All Posts
Cohort Study | Risk and timing of venous thromboembolism in patients with gastrointestinal cancer
23 Feb, 2023 | 13:08h | UTC
Review | Constipation in children and adolescents
23 Feb, 2023 | 13:06h | UTCConstipation in Children and Adolescents – Deutsches Ärzteblatt international
RCT | An initial 8-week bedaquiline-linezolid regimen shows promise for the treatment of rifampin-susceptible tuberculosis
22 Feb, 2023 | 12:50h | UTCSummary: This randomized trial compared a standard 6-month rifampin-based tuberculosis treatment to a strategy that involved shorter initial treatment with extended therapy for persistent disease, monitoring, and retreatment for relapse. The results showed that the strategy involving an 8-week bedaquiline-linezolid regimen was noninferior to standard treatment for clinical outcomes. The experimental strategy was associated with a shorter total duration of treatment with no evident safety concerns.
Article: Treatment Strategy for Rifampin-Susceptible Tuberculosis – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Shorter drug regimen shows promise in TB trial – CIDRAP
M-A | Past SARS-CoV-2 infection provides long-lasting protection against severe disease caused by all variants
22 Feb, 2023 | 12:48h | UTCSummary: The article describes a systematic review and meta-analysis of studies assessing protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease. The researchers identified 65 studies from 19 different countries and found that protection from past infection against re-infection from pre-omicron variants was high and remained so even after 40 weeks. However, protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants. Protection from severe disease was high for all variants, estimated at 90·2% for ancestral, alpha, and delta variants, and 88·9% for omicron BA.1 at 40 weeks. The study highlights the importance of considering past infection in assessing future disease burden from COVID-19, providing guidance on when individuals should be vaccinated, and designing policies that mandate vaccination for workers or restrict access. The findings also suggest that individuals with a documented infection should be treated similarly to those who have been fully vaccinated with high-quality vaccines.
Commentaries:
Previous COVID-19 may slash severe illness at reinfection by 89% – CIDRAP
M-A | Global and regional prevalence of multimorbidity in the adult population in community settings
22 Feb, 2023 | 12:47h | UTCSummary: The article presents a systematic review and meta-analysis of surveys that estimate the prevalence of multimorbidity among adults in community settings. The study analyzed data from 126 peer-reviewed studies, including nearly 15.4 million people from 54 countries worldwide. The overall global prevalence of multimorbidity was 37.2%, with South America having the highest prevalence, followed by North America, Europe, and Asia. The study also found that females have a higher prevalence of multimorbidity than males, and that more than half of the adult population worldwide above 60 years of age had multimorbid conditions.
Related:
Costs of multimorbidity: a systematic review and meta-analyses – BMC Medicine
Systematic review of high-cost patients’ characteristics and healthcare utilization – BMJ Open
Multimorbidity: a priority for global health research – The Academy of Medical Sciences
The global burden of multiple chronic conditions: a narrative review – Preventive Medicine Reports
Redesigning Care for High-Cost, High-Risk Patients – Harvard Business Review
Multimorbidity: clinical assessment and management – NICE Guideline
Richard Smith: The challenge of high need, high cost patients – The BMJ Blogs
Better Care for People with Complex Needs – Institute for Healthcare Improvement
Case-Control Study | Current pyuria cut-offs may promote inappropriate UTI diagnosis in older women
22 Feb, 2023 | 12:43h | UTCSummary: The presence of pyuria is commonly used as the cornerstone of urinary tract infection (UTI) diagnosis. However, over 90% of asymptomatic bacteriuria (ASB) patients also have pyuria, which can lead to unnecessary treatment. This is especially problematic in older women who may have pre-existing lower urinary tract symptoms, cognitive impairment, and a high prevalence of ASB. This study examined the diagnostic accuracy of different pyuria thresholds for UTI in older women. The study found that current pyuria cut-offs (10 leukocytes/µl) are too low and promote inappropriate UTI diagnosis in older women. A threshold of 300 leukocytes/µl is suggested as a considerable improvement, increasing specificity to avoid overtreatment, while still maintaining a fair sensitivity. This has implications for patient care, antimicrobial stewardship efforts, and research. The impact of higher cut-off values on prescription behavior and UTI related outcomes in older women deserves further study.
