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“Patients that lack acute hypertension-mediated end organ damage to the heart, retina, brain, kidneys, or large arteries do not have a hypertensive emergency and can be treated with oral BP-lowering agents and usually discharged after a brief period of observation.”

2 – ERS/EACTS statement on the management of malignant pleural effusions – European Respiratory Journal (free)

3 – Guideline for the management of hip and knee osteoarthritis – Royal Australian College of General Practitioners (free PDF)

News Release: Updated osteoarthritis guideline designed to reduce unnecessary imaging and surgery (free)

Commentary: Australia hopes to reduce unnecessary imaging, surgery with updated osteoarthritis guidelines – Health Imaging (free)

““The Guideline for the management of knee and hip osteoarthritis,” offer up exercise and weight loss as a first line defense, and warn against costly treatments using glucosamine, opioids and arthroscopic surgery, said David Hunter, co-chair of the RACGP group responsible for the update.” (from Health Imaging)

4 – Opinion: Is one drink per day really unsafe? That new alcohol study, explained – VOX (free)

Related Commentary: Study Causes Splash, but Here’s Why You Should Stay Calm on Alcohol’s Risks – The New York Times (10 articles per month are free)

Original Article: Alcohol Use and Burden for 195 Countries and Territories (free study and commentaries)

5 – Earwax, Of All Things, Poses Unrecognized Risk In Long-Term Care – Kaiser Health News (free)

“Of all the indignities that come with aging, excessive earwax may be the most insidious… when it goes unrecognized, it can pose serious problems, especially for the 2.2 million people who live in U.S. nursing homes and assisted living centers.”

6 – #ESCCongress – Early Versus Standard Care Invasive Examination and Treatment of Patients with Non-ST-Segment Elevation Acute Coronary Syndrome: The VERDICT (Very EaRly vs Deferred Invasive evaluation using Computerized Tomography) – Randomized Controlled Trial – Circulation (free PDF)

Editorial: Timing of Intervention in Non ST Elevation Acute Coronary Syndromes: And the VERDICT is? (free PDF)

Commentaries: VERDICT: Very Early Invasive Coronary Angiography vs. Standard Care in NSTE-ACS Patients- American College of Cardiology (free) AND ESC: Early Invasive Strategy in NSTEMI Does Not Improve Outcomes – MedPage Today (free registration required) AND VERDICT: Very Early Invasive Angiography No Help Overall for NSTE ACS – TCTMD (free)

7 – #ESCCongress – Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data – The Lancet (free)

Commentaries: Imaging of coronary inflammation for cardiovascular risk prediction – The Lancet (free) AND New Imaging Biomarker of Coronary Inflammation Shows Prognostic Value Exceeding All Current Noninvasive Measures – Cleveland Clinic (free) AND Imaging biomarker can predict coronary inflammation – UPI (free)

8 – #ESCCongress – Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial – The Lancet (link to abstract – $ for full-text)

Commentaries: MATRIX: 1-Year Results Confirm Superiority of Transradial PCI – TCTMD (free) AND Radial vs. Femoral Access for Angiography with or Without Bivalirudin in Patients with Acute Coronary Syndrome – NEJM Journal Watch (free for a limited period) AND ESC: Radial Access Tied to Better 1-Year Outcomes in ACS – MedPage Today (free registration required)

9 – #ESCCongress – Psychological Distress and Risk of Myocardial Infarction and Stroke in the 45 and Up Study: A Prospective Cohort Study – Circulation: Cardiovascular Quality and Outcomes (free)

Commentaries: Distress boosts heart attack and stroke risk – Medical News Today (free) AND High Mental Distress Tied to Heart Troubles – MedPage Today (free registration required)

10 – #ESCCongress – Deep forehead wrinkles may signal a higher risk for cardiovascular mortality – ESC Press Releases (free)

Commentaries: Forehead wrinkles – an early sign of cardiovascular disease? – Medical News Today (free) AND Excessive forehead wrinkles may be early sign of atherosclerosis – Cardiovascular Business (free)

Fri, August 31 – 10 Stories of The Day!

