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Chest Pain: Who needs additional testing beyond ECG and Troponin?

24 Nov, 2021 | 08:28h | UTC

Chest Pain: Who Needs Additional Testing Beyond ECG and Troponin? – JACC: Case Reports

RCT: A brief 5:2 diet advice resulted in similar weight loss at one year vs. a standard multicomponent weight-management advice (-2.6kg vs. -1.9kg, p = 0.37).

24 Nov, 2021 | 08:29h | UTC

A randomised controlled trial of the 5:2 diet – PLOS One

News Release: Brief 5:2 diet advice is as effective as traditional GP advice, but people like it better, according to new study – Queen Mary University of London

Commentary: Fasting 2 days a week can help obese people keep off the weight with modest results, study finds – CNN

A prospective cohort study showed a 3.1% risk for recurrent venous thromboembolism at 90 days in patients with subsegmental pulmonary embolism managed without anticoagulation.

24 Nov, 2021 | 08:31h | UTC

Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation: A Multicenter Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentary on Twitter

First prospective study including patients with isolated SSPE managed without anticoagulation published in @AnnalsofIM. Rate of recurrent VTE is 3.1% . Nice collaboration between @INNOVTE1 and @canvector funded by @HeartandStroke https://t.co/GdcbM1fRp1 @OttMethodsCentr

— Marc Carrier (@MarcCarrier1) November 23, 2021

Review: A Road Map of the Axial Spondyloarthritis Continuum.

24 Nov, 2021 | 08:27h | UTC

A Road Map of the Axial Spondyloarthritis Continuum – Mayo Clinic Proceedings

Opinion: Texting thumb, trigger finger, gamer’s thumb and other smartphone injuries.

24 Nov, 2021 | 08:24h | UTC

Texting Thumb, Trigger Finger, Gamer’s Thumb and Other Smartphone Injuries – Scientific American

Review: Prevention and treatment of atrial fibrillation via risk factor modification.

24 Nov, 2021 | 08:25h | UTC

Prevention and Treatment of Atrial Fibrillation via Risk Factor Modification – American Journal of Cardiology

Systematic Review: Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery.

24 Nov, 2021 | 08:22h | UTC

Summary: Selective serotonin reuptake inhibitors for stroke recovery – Cochrane Library

Original Article: Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery – Cochrane Library

RCT: Routine treatment with fluoxetine does not reduce the incidence of depression after stroke.

[Abstract Only] Randomized trial: Fluoxetine does not improve functional recovery after acute stroke

Randomized Trial: Effects of Fluoxetine on Functional Outcomes After Acute Stroke

Commentary on Twitter

Selective #serotonin reuptake inhibitors for #stroke recovery https://t.co/7R5bijz49e Updated @CochraneStroke systematic review: 'reduced risk of future depression by about a quarter, but led to a slight increase in the risk of seizures & increased the risk of bone fractures.'

— The Cochrane Library (@CochraneLibrary) November 19, 2021

[Preprint] Systematic Review: Duration of Effectiveness of Vaccines Against SARS-CoV-2 Infection and COVID-19 Disease – “effectiveness against COVID-19 severe disease remained high (>70%) in most studies in the six months after full vaccination, although it did decrease some (on average, 8-10 percentage points) between one and six months after full vaccination”.

23 Nov, 2021 | 08:57h | UTC

Duration of Effectiveness of Vaccines Against SARS-CoV-2 Infection and COVID-19 Disease: Results of a Systematic Review and Meta-Regression – Preprints with The Lancet – SSRN

Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine.

China’s COVID vaccines have been crucial — now immunity is waning.

[Preprint] Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – “Vaccine protection declined by mid-August 2021, decreasing from 91.9% in March to 53.9%”.

Observational study in Qatar showed the effectiveness of Pfizer vaccine against any SARS-CoV-2 infection dropped to 20% in months 5 through 7 after the second dose, but effectiveness against severe Covid-19 remained high.

Cohort study: Pfizer vaccine effectiveness against any infections declined from 88% during the first month after full vaccination to 47% after 5 months. Vaccine effectiveness against hospital admissions remained high; 87% within 1 month, and 88% at 5 months after full vaccination, with no significant waning.

Editorial | Covid-19 vaccination: evidence of waning immunity is overstated.

