GUIDELINES

New WHO Guidelines on HIV – The World Health Organization has published new recommendations on the care of people infected with HIV. The key points of the new guideline are:

– Antiretroviral therapy should be initiated in EVERYONE living with HIV at ANY CD4 cell count.

– Use of daily oral pre-exposure prophylaxis (PrEP) is recommended as a prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches.

Link to guideline and key recommendations

Screening for cognitive impairment – The Canadian Task Force on Preventive Health Care has recently published recommendations on screening for cognitive impairment in older adults.

Link to free full text

TRIALS AND REVIEWS

Cochrane review showed little benefit of antihistamines for common cold – the review found that antihistamines have a limited short-term (days one and two of treatment) beneficial effect on severity of overall symptoms but make no difference after that. There is no clinically significant effect on nasal obstruction, rhinorrhea or sneezing and there is no evidence of effectiveness of antihistamines in children. On the basis of this review, the authors conclude there is insufficient evidence to support the prescribing or purchasing over-the-counter antihistamines for common colds to alleviate symptoms.

Link to free full text

Link to summary

Higher resting heart rate associated with higher mortality – According to a meta-analysis published in the CMAJ involving 1.246.203 patients in 46 studies, for every 10 beats/min increment of resting heart rate the risk of all-cause mortality was increased by 9% (RR = 1.09; 95% CI 1.07-1.12) and the risk for cardiovascular mortality was increased by 8% (RR = 1.08; 95% CI 1.06-1.10).

Link to abstract and free full text

Link to Medscape commentary and summary

Progesterone ineffective for women with recurrent miscarriages – since endogenous progesterone is essential for the maintenance of pregnancy, many physicians prescribe progesterone supplementation in the first trimester for women with a history of unexplained recurrent miscarriages. However, current evidence does not support this practice and a large randomized controlled trial was undertaken to address the issue. 836 women with a history of recurrent miscarriages were randomized to receive twice-daily vaginal suppositories containing either 400 mg of micronized progesterone or matched placebo from confirmation of pregnancy up to 12 weeks. The results showed that progesterone therapy in the first trimester of pregnancy did not result in a significantly higher rate of live births among women with a history of unexplained recurrent miscarriages.

Link to abstract (full text require subscription)

WEEKLY REVIEWS BY OTHERS

American College of Physicians (ACP) Internist Weekly Review – News for the week of November 24, 2015. Link to free full text

Richard Lehman’s journal review: 30 November 2015 – Interesting evidence-based review with critical commentaries on the latest “breakthrough” articles. Link to free full text

The 207th Critical Care Reviews Newsletter – A selection of the latest publications in intensive care, a must read for those working in the field. Link to free full text

Life in the Fastlane Review #208 – Highlights of the latest available education resources and reviews on emergency medicine and critical care. Link to free full text

Research and Reviews in the Fastlane 110th edition – Selection of recent articles worth reading on emergency medicine and critical care. Link to free full text