Thu May 23 – 10 Stories of The Day!

1 – Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial – The Lancet (free)

Commentaries: Restarting antiplatelet therapy after intracerebral haemorrhage – The Lancet (free) AND Aspirin unlikely to cause more brain bleeds for stroke patients – UPI (free) AND Aspirin green light for brain bleed stroke patients, study suggests – University of Edinburgh (free)

“The risk of recurrent intracerebral hemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention.”

2 – Extending thrombolysis to 4·5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data – The Lancet (link to abstract – $ for full-text)

“Patients with ischemic stroke 4·5–9 h from stroke onset or wake-up stroke with salvageable brain tissue who were treated with alteplase achieved better functional outcomes than did patients given placebo. The rate of symptomatic intracerebral hemorrhage was higher with alteplase, but this increase did not negate the overall net benefit of thrombolysis.”

3 – Geospatial, racial, and educational variation in firearm mortality in the USA, Mexico, Brazil, and Colombia, 1990–2015: a comparative analysis of vital statistics data – The Lancet Public Health (free)

Commentaries: Making the case for a world without guns – The Lancet Public Health (free) AND Firearm mortality highest in young men, and is associated with race and education – The Lancet (free)

4 – Association of Changes in Air Quality With Incident Asthma in Children in California, 1993-2014 – JAMA (free for a limited period)

Editorial: Air Pollution Exposure and Asthma Incidence in Children: Demonstrating the Value of Air Quality Standards (free)

Commentary: When LA’s Air Got Better, Kids’ Asthma Cases Dropped – NPR (free)

5 – Consensus on the prevention, diagnosis, and treatment of Clostridium difficile infection – Revista de Gastroenterología de México (free)

Related Guidelines: IDSA Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children (free) AND 2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients – World Journal of Emergency Surgery (free) AND The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridium difficile infection and other potential indications (free) AND Guideline for the Management of Clostridium Difficile Infection in Children and Adolescents With Cancer and Pediatric Hematopoietic Stem-Cell Transplantation Recipients (free) AND Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection and Other Conditions in Children (free)

6 – Recommendations on the diagnosis and treatment of urinary tract infection – Anales de Pediatría (free)

7 – The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre‐eclampsia: A pragmatic guide for first‐trimester screening and prevention – International Journal of Gynecology & Obstetrics (free)

8 – Alex Nowbar’s journal reviews, 22 May 2019 – The BMJ Opinion (free)

9 – Evidence‐based diabetes care for older people with Type 2 diabetes: a critical review – Diabetic Medicine (free)

10 – Choosing Wisely Canada-Top Five List in Hepatology: Official Position Statement of the Canadian Association for the Study of the Liver (CASL) and Choosing Wisely Canada (CWC) – Annals of Hepatology (free)

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

1 – Don’t order serum ammonia to diagnose or manage hepatic encephalopathy (HE).

2 – Don’t routinely transfuse fresh frozen plasma, platelets or give Vitamin K to reverse abnormal tests of coagulation in patients with cirrhosis prior to abdominal paracentesis, endoscopic variceal band ligation, or any other minor invasive procedures.

3 – Don’t order HFE genotyping based on serum ferritin values alone to diagnose hereditary hemochromatosis.

4 – Don’t perform computed tomography (CT) or magnetic resonance imaging (MRI) routinely to monitor benign focal liver lesions (ex. focal nodal hyperplasia, hemangioma).

5 – Don’t repeat hepatitis C viral load testing in an individual who has established chronic infection, outside of antiviral treatment.

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