COVID vaccine immunity is waning — how much does that matter? – “As debates about booster shots heat up, what’s known about the duration of vaccine-based immunity is still evolving”.

COVID vaccine effects wane over time but still prevent death and severe illness.

Perspective | What we actually know about waning immunity.

Another study shows Pfizer mRNA vaccine immunity is reduced over time.

[Press release – not published yet] Study shows vaccine protection wanes over time, but vaccines still offer good protection against severe disease.

Studies: COVID vaccine protection waning against infection but not hospitalization.

Systematic Review: Vaccines for preventing rotavirus diarrhea.

24 Nov, 2021 | 08:20h | UTC

Vaccines for preventing rotavirus diarrhoea: vaccines in use – Cochrane Library

Summary: Are rotavirus vaccines safe and effective in preventing rotavirus diarrhoea in infants and children? – Cochrane Library

Commentary: Vaccines for preventing rotavirus diarrhoea: an updated Cochrane review – Cochrane Library

Optimal dose of aripiprazole for augmentation therapy of antidepressant-refractory depression: preliminary findings based on a systematic review and dose–effect meta-analysis.

24 Nov, 2021 | 08:23h | UTC

Optimal dose of aripiprazole for augmentation therapy of antidepressant-refractory depression: preliminary findings based on a systematic review and dose–effect meta-analysis – The British Journal of Psychiatry

Commentary on Twitter

Low-doses of aripiprazole [2-5 mg] as augmentation treatment for depression might achieve the optimal balance between efficacy, tolerability and acceptability, per this meta-analysis (certainty of evidence low to moderate)https://t.co/aTkcQOsORp

— Awais Aftab (@awaisaftab) November 21, 2021

Populational study in France did not show an increased incidence of acute myocardial infarction, stroke, and pulmonary embolism following the Pfizer vaccine.

23 Nov, 2021 | 08:51h | UTC

Myocardial Infarction, Stroke, and Pulmonary Embolism After BNT162b2 mRNA COVID-19 Vaccine in People Aged 75 Years or Older – JAMA

Scientists mystified, wary, as Africa avoids COVID disaster.

23 Nov, 2021 | 08:47h | UTC

Scientists mystified, wary, as Africa avoids COVID disaster – Associated Press

M-A: Colchicine doesn’t lessen COVID-19 severity or stave off risk of death.

23 Nov, 2021 | 08:55h | UTC

News release: Gout drug colchicine doesn’t lessen COVID-19 severity or stave off risk of death – BMJ

Original Study: Efficacy and safety of colchicine in COVID-19: a meta-analysis of randomised controlled trials – RMD Open

RECOVERY Trial: In patients admitted to hospital with COVID-19, Colchicine did not reduce 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death.

[Preprint] PRINCIPLE RCT: Colchicine does not improve time to recovery in outpatients with Covid-19 at higher risk of complications.

COLCORONA RCT: Colchicine for community-treated patients with COVID-19 – findings suggest it may lower death and hospital admission rates, but further studies are required.

[Preprint] RECOVERY Trial: Colchicine does not improve outcomes in patients admitted to hospital with COVID-19.

The COVID-19 Patient in the Surgical Intensive Care Unit.

23 Nov, 2021 | 08:46h | UTC

The COVID-19 Patient in the Surgical Intensive Care Unit – Surgical Clinics of North America

ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease.

23 Nov, 2021 | 08:40h | UTC

ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease – American Journal of Gastroenterology

Commentary on Twitter (thread – click for more)

⭐️NEW @AmCollegeGastro guidelines on #GERD!⭐️

🔥 🤭 🌶 💊 ✂️

"A lot has changed, much remains the same." 🧵 ⬇️#MedTwitter #GITwitter #GI #motility #MedEd https://t.co/HS26GDk8Jd

— John Damianos, M.D. (@john_damianosMD) November 22, 2021

GRADE Guidance 24. Optimizing the integration of randomized and non-randomized studies of interventions in evidence syntheses and health guidelines.

