All Posts | Links Medicus - Free Medical News & Perspective

M-A | Effects of statin therapy on glycemic control and insulin resistance

31 Mar, 2023 | 13:45h | UTC

Effects of statin therapy on glycemic control and insulin resistance: A systematic review and meta-analysis – European Journal of Pharmacology

Meta-Analysis: Medications that Reduce or Increase the Risk of New Onset Diabetes

Observational Study Points to an Increased Risk of Diabetes Among Patients Using Statins

Another Observational Study Showing Association of Statin Use with Risk of New‐Onset Diabetes Mellitus

Cohort Study: Statin Use Associated with a 38% Higher Risk of Incident Type 2 Diabetes

Study shows clinical instability and severity are predictors for psychiatric hospitalization

31 Mar, 2023 | 13:42h | UTC

Predicting Psychiatric Admissions: The Role of Early Clinical Trajectories Across Diagnoses – The Lancet Psychiatry

Commentaries:

New study reveals clinical instability predicts psychiatric hospitalization – MedicalXpress

Instability, Clinical Severity Predict Hospitalization Risk for Psychiatric Illness – HCP Live

Update | Optimal oxygen and mean arterial blood pressure targets after cardiac arrest

31 Mar, 2023 | 13:41h | UTC

Optimal oxygen and mean arterial blood pressure targets after cardiac arrest – Intensive Care Medicine

Commentary on Twitter

O2/MAP after CA? NO clear benefit from deviating from
🩸MAP >65-70 mmHg, if impaired 🧠autoregulation as high as 85-90
💨 PaO2 75-97 mmHg; more liberal O2 may be best if reliable monitoring difficult (ie transport or in ED)
More evidence needed (coming)
🖇️ https://t.co/ujsz09tDSJ pic.twitter.com/fft8Q1turt

— Intensive Care Medicine (@yourICM) March 21, 2023

M-A | Incidence and prognostic role of pleural effusion in patients with pulmonary embolism

31 Mar, 2023 | 13:40h | UTC

Incidence and Prognostic Role of Pleural Effusion in Patients with Pulmonary Embolism: A Systematic Review and Meta-Analysis – Journal of Clinical Medicine

SR | Etiologies of vertigo in the elderly

31 Mar, 2023 | 13:38h | UTC

Vertigo in the Elderly: A Systematic Literature Review – Journal of Clinical Medicine

RCT | Comparing exemestane dose regimens in early-stage ER+ breast cancer

31 Mar, 2023 | 13:37h | UTC

Efficacy of Alternative Dose Regimens of Exemestane in Postmenopausal Women With Stage 0 to II Estrogen Receptor–Positive Breast Cancer: A Randomized Clinical Trial – JAMA Oncology (link to abstract – $ for full-text)

Commentary: Lower-Dose Regimens of Exemestane in Postmenopausal Patients With Stage 0 to II ER-Positive Breast Cancer – The ASCO Post

Commentary on Twitter

Exemestane 25 mg (Exe) 3x/week (TIW) in compliant patients is comparable to daily dosing in reducing circulating estradiol; a weekly dose was less effective. Toxicity similar in all arms, suggesting Exe TIW may be used in breast cancer prevention. https://t.co/2NugINVrim #BCS

— JAMA Oncology (@JAMAOnc) March 23, 2023

Cohort Study | Subclinical coronary atherosclerosis and risk for myocardial infarction

31 Mar, 2023 | 13:36h | UTC

Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort: A Prospective Observational Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentary: CTA-detected coronary artery disease associated with increased risk for myocardial infarction – ACP Internist

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.

Cohort Study: Coronary Artery Calcium and Long-Term Risk of Death, Myocardial Infarction, and Stroke

USPSTF Statement: Risk Assessment for Cardiovascular Disease With Nontraditional Risk Factors

Research: Coronary Artery Calcium Score for Long-term Risk Classification in Individuals With Type 2 Diabetes and Metabolic Syndrome

The 10-Year Prognostic Value of Zero and Minimal CAC

Review | Exercise in octogenarians: how much is too little?

