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Cohort Study | Infections requiring hospitalization linked to increased short- and long-term cardiovascular risks
3 Apr, 2023 | 13:57h | UTCSummary: The study examined the association between severe infections and the risk of cardiovascular disease in people without prior cardiovascular issues. Data from 331,683 UK Biobank participants and 271,533 Finnish participants were analyzed. Cardiovascular risk factors were measured at baseline, and infectious diseases and subsequent cardiovascular events were diagnosed through the linkage of participants to hospital and mortality registers.
Results showed that hospitalization for infection was associated with an increased risk of major cardiovascular events, regardless of the type of infection. The risk was highest during the first month after infection, with hazard ratios of 7.87 and 7.64 in the UK Biobank and Finnish cohorts, respectively. However, the risk remained elevated throughout the follow-up period, with hazard ratios of 1.47 in the UK Biobank and 1.41 in the Finnish cohort.
The study suggests that severe infections requiring hospital treatment are associated with increased risks for major cardiovascular disease events both immediately after hospitalization and in the long-term. However, it is important to note that residual confounding cannot be excluded, and further research is needed to establish causality.
Article: Severe Infection and Risk of Cardiovascular Disease: A Multicohort Study – Circulation
Commentary: Severe Infections Linked to a Variety of CV Events, Both Acute and Long-term – TCTMD
Commentary on Twitter
#OriginalResearch: In this multicohort study, hospital-treated infections associated w/ significant increase in short-term risk and modest long-term risk of major CVD events. @MikaKivimaki @nellimarikki@PyrySipila #AHAJournals https://t.co/51JSJkS6l4 pic.twitter.com/U21U2IgYCO
— Circulation (@CircAHA) March 29, 2023
Lateral flow devices maintain detection sensitivity across Alpha, Delta, and Omicron waves
3 Apr, 2023 | 13:53h | UTCSummary: The study assessed the performance of antigen lateral flow devices (LFDs) during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic in the UK. Researchers aimed to understand LFD performance concerning changes in variant infections, vaccination, viral load, and LFD use, as well as the devices’ ability to detect infectious individuals. Paired LFD and RT-PCR test results were collected from both asymptomatic and symptomatic participants between November 2020 and March 2022.
When compared to RT-PCR testing, the overall LFD sensitivity was 63.2%, and specificity was 99.71%. The sensitivity was higher in symptomatic participants (68.7%) than in asymptomatic participants (52.8%). The study found that increased viral load was independently associated with a higher likelihood of being LFD positive. There was no evidence of a significant difference in LFD sensitivity between the alpha and delta variants, but sensitivity increased during the omicron wave. Vaccination status did not show an independent association with LFD sensitivity.
The study concluded that LFDs can detect most SARS-CoV-2 infections across different viral variants and during vaccine roll-out, contributing to reduced transmission risk. However, LFD performance is lower in asymptomatic individuals, which should be taken into account when designing testing programs.
Invited Commentary: The performance of rapid antigen tests against SARS-CoV-2 variants – The Lancet Infectious Diseases
Related:
Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ
Gastric Cancer: the combined impact of H. pylori infection and pathogenic gene variants
3 Apr, 2023 | 13:51h | UTCHelicobacter pylori, Homologous-Recombination Genes, and Gastric Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: H. Pylori Infection Negatively Modifies Genetically Increased Risk for Gastric Cancer – Physician’s Weekly
Commentary on Twitter
Infection with Helicobacter pylori is known to confer a risk of gastric cancer. In this study, persons who carried certain genetic variants and were infected with H. pylori had an excess risk of gastric cancer. https://t.co/jIcUiYu14G#genetics pic.twitter.com/jY4H1Mq6dO
— NEJM (@NEJM) March 29, 2023
RCT | Vedolizumab for the treatment of chronic pouchitis
3 Apr, 2023 | 13:49h | UTCVedolizumab for the Treatment of Chronic Pouchitis – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: New hope for patients after vedolizumab found effective to treat Chronic Pouchitis – University of Oxford
Commentary on Twitter
In a phase 4, double-blind, randomized trial, vedolizumab therapy was more effective than placebo in inducing remission in patients with chronic pouchitis after ileal pouch–anal anastomosis for ulcerative colitis. Full results of EARNEST trial: https://t.co/5OnC72j2Ik pic.twitter.com/RcH1uAB1AI
— NEJM (@NEJM) March 29, 2023
RCT | Pembrolizumab plus chemotherapy in advanced endometrial cancer
3 Apr, 2023 | 13:48h | UTCPembrolizumab plus Chemotherapy in Advanced Endometrial Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Original Article: Pembrolizumab plus Chemotherapy in Advanced Endometrial Cancer https://t.co/dTyV1zTO0I
#SGOMtg @SGO_org pic.twitter.com/R3FDom8pVY— NEJM (@NEJM) March 29, 2023
RCT | Dostarlimab for primary advanced or recurrent endometrial cancer
3 Apr, 2023 | 13:46h | UTCDostarlimab for Primary Advanced or Recurrent Endometrial Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary:
Dostarlimab Plus Chemotherapy Elicits PFS Benefit in Recurrent Endometrial Cancer – OncLive
ICU Delirium | Bayesian analysis suggests high probabilities of benefits and low probabilities of harm with the use of haloperidol
3 Apr, 2023 | 13:43h | UTCHaloperidol vs. placebo for the treatment of delirium in ICU patients: a pre-planned, secondary Bayesian analysis of the AID–ICU trial – Intensive Care Medicine (free for a limited period)
Original article: RCT | Haloperidol for the treatment of delirium in ICU patients did not significantly improve outcomes.
