Emergency Medicine
Bowel Perforation: ED presentations, evaluation, and management.
23 Nov, 2021 | 08:19h | UTCBowel Perforation: ED presentations, evaluation, and management – emDocs
Non-invasive respiratory support in the management of acute COVID-19 pneumonia: considerations for clinical practice and priorities for research – “The two randomized controlled trials indicate superiority of non-invasive ventilation over high-flow nasal oxygen in reducing the need for intubation”.
21 Nov, 2021 | 23:15h | UTC
Commentary on Twitter
NEW Personal View—Non-invasive respiratory support in the management of acute #COVID19 #pneumonia: considerations for clinical practice and priorities for research
From Prof Hugh Montgomery & colleagues https://t.co/LLEFz2VLFu pic.twitter.com/owgAjLX5Z6
— The Lancet Respiratory Medicine (@LancetRespirMed) November 10, 2021
M-A: Convalescent plasma does not reduce mortality in COVID-19.
21 Nov, 2021 | 23:09h | UTCRelated:
M-A: Convalescent plasma is safe but does not improve outcomes in the treatment of COVID-19.
RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.
Clinical Guideline Highlights for the Hospitalist: Management of Upper Gastrointestinal and Ulcer Bleeding.
21 Nov, 2021 | 22:44h | UTCClinical Guideline Highlights for the Hospitalist: Management of Upper Gastrointestinal and Ulcer Bleeding – Journal of Hospital Medicine (free for a limited period)
RECOVERY Trial: Aspirin as an add-on therapy did not reduce mortality in patients hospitalized with COVID-19.
19 Nov, 2021 | 11:01h | UTCInvited Commentary: Studying the coagulopathy of COVID-19 – The Lancet
Commentary from the author on Twitter (thread – click for more)
RECOVERY Publication: ASPIRIN
(a widely used anti-platelet treatment in other settings)14 892 patients hospitalised with COVID-19.
No impact on mortality.
Small improvement in hospital stay.
No impact on need for mechanical ventilation
6 more bleeds. 6 fewer thromboses (clots) pic.twitter.com/LxDzudss9F— Martin Landray (@MartinLandray) November 18, 2021
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
Commentary on Twitter
Basic #ultrasound skills in #ICU & NCCU, @ESICM consensus & expert recommendations:
➡️brain
➡️lung
➡️heart
➡️abdomen
➡️vascular#FOAMcc #FOAMus #echofirst #POCUS
🖇️https://t.co/T1IuLlsomS
DO NOT miss supplementary files including additional figures & links to video description! pic.twitter.com/kbuIvuHvGI— Intensive Care Medicine (@yourICM) November 17, 2021
[Preprint] M-A: Inhaled corticosteroids in COVID-19 outpatients.
18 Nov, 2021 | 08:48h | UTCInhaled Corticosteroids for Outpatients with Covid-19: A Meta-Analysis – medRxiv
Commentary: Favourable meta-analysis of inhaled corticosteroids in COVID-19 outpatients – News Medical
Related:
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
The first meta-analysis of the 4 completed & reported trials of outpatient inhaled corticosteroid #COVID19 treatment
The results support the use of inhaled corticosteroids (ciclesonide or budesonide) for the resolution of symptoms at day 14 of treatmenthttps://t.co/KnBDKhfYmi pic.twitter.com/WSd9htXwe4— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) November 5, 2021
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 | UTCCommentary: Noncontrast CT a cost-friendly alternative to select late-stroke patients for thrombectomy – Health Imaging
Commentary on Twitter
Don’t have CTP worry not! No MRI/MRP worry not! Good old non-contrast CTH performs just as well for pt selection! But I do like those colored CBF, CBV, MTT maps & don’t like the errors in image processing! This will inc access to late thrombectomy #NoELVOleftbehind @almuftifawaz https://t.co/vBv5y2IDjT
— Neha Dangayach MD MSCR FAAN FANA FCCP FCCM FNCS (@drdangayach) November 11, 2021
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 | UTCThrombectomy 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)
Editorial: Twenty recommendations to individualize interventions in the early resuscitation of patients with sepsis.
18 Nov, 2021 | 08:38h | UTCRelated: 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
Commentary on Twitter
NEW Research—In pts w/ #COVID19 who received IMV for mod-to-sev #ARDS, intravenous immunoglobulins did not improve clinical outcomes at day 28
Phase 3 ICAR trial from Prof Tarek Sharshar & colleagues https://t.co/TBWxngXIPT pic.twitter.com/W2dNBaM1o1
— The Lancet Respiratory Medicine (@LancetRespirMed) November 12, 2021
Review: Vaccine-induced immune thrombotic thrombocytopenia.
16 Nov, 2021 | 08:46h | UTCVaccine-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.
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
NEW Viewpoint by @Erik_Klok_MD, @MPaiMD, Menno Huisman & @ProfMakris discussing the epidemiology, pathophysiology, and optimal diagnostic and therapeutic management of vaccine-induced immune thrombotic thrombocytopenia #VITT #COVID19Vaccine https://t.co/FI4NynwzEn pic.twitter.com/9PbjaioA2T
— The Lancet Haematology (@TheLancetHaem) November 12, 2021
2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.
16 Nov, 2021 | 08:37h | UTC2021 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
Commentary on Twitter
Cardiac device troubleshooting in the intensive care unit: an educational review by @JeroenDauw et al. in #EHJACVC on how to deal with common issues of pacemakers, implantable cardioverter-defibrillators, & cardiac resynchronization devices in the CICU https://t.co/CISh3QVH2E pic.twitter.com/vHnfGdq6gU
— European Society of Cardiology Journals (@ESC_Journals) November 15, 2021
Cohort study suggests low-dose vs. standard radiation dose CT have similar diagnostic accuracy in suspected acute appendicitis.
14 Nov, 2021 | 19:37h | UTCNews 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
Commentary on Twitter
Despite guidelines suggesting otherwise, 27% of patients with an in-hospital cardiac arrest with a shockable rhythm received epinephrine before defibrillation
– and had a lower survival rate
– were defibrillated later-> dont do that!https://t.co/BGtNW02hav pic.twitter.com/WCJd7vtnEc
— Konstantin Krychtiuk (@krychtiukmd) November 13, 2021
ERS Guidelines: High-flow nasal cannula in acute respiratory failure.
12 Nov, 2021 | 10:29h | UTC
2022 ASA Guidelines for Management of the Difficult Airway.
12 Nov, 2021 | 10:31h | UTCRelated:
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 | UTCCOVID antiviral pills: what scientists still want to know – Nature
Related:
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.
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 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 | UTCA Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke – New England Journal of Medicine (link to abstract – $ for full-text)
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 | UTCAngiotensin Receptor–Neprilysin Inhibition in Acute Myocardial Infarction – New England Journal of Medicine (link to abstract – $ for full-text)
Review: Cardiogenic shock after acute myocardial infarction.
10 Nov, 2021 | 07:03h | UTCCardiogenic 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
Review: Uremic Encephalopathy.
10 Nov, 2021 | 06:49h | UTCUremic Encephalopathy – Kidney International
Practice Review: COVID-19 rapid diagnostics.
9 Nov, 2021 | 01:52h | UTCCOVID-19 rapid diagnostics: practice review – Emergency Medicine Journal