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A primer on what we know about mixing and matching Covid vaccines.

13 Oct, 2021 | 01:44h | UTC

A primer on what we know about mixing and matching Covid vaccines – STAT

Related:

Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination.

RCT: Safety and immunogenicity of heterologous vs. homologous prime-boost schedules with an adenoviral vectored and mRNA COVID-19 vaccine.

Another study shows increased immune response with heterologous Oxford-AstraZeneca/mRNA vaccination.

Heterologous Oxford–AstraZeneca and Moderna Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

Heterologous Oxford–AstraZeneca and BioNTech/Pfizer Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

[Preprint] Mixing Covid jabs has good immune response, study finds – “The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system”.

Phase 2 RCT: Immunogenicity and reactogenicity of a Pfizer-BioNTech booster in patients that have received a single dose of AstraZeneca vaccine – “BNT162b2 (Pfizer) given as a second dose in individuals prime vaccinated with ChAdOx1-S (AstraZeneca) induced a robust immune response, with an acceptable and manageable reactogenicity profile”.

Lab study shows heterologous AstraZeneca/Pfizer vaccination produces strong immune response against SARS-CoV-2 Delta variant.

Lab study shows a heterologous AstraZeneca + Pfizer immunization strategy provides stronger immunogenicity against Covid compared to homologous AZ + AZ or Pfizer + Pfizer strategies.

RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.

 

Seroconversion and fever are dose-dependent in a nonhuman primate model of inhalational COVID-19.

13 Oct, 2021 | 01:41h | UTC

Seroconversion and fever are dose-dependent in a nonhuman primate model of inhalational COVID-19 – PLOS Pathogens

Commentary: Dose-dependent COVID-19 symptoms – Nature Reviews Microbiology

 

Commentaries on Twitter

 

USPSTF draft statement revises previous guidance and now recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults aged 60 years or older.

13 Oct, 2021 | 01:36h | UTC

USPSTF Draft Recommendation Statement: Aspirin Use to Prevent Cardiovascular Disease – U.S. Preventive Services Task Force

Commentaries:

Advice shifting on aspirin use for preventing heart attacks – Associated Press

Taking aspirin to prevent heart attack may cause more harm than good, task force says – NPR

Related Randomized Trials:

Randomized Trial: Aspirin for Primary Prevention of Cardiovascular Disease

Randomized Trial: Effects of Aspirin for Primary Prevention in Persons with Diabetes

Randomized Trial: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly

Related Meta-Analysis:

Meta-Analysis: Association of Aspirin Use for Primary Prevention with Cardiovascular Events and Bleeding Events

Meta-Analysis: Efficacy and Safety of Aspirin for Primary Prevention of Cardiovascular Events

Aspirin for primary prevention of cardiovascular disease: a meta-analysis with a particular focus on subgroups – BMC Medicine

Related Opinions:

Aspirin for Primary Prevention: Is This the End of the Road?

Evidence evolving on aspirin as prevention – ACP Internist

 

Commentary on Twitter

 

M-A: Frequency of Neurologic Manifestations in COVID-19 – up to one-third of patients (89% hospitalized) experienced at least one neurological manifestation.

13 Oct, 2021 | 01:40h | UTC

Frequency of Neurologic Manifestations in COVID-19: A Systematic Review and Meta-analysis – Neurology

 

Consensus Guidance: Hyperkalemia management in the emergency department.

13 Oct, 2021 | 01:34h | UTC

Hyperkalemia management in the emergency department: An expert panel consensus – Journal of the American College of Emergency Physicians Open

Related: Review: Clinical Management of Hyperkalemia. Classification and monitoring, when to reinitiate RAASi therapy, use oral K+-binding agents, and more

Podcast: Hyperkalemia, Diet, K+ Binders, Exercise

Hyperkalemia: Pathophysiology, Risk Factors and Consequence

Hyperkalemia: Pathophysiology, Risk Factors and Consequence (several articles)

 

ACR Announces New Appropriateness Criteria for Diagnostic Exams.

13 Oct, 2021 | 01:32h | UTC

American College of Radiology Announces New Appropriateness Criteria – Medical Device News Magazine

New Guidance: ACR Appropriateness Criteria

 

RCT: Laser treatment not better than sham treatment on symptom severity in women with postmenopausal vaginal symptoms.

13 Oct, 2021 | 01:30h | UTC

Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial – JAMA (free for a limited period)

News release: This laser is supposed to rejuvenate vaginal tissue. But scientists say it’s no better than a placebo – University of New South Wales

Editorial: Time for a “Pause” on the Use of Vaginal Laser (free for a limited period)

Author Interview: Effect of Carbon Dioxide Laser vs Sham Therapy on Women With Postmenopausal Vaginal Symptoms

Commentary: Vagina lasering for postmenopausal women ‘may be placebo’ – The Guardian

 

Commentary on Twitter

 

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018.