Commentary on Twitter
Haloperidol vs placebo in acutely admitted, adult #ICU pts with #delirium? With IV haloperidol 2.5 mg × 3 daily & as needed doses up to max 20 mg daily:
➡️ high probabilities of benefits
➡️ low probabilities of harm for primary & most secondary outcomes
🖇️ https://t.co/iNRVVozlRJ pic.twitter.com/NJbhvxxdYx— Intensive Care Medicine (@yourICM) March 27, 2023
RCTs | Fitusiran prophylaxis reduces bleeding in people with hemophilia A or hemophilia B
3 Apr, 2023 | 13:44h | UTCEfficacy and safety of fitusiran prophylaxis in people with haemophilia A or haemophilia B with inhibitors (ATLAS-INH): a multicentre, open-label, randomised phase 3 trial – The Lancet (link to abstract – $ for full-text)
Fitusiran prophylaxis in people with severe haemophilia A or haemophilia B without inhibitors (ATLAS-A/B): a multicentre, open-label, randomised, phase 3 trial – The Lancet Haematology (link to abstract – $ for full-text)
News Release: Monthly injections of fitusiran reduces bleeds in patients with haemophilia A and B – The Lancet
Overcoming size disparity in liver transplant access: prioritizing smaller donors for smaller candidates
3 Apr, 2023 | 13:41h | UTCAssociation of Body Surface Area With Access to Deceased Donor Liver Transplant and Novel Allocation Policies – JAMA Surgery (free for a limited period)
Invited Commentary: Addressing Size-Based Disparities in Liver Transplant – JAMA Surgery (free for a limited period)
Commentary on Twitter
In this study, liver waitlist candidates with the smallest body surface areas had a disadvantage due to size. Prioritizing allocation of smaller liver donors to smaller candidates may help overcome this disparity. https://t.co/p5F76Hgzm0
— JAMA Surgery (@JAMASurgery) March 30, 2023
Review | Prolonged intermittent kidney replacement therapy
3 Apr, 2023 | 13:39h | UTCProlonged Intermittent Kidney Replacement Therapy – Clinical Journal of the American Society of Nephrology (free for a limited period)
Commentary on Twitter
Kidney replacement therapy (KRT) is a vital, supportive treatment for patients with critical illness and severe AKI. This Review discusses the option of prolonged intermittent KRT in the management of patients with kidney failure in the ICU https://t.co/jPHVLRnoqJ@VijayanMD pic.twitter.com/4oWJ6IDR4C
— CJASN (@CJASN) September 30, 2022
Review | Acute respiratory distress syndrome, mechanical ventilation, and inhalation injury in burn patients
3 Apr, 2023 | 13:38h | UTC
Review | Dysfunctional labor and delivery: adverse effects on offspring
3 Apr, 2023 | 13:36h | UTCDysfunctional labor and delivery: adverse effects on offspring – American Journal of Obstetrics & Gynecology (free for a limited period)
RCT | Sparsentan reduces proteinuria in patients with IgA nephropathy
3 Apr, 2023 | 13:35h | UTCSparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter
PROTECT (Interim results): Sparsentan reduces proteinuria in patients with IgA Nephropathy (IgAN)#ISNWCN 🇹🇭 #Nephpearls#VisualAbstract by @dakidneydochttps://t.co/ViW9YncwI6 pic.twitter.com/zEGRSY8N3x
— Edgar V. Lerma 🇵🇭 (@edgarvlermamd) April 1, 2023
Perspective | Teen girls are faring worse than boys on nearly all mental health measures—here’s why
3 Apr, 2023 | 13:33h | UTCTeen Girls Are Faring Worse Than Boys on Nearly All Mental Health Measures—Here’s Why – JAMA (free for a limited period)
Commentary on Twitter
The latest @CDCgov Youth Risk Behavior Survey, administered in 2021, shows that mental health has worsened for all adolescents, but especially for girls. Nearly a third of teen girls said they seriously considered suicide. https://t.co/gVHoLYtI5b #MedicalNews
— JAMA (@JAMA_current) March 28, 2023
Glomerular diseases in pregnancy: pragmatic recommendations for clinical management