31 Aug, 2018 | 01:12h | UTC

1 – Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study – The BMJ (free)

Commentaries: Vitamin D: a pseudo-vitamin for a pseudo-disease – The Conversation (free) AND Fracture risk not linked to low vitamin D or calcium levels – OnMedica (free)

Related: Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It (free commentaries and NICE Guideline)

2 – Bacterial Factors That Predict Relapse after Tuberculosis Therapy – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: Bacterial Factors That Predict Relapse after Antituberculosis Therapy – NEJM Resident 360 (free) AND MICs of Isoniazid, Rifampin May Predict Tuberculosis Relapse – Drugs.com (free) AND Variation in bacterial drug susceptibility tied to TB relapse risk – CHEST Physician (free)

3 – Revisiting the timetable of tuberculosis – The BMJ (free)

4 – Clinical Decisions: Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome – New England Journal of Medicine (free)

5 – 2018 STD Prevention Conference – Centers for Disease Control and Prevention (free)

Press Release: New CDC analysis shows steep and sustained increases in STDs in recent years (free)

Commentaries: 5 reasons why 3 STDs are roaring back in America – VOX (free) AND Rates of three STDs in US reach record high, CDC says – CNN (free) AND Record High Number Of STD Infections In U.S., As Prevention Funding Declines – NPR (free) AND STD cases in U.S. hit record highs as officials warn about resistant gonorrhea – STAT (free) AND US sees record STD cases, rising gonorrhea resistance – CIDRAP (free)

6 – Clinical Implications and Challenges of Artificial Intelligence and Deep Learning – JAMA (free for a limited period)

Related Viewpoints: Deep Learning—A Technology With the Potential to Transform Health Care – JAMA (free for a limited period) AND Deep Learning—A Technology With the Potential to Transform Health Care – JAMA (free for a limited period)

7 – Publication: Immigration as a Social Determinant of Health: Proceedings of a Workshop – National Academies of Sciences, Engineering, and Medicine (free PDF)

“Immigration as a social determinant of health – NEW publication explores complex interactions between immigration and health disparities + grappling with the complexities of immigration” (via @julianmfisher see Tweet)

8 – Optimal Blood Pressure Target in Diabetic and Nondiabetic Hypertensive Patients – Circulation Research (free)

See counterpoint suggesting lower BP targets: Sprinting Toward the Optimal Blood Pressure Target for Hypertensive Patients – Circulation Research (free)

“We have reviewed the randomized trial evidence in favor of a target blood pressure (BP) around 130/80 mm Hg in hypertensive patients with and without diabetes mellitus”

9 – Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis – The BMJ (free)

Editorial: Environmental metals and cardiovascular disease (free)

Commentary: Experts warn of cardiovascular risk from heavy metal pollution – University of Cambridge (free)

“Since metals are associated with cardiovascular disease even at relatively low levels of exposure, population wide strategies to minimize exposure can further contribute to overall cardiovascular prevention efforts” (from @bmj_latest see Tweet)

10 – Functional Status and Survival After Breast Cancer Surgery in Nursing Home Residents – JAMA Surgery (free for a limited period)

Commentaries: Surgical Decision Making in Elderly, Impaired Nursing Home Patients – JAMA Surgery (free for a limited period) AND For Nursing Home Patients, Breast Cancer Surgery May Do More Harm Than Good – Kaiser Health News (free)

Wed, August 29 – 10 Stories of The Day!

29 Aug, 2018 | 00:01h | UTC

1 – Report: Crossing the Global Quality Chasm: Improving Health Care Worldwide – National Academies Of Sciences, Engineering, and Medicine (free PDF)

News Release: Up to 8 Million Deaths Occur in Low- and Middle-Income Countries Yearly Due to Poor-Quality Health Care, Says New Report; Major Quality Chasm Must Be Fixed in Order to Reap Benefits of Universal Health Coverage (free)

Videos: The Scope of the Problem (free) AND Health Systems of the Future (free)

See also: Report Highlights (free PDF) AND Recommendations (free PDF)

2 – #ESCCongress – Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis – New England Journal of Medicine (free for a limited period)

Commentaries: Partial Oral Treatment of Endocarditis – POET – American College of Cardiology (free) AND New treatment can halve hospital stays for some patients with heart infection – ESC Press Releases (free)

3 – #ESCCongress – High-sensitivity troponin in the evaluation of patients with suspected acute coronary syndrome: a stepped-wedge, cluster-randomised controlled trial – The Lancet (free)

Commentaries: Diagnosing myocardial infarction: a highly sensitive issue – The Lancet (free) AND Hs-TnI in Suspected ACS: High-STEACS Trial – American College of Cardiology (free)

“Introduction of a high-sensitivity cardiac troponin I assay reclassified 1 in 6 patients with previously undetected myocardial necrosis, but did not lead to improved clinical outcomes in this large randomised trial” (via @chapdoc1 see Tweet)

