All Posts
RCT | Vitamin D supplementation shows no significant impact on psoriasis severity
4 Apr, 2023 | 13:51h | UTCSummary: In a randomized, double-blind, placebo-controlled clinical trial involving 122 participants with plaque psoriasis, researchers investigated the effects of vitamin D supplementation on psoriasis severity during winter. Participants received either vitamin D (cholecalciferol, 100,000 IU loading dose followed by 20,000 IU/week) or a placebo for four months. The primary outcome was Psoriasis Area Severity Index (PASI) scores, with secondary outcomes including Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores.
The study found no significant difference in PASI scores or secondary outcomes between the two groups. The results suggest that vitamin D supplementation does not affect psoriasis severity. However, low baseline severity scores and a lower than expected increase in 25-hydroxyvitamin D levels in the intervention group may have influenced the findings, indicating that further research may be needed to account for these factors.
Article: Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels: A Randomized Clinical Trial – JAMA Dermatology (free for a limited period)
Commentary on Twitter
This RCT, performed in North-Norway, found no measurable effect of vitamin D supplementation on psoriasis severity during winter. Low baseline severity, & lower-than-expected rise in 25(OH)D levels in intervention group, may have affected the results. https://t.co/ip17uFQsgM
— JAMA Dermatology (@JAMADerm) March 29, 2023
M-A | No significant health benefits found for low-volume alcohol intake
4 Apr, 2023 | 13:48h | UTCSummary: This systematic review and meta-analysis aimed to investigate the association between alcohol use and all-cause mortality, taking into account potential sources of bias. The study analyzed data from 107 cohort studies published between January 1980 and July 2021, which included 4,838,825 participants and 425,564 deaths.
The study found no significant reductions in all-cause mortality risk for drinkers who consumed less than 25 grams of ethanol per day compared to lifetime nondrinkers. However, there was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams per day and male drinkers who drank 45 or more grams per day.
The analysis highlighted the importance of controlling for former drinker bias and misclassification errors and found sex differences in the risk of all-cause mortality.
In conclusion, the updated meta-analysis found no significantly reduced risk of all-cause mortality associated with low-volume alcohol consumption after adjusting for potential confounding factors. The study recommends that future longitudinal studies in this field should attempt to minimize lifetime selection biases by not including former and occasional drinkers in the reference group and by using younger cohorts at baseline.
Commentary: Drinking Alcohol Brings No Health Benefits, Study Finds – HealthDay
Related:
Prioritising action on alcohol for health and development – The BMJ
Cohort study | Younger stroke survivors show elevated cancer risk for up to 8 years
4 Apr, 2023 | 13:46h | UTCSummary: In this cohort study, 390,398 patients aged 15 years or older in the Netherlands, without a history of cancer and with a first-ever ischemic stroke or intracerebral hemorrhage (ICH), were analyzed between January 1, 1998, and January 1, 2019. The primary outcome was the cumulative incidence of first-ever cancer after the index stroke, stratified by stroke subtype, age, and sex, compared with age-, sex-, and calendar year-matched peers from the general population.
The findings revealed that, in the first year after a stroke, patients aged 15 to 49 years had a 3- to 5-fold increased risk of cancer compared to individuals without a stroke. In contrast, the risk was only slightly elevated for patients aged 50 years or older. The cancer risk remained elevated for up to 8 years after an ischemic stroke and 6 years after an ICH in the younger age group, with the highest risks observed for lung cancer, gastrointestinal cancer, and hematologic cancer.
The findings may be confounded by shared risk factors, such as smoking. Alternatively, the increased cancer risk may have a causal mechanism between cancer and stroke, possibly related to the hypercoagulable state induced by cancer. However, the study design does not allow for conclusions about causal mechanisms, and the researchers called for further studies investigating the usefulness of cancer screening after a stroke.
