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Germany offers booster shots to everyone amid ‘very worrying’ surge in cases.

7 Nov, 2021 | 20:22h | UTC

Germany offers booster shots to everyone amid ‘very worrying’ surge in cases – CNN

RCT: In patients with chronic kidney diseases and anemia not undergoing dialysis, Daprodustat (oral drug) was noninferior to darbepoetin alfa in increasing hemoglobin levels and regarding cardiovascular outcomes.

7 Nov, 2021 | 20:17h | UTC

Daprodustat for the Treatment of Anemia in Patients Not Undergoing Dialysis – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Oral pill as safe, efficacious as conventional treatment for anemia in patients with kidney disease – Brigham and Women’s Hospital

Commentary on Twitter

In this trial, daprodustat was as effective as darbepoetin alfa in increasing and maintaining hemoglobin levels in patients with CKD and anemia who were not receiving dialysis. #KidneyWk https://t.co/D2unQFLH6T pic.twitter.com/KqdLfVlkuD

— NEJM (@NEJM) November 5, 2021

Among patients with atrial fibrillation, 4-year outcomes of PRAGUE-17 randomized trial showed that left atrial appendage closure was noninferior to non-warfarin oral anticoagulation for preventing net ischemic and bleeding events.

7 Nov, 2021 | 20:15h | UTC

Left Atrial Appendage Closure versus Non-Warfarin Oral Anticoagulation in Atrial Fibrillation: 4-Year Outcomes of PRAGUE-17 – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentaries:

PRAGUE-17: LAA Occlusion Noninferior to DOACs Over Longer Term – TCTMD

PRAGUE-17: LAAC Noninferior to NOACs For Major AFib-Related CV, Neurological Events Longer-Term – American College of Cardiology

Left Atrial Appendage Closure vs. Novel Anticoagulation Agents in High-Risk Atrial Fibrillation Patients – PRAGUE-17 – American College of Cardiology

Commentary on Twitter

📌 The PRAGUE-17 trial showed that left atrial appendage occlusion was noninferior to a #NOAC at preventing net ischemic & bleeding events. Check out ACC’s Visual Abstract from #TCT2021 to learn more here: https://t.co/NTVc4wpH6W pic.twitter.com/9EBWRvs72O

— American College of Cardiology (@ACCinTouch) November 6, 2021

RCT: In patients with advanced chronic kidney disease and poorly controlled hypertension, Chlortalidone had a significant impact in blood-pressure control (−11.0 mm Hg vs. −0.5 mm Hg in the placebo group).

7 Nov, 2021 | 20:20h | UTC

Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Cheap Diuretic, Chlorthalidone, Drops BP in Advanced Kidney Disease – Medscape (free registration required)

Commentary on Twitter

In this placebo-controlled trial involving patients with advanced chronic kidney disease and poorly controlled hypertension, chlorthalidone therapy improved blood-pressure control at 12 weeks as compared with placebo. #KidneyWk https://t.co/iNZc2mYy2c pic.twitter.com/7svX4RVtPI

— NEJM (@NEJM) November 5, 2021

New study challenges the idea that a coronary artery calcium score of 0 is enough for ruling out coronary stenosis in symptomatic patients, especially in young adults.

7 Nov, 2021 | 20:09h | UTC

Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients – JAMA Cardiology (link to abstract – $ for full-text)

Commentary: Zero CAC Questionable for Ruling Out Obstructive CAD in Young Adults – TCTMD

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

There has been a lot of discussion about our recent paper in JAMA Cardiology. In my opinion, much of the discussion is caused by a troublesome extrapolation of the results to the value of CAC in risk assessment in primary prevention. I will go through our findings in these tweets https://t.co/O0Rl12XYmV

— Martin Bødtker Mortensen (@MaBMortensen) November 1, 2021

Mapping conflict of interests: scoping review.

7 Nov, 2021 | 20:10h | UTC

Mapping conflict of interests: scoping review – The BMJ

Press release: Study reveals “extensive network” of industry ties with healthcare – BMJ

NICE draft guideline recommends SGLT2 inhibitor dapagliflozin for some patients with chronic kidney disease.