Related:
USPSTF Recommendation Statement: Screening for Asymptomatic Bacteriuria in Adults
Commentary on Twitter
Presence of pyuria remains the cornerstone of UTI diagnosis However, >90% of ASB patients have pyuria,prompt unnecessary Rx
🆕️⚡️⚡️study: current pyuria cut-off is too low promote inappropriate UTI diagnosis in older women suggesting a new higher cut offhttps://t.co/qAGdwSTiU6 pic.twitter.com/Vr63RnuMv1— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) February 20, 2023
Article under a https://creativecommons.org/licenses/by-nc-nd/4.0/ license
RCT | Another study shows Ivermectin does not benefit patients with Covid-19
22 Feb, 2023 | 12:45h | UTCSummary: The study aimed to evaluate whether Ivermectin, at a maximum dose of 600 μg/kg daily for 6 days, shortened symptom duration or prevented hospitalization among outpatients with mild to moderate COVID-19. A total of 1206 US adults were enrolled in the double-blind, randomized, placebo-controlled platform trial, with follow-up data through November 10, 2022. The study found that the median time to sustained recovery was 11 days in both the ivermectin and placebo groups. Among those receiving Ivermectin, 5.7% were hospitalized, died, or had urgent or emergency care visits compared with 6.0% receiving placebo. These findings, along with all the previous studies to date, do not support using Ivermectin in patients with mild to moderate COVID-19.
Editorials:
At a Higher Dose and Longer Duration, Ivermectin Still Not Effective Against COVID-19 – JAMA
The Ethics of Clinical Research: Managing Persistent Uncertainty – JAMA
Related:
RCT | Ivermectin does not improve time to recovery in outpatients with mild to moderate COVID-19.
RCT | Metformin, Ivermectin, and Fluvoxamine are not beneficial for obese outpatients with Covid-19.
Ivermectin for COVID-19 Cochrane review update: 11 trials and no evidence of benefit shown.
RCT: Early treatment with ivermectin does not improve outcomes in patients with Covid-19.
Case Series: Toxic effects from ivermectin use associated with prevention and treatment of Covid-19.
Long-term consequences of the misuse of ivermectin data.
Ivermectin: How false science created a Covid ‘miracle’ drug.
Fraudulent ivermectin studies open up new battleground between science and misinformation.
The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable.
Ivermectin: Cochrane’s most talked about review so far, ever. Why?
Flawed ivermectin preprint highlights challenges of COVID drug studies.
Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.
Why was a major study on ivermectin for covid-19 just retracted?
RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.
RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19
Bacteriuria in older adults triggers confusion in healthcare providers: a mindful pause to treat the worry
22 Feb, 2023 | 12:42h | UTCRelated:
USPSTF Recommendation Statement: Screening for Asymptomatic Bacteriuria in Adults
Commentary on Twitter
FANTASTIC⚡️⚡️
The evidence base for refraining from screening for or treating ASB in elderly is strong,but both practices remain prevalent
Bacteriuria in older adults triggers confusion in healthcare providers:A mindful pause to treat the worry #IDTwitter https://t.co/7ispdtFeFB pic.twitter.com/kOB5eGKkAc— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) January 10, 2023
Under a http://creativecommons.org/licenses/by/4.0/ license
Review | Comorbidities, multimorbidity and COVID-19
22 Feb, 2023 | 12:39h | UTCComorbidities, multimorbidity and COVID-19 – Nature Medicine
RCT | Temporary cessation vs. continuation of first-line tyrosine kinase inhibitor in advanced clear cell renal cell carcinoma
22 Feb, 2023 | 12:40h | UTCSummary: The STAR trial investigated whether a tyrosine kinase inhibitor drug-free interval strategy was non-inferior to a conventional continuation strategy for first-line treatment of advanced clear cell renal cell carcinoma. All patients received standard dosing schedules of oral sunitinib (50 mg per day) or oral pazopanib (800 mg per day) for 24 weeks before moving into their randomly allocated group. Although non-inferiority could not be concluded for the primary endpoint of overall survival, temporary treatment cessation was found to preserve quality of life and was cost-effective. Therefore, planned breaks in tyrosine kinase inhibitor treatment represent a reasonable option for selected patients with renal cell carcinoma, providing potential lifestyle and health economic benefits. The study provides a rationale for further exploration of treatment breaks in patients with other cancers.