3 Apr, 2023 | 13:29h | UTC
Cohort Study | Long-term quality of life and functional outcome of patients with rectal cancer following a watch-and-wait approach
3 Apr, 2023 | 13:31h | UTCLong-term Quality of Life and Functional Outcome of Patients With Rectal Cancer Following a Watch-and-Wait Approach – JAMA Surgery (free for a limited period)
Invited Commentary: Guiding Patients Through a “Watch-and-Wait” Approach for Rectal Cancer—Understanding the Functional Outcomes – JAMA Surgery (free for a limited period)
Related:
Commentary on Twitter
Results of this study suggest that patients with rectal cancer who were observed by a watch-and-wait approach had good quality of life, with some patients reporting bowel and sexual dysfunction. https://t.co/zaK3bjJA8n
— JAMA Surgery (@JAMASurgery) March 31, 2023
Assessment of childhood short stature: a GP guide
3 Apr, 2023 | 13:28h | UTCAssessment of childhood short stature: a GP guide – British Journal of General Practice (free for a limited period)
SR | Risk factors for length of NICU stay of newborns
3 Apr, 2023 | 13:23h | UTCRisk factors for length of NICU stay of newborns: A systematic review – Frontiers in Pediatrics
Cohort Study | Associations between fetal or infancy pet exposure and food allergies
3 Apr, 2023 | 13:26h | UTC
Postoperative delirium’s linked to long-term cognitive decline in elderly patients
3 Apr, 2023 | 13:20h | UTCPostoperative Delirium’s linked to Long-term Cognitive Decline in Elderly Patients – JAMA Internal Medicine (link to abstract – $ for full-text)
News Release: Developing postoperative delirium associated with a faster rate of cognitive decline, says study – EurekAlert
Commentary: Postoperative Delirium Associated With Accelerated Cognitive Decline, Study Finds – Psychiatric News Alert
Commentary on Twitter
Delirium associated with accelerated cognitive decline that continued for 72 months following the index delirium episode; it's uncertain if delirium causes cognitive decline or if pts with preclinical brain disease are more likely to develop delirium. https://t.co/ADz7yxEZiP
— JAMA Internal Medicine (@JAMAInternalMed) March 20, 2023
M-A | Coronary vasospasm in ANOCA patients: Prevalence, clinical features and prognosis
3 Apr, 2023 | 13:21h | UTC
Perspective | Should case management be considered a component of obstetrical interventions for pregnancies at risk of preterm birth?
3 Apr, 2023 | 13:18h | UTC
Commentary on Twitter
https://twitter.com/AJOG_thegray/status/1641380390735687680
Assessing heart failure risk: waist-to-height ratio outperforms BMI in HFrEF patients
31 Mar, 2023 | 13:49h | UTCCommentary: Study Debunks Obesity Paradox in HF, Encourages BMI Alternatives – TCTMD
RCT | Early postpartum IUD placement noninferior vs. placement at 6-8 weeks for complete expulsion, but not for partial expulsion
31 Mar, 2023 | 13:48h | UTCEarly vs Interval Postpartum Intrauterine Device Placement: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
News Release: Study: Risk of IUD Expulsion in Early Postpartum Placement – UC San Diego Health
Commentary: IUD Placement at Two to Four Weeks Postpartum Noninferior – HealthDay
Related:
Commentary on Twitter
Early IUD placement at 2 to 4 weeks postpartum compared with 6 to 8 weeks postpartum was noninferior for complete expulsion, but not partial expulsion. https://t.co/VMfWce3JJd pic.twitter.com/vdLrhCXa5Q
— JAMA (@JAMA_current) March 23, 2023
SCAI/HRS Expert consensus statement on transcatheter left atrial appendage closure
31 Mar, 2023 | 13:44h | UTCSCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure – JSCAI
Key Points: Consensus Statement on Transcatheter LA Appendage Closure – American College of Cardiology
Commentaries:
SCAI/HRS Consensus Document Covers the Ins and Outs of LAAO – TCTMD