Emergency Medicine
RCT: An active strategy for diagnosing pulmonary embolism did not improve outcomes in patients hospitalized for COPD exacerbation.
6 Oct, 2021 | 09:52h | UTCEffect of a Pulmonary Embolism Diagnostic Strategy on Clinical Outcomes in Patients Hospitalized for COPD Exacerbation: A Randomized Clinical Trial – JAMA (free for a limited period)
Commentary on Twitter
Among patients hospitalized for an exacerbation of #COPD, addition of an active diagnostic strategy for pulmonary embolism to usual care compared with usual care alone did not improve a composite set of health outcomes https://t.co/7mOi5lOBD8
— JAMA (@JAMA_current) October 5, 2021
RCT: Another study shows convalescent plasma does not improve outcomes in critically ill patients with Covid-19.
5 Oct, 2021 | 10:06h | 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.
Video | A Pill For COVID? A Doctor Explains Molnupiravir.
5 Oct, 2021 | 09:57h | UTCA Pill For COVID? | A Doctor Explains Molnupiravir – ZDoggMD
Merck’s Covid-19 pill is great news but may not be a game-changer.
5 Oct, 2021 | 09:59h | UTCMerck’s Covid-19 pill is great news but may not be a game-changer – CNN
[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.
3 Oct, 2021 | 23:02h | UTCCommentaries:
Expert reaction to interim analysis of oral antiviral molnupiravir – Science Media Centre
Covid antiviral pill can halve risk of hospitalization – BBC
Why Merck’s Covid-19 pill molnupiravir could be so important – Vox
Commentaries on Twitter
.@DrEricDing convinced many that stopping the #molnupiravir trial early for benefit was a good idea
But it was NOT
Large body of evidence suggests that stopping early for benefit biases the results: overestimates the benefits of the treatment #EBM https://t.co/b3tHEtliO0 https://t.co/LwuCgqcY0C pic.twitter.com/vyPWc0nd37
— Kari Tikkinen (@KariTikkinen) October 2, 2021
(thread – click for more)
💡BREAKING—New oral anti-viral drug *molnupiravir* cuts risk of #COVID19 hospitalization and death **in HALF** in a randomized trial. Results so astounding that the trial is being stopped early, and Merck plans to apply for emergency authorization ASAP. 🧵 https://t.co/g8JGNzvuRg pic.twitter.com/K1SwC3QFXS
— Eric Feigl-Ding (@DrEricDing) October 1, 2021
Vaccine induced immune thrombocytopenia and thrombosis: summary of NICE guidance.
3 Oct, 2021 | 22:59h | UTCVaccine induced immune thrombocytopenia and thrombosis: summary of NICE guidance – The BMJ
Original Guidance: NICE COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis.
Related:
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)
Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.
3 Oct, 2021 | 22:41h | UTC
Intensive care triage under exceptional resource scarcity.
3 Oct, 2021 | 22:48h | UTCIntensive care triage under exceptional resource scarcity – Swiss Medical Weekly
RCT: Early computed tomography coronary angiography in patients with suspected acute coronary syndrome did not improve one year clinical outcomes.
3 Oct, 2021 | 22:35h | UTC
Commentary on Twitter
In this RCT, early CT coronary angiography in the emergency department for patients with suspected / provisional diagnosis of acute coronary syndrome had no effect on rate of death or subsequent non-fatal #heartattack at 1 year.@bmj_latest #Wondrmedicalhttps://t.co/usNKEGPDa4
— Prof Chris P Gale (@cpgale3) October 1, 2021
Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.
1 Oct, 2021 | 10:35h | UTC
WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections.
1 Oct, 2021 | 10:24h | UTCRelated:
Cardiac troponin and defining myocardial infarction.
1 Oct, 2021 | 10:11h | UTCCardiac troponin and defining myocardial infarction – Cardiovascular Research
Doctor’s new first aid technique can stem blood loss after shark attack.
1 Oct, 2021 | 10:03h | UTCDoctor’s ‘brilliant’ new first aid technique can stem blood loss after shark attack – The Guardian
RCT: REGEN-COV antibody combination reduces hospitalizations in outpatients with Covid-19.
