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Emergency Medicine

Updated Guideline: Recommended drugs and biologics in adult patients with COVID-19.

24 Jan, 2022 | 08:52h | UTC

Clinical Practice Guideline Summary: Recommended Drugs and Biologics in Adult Patients with COVID-19 – Covid-19 Advisory for Ontario

 

Commentary on Twitter (thread – click for more)

 


A guide to immunotherapy for COVID-19.

24 Jan, 2022 | 08:29h | UTC

A guide to immunotherapy for COVID-19 – Nature Medicine

 


The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly.

24 Jan, 2022 | 08:24h | UTC

The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly – World Journal of Emergency Surgery

Related:

ACP Guideline: Diagnosis and management of acute left-sided colonic diverticulitis.

Review: Changing paradigms in the management of acute uncomplicated diverticulitis.

RCT: Another study shows that non-antibiotic outpatient treatment in mild acute diverticulitis is safe.

Review: Elective surgical management of diverticulitis

State of the Art Review | Management of colonic diverticulitis

Drains, germs, or steel: Multidisciplinary management of acute colonic diverticulitis

Diverticulitis: Observational study in outpatients suggests amoxicillin-clavulanate is a safe and effective option compared with metronidazole-fluoroquinolone

Randomized trial: Laparoscopic lavage vs. primary resection for perforated purulent diverticulitis; similar long-term results, but recurrence was more common after laparoscopic lavage

Randomized trial: In patients with recurrent, complicated, or persistent painful diverticulitis, sigmoid resection improved quality of life but was associated with a small but significant risk of major complications

Systematic review: Management of colonic diverticulitis

WSES Guidelines for the Management of Acute Colonic Diverticulitis

ASCRS Guidelines for the Treatment of Left-Sided Colonic Diverticulitis

 


Perioperative guidelines on antiplatelet and anticoagulant agents: 2022 Update.

21 Jan, 2022 | 09:53h | UTC

Perioperative Guidelines on Antiplatelet and Anticoagulant Agents: 2022 Update – Current Anesthesiology Reports

 


M-A: In comatose survivors of cardiac arrest, targeted hypothermia is not associated with improved survival or better neurological outcomes vs. targeted normothermia.

21 Jan, 2022 | 09:29h | UTC

Targeted Hypothermia Versus Targeted Normothermia In Survivors of Cardiac Arrest: A Systematic Review and Meta-Analysis of Randomized Trials – American Journal of Medicine

Related:

RCT: In comatose survivors of out-of-hospital cardiac arrest, there was no difference in mortality and neurologic outcomes with mild (target temperature of 34 °C) vs. moderate therapeutic hypothermia (target temperature of 31 °C).

M-A: Targeted temperature management following out-of-hospital cardiac arrest – “Routine use of moderate or deep hypothermia in comatose survivors of OHCA may potentially be associated with more harm than benefit”.

RCT: In patients with coma after out-of-hospital cardiac arrest, targeted hypothermia did not improve outcomes.

 


RCT: In non–critically ill hospitalized patients with COVID-19, the use of a P2Y12 Inhibitor (ticagrelor in 63% of patients and clopidogrel in 37%) in addition to a therapeutic dose of heparin did not improve survival free of organ support compared to therapeutic heparin alone.

19 Jan, 2022 | 08:56h | UTC

Effect of P2Y12 Inhibitors on Survival Free of Organ Support Among Non–Critically Ill Hospitalized Patients With COVID-19: A Randomized Clinical Trial – JAMA

Editorial: Antiplatelet Therapy in Patients With COVID-19—More Is Less? – JAMA

Commentary: Adding a P2Y12 Inhibitor Does Not Improve Outcomes in COVID-19 – HealthDay

 


RCT: In critically ill adults, using a balanced multielectrolyte solution did not lower the risk of death or acute kidney injury compared to standard saline.

19 Jan, 2022 | 08:41h | UTC

Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Australian study set to guide the treatment of critically ill patients worldwide – George Institute for Global Health

Related:

BaSICS RCT: Among critically ill patients requiring fluid therapy, treatment with a balanced solution did not lead to reduced mortality compared to a 0.9% saline solution.

BaSICS RCT: Among critically ill patients requiring fluid therapy, there was no difference in mortality with slower (333 mL/h) vs. faster (999 mL/h) intravenous fluid bolus rates.

Cochrane Review: Buffered Solutions Do Not Improve Mortality in Critically Ill Adults and Children Compared to 0,9% Saline

 

Commentary on Twitter

 


M-A: Evaluation of interventions to reduce opioid prescribing for patients discharged from the emergency department.