31 Mar, 2023 | 13:34h | UTC

Exercise in Octogenarians: How Much Is Too Little? – Annual Reviews of Medicine

Cohort Study | Diffusing capacity strongly predicts all-cause mortality in individuals with COPD

31 Mar, 2023 | 13:31h | UTC

Diffusing Capacity and Mortality in Chronic Obstructive Pulmonary Disease – Annals of the American Thoracic Society (link to abstract – $ for full-text)

Commentary: Diffusing capacity ‘strongly predicted’ mortality in COPD patients – Healio (free registration required)

Commentary on Twitter

Diffusing Capacity and Mortality in Chronic Obstructive Pulmonary Disease

🔗 https://t.co/F5Hqkx65hn pic.twitter.com/up0psKKE3i

— Annals of the ATS (@AnnalsATS) January 10, 2023

RCT | Pulsed oral azithromycin vs. 6-week oral doxycycline for moderate to severe meibomian gland dysfunction

31 Mar, 2023 | 13:33h | UTC

Pulsed Oral Azithromycin vs 6-Week Oral Doxycycline for Moderate to Severe Meibomian Gland Dysfunction: A Randomized Clinical Trial – JAMA Ophthalmology (link to abstract – $ for full-text)

Commentary: 3-Week MGD treatment equivalent to 6-week course in efficacy and adverse events – Ophthalmology Times

Commentary on Twitter

A 3-week course of weekly oral azithromycin was equivalent to a 6-week course of oral doxycycline in treating moderate to severe meibomian gland dysfunction. https://t.co/nE312KxGki pic.twitter.com/xWmqYWby7j

— JAMA Ophthalmology (@JAMAOphth) March 23, 2023

M-A | Impact of axillary lymph node dissection and sentinel lymph node biopsy on upper limb morbidity in breast cancer patients

31 Mar, 2023 | 13:30h | UTC

Impact of Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy on Upper Limb Morbidity in Breast Cancer Patients: A Systematic Review and Meta-Analysis – Annals of Surgery

SR | Nonopioid pharmacological management of acute low back pain

31 Mar, 2023 | 13:27h | UTC

Nonopioid pharmacological management of acute low back pain: A level I of evidence systematic review – Journal of Orthopaedic Research

Review | The failed peripheral nerve block

31 Mar, 2023 | 13:28h | UTC

The failed peripheral nerve block – BJA Education

RCT | Efficacy and safety of garadacimab, a factor XIIa inhibitor for hereditary angioedema prevention

31 Mar, 2023 | 13:26h | UTC

Efficacy and safety of garadacimab, a factor XIIa inhibitor for hereditary angioedema prevention (VANGUARD): a global, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial – The Lancet (link to abstract – $ for full-text)

Commentary on Twitter (thread – click for more)

Hereditary angioedema is a rare disease associated with unpredictable, recurrent angioedema attacks that can be life-threatening.

New study data support the use of garadacimab as a potential prophylactic therapy in adolescents and adults: https://t.co/xlxoA3J3sh 🧵 pic.twitter.com/VqCOHnaQAp

— The Lancet (@TheLancet) March 6, 2023

RCT | Zavegepant 10 mg nasal spray vs. placebo for the acute treatment of migraine

31 Mar, 2023 | 13:24h | UTC

Safety, tolerability, and efficacy of zavegepant 10 mg nasal spray for the acute treatment of migraine in the USA: a phase 3, double-blind, randomised, placebo-controlled multicentre trial – The Lancet Neurology (link to abstract – $ for full-text)

Methodology and Design of Platform Trials | A meta-epidemiological study

31 Mar, 2023 | 13:22h | UTC

Methodology and Design of Platform Trials: A meta-epidemiological study – Journal of Clinical Epidemiology

Platform Trials — Beware the Noncomparable Control Group – New England Journal of Medicine

Review | Management of immune related endocrinopathies following immune checkpoint inhibitor therapy for cancer

31 Mar, 2023 | 13:23h | UTC

Diagnostic criteria and management recommendations for immune related endocrinopathies following immune checkpoint inhibitor therapy for cancer – Endocrine Connections

The Diagnosis and Management of Endocrine Side Effects of Immune Checkpoint Inhibitors – Deutsches Ärzteblatt International

Spectrum of immune checkpoint inhibitors-induced endocrinopathies in cancer patients: a scoping review of case reports – Clinical Diabetes and Endocrinology

Palliative care in the intensive care unit: not just end-of-life care

31 Mar, 2023 | 13:21h | UTC

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care – Intensive Care Research

M-A | Exploring the efficacy of psychotherapies for depression

31 Mar, 2023 | 13:19h | UTC

Exploring the efficacy of psychotherapies for depression: a multiverse meta-analysis – BMJ Mental Health

RCT | Drain usage may increase the length of hospital stay following lumbar arthrodesis

31 Mar, 2023 | 13:18h | UTC

Wound drain in lumbar arthrodesis for degenerative disease: an experimental, multicenter, randomized controlled trial – The Spine Journal

Commentary: Wound drains increase hospital los after lumbar surgery? – Orthopedics This Week

ICU Burnout Crisis | Meta-analysis reveals over 40% prevalence in medical professionals

30 Mar, 2023 | 14:30h | UTC

High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis – Intensive Care Medicine (if the link is paywalled, try this one)

AAP Clinical Report | Physician health and wellness.