30 Sep, 2021 | 10:33h | UTC
Review: Clinical features, laboratory, and radiological findings of patients with acute inflammatory myelopathy after COVID-19 infection.
30 Sep, 2021 | 10:27h | UTC
RCT: Vasopressin + Methylprednisolone increase the likelihood of return of spontaneous circulation compared to placebo in patients with in-hospital cardiac arrest.
30 Sep, 2021 | 10:23h | UTCEffect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Vasopressin and Steroids as Adjunctive Treatment for In-Hospital Cardiac Arrest (free for a limited period)
Commentary on Twitter
Randomized trial among patients with in-hospital cardiac arrest found that administration of vasopressin and methylprednisolone, compared with placebo, significantly increased the likelihood of return of spontaneous circulation https://t.co/wfyl56wgpT pic.twitter.com/LjKoxx8Rav
— JAMA (@JAMA_current) September 29, 2021
EM Cases: Liver Emergencies – Acute liver failure, hepatic encephalopathy, hepatorenal syndrome, liver test interpretation & drugs to avoid.
30 Sep, 2021 | 10:04h | UTC
AGA Clinical Practice Guideline on the Management of Coagulation Disorders in Patients With Cirrhosis.
29 Sep, 2021 | 10:07h | UTCSee also: AGA Technical Review on Coagulation in Cirrhosis – Gastroenterology
Review: Implementing an early rule-out pathway for acute myocardial infarction in clinical practice.
29 Sep, 2021 | 10:00h | UTCImplementing an early rule-out pathway for acute myocardial infarction in clinical practice – Heart
Review: Life-threatening skin conditions presenting to critical care.
28 Sep, 2021 | 08:57h | UTCLife-threatening skin conditions presenting to critical care – BJA Education
Podcast: Neutropenic Fever.
28 Sep, 2021 | 08:52h | UTC#288 LIVE! Neutropenic Fever featuring Dr. Susan Seo – The Curbsiders
Updated WHO Living Guideline: Therapeutics and COVID-19.
26 Sep, 2021 | 22:16h | UTCTherapeutics and COVID-19: living guideline – World Health Organization
WHO Statement: On new recommendation for treatment of COVID-19 patients: WHO calls for equitable access to casirivimab and imdevimab for COVID-19
See also:
WHO recommends antibody treatment for COVID patients at high risk of hospital admission.
Commentary: WHO adds new recommendation for COVID-19 monoclonal antibody combo – CIDRAP
Evaluating the Cost-effectiveness of Prehospital Plasma Transfusion in Unstable Trauma Patients: A Secondary Analysis of the PAMPer Trial.
26 Sep, 2021 | 21:54h | UTCEvaluating the Cost-effectiveness of Prehospital Plasma Transfusion in Unstable Trauma Patients: A Secondary Analysis of the PAMPer Trial – JAMA Surgery (free for a limited period)
Commentaries:
CHEERS to You on a Well-done Cost-effectiveness Analysis of Prehospital Plasma for Helicopter Resuscitation of Patients With Traumatic Shock – JAMA Surgery (free for a limited period)
Prehospital Plasma: A Cheap, Effective Way to Save Trauma Patients’ Lives? – BreakingMed
Commentary on Twitter
A cost-effectiveness analysis of the pragmatic, randomized, multicenter PAMPer trial reveals thawed plasma administration for trauma patients in hemorrhagic shock during air medical transport is life-saving and cost-effective https://t.co/WDCoJctZox
— JAMA Surgery (@JAMASurgery) September 24, 2021
[Preprint] PRINCIPLE RCT: Colchicine does not improve time to recovery in outpatients with Covid-19 at higher risk of complications.
24 Sep, 2021 | 10:13h | UTC
Commentary on Twitter
While COLCORONA trial found limited evidence that colchicine may reduce COVID-19 related hospitalisation/death
🆕💥💥@TrialPrinciple preprint
Colchicine did NOT improve time to recovery in people at higher risk of complications w COVID-19 in the communityhttps://t.co/2sUoeD7sGV pic.twitter.com/fi2THbxewW— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) September 23, 2021
WHO recommends antibody treatment for COVID patients at high risk of hospital admission.
24 Sep, 2021 | 10:11h | UTCOriginal article and infographic: A living WHO guideline on drugs for covid-19 – The BMJ