Weekly Review in Medicine – 2nd edition: November 11 to November 17
18 Nov, 2015 | 19:06h | UTCGUIDELINES
Menopause: diagnosis and management – New clinical practice guideline from the National Institute for Health and Care Excellence (NICE). Link to free full text
Treatment of Rheumatoid Arthritis – Recently Released American College of Rheumatology Guideline. Link to free full text
Management of Acne – A new clinical practice guideline has been released from the Canadian Medical Association Journal. Link to free full text (PDF)
Management of Chronic Hepatitis B – An Overview of Practice Guidelines for Primary Care Providers from the Journal of the American Board of Family Medicine. Link to free full text
TRIALS AND REVIEWS
Trial of Continuous versus Interrupted Chest Compressions during CPR – this large cluster-randomized trial included 114 emergency medical service (EMS) agencies and over 23000 patients. The trial assessed whether outcomes after continuous compressions with positive-pressure ventilation differed from those after compressions interrupted for ventilations at a ratio of 30 compressions to two ventilations. The results showed that continuous and interrupted high-quality chest compressions strategies are equally effective for survival in out-of-hospital cardiac arrest. Link to free full text / Editorial / Link to NEJM Journal Watch Summary
Good news for coffee drinkers – with the limitations implied to observational studies of the kind, the data from 3 large prospective cohort studies involving over 200.000 health professionals (74,890 women in the Nurses’ Health Study (NHS), 93,054 women in the NHS 2, and 40,557 men in the Health Professionals Follow-up Study) showed that coffee consumption is safe and associated with lower risk for all-cause mortality. Link to abstract / Link to free full text (PDF) / Medscape summary and commentary / Link to NEJM Journal Watch Summary
Normal-Weight Central Obesity associated with increased cardiovascular risk – a population-based cohort study (NHANES III) made extensive anthropometric, physiologic, and laboratory testing examination in a sample of over 15000 persons from 1988 to 1994 with mortality follow-up from the date of the NHANES survey through 31 December 2006. The analysis showed that normal-weight U.S. adults with central obesity, defined by an increased waist-to-hip ratio (WHR), have the worst long-term survival compared with participants with normal fat distribution, regardless of BMI category, even after adjustment for potential mediators. Link to abstract (subscription required for full text) / Link to NEJM Journal Watch Summary
More from the SPRINT trial – in our last weekly review we made a brief comment on the SPRINT trial, which showed that targeting a systolic BP of < 120 mmHg (vs < 140 mmHg) reduces major CV events and death from any cause in patients older than 50 years with at least one additional high risk feature except diabetes or previous stroke Link to free full text. Lots of commentaries were made on the study and one of them, published in NEJM Journal Watch, is an excellent summary and has practice points to consider when adapting it to practice. Link to NEJM Journal Watch Summary
Courage Trial – long term analysis of this previously published paper showed that percutaneous coronary intervention (PCI) offers no benefit in long-term survival in patients with ischemic heart disease when compared to medical therapy alone. Link to free full text / One-minute NEJM Quick Take video shares results from 15 year follow-up of COURAGE trial / Link to NEJM Journal Watch Summary
Management of Resistant Hypertension Associated with Chronic Kidney Disease – A recent review article on the topic was published on The Lancet (The double challenge of resistant hypertension and chronic kidney disease – Subscription required / Link to abstract). An interesting summary of the article with 8 key practice points to remember was published in the “Latest in Cardiology” section in the American College of Cardiology Website. Link to summary
GLOBAL HEALTH
World Antibiotics Awareness Week: 16-22 November – The World Health Organization (WHO) is leading a global campaign “Antibiotics: Handle with Care”, in order to tackle the increasing problem of antibiotic resistance worldwide. Several materials from different organizations were made available to address the problem:
Homepage of WHO Antibiotics Awareness Week
WHO Fact Sheet on antibiotic resistance
WHO Global action plan on antimicrobial resistance
Centers for Disease Control and Prevention (CDC): Get Smart About Antibiotics Week – November 16-22
Cochrane UK page with related materials and systematic reviews on the topic
NICE stewardship guideline to help slow the problem of antibiotic resistance – August 2015
Sharing decisions about antibiotics – Commentary by Richard Lehman
PATIENT SAFETY
Improving Diagnosis in Health Care – New Institute of Medicine (IOM) report addresses the burden of diagnostic errors in medicine. Link to free publication / Link to commentary in the New England Journal of Medicine
WEEKLY REVIEWS BY OTHERS
Richard Lehman’s journal review: 16 November 2015 – Interesting evidence-based review with critical commentaries on the latest “breakthrough” articles. Link to free full text
The 205th Critical Care Reviews Newsletter – A great selection of the latest publications in intensive care, a must read for those working in the field.