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Chest Medicine

Review | Revised definition of pulmonary hypertension and approach to management

12 Apr, 2023 | 13:22h | UTC

Revised Definition of Pulmonary Hypertension and Approach to Management: A Clinical Primer – Journal of the American Heart Association

Related:

#ESCCongress | 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.

The ‘Ten Commandments’ of the 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension – European Heart Journal

Pulmonary hypertension: An update of Dx and Tx guidelines – Journal of Family Practice

Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis – European Respiratory Review

Recent advances in the management of pulmonary hypertension with interstitial lung disease – European Respiratory Review

The physiological basis of pulmonary arterial hypertension – European Respiratory Journal

Topic-Based, Recent Literature Review on Pulmonary Hypertension – Mayo Clinic Proceedings

 


Review | Managing respiratory muscle weakness during weaning from invasive ventilation

11 Apr, 2023 | 14:12h | UTC

Managing respiratory muscle weakness during weaning from invasive ventilation – European Respiratory Review

 


RCT | Targeted hypoglossal nerve stimulation may benefit patients with obstructive sleep apnea

11 Apr, 2023 | 14:07h | UTC

Targeted Hypoglossal Nerve Stimulation for Patients With Obstructive Sleep Apnea: A Randomized Clinical Trial – JAMA Otolaryngology – Head & Neck Surgery

 

Commentary on Twitter

 


M-A | Noninvasive respiratory support after extubation

11 Apr, 2023 | 14:03h | UTC

Noninvasive respiratory support after extubation: a systematic review and network meta-analysis – European Respiratory Review

 


Review | Pulmonary arterial hypertension in pregnancy

11 Apr, 2023 | 14:06h | UTC

Pulmonary arterial hypertension in pregnancy – Current Opinion in Cardiology

 


Review | Evaluation and management of chronic thromboembolic pulmonary hypertension

11 Apr, 2023 | 14:00h | UTC

Evaluation and Management of Chronic Thromboembolic Pulmonary Hypertension – Chest

 


Perspective | ARDS complicating traumatic brain injury. Can opposite strategies converge?

10 Apr, 2023 | 13:39h | UTC

Acute respiratory distress syndrome complicating traumatic brain injury. Can opposite strategies converge? – Intensive Care Medicine (free for a limited period)

 


M-A | High-flow nasal cannula vs. noninvasive positive pressure ventilation in acute hypoxic respiratory failure

10 Apr, 2023 | 13:37h | UTC

High-Flow Nasal Cannula Compared With Noninvasive Positive Pressure Ventilation in Acute Hypoxic Respiratory Failure: A Systematic Review and Meta-Analysis – Critical Care Explorations

 


Review | Post-COVID syndrome

6 Apr, 2023 | 13:21h | UTC

Post-COVID Syndrome – Deutsches Ärzteblatt International

Related:

Retrospective Study | Most patients with long Covid developed after mild infection get better within a year

Cohort Study | One third of patients hospitalized with Covid-19 persist with lung abnormalities after 2 years

Long COVID: major findings, mechanisms and recommendations – Nature Reviews Microbiology

 


ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia

5 Apr, 2023 | 13:45h | UTC

ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia – Intensive Care Medicine

 

Commentary on Twitter

 


Contrary to prior studies, new research finds no heightened postoperative risk after a recent covid-19 infection

4 Apr, 2023 | 13:54h | UTC

Estimated Risk of Adverse Surgical Outcomes Among Patients With Recent COVID-19 Infection Using Target Trial Emulation Methods – JAMA Network Open

Commentaries:

COVID infection within 60 days not tied to adverse postsurgical outcomes – CIDRAP

Adverse Postoperative Outcomes Not Increased With Recent COVID-19 – HealthDay

Related:

Statement | Pre-procedure and pre-admission COVID-19 testing no longer recommended for asymptomatic patients

ASA and APSF statement on perioperative testing for the COVID-19 virus.

Surgical Triage and Timing for Patients with COVID: A Guidance Statement from the Society of Thoracic Surgeons – Annals of Thoracic Surgery

When to operate after SARS-CoV-2 infection? A review on the recent consensus recommendation of the DGC/BDC and the DGAI/BDA – Langenbeck’s Archives of Surgery

Guideline Update: Timing of elective surgery and risk assessment after SARS-CoV-2 infection – “The guidance remains that patients should avoid elective surgery within 7 weeks of infection, unless the benefits of doing so exceed the risk of waiting”.

Perioperative cardiovascular considerations prior to elective noncardiac surgery in patients with a history of Covid-19.

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

BJS commission on surgery and perioperative care post-COVID-19.

The risk of postoperative complications following major elective surgery in active or resolved COVID-19 in the United States – Major, elective surgery 0–4 weeks after Covid-19 is associated with greatly increased risk of postoperative complications; surgery performed 4–8 weeks after infection is still associated with an increased risk of pneumonia.

ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.

Position statement: Perioperative management of post-COVID-19 surgical patients.