“Very important study. What’s weird is that the “better” (more sensitive) troponin assays get, the less helpful the test becomes at the bedside. Look for a coming tsunami of iatrogenesis from overzealous evaluation of troponin bumps.” (via @drjohnm see Tweet)

4 – #ESCCongress – One-Year Outcomes after PCI Strategies in Cardiogenic Shock – New England Journal of Medicine (free for a limited period)

Commentaries: Less Is Still More in Patients with Acute Myocardial Infarction and Cardiogenic Shock – NEJM Journal Watch (free for a limited period) AND 1-year outcomes still support culprit-only PCI for cardiogenic shock – Cardiovascular Business (free) AND CULPRIT-SHOCK: 1-Year Results Continue to Support Culprit-Only PCI for Shock Patients – TCTMD (free)

5 – #ESCCongress – Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial – The Lancet (link to abstract – $ for full-text)

Commentaries: Telemedicine in Heart Failure Patients (TIM-HF2) – American College of Cardiology (free) AND ESC: Telemonitoring of HF Cuts Admissions, Mortality MedPage Today (free registration required)

6 – Global Mortality From Firearms, 1990-2016 – JAMA (free for a limited period)

Video Summary: Global Firearm Mortality, 1990-2016 – JAMA (free)

Infographic: Firearm deaths around the world 1990–2016 – Institute for Health Metrics and Evaluation (free) (via @kleachkemon)

Commentaries: Six countries in the Americas account for half of all firearm deaths – Institute for Health Metrics and Evaluation (free) AND Gun-related homicides, suicides kill more people than war, study says – CNN (free)

7 – Zackary Berger’s journal reviews, 28 August 2018 – The BMJ Opinion (free)

8 – Guide to Statistics and Methods: Case-Control Studies: Using “Real-world” Evidence to Assess Association – JAMA (free for a limited period)

9 – Guiding Principles for the Care of People With or at Risk for Diabetes – National Institute of Diabetes and Digestive and Kidney Diseases (free PDF)

Commentaries: NIDDK Updates ‘Guiding Principles’ for Diabetes, Prediabetes – Medscape (free registration required) AND NDEP revises principles for managing diabetes, prediabetes – Cardiovascular Business (free)

Related Book: Diabetes in America, 3rd Edition – National Institutes of Health (free reference book, just released)

10 – Evaluating the replicability of social science experiments in Nature and Science between 2010 and 2015 – Nature Human Behavior (free for a limited period)

Commentaries: More social science studies just failed to replicate. Here’s why this is good – VOX (free) AND High-profile journals put to reproducibility test – Nature News (free) AND ‘Replication crisis’ spurs reforms in how science studies are done – ScienceNews (free) AND The Science Behind Social Science Gets Shaken Up—Again – WIRED (Free) AND In Psychology And Other Social Sciences, Many Studies Fail The Reproducibility Test – NPR (free)

“We replicated 21 social science experiments in Science or Nature. We succeeded with 13. Replication effect sizes were half of originals.” (via @BrianNosek see Tweet)

Tue, August 28 – 10 Stories of The Day!

28 Aug, 2018 | 00:01h | UTC

1 – Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis – Canadian Medical Association Journal (free)

Commentaries: Care coordination improves health of older patients with multiple chronic diseases – CMAJ, via EurekAlert (free) AND Seniors healthier when medical care is coordinated – Reuters (free)

Related: Ten Recommendations: Designing a High-Performing Health Care System for Patients with Complex Needs (free Guidance and related perspectives) AND Multimorbidity: A Priority for Global Health Research (free research and commentaries)

2 – A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure With Preserved Ejection Fraction – Circulation (free) (via @CircAHA see Tweet with Infographic)

Editorial: H₂FPEF Score: At Last, a Properly Validated Diagnostic Algorithm for Heart Failure With Preserved Ejection Fraction (free)

3 – Clinical Guideline Synopsis: Diagnosis and Treatment of Clostridium difficile Infection – JAMA (free for a limited period) (via @ABsteward and @Abraham_RMI)

Original Guideline: Clinical Practice Guidelines for Clostridium difficileInfection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) – Clinical Infectious Diseases (free)

4 – Review: Acute Clinical Care for Transgender Patients – JAMA Internal Medicine (free for a limited period) (via @CarlosdelRio7)

5 – Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report (free PDF)

