Critical Care & Emergencies (all articles)
Extremely rare cases of Guillain-Barré reported with Johnson & Johnson vaccine for Covid-19.
13 Jul, 2021 | 09:48h | UTCJ&J’s Covid-19 vaccine may trigger neurological condition in rare cases, FDA says – STAT
See also: Johnson & Johnson Vaccine Is Linked To Neurological Disorder In Extremely Rare Cases – NPR AND F.D.A. Attaches Warning of Rare Nerve Syndrome to Johnson & Johnson Vaccine – The New York Times
Another RCT evaluating the efficacy and quality of life of antibiotic-only treatment of acute uncomplicated appendicitis.
13 Jul, 2021 | 09:33h | UTCA Randomized Clinical Trial Evaluating the Efficacy and Quality of Life of Antibiotic-only Treatment of Acute Uncomplicated Appendicitis: Results of the COMMA Trial – Annals of Surgery (link to abstract – $ for full-text)
Related: A Randomized trial comparing antibiotics with appendectomy for appendicitis AND Antibiotics alone for uncomplicated appendicitis: Oral Moxifloxacin almost as good as intravenous Ertapenem + oral Levofloxacin AND Observational study: 67.1% success rate with nonoperative management of children with uncomplicated appendicitis AND Randomized Trial: Quality of Life and Patient Satisfaction at 7-Year Follow-up of Antibiotic Therapy vs. Appendectomy for Uncomplicated Acute Appendicitis AND Meta-Analysis: Antibiotic Treatment vs. Appendectomy for Uncomplicated Acute Appendicitis in Adults and Children AND Nonoperative treatment for nonperforated appendicitis in children: a systematic review and meta-analysis – Pediatric Surgery International
Commentary on Twitter
The debate continues!
Another RCT comparing antibiotics to surgery for uncomplicated appendicitis – COMMA trial from ??
Recurrence within 1-year : 25% after AB
Superior quality of life at 3 and 12mo after surgery.https://t.co/Yv51qpxchb
— Ville Sallinen (@villesallinen) July 11, 2021
Podcast | An Antibiotics Primer.
13 Jul, 2021 | 09:35h | UTC#284 An Antibiotics Primer, with @IDdocAdi – The Curbsiders
M-A: Similar mortality with Fluoroquinolones or Macrolides for the treatment of Legionella Pneumonia.
13 Jul, 2021 | 09:18h | UTCAre Fluoroquinolones or Macrolides Better for Treating Legionella Pneumonia? A Systematic Review and Meta-analysis – Clinical Infectious Diseases (link to abstract – $ for full-text)
Review: Infectious disease-associated encephalopathies.
13 Jul, 2021 | 09:30h | UTCInfectious disease-associated encephalopathies – Critical Care
Commentary on Twitter
A Review published in Critical Care focuses on the pathophysiology of encephalopathies associated with sepsis, malaria, influenza, and COVID-19; emerging therapeutic strategies; and the role of neuroinflammation. https://t.co/991S4kAKJk
— BMC (@BioMedCentral) July 11, 2021
Top 10 pearls for the recognition, evaluation, and management of maternal sepsis.
13 Jul, 2021 | 09:25h | UTC
RCT: Comparison of nebulized ketamine at three different dosing regimens for treating painful conditions in the emergency department.
13 Jul, 2021 | 09:22h | UTCComparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial – Annals of Emergency Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Nebulized Ketamine for pain in the ED? No way…Well- here you go-Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the ED. https://t.co/v3UT0Y0LdU #FOAMed #FOAMems #FOAMtox #FOAMcc #FOAMpharm
— Sergey Motov (@painfreeED) July 3, 2021
[Preprint] Heparin for Moderately Ill Patients with Covid-19 – “In moderately ill ward patients with Covid-19 and elevated D-dimer level, therapeutic heparin did not significantly reduce the primary outcome but decreased the odds of death at 28 days”.
12 Jul, 2021 | 03:14h | UTCHeparin for Moderately Ill Patients with Covid-19 – medRxiv
Related: RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk. AND [Preprint] Practice Changing RCT: Therapeutic-dose anticoagulation with heparin (LMWH or unfractionated heparin) improves outcomes in non-critically ill patients with Covid-19 – the superiority of therapeutic-dose anticoagulation was seen in both high and low D-dimer groups. AND [Preprint] RCT: Full-dose/therapeutic anticoagulation provides no benefit in critically ill patients with Covid-19
Commentary on Twitter (thread – click for more)
?Final results of the RAPID trial now pub'd @medrxivpreprint ? RAPID was an open-label trial that randomly assigned hospitalized ward patients with COVID-19 and elevated D-dimer levels to therapeutic or prophylactic heparin. ? 1/10 https://t.co/oxiyXQAPeK pic.twitter.com/V2GtruEyM2
— Michelle Sholzberg (@sholzberg) July 9, 2021
RCT: Another study shows Azithromycin does not improve outcomes in patients with Covid-19.
