Emergency Medicine
The cost-effectiveness of cefazolin compared to anti-staphylococcal penicillins for the treatment of methicillin-sensitive Staphylococcus aureus bacteremia.
24 Oct, 2021 | 23:41h | UTCRelated:
Meta-Analysis: Cefazolin vs. Antistaphylococcal Penicillins for MSSA Bacteremia
Commentaries on Twitter
While Cefazolin and anti-staphylococcal penicillins (ASPs), such as nafcillin, are the preferred treatments for MSSA bacteremia it looks more and more like Cefazolin is really the preferred approach. https://t.co/6FVVEWMxBY
— Daniel Griffin MD PhD (@DanielGriffinMD) October 8, 2021
New in OFID: The use of cefazolin is a cost-effective strategy for the treatment of methicillin-sensitive S. aureus bacteremia and, when clinically appropriate, results in health care cost-savings.
?: https://t.co/lRfsZdMjLJ#IDSAJournals @PaulSaxMD @DrJLi @ElMylonakis pic.twitter.com/hhzik4ppUW
— IDSA (@IDSAInfo) October 8, 2021
M-A: In patients with Staphylococcus aureus bacteremia, combination therapy does not reduce mortality and is associated with increased risks of adverse events.
24 Oct, 2021 | 23:42h | UTC
RCT: In adults with Covid-19 and severe hypoxemia, 12 mg vs. 6 mg of Dexamethasone did not result in a statistically significant difference in the number of days alive without life support.
22 Oct, 2021 | 10:32h | UTCEditorial: Glucocorticoid Dose in COVID-19: Lessons for Clinical Trials During a Pandemic – JAMA
Commentary on Twitter
In a randomized trial of patients with #COVID19 and severe hypoxemia, compared with 6 mg of dexamethasone, 12 mg of dexamethasone did not statistically significantly reduce the number of days alive without life support at 28 days https://t.co/BMgLTel4aU pic.twitter.com/WKwI8xCUYO
— JAMA (@JAMA_current) October 21, 2021
M-A: Diagnostic accuracy of handheld cardiac ultrasound device for assessment of left ventricular structure and function.
22 Oct, 2021 | 10:15h | UTC
COVID-19 pneumonia: pathophysiology and management.
21 Oct, 2021 | 10:12h | UTCCOVID-19 pneumonia: pathophysiology and management – European Respiratory Review
RCT: Interferon does not improve outcomes for hospitalized adults with COVID-19.
20 Oct, 2021 | 10:28h | UTCNews release: Interferon does not improve outcomes for hospitalized adults with COVID-19 – NIH News Releases
Things We Do for No Reason: fluid restriction for the management of acute decompensated heart failure in patients with reduced ejection fraction.
20 Oct, 2021 | 10:00h | UTCThings We Do for No Reason™: Fluid Restriction for the Management of Acute Decompensated Heart Failure in Patients With Reduced Ejection Fraction – Journal of Hospital Medicine (free for a limited period)
Commentary on Twitter
? Today’s Things We Do for No Reason ™️ from @JHospMedicine: Why do we think fluid restriction is important in managing ADHF? What’s the alternative? ?
? Sound off in the replies why you do or don’t follow this practice. ?#HeartFailure #ADHFhttps://t.co/QayZdqqNSd
— Society of Hospital Medicine (@SocietyHospMed) October 19, 2021
RECOVERY Trial: In patients admitted to hospital with COVID-19, Colchicine did not reduce 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death.
19 Oct, 2021 | 10:14h | UTCRelated:
Systematic Review: Colchicine for the treatment of COVID‐19 – not beneficial for hospitalized patients; inconclusive evidence for the treatment of non-hospitalized patients, “probably slightly reduces the need for hospitalization or death within 28 days compared to placebo”.
19 Oct, 2021 | 10:13h | UTCColchicine for the treatment of COVID‐19 – Cochrane Library
Related:
Commentary on Twitter
JUST PUBLISHED – Is #colchicine (often used to treat #gout) an effective treatment for people with #COVID19? ➡️ https://t.co/IF1enksFpn New @CochraneHaem systematic review includes evidence from 4 RCTS with 11,525 hospitalised & 4488 non‐hospitalised people.
— The Cochrane Library (@CochraneLibrary) October 18, 2021
Urolithiasis: ED presentations, evaluation, management, and disposition.
19 Oct, 2021 | 08:53h | UTCUrolithiasis: ED Presentations, Evaluation, Management, and Disposition – emDocs
RCT supports the use of therapeutic heparin in moderately ill patients admitted to the hospital with Covid-19.
17 Oct, 2021 | 21:35h | UTCRelated studies (some conflicting results)
Commentary on Twitter
What are the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with covid-19 admitted to hospital? #BMJResearch by @sholzberg and colleagues.
Includes a #VisualAbstract summarising the study #BMJInfographichttps://t.co/82VisuBKSU pic.twitter.com/b06TdIJvLX
— The BMJ (@bmj_latest) October 15, 2021
Review: Management of infectious emergencies for the inpatient dermatologist.
17 Oct, 2021 | 21:06h | UTCManagement of Infectious Emergencies for the Inpatient Dermatologist – Current Dermatology Reports (if this link is paywalled, try this one)
Serious injury risk higher for horse riding than for football, motor racing, or skiing – “Chest most common site of injury, but head and neck injuries most lethal”.