7 Nov, 2021 | 20:14h | UTC

NICE recommend dapagliflozin for people with chronic kidney disease – National Institute for Health and Care Excellence

See draft guideline:

Appraisal consultation document (online commenting)

Appraisal consultation document (PDF version)

NICE Guideline: Assessment and management of chronic kidney disease.

Secondary analysis of RCT finds Dapagliflozin is safe for patients with stage 4 chronic kidney disease.

Randomized trial: Dapagliflozin in patients with chronic kidney disease

A cohort study with 287 patients showed that those who fulfill 5 criteria 2 or 3 days after laparoscopic colorectal surgery (a CRP below 150 mg/dL, a return of bowel function, tolerance of a diet, little pain, and afebrile during the entire stay) have a low risk of developing an anastomotic leak. These criteria have the potential to allow for safe early discharge.

7 Nov, 2021 | 20:06h | UTC

Assessing Criteria for a Safe Early Discharge After Laparoscopic Colorectal Surgery – JAMA Surgery (free for a limited period)

Commentary on Twitter

A prospective observational study on 287 adults showing that patients with CRP<150mg/dL, bowel function, diet tolerance, pain<5/10 and no fever, 2-3 days after laparoscopic colorectal surgery have a low anastomotic leak risk and may be discharged early https://t.co/zq8lvHPoQ1

— JAMA Surgery (@JAMASurgery) November 5, 2021

Study compares the decline in effectiveness for Moderna, Pfizer, and Janssen vaccines and consequences for mortality.

5 Nov, 2021 | 09:59h | UTC

Original study: SARS-CoV-2 vaccine protection and deaths among US veterans during 2021 – Science

News release: Breakthrough Infection Study Compares Decline in Vaccine Effectiveness and Consequences for Mortality – Public Health Institute

Commentary on Twitter

A new study of more than 780,000 United States Veterans shows that, although vaccination remains protective against #SARSCoV2 infection, protection waned as the Delta variant emerged in America.

Read more: https://t.co/8qRlKE107H #ScienceResearch pic.twitter.com/XmDQ7frIlT

— Science Magazine (@ScienceMagazine) November 4, 2021

M-A: Comparison of outcomes between neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in patients with locally advanced esophageal cancer.

7 Nov, 2021 | 20:07h | UTC

Comparison of outcomes between neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in patients with locally advanced esophageal cancer: A network meta-analysis – EClinicalMedicine

Review: SARS-CoV-2 indoor air transmission is a threat that can be addressed with science.

5 Nov, 2021 | 09:55h | UTC

SARS-CoV-2 indoor air transmission is a threat that can be addressed with science – Proceedings of the National Academies of Sciences

Ten scientific reasons in support of airborne transmission of SARS-CoV-2

Editorial: Covid-19 has redefined airborne transmission

Covid-19: What do we know about airborne transmission of SARS-CoV-2?

Real-world data show that filters clean COVID-causing virus from air.

Perspective | The plan to stop every respiratory virus at once – “The benefits of ventilation reach far beyond the coronavirus. What if we stop taking colds and flus for granted, too?”

Recommendations for ventilation of indoor spaces to reduce COVID-19 transmission.

We studied how to reduce airborne COVID spread in hospitals. Here’s what we learnt.

Report: Improved ventilation essential to safe use of buildings and public spaces, say leading engineers.

WHO: Roadmap to improve and ensure good indoor ventilation in the context of COVID-19

CDC releases new ventilation guidelines for indoor environments to reduce Covid-19 risk

Guidance: Using Ventilation and filtration to reduce aerosol transmission of COVID-19 in long-term care homes

It’s not just SARS-CoV-2: Most respiratory viruses spread by aerosols.

Commentary on Twitter

Addressing #CovidisAirborne with sciencehttps://t.co/puzxHQ6xGD
proceedings of a workshop with the experts @PNASNews w/ @Smogdr @linseymarr @kprather88 @Lakdawala_Lab @Prof_Lowe pic.twitter.com/xdjjFZ8Uto

— Eric Topol (@EricTopol) November 5, 2021

Effects of the Covid-19 pandemic on life expectancy and premature mortality in 2020 – this time series analysis showed there were more than 28 million excess years of life lost in 2020 in 31 countries.