12 Jul, 2021 | 03:09h | UTCCommentaries: Trial shows that the antibiotic azithromycin does not prevent mild COVID cases progressing to hospitalization, death – European Society of Clinical Microbiology and Infectious Diseases AND Azithromycin: can its benefit be ruled out in mild COVID-19? – The Lancet Respiratory Medicine
Related: M-A: Azithromycin does not reduce the need for invasive mechanical ventilation or mortality in patients with Covid-19. AND RCT: Azithromycin provides no benefit for community treatment of patients with suspected COVID-19 AND RECOVERY trial: Azithromycin not beneficial for patients admitted to hospital with COVID-19 AND [Press release – not published yet] Azithromycin and doxycycline are not generally effective against COVID-19 in patients treated at home, shows PRINCIPLE trial AND Coalition Covid-19 Brazil – Randomized trial: Azithromycin not beneficial for patients admitted to the hospital with severe Covid-19 AND Coalition Covid-19 Brazil – Randomized trial: hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19
Commentary on Twitter
In patients with mild-to-mod #COVID19 managed without hospital admission, azithromycin + SOC did not reduce the risk of subsequent hospital admission or death
Read the ATOMIC2 trial here https://t.co/QXJ7T08JZS, being presented at #ECCMID2021 by lead author Tim Hinks @HinksLab pic.twitter.com/ZDiPhuQqFB
— The Lancet Respiratory Medicine (@LancetRespirMed) July 9, 2021
Understanding the Host in the Management of Pneumonia. An Official American Thoracic Society Workshop Report.
12 Jul, 2021 | 01:41h | UTC
RCT: Another study shows that non-antibiotic outpatient treatment in mild acute diverticulitis is safe.
12 Jul, 2021 | 01:29h | UTCEfficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis (DINAMO-study): A Multicentre, Randomised, Open-Label, Non-Inferiority Trial – Annals of Surgery (link to abstract – $ for full-text)
Related: State of the Art Review: Management of colonic diverticulitis AND Treatment of Uncomplicated Acute Diverticulitis Without Antibiotics: A Systematic Review and Meta-analysis – Diseases of the Colon & Rectum AND Antibiotics Do Not Reduce Length of Hospital Stay for Uncomplicated Diverticulitis in a Pragmatic Double-Blind Randomized Trial – Clinical Gastroenterology and Hepatology AND Randomized Trial: Antibiotic Avoidance Associated with Similar Long-term Outcomes in Uncomplicated Diverticulitis
Commentary on Twitter
Another (final?) nail in the coffin for antibiotics in uncomplicated diverticulitis? DINAMO study from Spain – Outpatient treatment with antibiotics versus symptomatic Tx.
No difference in hospitalization rate or revisits to ER.https://t.co/wOc3tBGfxr @AnnalsofSurgery
— Ville Sallinen (@villesallinen) July 9, 2021
M-A: Comparative efficacy and safety of vancomycin, linezolid, tedizolid, and daptomycin in treating patients with suspected or proven complicated skin and soft tissue infections.
9 Jul, 2021 | 09:57h | UTC
Commentary on Twitter
?? Network Meta-Analysis @InfectDis_Ther
20 RCTs N=7804
Comparative Efficacy& Safety of Vancomycin,Linezolid,Tedizolid, and Daptomycin in Treating Patients with Suspected or Proven cSSTI
Linezolid was superior to vancomycin in improving clinical successhttps://t.co/qlZfXoWfaa pic.twitter.com/tO3sIoOMY4— Antibiotic Steward ???Bassam Ghanem (@ABsteward) June 20, 2021
Assessment and management of cardiovascular disease in the intensive care unit.
9 Jul, 2021 | 09:54h | UTCAssessment and management of cardiovascular disease in the intensive care unit – Heart
Case series: therapeutic plasma exchange in 3 patients with vaccine-induced immune thrombotic thrombocytopenia.
8 Jul, 2021 | 09:17h | UTC
Commentary on Twitter
Three patients with severe manifestations of VITT after #COVID19 vaccination had poor response to initial therapy with anticoagulants and intravenous immune globulin. Their condition improved after therapeutic plasma exchange was initiated.
— NEJM (@NEJM) July 7, 2021
Review: Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS.
8 Jul, 2021 | 09:01h | UTC
Commentary on Twitter
Physiology-to-bedside overview about non-invasive ventilatory support in AHRF & #ARDS
➡️spontaneous breathing: benefits/harms
➡️how to make spontaneous effort non‑injurious?
➡️optimizing HFNO & NIV
➡️monitoring to detect failure & be protective
➡️evidencehttps://t.co/KPW2u8akhA pic.twitter.com/yKVxrYaFmZ— Intens Care Med (@yourICM) July 7, 2021
Predictors of death and new disability after critical illness: a multicenter prospective cohort study.