23 Nov, 2021 | 08:38h | UTC

GRADE Guidance 24. Optimizing the integration of randomized and non-randomized studies of interventions in evidence syntheses and health guidelines – Journal of Clinical Epidemiology

Commentary on Twitter

🆕#gradeguidance how & when to appropriately integrate non-randomized |observational studies in your #evidencesynthesis of intervention effects & some of the implications for @GRADE_WG approach @CharlieNeck @schunemann_mac @RMorganPhD @Elie__Akl +@JClinEpi https://t.co/2pAdQShX9q

— GRADE Working Group (@GRADE_WG) November 19, 2021

In a survey of about 27,600 U.S. individuals, 18.5% of adults with hypertension used medications that may raise blood pressure; the most commonly reported classes were antidepressants, nonsteroidal anti-inflammatory drugs, steroids, and estrogens.

23 Nov, 2021 | 08:33h | UTC

Prevalence of Medications That May Raise Blood Pressure Among Adults With Hypertension in the United States – JAMA Internal Medicine (free for a limited period)

Commentary from the author on Twitter (thread – click for more)

🚨New work from our team in @JAMAInternalMed 🚨

18% of adults with #hypertension report using medications (💊) that may raise blood pressure.

Use of these 💊 associated with:
⬇️ odds of achieving BP control
⬆️ # of antihypertensives usedhttps://t.co/DlV5rlHLu3

Thread
/1 pic.twitter.com/q7b7FQ4jHH

— Tim Anderson (@TimAndersonMD) November 22, 2021

RCT: Educating outpatients for bowel preparation before colonoscopy using virtual reality videos improved bowel preparation, polyp and adenoma detection rates, and improved compliance and satisfaction.

23 Nov, 2021 | 08:28h | UTC

Educating Outpatients for Bowel Preparation Before Colonoscopy Using Conventional Methods vs Virtual Reality Videos Plus Conventional MethodsA Randomized Clinical Trial – JAMA Network Open

Commentary on Twitter

RCT finds patients who received virtual reality video education before a colonoscopy had better bowel preparation, higher polyp and adenoma detection rates, and improved compliance and satisfaction. https://t.co/dAUtFf2m4B pic.twitter.com/RKAVZcVGuy

— JAMA Network Open (@JAMANetworkOpen) November 22, 2021

M-A: Antiemetics for adults for prevention of nausea and vomiting caused by moderately or highly emetogenic chemotherapy.

23 Nov, 2021 | 08:21h | UTC

Antiemetics for adults for prevention of nausea and vomiting caused by moderately or highly emetogenic chemotherapy: a network meta‐analysis – Cochrane Library

Summary: Which drug combinations are best for prevention of nausea and vomiting caused by chemotherapy in adults with cancer? – Cochrane Library

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.

23 Nov, 2021 | 08:45h | UTC

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections – Infectious Diseases Society of America

Commentary on Twitter

IDSA has released NEW guidance on treating infections caused by three of the most common drug-resistant pathogens:

• AmpC-E
• CRAB
• S. maltophilia

Guidelines: https://t.co/gjxEZcxtmy
Press release: https://t.co/ulorKCmvQ4 #IDSAGuidelines #WAAW21 pic.twitter.com/Wy7uBaq2DN

— IDSA (@IDSAInfo) November 22, 2021

Antibiotic Awareness: a round-up of Cochrane evidence.

23 Nov, 2021 | 08:23h | UTC

Antibiotic Awareness: a round-up of Cochrane evidence – Cochrane Library

Commentary on Twitter

https://t.co/oVkKaj433K

@CochraneUK – excellent resources and collection of antibiotic evidence review. #tldr
Azithro doesn’t work for COVID; procalcitonin reduces antibiotic use effectively; short course durations have similar outcomes to long; & so much more

— Susan Hopkins (@SMHopkins) November 21, 2021

M-A: Current evidence does not support intensive blood pressure reduction as a preventive strategy for cognitive decline and dementia.

23 Nov, 2021 | 08:26h | UTC

Evaluation of Intensive vs Standard Blood Pressure Reduction and Association With Cognitive Decline and Dementia: A Systematic Review and Meta-analysis – JAMA Network Open

Commentary on Twitter

Meta-analysis found no associated reduction in the risk of cognitive decline with intensive as compared to standard blood pressure (BP) interventions. There is insufficient evidence to support intensive BP management to prevent cognitive impairment. https://t.co/2BEV1ywrCO

— JAMA Network Open (@JAMANetworkOpen) November 22, 2021