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Emergency Medicine

Study shows cardiac troponin concentrations at presentation are insufficient to distinguish type 1 myocardial infarction from other causes of myocardial injury.

6 Sep, 2021 | 10:42h | UTC

Cardiac Troponin Thresholds and Kinetics to Differentiate Myocardial Injury and Myocardial Infarction – Circulation

 

Commentary on Twitter

 

Differentiating central from peripheral causes of acute vertigo in an emergency setting with the HINTS, STANDING, and ABCD2 tests: A diagnostic cohort study.

6 Sep, 2021 | 10:36h | UTC

Differentiating central from peripheral causes of acute vertigo in an emergency setting with the HINTS, STANDING, and ABCD2 tests: A diagnostic cohort study – Academic Emergency Medicine (link to abstract – $ for full-text)

Commentary: Can We Detect Central Vertigo on Exam? – Journal Feed

 

RCT: Baricitinib reduced mortality in hospitalized adults with COVID-19.

2 Sep, 2021 | 10:17h | UTC

Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): a randomised, double-blind, parallel-group, placebo-controlled phase 3 trial – The Lancet Respiratory Medicine

Commentaries:

Baricitinib: the first immunomodulatory treatment to reduce COVID-19 mortality in a placebo-controlled trial – The Lancet Respiratory Medicine

Rheumatoid Arthritis Drug Combined with Standard of Care May Help Reduce Mortality for Hospitalized COVID-19 Patients – Vanderbilt University Medical Center

 

Commentaries on Twitter

(thread – click for more)

 

Scientific Statement: Coronavirus Disease-2019 and Heart Failure.

2 Sep, 2021 | 10:08h | UTC

Coronavirus Disease-2019 and Heart Failure: A Scientific Statement From the Heart Failure Society of America – Journal of Cardiac Failure

 

Commentary on Twitter

 

RCT: Among critically ill patients, targeting oxygenation to a low-normal range vs. high-normal range did not result in a reduction in organ dysfunction.

2 Sep, 2021 | 08:23h | UTC

Effect of Low-Normal vs High-Normal Oxygenation Targets on Organ Dysfunction in Critically Ill Patients: A Randomized Clinical Trial – JAMA (free for a limited period)

Related:

M-A of randomized trials: Conservative oxygen therapy for critically ill patients.

Oxygen administration for patients with ARDS – Journal of Intensive Care

Randomized trial: Similar outcomes with lower vs. higher oxygenation targets for acute hypoxemic respiratory failure

Systematic Review: Higher vs. Lower Fraction of Inspired Oxygen or Targets of Arterial Oxygenation for Adults Admitted to the Intensive Care Unit

 

Commentary on Twitter

 

RCT: In patients with acute hypoxemic respiratory failure, a strategy of lower tidal volume ventilation facilitated by extracorporeal carbon dioxide removal was not associated with improved outcomes.

2 Sep, 2021 | 08:21h | UTC

Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal vs Standard Care Ventilation on 90-Day Mortality in Patients With Acute Hypoxemic Respiratory Failure: The REST Randomized Clinical Trial – JAMA (free for a limited period)

Related: Randomized Trial: Low vs Intermediate Tidal Volume Strategy in ICU Patients Without ARDS

 

Commentary on Twitter

 

RCT: Ketamine administration in patients with acute painful sickle cell crisis was effective for pain control and reduced the cumulative morphine dose in the emergency department.

2 Sep, 2021 | 08:11h | UTC

Ketamine Administration for Acute Painful Sickle Cell Crisis: A Randomized Controlled Trial – Academic Emergency Medicine (link to abstract – $ for full-text)

 

Review: Initial antimicrobial management of sepsis – immediate, empiric, broad-spectrum therapy is key, but it must be accompanied by a commitment to de-escalation and antimicrobial stewardship.

1 Sep, 2021 | 08:59h | UTC

Initial antimicrobial management of sepsis – Critical Care

 

Cohort study: A strategy combining a rapid antigen test and chest CT was effective in ruling out COVID-19 in the emergency department.

31 Aug, 2021 | 09:00h | UTC

Rapid Antigen Test Combined with Chest Computed Tomography to Rule Out COVID-19 in Patients Admitted to the Emergency Department – Journal of Clinical Medicine

 

Cohort study: Patients with Covid-19 infected with the Delta variant are twice as likely to need hospital admission or emergency care attendance.

29 Aug, 2021 | 19:02h | UTC

Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study – The Lancet Infectious Diseases

Commentaries:

Importance of epidemiological factors in the evaluation of transmissibility and clinical severity of SARS-CoV-2 variants – The Lancet Infectious Diseases

Covid: Delta variant patients twice as likely to need hospital care – BBC

Covid-19 hospitalization risk doubles with Delta variant, UK study suggests – CNN

Expert reaction to study looking at risk of hospitalisation from the delta variant compared with alpha – Science Media Centre

 

Commentary on Twitter

 

#ESCCongress – RCT: Immediate coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation did not improve outcomes compared to delayed/selective angiography.

29 Aug, 2021 | 18:12h | UTC

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation – New England Journal of Medicine

News release: Trial does not support early coronary angiography in cardiac arrest without ST elevation – European Society of Cardiology

Commentaries:

Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation – TOMAHAWK – American College of Cardiology

TOMAHAWK: Immediate Coronary Angiography vs. Delayed Angiography in OHCA Patients Without ST-Segment Elevation – American College of Cardiology

 

Commentary on Twitter

 

#ESCCongress – Pilot study in Sweden showed drones delivered defibrillators faster than ambulances to patients with suspected cardiac arrest.

