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Emergency Medicine

Consensus and expert recommendations: basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population.

19 Nov, 2021 | 10:37h | UTC

Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine

 

Commentary on Twitter

 


[Preprint] M-A: Inhaled corticosteroids in COVID-19 outpatients.

18 Nov, 2021 | 08:48h | UTC

Inhaled Corticosteroids for Outpatients with Covid-19: A Meta-Analysis – medRxiv

Commentary: Favourable meta-analysis of inhaled corticosteroids in COVID-19 outpatients – News Medical

Related:

PRINCIPLE RCT: Inhaled budesonide improves time to recovery from COVID-19 in people at high risk of complications in the community.

Position Paper: Recommendations for the use of topical inhalant budesonide in COVID-19.

RCT: Inhaled budesonide shortens recovery time in non-hospitalized patients with COVID-19

Phase 2 RCT: Inhaled budesonide shows promise for the treatment of early COVID-19

 

Commentary on Twitter

 


M-A: In patients with anterior circulation acute stroke and evidence of reversible cerebral ischemia across the 6–24 h time window, thrombectomy was associated with higher rates of independence in activities of daily living at 90 days than best medical therapy alone.

18 Nov, 2021 | 08:43h | UTC

Thrombectomy for anterior circulation stroke beyond 6 h from time last known well (AURORA): a systematic review and individual patient data meta-analysis – The Lancet (link to abstract – $ for full-text)

 


Observational study in patients with stroke with large-vessel occlusion presenting in the extended window suggests non-contrast CT is as good as CT perfusion or MRI to select patients for thrombectomy.

18 Nov, 2021 | 08:41h | UTC

Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion – JAMA Neurology

Commentary: Noncontrast CT a cost-friendly alternative to select late-stroke patients for thrombectomy – Health Imaging

 

Commentary on Twitter

 


Editorial: Twenty recommendations to individualize interventions in the early resuscitation of patients with sepsis.

18 Nov, 2021 | 08:38h | UTC

Twenty recommendations to individualize interventions in the early resuscitation of patients with sepsis – Critical Care

Related: Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.

 


RCT: Intravenous immunoglobulins do not improve outcomes in patients with COVID-19-associated moderate-to-severe acute respiratory distress syndrome.

16 Nov, 2021 | 08:48h | UTC

Intravenous immunoglobulins in patients with COVID-19-associated moderate-to-severe acute respiratory distress syndrome (ICAR): multicentre, double-blind, placebo-controlled, phase 3 trial – The Lancet Respiratory Medicine

 

Commentary on Twitter

 


Review: Vaccine-induced immune thrombotic thrombocytopenia.

16 Nov, 2021 | 08:46h | UTC

Vaccine-induced immune thrombotic thrombocytopenia – The Lancet Haematology

Related:

Vaccine induced immune thrombocytopenia and thrombosis: summary of NICE guidance.

Clinical features of vaccine-induced immune thrombocytopenia and thrombosis.

Review: Clinical characteristics and pharmacological management of COVID-19 vaccine–induced immune thrombotic thrombocytopenia with cerebral venous sinus thrombosis.

Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know.

Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees. (several articles and resources on the subject)

 

Commentary on Twitter

 


2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.

16 Nov, 2021 | 08:37h | UTC

2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group – Circulation (for an HTML version click here)

Top Things to Know: International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) – American Heart Association

 


Review: Cardiac device troubleshooting in the intensive care unit.

16 Nov, 2021 | 08:21h | UTC

Cardiac device troubleshooting in the intensive care unit: an educational review – European Heart Journal. Acute Cardiovascular Care

 

Commentary on Twitter

 


Cohort study suggests low-dose vs. standard radiation dose CT have similar diagnostic accuracy in suspected acute appendicitis.

14 Nov, 2021 | 19:37h | UTC

News release: Doctors can use CT scans with less radiation to diagnose appendicitis – Oxford University

Original study: Diagnostic accuracy using low-dose versus standard radiation dose CT in suspected acute appendicitis: prospective cohort study – British Journal of Surgery (link to abstract – $ for full-text)

 


Observational Study: In patients with shockable in-hospital cardiac arrest, epinephrine before defibrillation was associated with worse survival.

14 Nov, 2021 | 19:33h | UTC

Epinephrine before defibrillation in patients with shockable in-hospital cardiac arrest: propensity matched analysis – The BMJ

 

Commentary on Twitter

 


ERS Guidelines: High-flow nasal cannula in acute respiratory failure.

12 Nov, 2021 | 10:29h | UTC

ERS Clinical Practice Guidelines: High-flow nasal cannula in acute respiratory failure – European Respiratory Journal

 


2022 ASA Guidelines for Management of the Difficult Airway.

12 Nov, 2021 | 10:31h | UTC

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway – Anesthesiology

Related:

Consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient.

Difficult airway management in neonates and infants: knowledge of devices and a device-oriented strategy.

