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#OHCA? 6 trials with potential to influence guidelines/practice:
💉 COCA: Calcium for #OHCA
⚡️ DOSE VF: double sequential external defib
🩸 INCEPTION: early #ECLS
💨 EXACT: ⬇️ O2
❄️ TTM2: targeted hypo vs normothermia
🩸 BOX: BP & O2 targets post #resus
🖇️ https://t.co/xtGmuYtXKF pic.twitter.com/3BOlfl5hRd

— Intensive Care Medicine (@yourICM) March 13, 2023

SR | Yoga may improve frailty markers in older adults

15 Mar, 2023 | 15:08h | UTC

Effect of Yoga on Frailty in Older Adults: A Systematic Review – Annals of Internal Medicine (link to abstract – $ for full-text)

Annals Video Summary: Effect of Yoga on Frailty in Older Adults: A Systematic Review

News Release: Yoga may help to prevent frailty in older adults – American College of Physicians

Deprescribing strategies for opioids and benzodiazepines with emphasis on concurrent use: a scoping review

15 Mar, 2023 | 15:06h | UTC

Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review – Journal of Clinical Medicine

Physician-led medication reviews in polypharmacy patients treated with at least 12 medications in a type 2 diabetes outpatient clinic: a randomised trial – Diabetic Medicine

RCT | A deprescribing intervention reduced medication burden among older adults in post-acute care

Achieving sustainable healthcare through deprescribing of unnecessary medications: making sense of the evidence – Cochrane Library

Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis – Health Technology Assessment

Barriers and facilitators to deprescribing of cardiovascular medications: a systematic review – BMJ Open

A National Modified Delphi Consensus Process to Prioritize Experiences and Interventions for Antipsychotic Medication Deprescribing Among Adult Patients With Critical Illness – Critical Care Explorations

Deprescribing proton pump inhibitors – Australian Journal of General Practice

Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis – Age and Ageing

Optimizing Medication Use in Older Adults With Rheumatic Musculoskeletal Diseases: Deprescribing as an Approach When Less May Be More – ACP Open Rheumatology

Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy – European Heart Journal – Cardiovascular Pharmacotherapy

Deprescribing in Older Adults with Cardiovascular Disease – Journal of the American College of Cardiology

Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology

Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports

How-to guide for medication reviews in older adults with cancer: A Young International Society of Geriatric Oncology and Nursing & Allied Health Interest Group initiative – Journal of Geriatric Oncology

Deprescribing in Palliative Cancer Care – Life

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360

Process evaluation of implementation strategies to reduce potentially inappropriate medication prescribing in older population: A scoping review – Research in Social and Administrative Pharmacy

AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review – Gastroenterology

Development of a Metric to Detect and Decrease Low-Value Prescribing in Older Adults – JAMA Network Open

The MedSafer Study—Electronic Decision Support for Deprescribing in Hospitalized Older Adults: A Cluster Randomized Clinical Trial – JAMA Internal Medicine

Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models – Drugs & Aging

Deprescribing in palliative patients with cancer: a concise review of tools and guidelines – Supportive Care in Cancer

Prescribing practices, patterns, and potential harms in patients receiving palliative care: A systematic scoping review – Exploratory Research in Clinical and Social Pharmacy

A narrative review of evidence to guide deprescribing among older adults – Journal of General and Family Medicine

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens – The Lancet Health Longevity

Polypharmacy Management in Older Patients – Mayo Clinic Proceedings

Psychopharmacological Treatment in Older People: Avoiding Drug Interactions and Polypharmacy – Deutsches Ärzteblatt international

Eliminating Medication Overload: A National Action Plan – Lown Institute

International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): Position Statement and 10 Recommendations for Action – Drugs & Aging

Common ED Medication Errors: Polypharmacy – emDocs

Current and future perspectives on the management of polypharmacy – BMC Family Practice

Routine deprescribing of chronic medications to combat polypharmacy – Therapeutic Advances in Drug Safety

Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international

Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety

Review | Approach to the patient with adrenal hemorrhage

15 Mar, 2023 | 15:03h | UTC

Approach to the Patient With Adrenal Hemorrhage – The Journal of Clinical Endocrinology & Metabolism