8 Jul, 2021 | 08:59h | UTC
Commentary on Twitter
Predicting death & new disability after #ICU admission: only 41% of pts requiring > 24h of mechanical ventilation are alive/free of new disability at 6 months. Potentially impacting? age, illness severity, diagnosis. Results #FOAMcc https://t.co/bpto5JUumB
Here visual abstract ⬇️ pic.twitter.com/hRqybdNpLa— Intens Care Med (@yourICM) July 3, 2021
Study Commentary: Febrile Neutropenia – Procalcitonin vs. MASCC Score.
8 Jul, 2021 | 08:57h | UTCFebrile Neutropenia – Procalcitonin vs MASCC Score – Journal Feed
M-A: Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19 – “The 4% absolute risk reduction in mortality from 25% to 21% with IL-6 inhibition added to glucocorticoids may not translate to patients with a lower baseline mortality risk and likely do not justify the additional expense and risk for toxicities for patients hospitalized with modest oxygen requirements and a stable clinical course (from editorial)”.
7 Jul, 2021 | 09:02h | UTCEditorial: IL-6 Receptor Antagonist Therapy for Patients Hospitalized for COVID-19: Who, When, and How? – JAMA
Commentaries: Interleukin-6 antagonists improve outcomes in hospitalised COVID-19 patients – King’s College London AND WHO advises 2 monoclonal antibodies for severe COVID – CIDRAP
Commentary on Twitter (thread – click for more)
1/n
Here we go –
Our paper assessing the role of interleukin-6 antagonists treatments in the management of COVID-19 patients?https://t.co/AJErHypx9a@WHO @jonathanasterne @diazjv @JAMA_current @KCLImmunoMicro @GSTT_ICU @GSTTresearch— Manu Shankar-Hari (@msh_manu) July 6, 2021
A living WHO guideline on drugs for covid-19 – interleukin-6 receptor blockers are now recommended for patients with severe or critical covid-19.
7 Jul, 2021 | 09:03h | UTCA living WHO guideline on drugs for covid-19 – The BMJ
Commentary on Twitter
The latest version of this @WHO living guidance provides a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19. Read the updated WHO guideline on drugs for #COVID19 https://t.co/FUb9yzFRwo
— The BMJ (@bmj_latest) July 6, 2021
WHO recommends life-saving interleukin-6 receptor blockers for COVID-19 and urges producers to join efforts to rapidly increase access – “These are the first drugs found to be effective against COVID-19 since corticosteroids were recommended by WHO in September 2020”.
7 Jul, 2021 | 09:00h | UTC
Commentary on Twitter (thread – click for more)
? treatment recommendation from WHO:
WHO recommends life-saving interleukin-6 receptor blockers to treat #COVID19 and urges producers to join efforts to rapidly increase access.?https://t.co/h4IcZad2VA pic.twitter.com/YXPkuBVwY4
— World Health Organization (WHO) (@WHO) July 6, 2021
SAEM Guidelines for reasonable and appropriate care in the emergency department (GRACE): Recurrent, low-risk chest pain in the emergency department.
7 Jul, 2021 | 08:48h | UTCNews release: SAEM publishes GRACE guidelines for recurrent, low-risk chest pain care in the ED – Society for Academic Emergency Medicine
Invited commentaries: GRACE-recurrent low-risk chest pain: A user’s guide AND Navigating uncertainty with GRACE: Society for Academic Emergency Medicine’s guidelines for reasonable and appropriate care in the emergency department
M-A: Convalescent plasma is safe but does not improve outcomes in the treatment of COVID-19.
7 Jul, 2021 | 08:52h | UTC
RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.
6 Jul, 2021 | 10:16h | UTCCommentary: Ivermectin: balance of evidence shows no significant benefit against Covid-19 – MSN News
Related: Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – “IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease”. AND Ivermectin is the new hydroxychloroquine, take 2 – “Ivermectin shouldn’t be used to treat COVID-19 outside of the context of a well-designed clinical trial”. AND Therapeutics and COVID-19 | WHO guideline update advises Ivermectin should only be used to treat COVID-19 within clinical trials AND RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19
Choosing Wisely for COVID-19: ten evidence-based recommendations for patients and physicians.
6 Jul, 2021 | 10:21h | UTC
Editorial | Do not just sit there, do something … but do no harm: the worrying aspects of COVID-19 experimental interventions.
6 Jul, 2021 | 10:14h | UTC
Commentary on Twitter
Shortcutting science perpetuates ineffective/unsafe treatments: with #COVID19 plethora of interventions (most next-to-no basis/inconsistent effects) trialled or given on compassionate grounds regardless risks. Will mistakes be acknowledged & lessons learnt?https://t.co/p53WyeMLEC pic.twitter.com/zUwlML8Pft
— Intens Care Med (@yourICM) July 5, 2021