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

 


Bivalent Booster | Observational data suggests no increased cardiovascular risks compared to monovalent vaccine

4 Apr, 2023 | 13:55h | UTC

Stroke, Myocardial Infarction, and Pulmonary Embolism after Bivalent Booster – New England Journal of Medicine

Commentary: Similarly Low Risk of CV Events With Bivalent and Monovalent mRNA Boosters – TCTMD

 

Commentary on Twitter

 


M-A | Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2

4 Apr, 2023 | 13:52h | UTC

Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2: a rapid review with network meta-analysis of diagnostic test accuracy studies – BMC Medicine

Related:

Performance of antigen lateral flow devices in the UK during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic: a diagnostic and observational study – The Lancet Infectious Diseases

Accuracy of rapid point-of-care antigen-based diagnostics for SARS-CoV-2: An updated systematic review and meta-analysis with meta-regression analyzing influencing factors – PLOS Medicine

Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ

Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection – Cochrane Library

 


Lateral flow devices maintain detection sensitivity across Alpha, Delta, and Omicron waves

3 Apr, 2023 | 13:53h | UTC

Summary: 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.

Article: Performance of antigen lateral flow devices in the UK during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic: a diagnostic and observational study – The Lancet Infectious Diseases

Invited Commentary: The performance of rapid antigen tests against SARS-CoV-2 variants – The Lancet Infectious Diseases

Related:

Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2: a rapid review with network meta-analysis of diagnostic test accuracy studies – BMC Medicine

Accuracy of rapid point-of-care antigen-based diagnostics for SARS-CoV-2: An updated systematic review and meta-analysis with meta-regression analyzing influencing factors – PLOS Medicine

Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ

Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection – Cochrane Library

 


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

 


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

 


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)

 


Review | Supplemental oxygen and noninvasive ventilation

29 Mar, 2023 | 13:18h | UTC

Supplemental oxygen and noninvasive ventilation – European Respiratory Review

 


Consensus Paper | Diagnosis and treatment of anticancer drug-induced interstitial lung disease

29 Mar, 2023 | 13:04h | UTC

Expert Consensus on the Diagnosis and Treatment of Anticancer Drug-Induced Interstitial Lung Disease – Current Medical Science

 


M-A | Risk factors associated with post−COVID-19 condition

28 Mar, 2023 | 15:07h | UTC

Risk Factors Associated With Post−COVID-19 Condition: A Systematic Review and Meta-analysis – JAMA Internal Medicine

Editorial: While Waiting for a Randomized Clinical Trial of Nirmatrelvir for Prevention of Post–COVID-19 Condition – JAMA Internal Medicine

Commentary:

Meta-analysis reveals risk, protective factors for long COVID – CIDRAP

Long Covid: University of East Anglia study finds women more likely affected – BBC

 


People who catch Omicron are less likely to get Long Covid

28 Mar, 2023 | 15:04h | UTC

People who catch Omicron are less likely to get Long Covid – Science

 


M-A | The natural history of untreated pulmonary tuberculosis in adults

28 Mar, 2023 | 14:42h | UTC

The natural history of untreated pulmonary tuberculosis in adults: a systematic review and meta-analysis – The Lancet Respiratory Medicine (free registration required)

 

Commentary from the author on Twitter

https://twitter.com/bianca_sossen/status/1639143776613482497

 


Pulmonary hypertension | An update of Dx and Tx guidelines

28 Mar, 2023 | 14:32h | UTC

Pulmonary hypertension: An update of Dx and Tx guidelines – Journal of Family Practice

 


M-A | Examining shorter antibiotic treatment durations for community acquired pneumonia in adults

27 Mar, 2023 | 13:29h | UTC

Summary: The systematic review and duration-effect meta-analysis included nine randomized trials with a total of 2,399 patients, analyzing antibiotic treatment durations for community-acquired pneumonia (CAP) in adults. The primary outcome was clinical improvement on day 15, with secondary outcomes including all-cause mortality, serious adverse events, and clinical improvement on day 30.

The study found that shorter treatment durations (3–9 days) were likely to be non-inferior to the standard 10-day treatment, and no significant difference in all-cause mortality or serious adverse events was observed. The study suggests that a 3–5 day treatment duration likely offers the optimal balance between efficacy and treatment burden if patients are clinically stable. However, the results are limited by the small number of included studies, the overall moderate-to-high risk of bias, and the varying severity of CAP among patients in the studies. Therefore, further research focusing on the shorter duration range is required.

Article: Optimal duration of antibiotic treatment for community-acquired pneumonia in adults: a systematic review and duration-effect meta-analysis – BMJ Open

Related:

Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians – Annals of Internal Medicine

Efficacy of short-course antibiotic treatments for community-acquired pneumonia in adults: A systematic review and meta-analysis – Antimicrobial Agents and Chemotherapy

Short-Course vs Long-Course Antibiotic Therapy for Children With Nonsevere Community-Acquired Pneumonia: A Systematic Review and Meta-analysis – JAMA Pediatrics

Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children: The SCOUT-CAP Randomized Clinical Trial – JAMA Pediatrics

Short-Course Antimicrobial Therapy for Pediatric Community-Acquired Pneumonia: The SAFER Randomized Clinical Trial – JAMA Pediatrics

Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial – JAMA

 


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