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Contrary to prior studies, new research finds no heightened postoperative risk after a recent covid-19 infection

4 Apr, 2023 | 13:54h | UTC

Estimated Risk of Adverse Surgical Outcomes Among Patients With Recent COVID-19 Infection Using Target Trial Emulation Methods – JAMA Network Open

Commentaries:

COVID infection within 60 days not tied to adverse postsurgical outcomes – CIDRAP

Adverse Postoperative Outcomes Not Increased With Recent COVID-19 – HealthDay

Related:

Statement | Pre-procedure and pre-admission COVID-19 testing no longer recommended for asymptomatic patients

ASA and APSF statement on perioperative testing for the COVID-19 virus.

Surgical Triage and Timing for Patients with COVID: A Guidance Statement from the Society of Thoracic Surgeons – Annals of Thoracic Surgery

When to operate after SARS-CoV-2 infection? A review on the recent consensus recommendation of the DGC/BDC and the DGAI/BDA – Langenbeck’s Archives of Surgery

Guideline Update: Timing of elective surgery and risk assessment after SARS-CoV-2 infection – “The guidance remains that patients should avoid elective surgery within 7 weeks of infection, unless the benefits of doing so exceed the risk of waiting”.

Perioperative cardiovascular considerations prior to elective noncardiac surgery in patients with a history of Covid-19.

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

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

The risk of postoperative complications following major elective surgery in active or resolved COVID-19 in the United States – Major, elective surgery 0–4 weeks after Covid-19 is associated with greatly increased risk of postoperative complications; surgery performed 4–8 weeks after infection is still associated with an increased risk of pneumonia.

ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.

Position statement: Perioperative management of post-COVID-19 surgical patients.

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

 


Bivalent Booster | Observational data suggests no increased cardiovascular risks compared to monovalent vaccine

4 Apr, 2023 | 13:55h | UTC

Stroke, Myocardial Infarction, and Pulmonary Embolism after Bivalent Booster – New England Journal of Medicine

Commentary: Similarly Low Risk of CV Events With Bivalent and Monovalent mRNA Boosters – TCTMD

 

Commentary on Twitter

 


M-A | Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2

4 Apr, 2023 | 13:52h | UTC

Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2: a rapid review with network meta-analysis of diagnostic test accuracy studies – BMC Medicine

Related:

Performance of antigen lateral flow devices in the UK during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic: a diagnostic and observational study – The Lancet Infectious Diseases

Accuracy of rapid point-of-care antigen-based diagnostics for SARS-CoV-2: An updated systematic review and meta-analysis with meta-regression analyzing influencing factors – PLOS Medicine

Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ

Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection – Cochrane Library

 


RCT | Vitamin D supplementation shows no significant impact on psoriasis severity

4 Apr, 2023 | 13:51h | UTC

Summary: In a randomized, double-blind, placebo-controlled clinical trial involving 122 participants with plaque psoriasis, researchers investigated the effects of vitamin D supplementation on psoriasis severity during winter. Participants received either vitamin D (cholecalciferol, 100,000 IU loading dose followed by 20,000 IU/week) or a placebo for four months. The primary outcome was Psoriasis Area Severity Index (PASI) scores, with secondary outcomes including Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores.

The study found no significant difference in PASI scores or secondary outcomes between the two groups. The results suggest that vitamin D supplementation does not affect psoriasis severity. However, low baseline severity scores and a lower than expected increase in 25-hydroxyvitamin D levels in the intervention group may have influenced the findings, indicating that further research may be needed to account for these factors.

Article: Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels: A Randomized Clinical Trial – JAMA Dermatology (free for a limited period)

Commentary: Vitamin D Ineffective for Psoriasis Patients with Lower Serum 25-Hydroxyvitamin D Levels in Winter – HCP Live

 

Commentary on Twitter

 


M-A | No significant health benefits found for low-volume alcohol intake

4 Apr, 2023 | 13:48h | UTC

Summary: This systematic review and meta-analysis aimed to investigate the association between alcohol use and all-cause mortality, taking into account potential sources of bias. The study analyzed data from 107 cohort studies published between January 1980 and July 2021, which included 4,838,825 participants and 425,564 deaths.

The study found no significant reductions in all-cause mortality risk for drinkers who consumed less than 25 grams of ethanol per day compared to lifetime nondrinkers. However, there was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams per day and male drinkers who drank 45 or more grams per day.