News Release: The American College of Chest Physicians updates their antithrombotic therapy guidelines for patients with atrial fibrillation (free)

6 – Clinical Report: Marijuana Use During Pregnancy and Breastfeeding: Implications for Neonatal and Childhood Outcomes – Pediatrics (free)

News Release: Counsel against marijuana use in pregnancy, breastfeeding – American Academy of Pediatrics (free)

Commentaries: A Modern Conundrum for the Pediatrician: The Safety of Breast Milk and the Cannabis-Using Mother – Pediatrics (free) AND Marijuana study finds THC in breast milk up to 6 days after mom’s use – CNN (free) AND Pediatricians Put It Bluntly: Motherhood And Marijuana Don’t Mix – Kaiser Health News (free) AND Clinical report provides guidance on marijuana use in pregnancy and lactation – 2 Minute Medicine (free)

7 – #ESCCongress – Effects of n−3 Fatty Acid Supplements in Diabetes Mellitus – New England Journal of Medicine (free for a limited period)

Commentaries: Fish oils do not prevent heart attack or strokes in people with diabetes – ESC News Releases (free) AND Omega-3 Fatty Acids Fail to Reduce CVD Events in Diabetic Patients: ASCEND – TCTMD (free)

Related Cochrane Review: Omega-3 fatty Acids for the Prevention of Cardiovascular Disease (link to abstract and commentaries)

Related Meta-Analysis: Omega-3 Fatty Acid Supplements Don’t Reduce Cardiovascular Risk (free study and commentary)

8 – #ESCCongress – Cardiovascular Safety of Lorcaserin in Overweight or Obese Patients – New England Journal of Medicine (free for a limited period)

Editorial: Lorcaserin — Elixir or Liability? (free for a limited period)

Commentaries: CAMELLIA-TIMI 61: Weight Loss Drug Lorcaserin Did Not Increase CV Events – American College of Cardiology (free) AND Weight-Loss Drug Lorcaserin Clears Cardiovascular Safety Hurdle: CAMELLIA-TIMI 61 – TCTMD (free) AND Weight loss drug lorcaserin found safe in large study – Reuters (free)

9 – #ESCCongress – Rivaroxaban for Thromboprophylaxis after Hospitalization for Medical Illness – New England Journal of Medicine (free for a limited period)

Commentaries: VTE risk unchanged by rivaroxaban after discharge – The Hospitalist (free) AND MARINER: Rivaroxaban vs. Placebo Post-Discharge in Patients at High Risk For VTE – American College of Cardiology (free) AND MARINER: No Reduction in Death, VTE With Rivaroxaban After Discharge in Medically Ill Patients – Medscape (free registration required)

10 – #ESCCongress – Tafamidis Treatment for Patients with Transthyretin Amyloid Cardiomyopathy – New England Journal of Medicine (free for a limited period)

Editorial: Stabilizing Transthyretin to Treat ATTR Cardiomyopathy (free for a limited period)

Commentaries: Tafamidis, a Transthyretin Stabilizer, Offers Hope for Rare Cardiomyopathy – TCTMD (free) AND ATTR-ACT: Tafamidis Findings Offer Hope For Patients With ATTR-CM – American College of Cardiology (free) AND Drug reduces deaths and hospitalizations from underdiagnosed form of heart failure – Columbia University Irving Medical Center, via EurekAlert (free)

Fri, August 24 – 10 Stories of The Day!

24 Aug, 2018 | 00:01h | UTC

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

Commentaries: No level of alcohol consumption improves health – The Lancet (free) AND No amount of alcohol is good for your overall health, global study says – CNN (free) AND New scientific study: no safe level of alcohol – Institute for Health Metrics and Evaluation (free)

“Alcohol was responsible for nearly 3 million deaths in 2016, the study says. It was the leading risk factor for disease and premature death in men and women between the ages of 15 and 49 worldwide in 2016, accounting for nearly one in 10 deaths.” (from @cnni see Tweet)

2 – Antibiotics should not be issued as first line of treatment for a cough, says NICE and PHE – NICE News and Features (free)

Commentaries: Promote honey rather than antibiotics for coughs, doctors told – The Guardian (free) AND Use honey first for a cough, new guidelines say – BBC (free)

Related: Honey for acute cough in children – Cochrane Library (free systematic review and commentary)

3 – How scientists are learning to predict your future with your genes – VOX (free) (via @EricTopol)

“There’s not one light switch but hundreds, each with the ability to slightly increase or decrease the chances of developing the illness.”