19 Jan, 2022 | 08:13h | UTC

Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged From the Emergency Department: A Systematic Review and Meta-analysis – JAMA Network Open

Invited commentary: Optimizing Opioid Prescriptions for Patients in the Emergency Department—How Much Is Almost Never? – JAMA Network Open

 

Commentary on Twitter

 


COVID-19 updated evidence: a Cochrane round-up.

18 Jan, 2022 | 09:53h | UTC

COVID-19 evidence: a Cochrane round-up – Cochrane Library

 


ACP Guideline: Diagnosis and management of acute left-sided colonic diverticulitis.

18 Jan, 2022 | 09:38h | UTC

Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Related Guideline: Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Related Systematic Reviews:

Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Evaluation and Management After Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Annals Video Summary: Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

News Release: ACP releases two new clinical guidelines on the diagnosis and management of diverticulitis – American College of Physicians

 


WHO recommends two new drugs (Baricitinib and Sotrovimab) to treat COVID-19.

17 Jan, 2022 | 00:48h | UTC

News release: WHO recommends two new drugs to treat COVID-19 – World Health Organization

Infographic with the updated recommendations: A living WHO guideline on drugs for covid-19 – The BMJ

Commentaries:

WHO Recommends Two New COVID-19 Treatments – Cost and Availability Likely Barriers – Health Policy Watch

Expert reaction to WHO recommending two drugs, sotrovimab and baricitinib, to treat patients with COVID-19 – Science Media Centre

 

Commentary on Twitter (thread – click for more)

 


Viewpoint: COVID-19 therapeutics for nonhospitalized patients.

17 Jan, 2022 | 00:31h | UTC

COVID-19 Therapeutics for Nonhospitalized Patients – JAMA

Editorial: Realizing the Potential of Anti–SARS-CoV-2 Monoclonal Antibodies for COVID-19 Management – JAMA

 


Multi-Disciplinary Guideline: Management of nephrolithiasis in pregnancy.

16 Jan, 2022 | 23:17h | UTC

Management of Nephrolithiasis in Pregnancy: Multi-Disciplinary Guidelines From an Academic Medical Center – Frontiers in Surgery

 

Commentary from the author on Twitter

 


RCT: In patients undergoing emergency endotracheal intubation, 7-day survival was significantly lower with etomidate vs. ketamine (77.3% versus 85.1%), but 28 survival rates were not significantly different (etomidate 64.1% vs. ketamine 66.8%, p = 0.294).

16 Jan, 2022 | 23:09h | UTC

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial – Intensive Care Medicine

Commentary: SGEM#356: Drugs are gonna knock you out – etomidate vs. ketamine for emergency endotracheal intubation – The Skeptics’ Guide to EM

 

Commentary on Twitter

 


Fluvoxamine for Covid-19: What Prescribers and Pharmacists Need to Know.

14 Jan, 2022 | 08:37h | UTC

Fluvoxamine: What Prescribers and Pharmacists Need to Know – Covid-19 Advisory for Ontario

Related:

Fluvoxamine for the early treatment of SARS-CoV-2 Infection: a review of current evidence.

RCT: Early treatment with fluvoxamine reduced the risk of emergency care and hospitalization among patients with COVID-19.

[Preprint] RCT: Fluvoxamine reduced the risk for ER visits and hospitalization among patients with Covid-19.

Opinion | Could this be our first effective, inexpensive, widely available outpatient treatment for COVID-19? (It’s fluvoxamine).

Preliminary study shows fluvoxamine may reduce clinical deterioration in outpatients with symptomatic COVID-19

 

Commentary on Twitter

 


AAN Position Statement: Consent Issues in the Management of Acute Ischemic Stroke.

14 Jan, 2022 | 08:24h | UTC

Consent Issues in the Management of Acute Ischemic Stroke: AAN Position Statement – Neurology

News Release: Who gives consent for treatment when a person with stroke cannot? – American Academy of Neurology

 


Systematic Review: Restrictive transfusion thresholds can safely decrease transfusions by 41% across a broad range of clinical contexts.