29 Aug, 2021 | 18:02h | UTC

Automated external defibrillators delivered by drones to patients with suspected out-of-hospital cardiac arrest – European Heart Journal

Editorial: Automated external defibrillator delivery by drones: are we ready for prime time?

News releases:

Drones delivered defibrillators to patients with suspected cardiac arrests – Karolinska Institutet

Drones could deliver defibrillators to cardiac arrest victims faster than ambulances – European Society of Cardiology

 

Commentary on Twitter

 

COVID-19 associated Mucormycosis: risk factors and mechanisms of disease.

27 Aug, 2021 | 10:07h | UTC

COVID-19 associated Mucormycosis (CAM): risk factors and mechanisms of disease – Clinical Infectious Diseases

Related: Clinical Picture: Mucormycosis after COVID-19 in a patient with diabetes. (several articles on the subject)

 

Commentary on Twitter

 

M-A of randomized trials: Effectiveness of the modified Valsalva maneuver in adults with supraventricular – “The meta-analysis demonstrated a significantly higher success rate for reconversion to sinus rhythm when using the modified VM compared to the standard VM in patients with an SVT (odds ratio = 4.36; 95% confidence interval, 3.30–5.76; P < 0.001)”.

26 Aug, 2021 | 08:51h | UTC

Effectiveness of the modified Valsalva manoeuvre in adults with supraventricular tachycardia: a systematic review and meta-analysis – European Journal of Emergency Medicine (link to abstract – $ for full-text)

Related: Randomized Trial: Standard Valsalva vs. Modified Valsalva for Cardioversion of SVT (studies and commentaries on the subject)

Video: Modified Valsalva manoeuvre for supraventricular tachycardia – The Lancet

 

Review: Acute and chronic hyponatremia.

25 Aug, 2021 | 08:50h | UTC

Acute and Chronic Hyponatremia – Frontiers in Medicine

Related:

Randomized trial suggests rapid intermittent bolus of hypertonic saline is the best approach for the treatment of symptomatic hyponatremia

Podcast: Hyponatremia deconstructed

Diagnosis and Management of Disorders of Body Tonicity—Hyponatremia and Hypernatremia: Core Curriculum 2020 – American Journal of Kidney Diseases

Guidelines for the Management of Exercise-Associated Hyponatremia

 

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

24 Aug, 2021 | 10:06h | UTC

RCT: Effect of Early Treatment with Fluvoxamine on Risk of Emergency Care and Hospitalization Among Patients with COVID-19 – Together Clinical Trials

Related:

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

 

RCT: Awake prone positioning reduces the need for intubation in patients with COVID-19.

23 Aug, 2021 | 00:03h | UTC

Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial – The Lancet Respiratory Medicine

Invited commentary: Awake prone positioning in COVID-19: is tummy time ready for prime time?

Related:

RCT: Awake prone positioning in patients with hypoxemic respiratory failure due to COVID-19 – no difference in intubation rates compared to standard care.

M-A: Prone positioning of nonintubated patients with Covid-19 improve oxygenation variables without any reported serious adverse events – randomized trials with patient-relevant outcomes such as the need for intubation or mortality rates are required

 

Commentary on Twitter

 

Study Commentaries: Non-invasive ventilation for COVID 19 patients. The Recovery RS trial.

22 Aug, 2021 | 23:52h | UTC

Commentary 1: JC: Non-invasive ventilation for COVID 19 patients. The Recovery RS trial – St Emlyn’s

Commentary 2: An adaptive randomized controlled trial of non-invasive respiratory strategies in acute respiratory failure patients with COVID-19 – The Bottom Line

Original study: [Preprint] RCT: non-invasive respiratory strategies in acute respiratory failure in patients with COVID-19 – CPAP reduced the composite outcome of intubation or death within 30 days; high-flow nasal oxygenation was not associated with better outcomes.

 

Survey: Workplace mistreatment reported frequently by emergency medicine residents.

22 Aug, 2021 | 22:18h | UTC

Workplace Mistreatment Reported Frequently by Emergency Medicine Residents – HealthDay

Original study: Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US – JAMA Network Open

 

Commentary on Twitter

 

Review: Viral respiratory pathogens and lung injury.

20 Aug, 2021 | 08:43h | UTC

Viral Respiratory Pathogens and Lung Injury – Clinical Microbiology Reviews

 

Viewpoint: Confronting the Delta variant of SARS-CoV-2.

19 Aug, 2021 | 09:03h | UTC

Confronting the Delta Variant of SARS-CoV-2, Summer 2021 – JAMA

 

NIH study shows no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms.

19 Aug, 2021 | 09:06h | UTC

NIH study shows no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms – NIH News Releases

Original study: Early Convalescent Plasma for High-Risk Outpatients with Covid-19 – New England Journal of Medicine

 

Commentary on Twitter

 

Hemophagocytic lymphohistiocytosis secondary to COVID-19: a case series.

19 Aug, 2021 | 08:57h | UTC

Haemophagocytic lymphohistiocytosis secondary to COVID-19: a case series – The Lancet Rheumatology

 

Systematic review: Systemic corticosteroids for the treatment of COVID‐19.

17 Aug, 2021 | 09:11h | UTC

Systemic corticosteroids for the treatment of COVID‐19 – Cochrane Library

Summary: Are corticosteroids given orally or by injection an effective treatment for people with COVID-19? – Cochrane Library

 

Commentary on Twitter (thread – click for more)

 

Cohort study: Early invasive coronary angiography in patients with acute ischemic heart failure is linked to better outcomes.

17 Aug, 2021 | 08:44h | UTC

Early invasive coronary angiography and acute ischaemic heart failure outcomes – European Heart Journal

Commentary: Early Invasive Angiography in Acute Heart Failure – American College of Cardiology

 

Commentary on Twitter

 

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