patient and the Insistent Doctor.

19 Oct, 2021 | 08:50h | UTC

The Reluctant Patient and the Insistent Doctor – The American Journal of Medicine

 

Review: Wilms Tumor.

19 Oct, 2021 | 08:44h | UTC

Wilms tumour – Nature Reviews Disease Primers (free for a limited period)

Infographic: Wilms tumour

 

Commentary on Twitter

 

Opinion | Multi-cancer screening tests: communicating about risks should be prioritized.

19 Oct, 2021 | 08:49h | UTC

Multi-cancer screening tests: communicating about risks should be prioritized. – The American Journal of Medicine

 

RCT supports the use of therapeutic heparin in moderately ill patients admitted to the hospital with Covid-19.

17 Oct, 2021 | 21:35h | UTC

Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial – The BMJ

Commentary: High-dose of readily available blood thinner reduces risk of death for moderately ill COVID-19 patients – St. Michael’s Hospital

Related studies (some conflicting results)

RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.

Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.

M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

RCT: In noncritically ill patients hospitalized with Covid-19, therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge compared with usual-care thromboprophylaxis.

RCT: In critically ill patients with Covid-19, therapeutic anticoagulation with heparin did not result in improved outcomes compared to usual-care pharmacologic thromboprophylaxis.

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

 

Commentary on Twitter

 

Review: Stroke prevention after cryptogenic stroke.

19 Oct, 2021 | 08:46h | UTC

Stroke Prevention After Cryptogenic Stroke – Current Cardiology Reports

Related:

2 recent meta-analysis highlight the benefits of short term (30 days) dual antiplatelet therapy with aspirin + clopidogrel in patients within 24 hours of high-risk transient ischemic attack or mild-moderate ischemic stroke.

Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke – The BMJ

Stroke and transient ischaemic attack in over 16s: diagnosis and initial management – National Institute for Health and Care Excellence

Canadian Stroke Best Practice Recommendations for Acute Stroke Management

 

M-A: Risk factors for invasive candida infection in critically ill patients – The risk factors associated with the highest risk for ICI were broad spectrum antibiotics (OR 5.6), blood transfusion (OR 4.9), Candida colonization (OR 4.7), central venous catheter (OR 4.7) and total parenteral nutrition (OR 4.6).

19 Oct, 2021 | 08:47h | UTC

Risk factors for invasive candida infection in critically ill patients – a systematic review and meta-analysis – Chest

 

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.

17 Oct, 2021 | 21:32h | UTC

News release: Johnson & Johnson COVID-19 Vaccine Booster Shot Unanimously Recommended for Emergency Use Authorization by U.S. FDA Advisory Committee

Commentaries:

FDA panel endorses booster shot for J&J COVID-19 vaccine – Associated Press

The Johnson & Johnson one-dose vaccine offers good protection now. A booster shot will maximize that, experts say – CNN

FDA advisers recommend J&J Covid-19 vaccine boosters, talk mix and match boosters – CNN

Related: [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.

 

[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%”.

17 Oct, 2021 | 21:29h | UTC

Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – medRxiv

Related:

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.

 

Commentary on Twitter

 

Review: SARS-CoV-2 Dose, Infection, and Disease Outcomes for COVID-19.

17 Oct, 2021 | 21:30h | UTC

SARS-CoV-2 Dose, Infection, and Disease Outcomes for COVID-19 – A Review – Clinical Infectious Diseases

Related: Seroconversion and fever are dose-dependent in a nonhuman primate model of inhalational COVID-19.

 

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

 

Management of Diabetes Mellitus in patients with CKD: Core Curriculum 2022.

17 Oct, 2021 | 21:23h | UTC

Management of Diabetes Mellitus in Patients With CKD: Core Curriculum 2022 – American Journal of Kidney Diseases

 

What can masks do? Part 2: What makes for a good mask study — and why most fail.

17 Oct, 2021 | 21:25h | UTC

COMMENTARY: What can masks do? Part 2: What makes for a good mask study — and why most fail – CIDRAP

See also: COMMENTARY: What can masks do? Part 1: The science behind COVID-19 protection – CIDRAP

 

Guidelines for the surgical management of ulcerative colitis.

17 Oct, 2021 | 21:21h | UTC

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Ulcerative Colitis – Diseases of the Colon & Rectum

 

Commentary on Twitter

 

Eight months later: Researchers compare immune responses elicited by three COVID-19 vaccines.