14 Jan, 2022 | 08:18h | UTC

Transfusion thresholds for guiding red blood cell transfusion – Cochrane Library

Summary: Is it safe to use lower blood counts (haemoglobin levels) as a trigger for blood transfusion in order to give fewer blood transfusions? – Cochrane Library

Related:

RCT: Among patients with acute MI and anemia, a restrictive transfusion strategy resulted in a noninferior rate of major cardiovascular events compared to a liberal transfusion strategy

Randomized trial: Liberal vs. restrictive transfusion thresholds in extremely low-birth-weight infants

Meta-Analysis: Effects of Restrictive vs. Liberal Transfusion Strategies on Longer-term Outcomes After Cardiac Surgery

Randomized Trial: In Patients Undergoing Cardiac Surgery, A Restrictive Transfusion Approach Does Not Increase the Risk of Acute Kidney Injury

Effects of restrictive red blood cell transfusion on the prognoses of adult patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials – Critical Care

Research: Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

Transfusion Requirements After Cardiac Surgery: The TRACS Randomized Controlled Trial – JAMA

 

Commentary on Twitter

 


RCT: Early Remdesivir in outpatients can prevent progression to severe Covid-19.

13 Jan, 2022 | 08:54h | UTC

Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients – New England Journal of Medicine

Editorial: The Goldilocks Time for Remdesivir — Is Any Indication Just Right?

Commentary: Three days of remdesivir cuts risk for severe COVID-19 in outpatients – MedicalXpress

 

Commentary on Twitter

 


Another study showed neutralizing monoclonal antibody therapies are not effective when given after the patient is already hospitalized.

13 Jan, 2022 | 08:48h | UTC

Efficacy and safety of two neutralising monoclonal antibody therapies, sotrovimab and BRII-196 plus BRII-198, for adults hospitalised with COVID-19 (TICO): a randomised controlled trial – The Lancet Infectious Diseases

Invited Commentary: Time to knock monoclonal antibodies off the platform for patients hospitalised with COVID-19

 


Cohort Study: Patient factors associated with appendectomy within 30 days of initiating antibiotic treatment for appendicitis – the presence of an appendicolith was associated with a nearly 2-fold increased risk of undergoing appendectomy within 30 days.

13 Jan, 2022 | 08:39h | UTC

Patient Factors Associated With Appendectomy Within 30 Days of Initiating Antibiotic Treatment for Appendicitis – JAMA Surgery (free for a limited period)

Invited commentary: Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty? – JAMA Surgery

 


The COVID-19 Treatment Guidelines Panel’s Statement on Anticoagulation in Hospitalized Patients With COVID-19 – in the absence of contraindications, use therapeutic-dose anticoagulation with low molecular weight heparin for hospitalized patients not in the ICU who have a D-dimer above the upper limit of normal.

12 Jan, 2022 | 09:11h | UTC

The COVID-19 Treatment Guidelines Panel’s Statement on Anticoagulation in Hospitalized Patients With COVID-19 – NIH COVID-19 Treatment Guidelines

 


Statement on potential drug-drug interactions between Ritonavir-boosted Nirmatrelvir (Paxlovid) and concomitant medications; antiarrhythmics, oral anticoagulants, immunosuppressants, anticonvulsants, antineoplastics, and neuropsychiatric drugs are among the drugs of concern.

12 Jan, 2022 | 09:09h | UTC

The COVID-19 Treatment Guidelines Panel’s Statement on Potential Drug-Drug Interactions Between Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Concomitant Medications – NIH COVID-19 Treatment Guidelines Panel

Commentaries:

Pfizer antiviral pills may be risky with other medications – NBC News

The New COVID-19 Pill, Paxlovid, Interacts with Many Medications: Cardiac Patients Take Note – The Skeptical Cardiologist

See also: What’s New in the Guidelines – NIH COVID-19 Treatment Guidelines

 


German Guideline: Oxygen therapy in the acute care of adult patients.

12 Jan, 2022 | 08:57h | UTC

German S3 Guideline: Oxygen Therapy in the Acute Care of Adult Patients – Respiration

 


RCT: Among patients younger than 21 years of age with provoked thromboembolism, anticoagulation for 6 weeks was non-inferior vs. 12 weeks on the risk of recurrence and bleeding events.

12 Jan, 2022 | 08:53h | UTC

Effect of Anticoagulant Therapy for 6 Weeks vs 3 Months on Recurrence and Bleeding Events in Patients Younger Than 21 Years of Age With Provoked Venous Thromboembolism: The Kids-DOTT Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Duration of Anticoagulant Treatment for Acute Provoked Venous Thromboembolism in Pediatric Patients – JAMA (free for a limited period)

 


Review: Management of coagulopathy in bleeding patients.

12 Jan, 2022 | 08:34h | UTC

Management of Coagulopathy in Bleeding Patients – Journal of Clinical Medicine

 


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