M-A | Physicians suffering burnout are twice as likely to be involved in patient safety incidents.

Systematic Review | Predictors of burnout among healthcare providers.

Prevalence of burnout among GPs: a systematic review and meta-analysis – British Journal of General Practice

Physician Well-being 2.0: Where Are We and Where Are We Going? – Mayo Clinic Proceedings

Consensus Study – Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being – National Academies of Medicine

Assessment of Risk Factors for Suicide Among US Health Care Professionals

Beyond Burnout: Docs Decry ‘Moral Injury’ From Financial Pressures of Health Care

Hospital administration response to physician stress and burnout – Journal of Hospital Practice

Opinion: It’s Time to Talk About Physician Burnout and Moral Injury

Systematic Review: Effect of Organization-Directed Workplace Interventions on Physician Burnout

The 3 Causes Of Physician Burnout (And Why There’s No Simple Solution) – Forbes

Physician Burnout: A Global Crisis

The Burnout Crisis in American Medicine – The Atlantic

To Combat Physician Burnout and Improve Care, Fix the Electronic Health Record – Harvard Business Review

Physician burnout costs up to $17B a year, task force says – HealthcareDive

Systematic Review: Prevalence of Burnout Among Physicians

Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis – International Journal of Environmental Research and Public Health

Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction

Commentary on Twitter

High-level burnout in adult ICUs physicians & nurses, SR/MA
➡️ prevalence > 40% in all #ICU HCWs, 41% physicians/44% nurses
➡️ #COVID19? ⬆️ burnout only in nurses
Preventive/therapeutic measures to improve well-being crucial as a consensual definitio.
🖇️ https://t.co/kUcZ7P9iqz pic.twitter.com/owqC1W5yLu

— Intensive Care Medicine (@yourICM) March 28, 2023

Updated WHO Guidelines | COVID-19 boosters no longer routinely recommended for low-risk groups

30 Mar, 2023 | 14:33h | UTC

Summary: The WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) has revised its COVID-19 vaccination roadmap in light of the Omicron variant and widespread population immunity. The revised roadmap prioritizes protecting those at the highest risk of severe disease and death while maintaining resilient health systems. It introduces cost-effectiveness considerations for vaccinating lower-risk individuals, such as healthy children and adolescents, and presents revised booster dose recommendations.

Priority groups are categorized as high, medium, and low, based on factors like risk of severe disease and death. People in the high-priority group, consisting of older adults, individuals with significant comorbidities or immunocompromising conditions, pregnant persons, and frontline health workers, are advised to receive additional boosters 6 or 12 months after the last dose. The medium priority group, which includes healthy adults without comorbidities and children with comorbidities, is recommended to receive primary series and first booster doses. However, SAGE no longer routinely recommends additional boosters for this group due to limited public health gains.

For the low-priority group, encompassing healthy children and adolescents, vaccination decisions should take into account factors such as disease prevalence and cost-effectiveness. It is important to note that the public health benefits of vaccinating healthy children and adolescents are considerably lower compared to established essential vaccines for children, like rotavirus, measles, and pneumococcal conjugate vaccines.

News Release: SAGE updates COVID-19 vaccination guidance – World Health Organization

Commentaries:

No More COVID-19 Boosters for Healthy People, WHO Experts Recommend – Health Policy Watch

WHO vaccine advisers update COVID vaccine recommendations – CIDRAP

Study suggests no heightened death risk in young people with mRNA vaccines, but ChAdOx1 nCoV-19 vaccine linked to female cardiac deaths

30 Mar, 2023 | 14:28h | UTC

Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England – Nature Communications

Commentary: Expert reaction to ONS data on risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people, England: 8 December 2020 to 25 May 2022 – Science Media Centre

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

Our latest @NatureComms research: Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England. Led by @Vnafilyan @kamleshkhunti @IsobelLWard et al. https://t.co/oxNdgEAflQ (1/3)

— Prof Amitava Banerjee💙 (@amibanerjee1) March 28, 2023