17 Oct, 2021 | 21:27h | UTC

News release: Eight months later: Researchers compare immune responses elicited by three COVID-19 vaccines – Beth Israel Deaconess Medical Center

Original study: Differential Kinetics of Immune Responses Elicited by Covid-19 Vaccines – New England Journal of Medicine

 

Commentary on Twitter

 

Viewpoint: Surgical overtreatment and shared decision-making—the limits of choice. – “Payment models further incentivize surgical intervention. Fee-for-service payment plans reward surgeons for operating, not for ensuring that surgery is right for a patient”.

17 Oct, 2021 | 21:17h | UTC

Surgical Overtreatment and Shared Decision-making—The Limits of Choice – JAMA Surgery (free for a limited period)

 

Commentary on Twitter

 

Guidelines for anesthesiologists on patient blood management in cardiac surgery.

17 Oct, 2021 | 21:22h | UTC

2021 Clinical Practice Guidelines for Anesthesiologists on Patient Blood Management in Cardiac Surgery – Journal of Cardiothoracic and Vascular Anesthesia

 

Commentary on Twitter

 

M-A: Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis – although Etoricoxib 60 mg/day and diclofenac 150 mg/day seem to be most effective treatments, topical diclofenac 70-81 mg/day is safer and should be considered as first line treatment.

17 Oct, 2021 | 21:14h | UTC

Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis – The BMJ

News release: Topical pain-killers more effective, safer than opioids for knee osteoarthritis pain – St. Michael’s Hospital

Commentary: Network meta-analysis compares analgesic regimens for osteoarthritis – medwire News

 

Commentary on Twitter

 

RCT: After third molar surgery, Ibuprofen doses above 400 mg did not significantly increase the analgesic effect, and Paracetamol 1000/codeine 60 mg was not more effective than ibuprofen 400 mg.

17 Oct, 2021 | 21:16h | UTC

Analgesic effect of oral ibuprofen 400, 600, and 800 mg; paracetamol 500 and 1000 mg; and paracetamol 1000 mg plus 60 mg codeine in acute postoperative pain: a single-dose, randomized, placebo-controlled, and double-blind study – European Journal of Clinical Pharmacology

 

Review: Management of infectious emergencies for the inpatient dermatologist.

17 Oct, 2021 | 21:06h | UTC

Management of Infectious Emergencies for the Inpatient Dermatologist – Current Dermatology Reports (if this link is paywalled, try this one)

 

Serious injury risk higher for horse riding than for football, motor racing, or skiing – “Chest most common site of injury, but head and neck injuries most lethal”.

17 Oct, 2021 | 21:08h | UTC

News release: Serious injury risk higher for horse riding than for football, motor racing, or skiing – BMJ

Original study: Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA – Trauma Surgery & Acute Care Open

Commentary: Horse Riding More Dangerous Than Skiis And Motorcycles, Injury Data Reveal – Science Alert

 

M-A: Psychosocial and psychological interventions for relapse prevention in schizophrenia.

17 Oct, 2021 | 21:12h | UTC

Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis – The Lancet Psychiatry

 

Commentary on Twitter

 

PHE Statement: The role of face coverings in mitigating the transmission of SARS-CoV-2 virus.

15 Oct, 2021 | 02:52h | UTC

The role of face coverings in mitigating the transmission of SARS-CoV-2 virus: statement from the Respiratory Evidence Panel – Public Health England

 

Commentary on Twitter

https://twitter.com/OutbreakJake/status/1448651504563355657

 

What can masks do? The science behind COVID-19 protection.

15 Oct, 2021 | 02:51h | UTC

COMMENTARY: What can masks do? Part 1: The science behind COVID-19 protection – CIDRAP

 

Review: Timing of antibiotic therapy in the ICU.

17 Oct, 2021 | 21:05h | UTC

Timing of antibiotic therapy in the ICU – Critical Care

 

Study evaluated several heterologous SARS-CoV-2 vaccine regimens; no efficacy data but there was increased antibody production on study days 15 and 29 after booster shots from Moderna and Pfizer.

15 Oct, 2021 | 02:49h | UTC

Heterologous SARS-CoV-2 Booster Vaccinations: Preliminary Report – medRxiv

Commentary: Study: Mixing and Matching COVID-19 Booster Shots Is Effective, Safe – U.S. News

 

Commentary on Twitter

 

‘I hope you die’: how the COVID pandemic unleashed attacks on scientists.

15 Oct, 2021 | 02:46h | UTC

‘I hope you die’: how the COVID pandemic unleashed attacks on scientists – Nature

 

Commentary on Twitter

 

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