Commentary on Twitter
NOW OF: The STAR open-label ph 2/3 RCT could not conclude that a TKI drug-free interval strategy was non-inferior to a conventional continuation strategy for first-line treatment of advanced clear cell renal cell carcinoma. #rccsmhttps://t.co/xzCU1jdLE7 pic.twitter.com/Ks1Eh0vMId
— The Lancet Oncology (@TheLancetOncol) February 14, 2023
AGA Guideline | Role of biomarkers for the management of ulcerative colitis
22 Feb, 2023 | 12:38h | UTC
AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease
22 Feb, 2023 | 12:37h | UTCRelated:
Management of NAFLD in primary care settings – Liver International
Non-alcoholic fatty liver disease: A patient guideline – JHEP Reports
M-A | Interventions for myopia control in children
22 Feb, 2023 | 12:36h | UTCRelated:
RCT | Effect of low-concentration atropine eyedrops vs. placebo on myopia incidence in children
Crossover RCT | Spectacle lenses with highly aspherical lenslets for slowing myopia.
RCT | Effect of text messaging parents of school-aged children on outdoor time to control myopia.
RCT | Myopia control effect of repeated low-level red-light therapy in children.
RCT | Cold snare polypectomy reduces bleeding compared to hot snare polypectomy
22 Feb, 2023 | 12:34h | UTCCold Versus Hot Snare Polypectomy for Small Colorectal Polyps: A Pragmatic Randomized Controlled Trial – Annals of Internal Medicine (link to abstract – $ for full-text)
News Release: Cold snare polypectomy significantly reduces bleeding risk compared to hot snare polypectomy – Science News Net
Perspective | Application of Bayesian approaches in drug development: starting a virtuous cycle
22 Feb, 2023 | 12:32h | UTC
Commentary on Twitter
Application of Bayesian approaches in drug development: starting a virtuous cycle https://t.co/GxPFRA3J6u
A new Perspective that highlights the value of Bayesian methods in drug development, discusses barriers to their application and recommends approaches to address them pic.twitter.com/JTgo02aPdI
— Nature Reviews Drug Discovery (@NatRevDrugDisc) February 16, 2023
Health and nutrition claims for infant formula: international cross sectional survey
22 Feb, 2023 | 12:31h | UTCHealth and nutrition claims for infant formula: international cross sectional survey – The BMJ
Editorial: Poorly substantiated health claims on infant formula – The BMJ
News Release: Most health claims on infant formula products seem to have little evidence – BMJ Newsroom
Commentary: Little evidence to support health claims made on formula milk – BBC
Commentary from one of the authors on Twitter (thread – click for more)
https://twitter.com/mbrockwa/status/1626034305393893376
Single-arm study | Andexanet Alfa seems effective for the reduction of bleeding associated with factor Xa inhibitors
22 Feb, 2023 | 12:29h | UTCFinal Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors – Circulation
M-A | Sugar-sweetened beverage consumption and weight gain in children and adults
22 Feb, 2023 | 12:26h | UTC
Bacteremia | ED presentations, evaluation, and management
22 Feb, 2023 | 12:25h | UTCBacteremia: ED Presentations, Evaluation, and Management – emDocs
M-A | Monoclonal antibody for the prevention of respiratory syncytial virus in infants and children
22 Feb, 2023 | 12:24h | UTCCommentary: Study Finds 3 Monoclonal Antibodies Reduce RSV Infections in High-Risk Infants, Children – HCP Live
Commentary on Twitter
Network meta-analysis of 4 monoclonal antibodies for the prevention of RSV in children finds 3 may be useful in preventing RSV; more research to confirm efficacy, safety, and cost effectiveness is needed. https://t.co/wz9yCVAFWo
— JAMA Network Open (@JAMANetworkOpen) February 17, 2023
Prevalence of long-term decision regret and associated risk factors in a large cohort of ICU surrogate decision makers
22 Feb, 2023 | 12:22h | UTC
Commentary on Twitter
One in five #ICU surrogate decision makers experience moderate to strong regret about life support decisions in ICU.
Read the full article: https://t.co/epCXB4QHRY@jlvincen @ISICEM #FOAMed #FOAMcc pic.twitter.com/0Q3X2uFYk0
— Critical Care (@Crit_Care) February 20, 2023
Phase 2b RCT | Effects of OPT-302, a VEGF-C/D inhibitor for neovascular age-related macular degeneration
22 Feb, 2023 | 12:21h | UTC
SR | Probiotics for management of functional abdominal pain disorders in children
22 Feb, 2023 | 12:20h | UTCProbiotics for management of functional abdominal pain disorders in children – Cochrane Library
Review | Excessive trabeculation of the left ventricle
22 Feb, 2023 | 12:18h | UTCNews Release: Review calls for a refreshed look at clinical approach to heart muscle disorder – Queen Mary, University of London
Podcast | Abnormal uterine bleeding pearls
22 Feb, 2023 | 12:19h | UTC#382 Abnormal Uterine Bleeding – The Curbsiders