RCT | Comparable results in endovascular therapy using general anesthesia vs. procedural sedation for stroke treatment
4 Apr, 2023 | 13:45h | UTCOutcomes After Endovascular Therapy With Procedural Sedation vs General Anesthesia in Patients With Acute Ischemic Stroke: The AMETIS Randomized Clinical Trial – JAMA Neurology (free for a limited period)
See also: Visual Abstract
Related: M-A | General Anesthesia vs. to Non-GA in endovascular thrombectomy for ischemic stroke
RCT | Pelvic intraoperative neuromonitoring prevents dysfunction in patients with rectal cancer
4 Apr, 2023 | 13:43h | UTC
RCT | Memantine outperforms placebo for hair-pulling and skin-picking behaviors
4 Apr, 2023 | 13:40h | UTCDouble-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder – American Journal of Psychiatry (link to abstract – $ for full-text)
News release: New research points to drug option for hair-pulling, skin-picking disorders – University of Chicago
Commentary: Memantine May Reduce Symptoms of Hair-Pulling, Skin-Picking Disorder – Psychiatric News Alert
Cross-sectional study | Association between sodium intake and coronary and carotid atherosclerosis
4 Apr, 2023 | 13:42h | UTCEditorial: Dietary salt intake and atherosclerosis: an area not fully explored – European Heart Journal Open
News Release: High salt diet associated with hardened arteries even in people with normal blood pressure – European Society of Cardiology
RCT | Baricitinib + topical corticosteroids effective in kids with moderate-severe atopic dermatitis
4 Apr, 2023 | 13:39h | UTC
S1-guideline cutaneous and subcutaneous leiomyosarcoma
4 Apr, 2023 | 13:37h | UTCS1-guideline cutaneous and subcutaneous leiomyosarcoma – Journal of the German Dermatology Society
Cochrane Library | Hearing conditions: evidence, experience and resources
4 Apr, 2023 | 13:36h | UTCHearing conditions: evidence, experience and resources – Evidently Cochrane
Perspective | Coping with anastomotic leaks: harder as one gets older?
4 Apr, 2023 | 13:34h | UTCCoping with anastomotic leaks: harder as one gets older? – British Journal of Surgery
RCT | Effectiveness of nail bed repair in children with vs. without replacing the fingernail
4 Apr, 2023 | 13:33h | UTCNews Release: New approach to nail bed injury surgery could significantly cut NHS costs – University of Oxford
Two FITs better than one: enhancing diagnostic performance for colorectal cancer in symptomatic populations
4 Apr, 2023 | 13:32h | UTC
Brief Review | What every gastroenterologist should know about gastrointestinal neuroendocrine tumors
4 Apr, 2023 | 13:29h | UTC
M-A | Evolution and refinement of magnetically guided sentinel lymph node detection in breast cancer
4 Apr, 2023 | 13:30h | UTC
Perspective | Create intensive care green teams, there is no time to waste
4 Apr, 2023 | 13:27h | UTCCreate intensive care green teams, there is no time to waste – Intensive Care Medicine
Commentary on Twitter
🌳 #ICU green teams: form or join now, no time to waste!!
🌿 how common are environmental sustainability teams?
🌱 how to create a successful green team
🌿 what could teams be doing?
🌱 evidence for effectiveness
Free to read #FOAMcc on @yourICM
🖇️ https://t.co/SPDVv3xSwd pic.twitter.com/xVD4I5pOoz— Intensive Care Medicine (@yourICM) April 3, 2023
Cohort Study | Preoperative depression has minimal impact on 5-year bariatric surgery outcomes
4 Apr, 2023 | 13:23h | UTC
Applying AI to MRI | A promising approach for detecting severe mental illness risk
4 Apr, 2023 | 13:25h | UTC
Single-arm study | Transcatheter arterialization of deep veins may help avoid amputation in chronic limb-threatening ischemia
3 Apr, 2023 | 14:03h | UTCTranscatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
New procedure helps patients avoid leg amputation – Vanderbilt University
PROMISE II: Flow-Diverting Procedure May Save Limbs in CLTI – TCTMD
Transcatheter Arterialization Could Revolutionize Treatment of Limb-Threatening Ischemia – HCP Live
Transcatheter Arterialization for Limb Ischemia – American College of Cardiology
Commentary on Twitter
https://twitter.com/NEJM/status/1641192272539824128
Cohort Study | Celiac axis stenosis is an underestimated risk factor for increased morbidity after pancreatoduodenectomy
4 Apr, 2023 | 13:20h | UTC
Cohort Study | Assessing active surveillance outcomes in non-intraabdominal desmoid-type fibromatosis patients
4 Apr, 2023 | 13:21h | UTC
AHA Scientific Statement | Pediatric primary hypertension: An underrecognized condition
3 Apr, 2023 | 14:05h | UTCTop Things to Know: Pediatric Primary Hypertension: An Underrecognized Condition – American Heart Association
News Release: Children with high blood pressure often become adults with high blood pressure – American Heart Association
Commentaries:
The Birth of Pediatric Primary Hypertension – American Heart Association
AHA Highlights Pediatric Hypertension in Scientific Statement – HCP Live
RCT | Comparable efficacy of cefotaxime, ceftriaxone, and ciprofloxacin in treating spontaneous bacterial peritonitis
3 Apr, 2023 | 14:01h | UTCSummary: This multicenter, prospective, open-label, randomized controlled trial compared the efficacy of cefotaxime, ceftriaxone, and ciprofloxacin as initial treatments for spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. The study included 261 patients aged 16 to 75, with liver cirrhosis, ascites, and a polymorphonuclear cell count of >250/mm3. Researchers performed follow-up paracentesis at 48 hours to evaluate the assigned antibiotics, and assessed resolution rates at 120 and 168 hours of treatment.