13 Oct, 2021 | 01:21h | UTC

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018 – Nature Medicine

Invited commentary: Anemia in women — an intractable problem that requires innovative solutions – Nature Medicine

 

RCT: FODMAPs, but not gluten, elicit modest symptoms of irritable bowel syndrome.

13 Oct, 2021 | 01:25h | UTC

FODMAPs, but not gluten, elicit modest symptoms of irritable bowel syndrome: a double-blind, placebo-controlled, randomized three-way crossover trial – American Journal of Clinical Nutrition

 

Commentary on Twitter

 

M-A: Omega-3 fatty acids supplementation is associated with increased risk of atrial fibrillation.

13 Oct, 2021 | 01:27h | UTC

Effect of Long-Term Marine Omega-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis – Circulation (link to abstract – $ for full-text)

Related:

M-A: Omega-3 fatty acids supplementation increases the risk of atrial fibrillation in patients with lipid disorders.

More data suggests no cardiovascular benefit from Omega-3 supplementation – secondary analysis of STRENGHT trial did not show an association between achieved Omega-3 fatty acid levels and major adverse cardiovascular outcomes in patients with high cardiovascular risk.

RCT: Omega-3 supplements do not reduce cardiovascular events in elderly patients after myocardial infarction

#AHA20 – Randomized trial: High-dose Omega-3 fatty acids did not reduce the risk of cardiac events in patients at high cardiovascular risk

Meta-Analysis of Randomized Trials: Little Benefit from Omega-3 Intake to Reduce Cardiovascular Disease Risk

 

Commentary on Twitter

 

Review: Optimal diet for cardiovascular and planetary health.

13 Oct, 2021 | 01:22h | UTC

Optimal diet for cardiovascular and planetary health – Heart

 

M-A: New pharmacologic agents (Ditans and Gepants) are not as good as triptans for treating migraines.

13 Oct, 2021 | 01:17h | UTC

Comparison of New Pharmacologic Agents With Triptans for Treatment of Migraine: A Systematic Review and Meta-analysis – JAMA Network Open

Commentary: Migraine: Older Drugs May Be Best Bet for Lessening Pain – Physician’s Weekly

 

Commentary on Twitter

 

Editorial: How to develop a quality research article and avoid a journal desk rejection.

13 Oct, 2021 | 01:18h | UTC

Editorial: How to develop a quality research article and avoid a journal desk rejection – International Journal of Information Management (free for a limited period)

 

RCT: No benefit from antithrombotic therapy (aspirin or apixaban) in outpatients with clinically stable symptomatic COVID-19.

12 Oct, 2021 | 00:28h | UTC

Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial – JAMA

Editorial: Antithrombotic Therapy for Outpatients With COVID-19: Implications for Clinical Practice and Future Research – JAMA

 

Commentary on Twitter

 

Nationwide study in Sweden shows link between COVID vaccination and reduced household transmission.

12 Oct, 2021 | 00:25h | UTC

News release: Nationwide study shows link between COVID vaccination and reduced household transmission – Umea University

Original study: Association Between Risk of COVID-19 Infection in Nonimmune Individuals and COVID-19 Immunity in Their Family Members – JAMA Internal Medicine

Related:

Review | Prevention of host-to-host transmission by SARS-CoV-2 vaccines.

Study ties COVID vaccines to lower transmission rates.

Effect of Vaccination on Household Transmission of SARS-CoV-2 in England – “the likelihood of household transmission was approximately 40 to 50% lower in households of index patients who had been vaccinated 21 days or more before testing positive than in households of unvaccinated index patients”.

Study in England showed one dose of COVID-19 vaccine can cut household transmission by up to half – This protection is on top of the reduced risk of a vaccinated person developing symptomatic infection, which is around 60 to 65% after the first dose

Covid-19 vaccination prevents transmission from vaccinated to unvaccinated household members.

 

D-Dimer testing for the exclusion of pulmonary embolism has limited clinical utility among hospitalized patients with COVID-19 – most patients with or without pulmonary embolism have increased levels.

12 Oct, 2021 | 00:26h | UTC

D-Dimer Testing for the Exclusion of Pulmonary Embolism Among Hospitalized Patients With COVID-19 – JAMA Network Open

Commentary: D-Dimer Level Not Useful for Ruling Out PE in COVID-19 Patients – HealthDay

 

Covid-19: Is New Zealand’s switch in policy a step forward or a retreat?