5 Nov, 2021 | 09:56h | UTC

Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries – The BMJ

Global Covid-19 deaths surpass five million.

Under-reporting of deaths limits our understanding of true burden of covid-19.

Study shows COVID-19 has caused the biggest decrease in life expectancy since World War II.

Just how do deaths due to COVID-19 stack up?

Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset.

Exploring the gap between excess mortality and COVID-19 deaths in 67 countries.

Report: Three new estimates of India’s all-cause excess mortality during the COVID-19 Pandemic – pandemic death toll estimated to be between 3.4 million and 4.9 million excess deaths.

COVID-19 has caused 6.9 million deaths globally, more than double what official reports show

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

THREAD:

Our new #BMJ @bmj_latest study: >28 million EXCESS years of life were lost in 31 countries in 2020 alone! (more below)

w/ @martinwhite33 @kamleshkhunti @DmitriJdanov @Oxford_NDPH @bdi_oxford @UniofOxford @MRC_Epid @Cambridge_Uni @LDC_tweets @uniofleicester @MPIDRnews https://t.co/FGZau2Fg75

— Nazrul Islam (@_Nazrul_Islam) November 4, 2021

The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first.

5 Nov, 2021 | 09:51h | UTC

The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first – NPR

Merck to allow other nations to produce new COVID-19 antiviral.

Video: Merck’s Covid pill could transform treatment. Here’s how it works.

How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.

What we know — and don’t know — about Merck’s new Covid-19 pill.

[Press release – not published yet] Merck announces oral antiviral Molnupiravir reduced the risk of hospitalization or death by approximately 50 Percent compared to placebo for patients with mild or moderate COVID-19.

Merck’s Covid-19 pill is great news but may not be a game-changer.

Video | A Pill For COVID? A Doctor Explains Molnupiravir.

Debate: Are vaccine passports and covid passes a valid alternative to lockdown?

5 Nov, 2021 | 09:53h | UTC

Are vaccine passports and covid passes a valid alternative to lockdown? – The BMJ

News Release: Covid passes: the best way of preventing another lockdown or a threat to civil freedoms and rights? – BMJ

Clinical Care Pathway for the Risk Stratification and Management of Patients with Nonalcoholic Fatty Liver Disease.

5 Nov, 2021 | 09:50h | UTC

Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease – Gastroenterology

News release: International experts develop Clinical Care Pathway in response to NASH epidemic – American Gastroenterology Association

Non-alcoholic fatty liver disease: A patient guideline.

State of the art review: Management of non-alcoholic fatty liver disease

M-A: Non-alcoholic fatty liver disease linked to increased risk of fatal and non-fatal cardiovascular events.

M-A: non-invasive tests for advanced fibrosis can reduce the need for biopsy in patients with non-alcoholic fatty liver disease.

Review: Dietary carbohydrates and fats in nonalcoholic fatty liver disease.

M-A: Renal denervation for hypertension is associated with a modest reduction in ambulatory blood pressure control (3.61 mm Hg reduction in ambulatory systolic BP and 1.85 mm Hg reduction in ambulatory diastolic BP).

5 Nov, 2021 | 09:46h | UTC

Renal Denervation for Hypertension: A Systematic Review and Meta-Analysis of Randomized, Blinded, Placebo-Controlled Trials – JACC: Cardiovascular Interventions

Commentaries:

Meta-Analysis of Renal Denervation for Hypertension – American College of Cardiology

Is Renal Denervation a Useful Strategy in BP Management? – American College of Cardiology

#ACC21 – RCT: Among patients with resistant hypertension, ultrasound renal denervation resulted in a modest improvement in systolic BP (–4.5 mm Hg) vs. sham procedure.