M-A | Risk of recurrence and reintervention after uterine-sparing interventions for symptomatic adenomyosis

15 Mar, 2023 | 15:05h | UTC

Risk of Recurrence and Reintervention After Uterine-Sparing Interventions for Symptomatic Adenomyosis: A Systematic Review and Meta-Analysis – Obstetrics & Gynecology

Review | MRI image features with an evident relation to low back pain

15 Mar, 2023 | 15:01h | UTC

MRI image features with an evident relation to low back pain: a narrative review – European Spine Journal

RCT | Nirogacestat for desmoid tumors

15 Mar, 2023 | 14:57h | UTC

Nirogacestat, a γ-Secretase Inhibitor for Desmoid Tumors – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Nirogacestat Improves Outcomes for Patients With Desmoid Tumors – Memorial Sloan Kettering Cancer Center

Commentary on Twitter

In a randomized, placebo-controlled trial, oral nirogacestat twice daily led to 41% of patients having a tumor response, and 2-year progression-free survival was 76%. Most adverse events were low grade. https://t.co/wtt7solTHW pic.twitter.com/qkRchfnXU2

— NEJM (@NEJM) March 10, 2023

Proposed triggers for retiring a living systematic review

15 Mar, 2023 | 15:02h | UTC

Proposed triggers for retiring a living systematic review – BMJ Evidence-Based Medicine

M-A | Comparison of pediatric emergency department visits for attempted suicide before and during the COVID-19 pandemic

15 Mar, 2023 | 14:56h | UTC

Comparison of paediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation before and during the COVID-19 pandemic: a systematic review and meta-analysis – The Lancet Psychiatry

News Release: Emergency department visits for attempted suicides rose globally among youth during pandemic, shows meta-analysis – University of Calgary

Review | Surveillance strategies following curative resection and non-operative approach of rectal cancer: how and how long?

15 Mar, 2023 | 14:59h | UTC

Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations – World Journal of Gastrointestinal Surgery

Review | Prehospital stroke management and mobile stroke units

15 Mar, 2023 | 14:54h | UTC

Prehospital stroke management and mobile stroke units – Current Opinion in Neurology

20 million pregnant women with group B streptococcus carriage: consequences, challenges, and opportunities for prevention

15 Mar, 2023 | 14:53h | UTC

20 million pregnant women with group B streptococcus carriage: consequences, challenges, and opportunities for prevention – Current Opinion in Pediatrics

M-A | Laparoscopic vs. open distal gastrectomy for locally advanced gastric cancer

15 Mar, 2023 | 14:52h | UTC

Laparoscopic vs. open distal gastrectomy for locally advanced gastric cancer: A systematic review and meta-analysis of randomized controlled trials – Frontiers in Surgery

Short-and long-term outcomes of laparoscopic versus open gastrectomy in patients with gastric cancer: a systematic review and meta-analysis of randomized controlled trials – World Journal of Surgical Oncology

Laparoscopic versus open distal gastrectomy for gastric cancer: A systematic review and meta-analysis – Surgery

Laparoscopic vs Open Distal Gastrectomy for Locally Advanced Gastric Cancer: Five-Year Outcomes From the CLASS-01 Randomized Clinical Trial – JAMA Surgery

Laparoscopic Versus Open Gastrectomy for Gastric Cancer (LOGICA): A Multicenter Randomized Clinical Trial – Journal of Clinical Oncology

Morbidity and Mortality of Laparoscopic vs Open Total Gastrectomy for Clinical Stage I Gastric Cancer: The CLASS02 Multicenter Randomized Clinical Trial – JAMA Oncology

Survival outcomes after laparoscopy-assisted distal gastrectomy versus open distal gastrectomy with nodal dissection for clinical stage IA or IB gastric cancer (JCOG0912): a multicentre, non-inferiority, phase 3 randomised controlled trial – The Lancet Gastroenterology & Hepatology

Effect of Laparoscopic Distal Gastrectomy vs Open Distal Gastrectomy on Long-term Survival Among Patients With Stage I Gastric Cancer: The KLASS-01 Randomized Clinical Trial – JAMA Oncology