The analysis highlighted the importance of controlling for former drinker bias and misclassification errors and found sex differences in the risk of all-cause mortality.

In conclusion, the updated meta-analysis found no significantly reduced risk of all-cause mortality associated with low-volume alcohol consumption after adjusting for potential confounding factors. The study recommends that future longitudinal studies in this field should attempt to minimize lifetime selection biases by not including former and occasional drinkers in the reference group and by using younger cohorts at baseline.

Article: Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses – JAMA Network Open

Commentary: Drinking Alcohol Brings No Health Benefits, Study Finds – HealthDay

Related:

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020 – The Lancet

National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study – The Lancet Public Health

Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet

The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet Psychiatry

Prioritising action on alcohol for health and development – The BMJ

Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study – The Lancet Oncology

 


Cohort study | Younger stroke survivors show elevated cancer risk for up to 8 years

4 Apr, 2023 | 13:46h | UTC

Summary: In this cohort study, 390,398 patients aged 15 years or older in the Netherlands, without a history of cancer and with a first-ever ischemic stroke or intracerebral hemorrhage (ICH), were analyzed between January 1, 1998, and January 1, 2019. The primary outcome was the cumulative incidence of first-ever cancer after the index stroke, stratified by stroke subtype, age, and sex, compared with age-, sex-, and calendar year-matched peers from the general population.

The findings revealed that, in the first year after a stroke, patients aged 15 to 49 years had a 3- to 5-fold increased risk of cancer compared to individuals without a stroke. In contrast, the risk was only slightly elevated for patients aged 50 years or older. The cancer risk remained elevated for up to 8 years after an ischemic stroke and 6 years after an ICH in the younger age group, with the highest risks observed for lung cancer, gastrointestinal cancer, and hematologic cancer.

The findings may be confounded by shared risk factors, such as smoking. Alternatively, the increased cancer risk may have a causal mechanism between cancer and stroke, possibly related to the hypercoagulable state induced by cancer. However, the study design does not allow for conclusions about causal mechanisms, and the researchers called for further studies investigating the usefulness of cancer screening after a stroke.

Article: Association of Stroke at Young Age With New Cancer in the Years After Stroke Among Patients in the Netherlands – JAMA Network Open

 


RCT | Comparable results in endovascular therapy using general anesthesia vs. procedural sedation for stroke treatment

4 Apr, 2023 | 13:45h | UTC

Outcomes After Endovascular Therapy With Procedural Sedation vs General Anesthesia in Patients With Acute Ischemic Stroke: The AMETIS Randomized Clinical Trial – JAMA Neurology (free for a limited period)

See also: Visual Abstract

Related: M-A | General Anesthesia vs. to Non-GA in endovascular thrombectomy for ischemic stroke

 


RCT | Pelvic intraoperative neuromonitoring prevents dysfunction in patients with rectal cancer

4 Apr, 2023 | 13:43h | UTC

Pelvic Intraoperative Neuromonitoring Prevents Dysfunction in Patients With Rectal Cancer: Results From a Multicenter, Randomized, Controlled Clinical Trial of a NEUROmonitoring System (NEUROS) – Annals of Surgery

 


RCT | Memantine outperforms placebo for hair-pulling and skin-picking behaviors

4 Apr, 2023 | 13:40h | UTC

Double-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder – American Journal of Psychiatry (link to abstract – $ for full-text)

News release: New research points to drug option for hair-pulling, skin-picking disorders – University of Chicago

Commentary: Memantine May Reduce Symptoms of Hair-Pulling, Skin-Picking Disorder – Psychiatric News Alert

 


Cross-sectional study | Association between sodium intake and coronary and carotid atherosclerosis

4 Apr, 2023 | 13:42h | UTC

The association between sodium intake and coronary and carotid atherosclerosis in the general Swedish population – European Heart Journal Open

Editorial: Dietary salt intake and atherosclerosis: an area not fully explored – European Heart Journal Open

News Release: High salt diet associated with hardened arteries even in people with normal blood pressure – European Society of Cardiology

 


RCT | Baricitinib + topical corticosteroids effective in kids with moderate-severe atopic dermatitis

4 Apr, 2023 | 13:39h | UTC

Efficacy and safety of baricitinib in combination with topical corticosteroids in pediatric patients with moderate-to-severe atopic dermatitis with inadequate response to topical corticosteroids: results from a phase 3, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS) – British Journal of Dermatology

 


S1-guideline cutaneous and subcutaneous leiomyosarcoma

4 Apr, 2023 | 13:37h | UTC

S1-guideline cutaneous and subcutaneous leiomyosarcoma – Journal of the German Dermatology Society

 


Cochrane Library | Hearing conditions: evidence, experience and resources

4 Apr, 2023 | 13:36h | UTC

Hearing conditions: evidence, experience and resources – Evidently Cochrane

 


Perspective | Coping with anastomotic leaks: harder as one gets older?