4 – Perspective: Adolescents’ Use of “Pod Mod” E-Cigarettes — Urgent Concerns – New England Journal of Medicine (free)

5 – A Late-Life Surprise: Taking Care Of Frail, Aging Parents – Kaiser Health News (free)

6 – Viewpoint: The Challenge of Reforming Nutritional Epidemiologic Research – JAMA (free)

“…the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles. The field needs radical reform.”

7 – Review: Difficult tracheal intubation in critically ill – Journal of Intensive Care (free)

8 – Glucocorticoids for croup in children – Cochrane Library (free for a limited period)

Summary: Glucocorticoids for croup in children – Cochrane Library (free)

Commentary: Glucocorticoid Therapy Examined in Pediatric Patients With Croup – MPR (free)

9 – Risk of Esophageal Adenocarcinoma After Antireflux Surgery in Patients With Gastroesophageal Reflux Disease in the Nordic Countries – JAMA Oncology (free for a limited period)

10 – Association of Cardiovascular Health Level in Older Age With Cognitive Decline and Incident Dementia – JAMA (link to abstract – $ for full-text)

Commentaries: Study confirms that keeping the heart healthy also reduces dementia risk – NHS Choices (free) AND The Healthier Your Heart, the Healthier Your Brain May Be – The New York Times (10 articles per month are free) AND Cardiovascular Risk Factors Also Linked to Dementia – MedicalResearch.com (free) AND Reducing CV Risk May Improve Brain Health at Any Stage in Life, Studies Hint – TCTMD (free)

Mon, August 27 – 10 Stories of The Day!

27 Aug, 2018 | 00:44h | UTC

#ESCCongress – Highlights from the 2018 Meeting of the European Society of Cardiology

1 – #ESCCongress – 2018 ESC/ESH Guidelines for the management of arterial hypertension – European Heart Journal (free) (via @escardio see Tweet with Key Infographics)

2 – #ESCCongress – 2018 ESC/EACTS Guidelines on myocardial revascularization – European Heart Journal (free) (via @escardio see Tweet with Key Infographics)

3 – #ESCCongress – Fourth universal definition of myocardial infarction (2018) – European Heart Journal (free) (via @escardio see Tweet with Key Infographics)

4 – #ESCCongress – 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy – European Heart Journal (free) (via @escardio see Tweet with Key Infographics)

5 – #ESCCongress – Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC) – European Heart Journal (free)

6 – #ESCCongress – Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery – New England Journal of Medicine (free for a limited period)

“In moderate-to-high-risk patients undergoing cardiac surgery, six-month outcomes show that a restrictive red-cell transfusion strategy is noninferior to a liberal strategy” (via @NEJM see Tweet with Visual Abstract)

7 – #ESCCongress – CLARIFY: No Survival Benefit With Beta-Blockers Beyond 1 Year Post-MI in Stable CAD – TCTMD (free)

“The problem, said Sorbets, is that there have never been large randomized trials to test the prognostic effects of beta-blockers in this patient group and instead, recommendations have been drawn from meta-analyses using data extracted from the acute MI setting or from observational studies.”

8 – #ESCCongress – Coronary CT Angiography and 5-Year Risk of Myocardial Infarction – New England Journal of Medicine (free for a limited period)

Commentary: Five Reasons I Don’t Believe an Imaging Test Improves Outcomes – by Dr. John Mandrola, in Medscape (free registration required)

See also an interesting Tweetorial by @AnilMakam, also suggesting caution before adopting this study results in clinical practice.

9 – #ESCCongress – Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus – New England Journal of Medicine (free for a limited period)

Commentaries: Bleeds and benefit with aspirin balanced in patients with diabetes and no effect on cancer – ESC Press Releases (free) AND ASCEND: Aspirin Doesn’t Look Good for Primary CV Prevention in Diabetic Patients – TCTMD (free)

10 – #ESCCongress – Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial – The Lancet (link to abstract – $ for full-text)

Commentaries: Aspirin Fails to Prevent CV Events in People at ‘Moderate’ Risk of Disease: ARRIVE – TCTMD (free) AND ARRIVE: New Findings Contribute to Growing Body of Evidence Surrounding Aspirin Use – American College of Cardiology (free) AND Daily Aspirin Fails to Lower CV Risk in Long-term, Primary Prevention ARRIVE Trial – Medscape (free registration required) AND Jury still out on aspirin a day to prevent heart attack and stroke – ESC Press Releases (free)