M-A | Pretest probability assessment and D-Dimer are preferred for the initial evaluation of suspected PE in pregnant women

15 Mar, 2023 | 14:50h | UTC

Noninvasive diagnostic work-up for suspected acute pulmonary embolism during pregnancy: a systematic review and meta-analysis of individual patient data – Journal of Thrombosis and Haemostasis

Cohort Study | Higher ultra-processed food consumption linked to increased cancer incidence and mortality

15 Mar, 2023 | 14:48h | UTC

Ultra-processed food consumption, cancer risk and cancer mortality: a large-scale prospective analysis within the UK Biobank – eClinicalMedicine

News Release: Ultra-processed foods may be linked to increased risk of cancer – Imperial College London

Commentary: Expert reaction to study looking at ultra-processed foods and risk of different cancers – Science Media Centre

Joint association of food nutritional profile by Nutri-Score front-of-pack label and ultra-processed food intake with mortality: Moli-sani prospective cohort study – The BMJ

Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study – The BMJ

Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé) – The BMJ

RCT | Immersive virtual reality intervention reduces pain among pediatric patients undergoing venipuncture

15 Mar, 2023 | 14:46h | UTC

Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture: A Randomized Clinical Trial – JAMA Network Open

Commentary: Immersive Virtual Reality Beneficial for Children Undergoing Venipuncture – HealthDay

RCT | Intrapartum azithromycin fails to reduce neonatal sepsis and death

14 Mar, 2023 | 14:00h | UTC

Summary: This randomized controlled trial aimed to evaluate the effectiveness of administering azithromycin during labor to reduce neonatal sepsis and mortality. The randomized trial involved 11,983 birthing parents and their infants in West Africa.

The study found no significant difference in the incidence of neonatal sepsis or mortality between the azithromycin and placebo groups. On the other hand, the rate of non-invasive infections, including skin infections in newborns, and mastitis and puerperal fever in parents, was lower in the azithromycin group in the following four weeks.

The authors concluded that these results do not support the routine introduction of oral intrapartum azithromycin to reduce neonatal sepsis or mortality. However, it is important to notice that a recent large study published in the New England Journal of Medicine showed conflicting results.

Article: Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentaries:

Azithromycin during labor doesn’t reduce sepsis, mortality in newborns – CIDRAP

Effect of antibiotics during pregnancy on neonatal sepsis and mortality – MedicalResearch.com

Related study with conflicting results: Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Single-dose antibiotic prevents maternal sepsis and death – NIH News

Commentaries:

In large study, a single antibiotic dose slashed rate of sepsis in childbirth – STAT

Dose of azithromycin found to cut risk of maternal death, sepsis in childbirth – CIDRAP

Commentary on Twitter

Study results do not support routine introduction of oral intrapartum azithromycin to reduce neonatal sepsis or mortality. https://t.co/yDpg1CCGa2 pic.twitter.com/5Oc4HqZ4sX

— JAMA (@JAMA_current) March 7, 2023

AHA Scientific Statement | Atrial fibrillation occurring during acute hospitalization

14 Mar, 2023 | 14:04h | UTC

Atrial Fibrillation Occurring During Acute Hospitalization: A Scientific Statement From the American Heart Association – Circulation

RCT | Sotatercept improves exercise capacity in patients with pulmonary arterial hypertension

14 Mar, 2023 | 14:02h | UTC

Summary: This multicenter, double-blind randomized trial involved 323 adults with Pulmonary Arterial Hypertension (PAH) who were randomized to receive either subcutaneous sotatercept or placebo every three weeks for 24 weeks.

The primary endpoint was the change from baseline in the 6-minute walk distance. Sotatercept demonstrated a greater improvement in exercise capacity compared to placebo and improved secondary endpoints, including pulmonary vascular resistance and WHO functional class.

Adverse events were more common in the sotatercept group and included epistaxis, dizziness, telangiectasia, increased hemoglobin levels, thrombocytopenia, and increased blood pressure.

Article: Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

STELLAR, ‘Impressive’ Results With Novel Drug Sotatercept in PAH – TCTMD

A Study of Sotaterceptin Combination With Background Therapy for the Treatment of Pulmonary Arterial Hypertension – STELLAR – American College of Cardiology

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