4 Apr, 2023 | 13:34h | UTC

Coping with anastomotic leaks: harder as one gets older? – British Journal of Surgery

 


RCT | Effectiveness of nail bed repair in children with vs. without replacing the fingernail

4 Apr, 2023 | 13:33h | UTC

Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial – British Journal of Surgery

News Release: New approach to nail bed injury surgery could significantly cut NHS costs – University of Oxford

 


Two FITs better than one: enhancing diagnostic performance for colorectal cancer in symptomatic populations

4 Apr, 2023 | 13:32h | UTC

Double faecal immunochemical testing in patients with symptoms suspicious of colorectal cancer – British Journal of Surgery

 


Brief Review | What every gastroenterologist should know about gastrointestinal neuroendocrine tumors

4 Apr, 2023 | 13:29h | UTC

What Every Gastroenterologist Should Know About Gastrointestinal NETs – American Journal of Gastroenterology

 


M-A | Evolution and refinement of magnetically guided sentinel lymph node detection in breast cancer

4 Apr, 2023 | 13:30h | UTC

Evolution and refinement of magnetically guided sentinel lymph node detection in breast cancer: meta-analysis – British Journal of Surgery

 


Perspective | Create intensive care green teams, there is no time to waste

4 Apr, 2023 | 13:27h | UTC

Create intensive care green teams, there is no time to waste – Intensive Care Medicine

 

Commentary on Twitter

 


Cohort Study | Preoperative depression has minimal impact on 5-year bariatric surgery outcomes

4 Apr, 2023 | 13:23h | UTC

Preoperative Depression Status and 5 Year Metabolic and Bariatric Surgery Outcomes in the PCORnet Bariatric Study Cohort – Annals of Surgery

 


Applying AI to MRI | A promising approach for detecting severe mental illness risk

4 Apr, 2023 | 13:25h | UTC

Detecting individuals with severe mental illness using artificial intelligence applied to magnetic resonance imaging – eBioMedicine

 


Single-arm study | Transcatheter arterialization of deep veins may help avoid amputation in chronic limb-threatening ischemia

3 Apr, 2023 | 14:03h | UTC

Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

New procedure helps patients avoid leg amputation – Vanderbilt University

PROMISE II: Flow-Diverting Procedure May Save Limbs in CLTI – TCTMD

Transcatheter Arterialization Could Revolutionize Treatment of Limb-Threatening Ischemia – HCP Live

Transcatheter Arterialization for Limb Ischemia – American College of Cardiology

 

Commentary on Twitter

https://twitter.com/NEJM/status/1641192272539824128

 


Cohort Study | Celiac axis stenosis is an underestimated risk factor for increased morbidity after pancreatoduodenectomy

4 Apr, 2023 | 13:20h | UTC

Celiac Axis Stenosis is an Underestimated Risk Factor for Increased Morbidity After Pancreatoduodenectomy – Annals of Surgery

 


Cohort Study | Assessing active surveillance outcomes in non-intraabdominal desmoid-type fibromatosis patients

4 Apr, 2023 | 13:21h | UTC

A Nationwide Prospective Clinical Trial on Active Surveillance in Patients With Non-intraabdominal Desmoid-type Fibromatosis: The GRAFITI Trial – Annals of Surgery

 


AHA Scientific Statement | Pediatric primary hypertension: An underrecognized condition

3 Apr, 2023 | 14:05h | UTC

Pediatric Primary Hypertension: An Underrecognized Condition: A Scientific Statement From the American Heart Association – Hypertension

Top Things to Know: Pediatric Primary Hypertension: An Underrecognized Condition – American Heart Association

News Release: Children with high blood pressure often become adults with high blood pressure – American Heart Association

Commentaries:

The Birth of Pediatric Primary Hypertension – American Heart Association

AHA Highlights Pediatric Hypertension in Scientific Statement – HCP Live

 


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