The primary endpoint, resolution rates at 120 hours, showed no statistically significant difference between the groups: 67.8% for cefotaxime, 77.0% for ceftriaxone, and 73.6% for ciprofloxacin. One-month mortality rates were also similar. The study concluded that these antibiotics are equally effective as initial treatments for SBP, particularly for community-acquired infections, when administered based on response-guided therapy.
Article: Response-Guided Therapy With Cefotaxime, Ceftriaxone, or Ciprofloxacin for Spontaneous Bacterial Peritonitis: A Randomized Trial: A Validation Study of 2021 AASLD Practice Guidance for SBP – American Journal of Gastroenterology (free for a limited period)
M-A | Mediterranean & low-fat diets may reduce mortality and non-fatal MI in patients with high cardiovascular risk
3 Apr, 2023 | 13:59h | UTCSummary: This systematic review and network meta-analysis aimed to determine the relative efficacy of different diets for preventing mortality and major cardiovascular events in patients at increased risk of cardiovascular disease. The study identified 40 randomized trials with 35,548 participants across seven dietary programs.
Moderate certainty evidence showed that Mediterranean and low-fat diets, with or without physical activity or other interventions, reduced all-cause mortality and non-fatal myocardial infarction in patients with increased cardiovascular risk. Mediterranean diet programs were also likely to reduce stroke risk.
Other dietary programs generally were not superior to minimal intervention. When compared with one another, no convincing evidence was found that the Mediterranean diet was superior to the low-fat diets in preventing mortality or non-fatal myocardial infarction.
News Release: Benefits of Mediterranean and low fat diet programmes in patients at risk of cardiovascular disease – BMJ Newsroom
Commentary: Mediterranean, Low-Fat Diets Both Good for Health: Network Meta-analysis – TCTMD
SR | Adding ultrasound to mammography increases breast cancer detection, but increases false-positives and biopsies
3 Apr, 2023 | 13:55h | UTCSummary: The systematic review examined the effectiveness and safety of combining mammography with breast ultrasonography versus mammography alone for breast cancer screening in women at average risk. The research included one randomized controlled trial, two prospective cohort studies, and five retrospective cohort studies, involving a total of 209,207 women.
High certainty evidence from one trial indicated that combining mammography with ultrasonography led to the detection of more breast cancer cases than mammography alone (5 vs. 3 per 1000 women). However, this combination also led to a higher number of false-positive results and biopsies. For every 1000 women screened with the combined approach, 37 more received a false-positive result, and 27 more women underwent a biopsy.
Secondary analysis of the trial data revealed that in women with dense breasts, the combined screening detected more cancer cases than mammography alone, while cohort studies for women with non-dense breasts showed no statistically significant difference between the two screening methods.
The included studies did not analyze whether the higher number of detected cancers with the combined screening method resulted in lower mortality rates compared to mammography alone. Further research, including randomized controlled trials or prospective cohort studies with longer observation periods, is needed to assess the impact of the two screening interventions on morbidity and mortality.