Meta-Analysis: Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients with Hypertension

RCT: In patients with three-vessel coronary artery disease, an FFR–guided PCI strategy was NOT noninferior to coronary bypass surgery – The 1-year incidence of the composite primary end point (death, myocardial infarction, or stroke) was 7.3% in the FFR-guided PCI group and 5.2% in the CABG group.

5 Nov, 2021 | 09:49h | UTC

Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery – New England Journal of Medicine

Commentaries:

FAME 3: PCI Fails to Demonstrate Noninferiority to Surgery in Three-Vessel CAD – TCTMD

FAME 3: FFR-Guided PCI vs. CABG in Patients With Three-Vessel CAD – American College of Cardiology

Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3 – FAME 3 – American College of Cardiology

Commentary on Twitter

In this trial, patients with three-vessel coronary artery disease, PCI guided by assessment of fractional flow reserve was not noninferior to CABG with respect to the composite end point of death, myocardial infarction, stroke, or repeat revascularization. https://t.co/uYZGZWub0T pic.twitter.com/zsghs2SlsA

— NEJM (@NEJM) November 4, 2021

Cluster RCT: In older adults with advanced cancer, a geriatric assessment program reduced the toxic effects of cancer treatment.

5 Nov, 2021 | 09:48h | UTC

Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised study – The Lancet

News Release: Less Chemotherapy, Personalized Care: Wilmot Study Reinforces Major Strides in Geriatric Oncology – University of Rochester Medical Center

RCT: A geriatric assessment–driven intervention can reduce chemotherapy-related toxic effects in older adults with cancer.

Perspective: A Cancer Care Approach Tailored to The Elderly May Have Better Results

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

https://twitter.com/rochgerionc/status/1456046017766375425

Observational study showed J&J single shot vaccine had an effectiveness of 74% against symptomatic Covid-19.

4 Nov, 2021 | 10:08h | UTC

Analysis of the Effectiveness of the Ad26.COV2.S Adenoviral Vector Vaccine for Preventing COVID-19 – JAMA Network Open

Commentaries:

Single-Dose Ad26.COV2.S Vaccine—Room for Improvement – JAMA Network Open

Real-world study shows J&J COVID-19 vaccine 74% effective – CIDRAP

J&J COVID-19 Vaccine: FDA recommends booster shot for all adults aged 18 and older at least two months following initial vaccination with the single-shot vaccine.

[Press release – not published yet] J&J says booster shot at two months provided 75% protection against moderate to severe COVID-19 globally and 94% of such cases in the U.S.

CDC Report: Moderna’s vaccine associated with greater effectiveness (93%) against Covid-19 hospitalization compared to Pfizer (88%) and J&J (71%) vaccines.

[Preprint] Observational study finds single-dose Johnson & Johnson vaccine is 76.7% effective in preventing SARS-CoV-2 infection

RCT: Single-Dose Johnson & Johnson Vaccine has 85% efficacy against severe/critical Covid-19 and maintains efficacy against variant B.1.351

Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain.

5 Nov, 2021 | 09:44h | UTC

Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain – Journal of Hospital Medicine

Large observational study suggests Tramadol is associated with increased risk of adverse outcomes compared to Codeine.

Tramadol: Where do we go from here? – “Tramadol’s unpredictability, unique potential harms, and lack of advantage over other opioids or NSAIDs are now well recognized”.

Cohort Study: Chronic Use of Tramadol After Acute Pain Episode

WHO issues emergency use approval for India’s Covaxin.

4 Nov, 2021 | 10:11h | UTC

WHO issues emergency use listing for eighth COVID-19 vaccine – World Health Organization

Commentaries:

WHO Gives India’s Covaxin Approval, Opening the Door to COVAX distribution – Health Policy Watch

WHO green-lights India’s COVID vaccine as global cases rise – CIDRAP

Commentary on Twitter (thread – click for more)

🆕 WHO has granted emergency use listing (EUL) to #COVAXIN® (developed by Bharat Biotech), adding to a growing portfolio of vaccines validated by WHO for the prevention of #COVID19. pic.twitter.com/dp2A1knGtT

— World Health Organization (WHO) (@WHO) November 3, 2021