Consensus Guideline: Pediatric Airway Management in COVID-19 Patients

Guidelines for Awake Tracheal Intubation in Adults

Position Paper: Management of Unanticipated Difficult Airways in Children in Anesthetic Practice

Review: Difficult Airway Management Algorithms (several resources on the subject)

The Difficult Airway Trolley: A Narrative Review and Practical Guide

 


COVID antiviral pills: what scientists still want to know – “Drugs like Molnupiravir and Paxlovid could change the course of the pandemic if clinical trial results hold up in the real world”.

11 Nov, 2021 | 08:59h | UTC

COVID antiviral pills: what scientists still want to know – Nature

Related:

[Press release – not published yet] RCT: Pfizer’s novel Covid-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR study.

A prominent virologist warns new COVID-19 pill could unleash dangerous mutants. Others see little cause for alarm.

The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first.

Merck to allow other nations to produce new COVID-19 antiviral.

Video: Merck’s Covid pill could transform treatment. Here’s how it works.

How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.

What we know — and don’t know — about Merck’s new Covid-19 pill.

[Press release – not published yet] Merck announces oral antiviral Molnupiravir reduced the risk of hospitalization or death by approximately 50 Percent compared to placebo for patients with mild or moderate COVID-19.

Merck’s Covid-19 pill is great news but may not be a game-changer.

Video | A Pill For COVID? A Doctor Explains Molnupiravir.

 


RCT: In patients with acute myocardial infarction complicated by a reduced left ventricular ejection fraction, pulmonary congestion, or both, Sacubitril–valsartan was not associated with improved outcomes compared to Ramipril.

11 Nov, 2021 | 08:44h | UTC

Angiotensin Receptor–Neprilysin Inhibition in Acute Myocardial Infarction – New England Journal of Medicine (link to abstract – $ for full-text)

 


RCT: In patients with acute stroke eligible for intravenous alteplase and endovascular treatment, intravenous alteplase before endovascular treatment did not improve outcomes compared to endovascular treatment alone.

11 Nov, 2021 | 08:43h | UTC

A Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke – New England Journal of Medicine (link to abstract – $ for full-text)

 


Review: Cardiogenic shock after acute myocardial infarction.

10 Nov, 2021 | 07:03h | UTC

Cardiogenic Shock After Acute Myocardial Infarction: A Review – JAMA (free for a limited period)

 


M-A: Among patients with acute intracerebral hemorrhage, interventions to lower blood pressure within 7 days of the onset had no overall benefit on functional recovery, despite reducing bleeding.

10 Nov, 2021 | 06:55h | UTC

Early lowering of blood pressure after acute intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data – Journal of Neurology, Neurosurgery & Psychiatry

 


Review: Uremic Encephalopathy.

10 Nov, 2021 | 06:49h | UTC

Uremic Encephalopathy – Kidney International

 


Practice Review: COVID-19 rapid diagnostics.

9 Nov, 2021 | 01:52h | UTC

COVID-19 rapid diagnostics: practice review – Emergency Medicine Journal

 


[Press release – not published yet] RCT: Pfizer’s novel Covid-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR study.

7 Nov, 2021 | 20:35h | UTC

Pfizer’s novel Covid-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR Study

Commentaries:

Expert reaction to press release from Pfizer giving interim analysis of their Phase 2/3 EPIC-HR study of PAXLOVID™ in non-hospitalized high-risk adults with COVID-19 – Science Media Centre

Pfizer’s Good News Is the World’s Good News – Science

Experimental Pfizer pill prevents Covid hospitalizations and deaths – STAT

Pfizer Says New Anti-Viral Drug Combination Cuts Risks Of Serious COVID-19 By 89% – Health Policy Watch

Pfizer reports good results against severe COVID-19 for its antiviral pill – CIDRAP

Covid: Pfizer says antiviral pill 89% effective in high-risk cases – BBC

Pfizer says COVID-19 pill cut hospital, death risk by 90% – Associated Press

Pfizer’s COVID-19 pill treatment reduces risk of being hospitalized or dying by 89%, company says – ABC News

 

Commentary on Twitter (thread – click for more)

 


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.

7 Nov, 2021 | 20:09h | UTC

Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients – JAMA Cardiology (link to abstract – $ for full-text)

Commentary: Zero CAC Questionable for Ruling Out Obstructive CAD in Young Adults – TCTMD

 

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

 


Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain.

5 Nov, 2021 | 09:44h | UTC

Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain – Journal of Hospital Medicine

Related:

Large observational study suggests Tramadol is associated with increased risk of adverse outcomes compared to Codeine.

Tramadol: Where do we go from here? – “Tramadol’s unpredictability, unique potential harms, and lack of advantage over other opioids or NSAIDs are now well recognized”.

Cohort Study: Chronic Use of Tramadol After Acute Pain Episode

 


ASH Guideline issued a conditional recommendation against routine use of outpatient anticoagulant prophylaxis in patients with COVID-19 being discharged from the hospital.

4 Nov, 2021 | 10:03h | UTC

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: July 2021 update on post-discharge thromboprophylaxis – Blood Advances

 


Review: The role of chest imaging in the diagnosis, management, and monitoring of Covid-19.

3 Nov, 2021 | 10:05h | UTC

The role of chest imaging in the diagnosis, management, and monitoring of coronavirus disease 2019 (COVID-19) – Insights into Imaging

 


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