17 Oct, 2021 | 21:08h | UTCNews release: Serious injury risk higher for horse riding than for football, motor racing, or skiing – BMJ
Commentary: Horse Riding More Dangerous Than Skiis And Motorcycles, Injury Data Reveal – Science Alert
Intracerebral hemorrhage: diagnosis, emergency management, and prognosis.
15 Oct, 2021 | 02:12h | UTCIntracerebral Hemorrhage: Diagnosis, Emergency Management, and Prognosis – emDocs
Systematic Review: Ultrasound guidance for arterial (other than femoral) catheterization in adults may improve first attempt and overall success rates compared to palpation.
14 Oct, 2021 | 09:41h | UTCUltrasound guidance for arterial (other than femoral) catheterisation in adults – Cochrane Library
M-A: Frequency of Neurologic Manifestations in COVID-19 – up to one-third of patients (89% hospitalized) experienced at least one neurological manifestation.
13 Oct, 2021 | 01:40h | UTC
Consensus Guidance: Hyperkalemia management in the emergency department.
13 Oct, 2021 | 01:34h | UTCPodcast: Hyperkalemia, Diet, K+ Binders, Exercise
Hyperkalemia: Pathophysiology, Risk Factors and Consequence
Hyperkalemia: Pathophysiology, Risk Factors and Consequence (several articles)
RCT: No benefit from antithrombotic therapy (aspirin or apixaban) in outpatients with clinically stable symptomatic COVID-19.
12 Oct, 2021 | 00:28h | UTC
Commentary on Twitter
Data do not support the use of aspirin or apixaban in the outpatient setting to reduce the major adverse cardiovascular or pulmonary consequences associated with symptomatic but clinically stable #SARSCoV2 infection https://t.co/SH6OefXOCj #COVID19
— JAMA (@JAMA_current) October 11, 2021
D-Dimer testing for the exclusion of pulmonary embolism has limited clinical utility among hospitalized patients with COVID-19 – most patients with or without pulmonary embolism have increased levels.
12 Oct, 2021 | 00:26h | UTCCommentary: D-Dimer Level Not Useful for Ruling Out PE in COVID-19 Patients – HealthDay
How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.
12 Oct, 2021 | 00:18h | UTCHow antiviral pill molnupiravir shot ahead in the COVID drug hunt – Nature
Related:
What we know — and don’t know — about Merck’s new Covid-19 pill.
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 ischemic stroke and large vessel occlusion, thrombectomy with combined contact aspiration and stent retriever was not better than stent retriever alone.
12 Oct, 2021 | 00:04h | UTCEffect of Thrombectomy With Combined Contact Aspiration and Stent Retriever vs Stent Retriever Alone on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER2 Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentaries:
Little Benefit From Adding Aspiration to Thrombectomy for Stroke – Medscape (free registration required)
Combo Thrombectomy Approach No Better for Large Vessel Strokes – MedPage Today (free registration required)
Commentary on Twitter
Clinical trial found the rate of near-total or total reperfusion at the end of the endovascular procedure was not significantly different for patients receiving thrombectomy with contact aspiration and stent retriever combined vs stent retriever alone https://t.co/SQTEnysFBG
— JAMA (@JAMA_current) September 28, 2021
Cluster RCT: An antimicrobial stewardship intervention safely reduced the use of broad-spectrum antibiotics among patients hospitalized with moderately severe community-acquired pneumonia.
11 Oct, 2021 | 23:55h | UTCNarrow-spectrum antibiotics for community-acquired pneumonia in Dutch adults (CAP-PACT): a cross-sectional, stepped-wedge, cluster-randomised, non-inferiority, antimicrobial stewardship intervention trial – The Lancet Infectious Diseases (link to abstract – $ for full-text)
RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.
10 Oct, 2021 | 21:53h | UTCInvited commentary: Anticoagulant Therapy in Patients Hospitalized With COVID-19 – JAMA Internal Medicine
Related studies (some conflicting results)
Commentary on Twitter
Thromboprophylaxis w therapeutic-dose LMWH reduced major thromboembolism and death by 32% compared with institutional standard heparin without increased major bleeding among #COVID19 inpatients with elevated D-dimers. The effect wasn't seen in ICU patients https://t.co/Wrgj2Ho5lv
— JAMA Internal Medicine (@JAMAInternalMed) October 7, 2021
WHO Guidance: Antigen-detection in the diagnosis of SARS-CoV-2 infection.
8 Oct, 2021 | 10:47h | UTCAntigen-detection in the diagnosis of SARS-CoV-2 infection – World Health Organization
Related infographics:
Use of antigen detection rapid diagnostic testing – World Health Organization
Diagnostic testing for SARS-CoV-2 infection – World Health Organization
Commentary on Twitter (thread – click for more)
Testing remains a critical component to the strategy to end the #COVID19 pandemic, and testing needs to be reliable, accessible, affordable, fast and linked to public health action.
So many around ? have worked hard to increase testing capacities @WHOhttps://t.co/VDPdU0VK4g
— Maria Van Kerkhove (@mvankerkhove) October 7, 2021
Study shows an increased risk of Guillain-Barré Syndrome with the J&J vaccine; the estimated observed to expected rate ratio was 4.18 for the 42-day window.
8 Oct, 2021 | 10:40h | UTC
Commentary on Twitter
Study suggests a potential small but statistically significant safety concern for #GuillainBarré syndrome following receipt of the @JanssenUS #COVID19 vaccine; findings considered preliminary pending analysis of medical records to establish a definitive Dx https://t.co/yZjJVkp6BA
— JAMA (@JAMA_current) October 7, 2021