12 Oct, 2021 | 00:21h | UTC

Covid-19: Is New Zealand’s switch in policy a step forward or a retreat? – The BMJ

Related:

New Zealand acknowledges it can no longer completely get rid of the coronavirus.

Why we must not allow COVID to become endemic in New Zealand – The Conversation

 

Commentary on Twitter

 

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

12 Oct, 2021 | 00:18h | UTC

How antiviral pill molnupiravir shot ahead in the COVID drug hunt – Nature

Related:

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.

 

WHO’s Special Report on Climate Change and Health.

12 Oct, 2021 | 00:12h | UTC

News release: WHO’s 10 calls for climate action to assure sustained recovery from COVID-19 – World Health Organization

Report: COP26 Special Report on Climate Change and Health – World Health Organization

Commentary: ‘Burning of Fossil Fuels is Killing Us’ – Declares New WHO Climate and Health Report – Health Policy Watch

 

Commentary on Twitter (thread – click for more)

 

Why easing COVID restrictions could prompt a fierce flu rebound – “As pandemic restrictions ease, other respiratory viruses are returning in unexpected ways”.

12 Oct, 2021 | 00:19h | UTC

Why easing COVID restrictions could prompt a fierce flu rebound – Nature

 

The BMJ Series on Climate Emergency and Health Professionals – Call for emergency action to limit global temperature increases, restore biodiversity, and protect health.

12 Oct, 2021 | 00:10h | UTC

Homepage

Accelerating climate action: the role of health professionals

Changing behaviour for net zero 2050

From drug discovery to coronaviruses: why restoring natural habitats is good for human health

Covid-19, climate change, and the environment: a sustainable, inclusive, and resilient global recovery

Health risks of extreme heat

How to achieve a net zero carbon NHS during a pandemic

A world on the edge of climate disaster

David Oliver: Outpatient clinics’ role in sustainability

Helen Salisbury: The time is now

Rammya Mathew: Climate action will require radical reform of how we practise medicine

Overdiagnosis is increasing the carbon footprint of healthcare

The climate crisis and the rise of eco-anxiety

How can I be an environmentally conscious healthcare practitioner?

Talking to patients about the climate emergency

COP26: a missed opportunity for climate leadership

Making outpatient care sustainable for the future

A planetary health curriculum for medicine

Why I . . . am a green GP

 

AHA Scientific Statement: Medication Adherence and Blood Pressure Control.

12 Oct, 2021 | 00:09h | UTC

Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association – Hypertension

News release: Health system crucial to improve medication adherence for people managing hypertension – American Heart Association

Top Things to Know: Medication Adherence and Blood Pressure Control – American Heart Association

Commentary: Medication Adherence – Is It Really the Patient’s Fault? – American Heart Association

 

RCT: In stable patients who have undergone PCI for acute myocardial infarction, de-escalation from aspirin + ticagrelor to aspirin + clopidogrel after 1 month reduced bleeding events without increasing cardiovascular risk.

12 Oct, 2021 | 00:06h | UTC

Unguided de-escalation from ticagrelor to clopidogrel in stabilised patients with acute myocardial infarction undergoing percutaneous coronary intervention (TALOS-AMI): an investigator-initiated, open-label, multicentre, non-inferiority, randomised trial – The Lancet (link to abstract – $ for full-text)

Commentary: Adopting a clopidogrel-based DAPT strategy after PCI boosts outcomes for heart attack patients – Cardiovascular Business

 

RCT: Spinal Anesthesia not Superior to General Anesthesia for Hip Surgery in Older Adults.

12 Oct, 2021 | 00:07h | UTC

Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)

News release: Myth busted: General anesthesia just as safe as spinal anesthesia after broken hip surgery – Penn Medicine

Commentary: Study Finds Spinal Anesthesia Not Superior to General Anesthesia for Hip-Fracture Surgery – BreakingMed

Related: RCT: Similar long-term survival after combined epidural–general anesthesia vs. general anesthesia alone.

 

RCT: In patients with acute ischemic stroke and large vessel occlusion, thrombectomy with combined contact aspiration and stent retriever was not better than stent retriever alone.

12 Oct, 2021 | 00:04h | UTC

Effect of Thrombectomy With Combined Contact Aspiration and Stent Retriever vs Stent Retriever Alone on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER2 Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentaries:

Little Benefit From Adding Aspiration to Thrombectomy for Stroke – Medscape (free registration required)

Combo Thrombectomy Approach No Better for Large Vessel Strokes – MedPage Today (free registration required)

 

Commentary on Twitter

 

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