Editor's Choice
ACC/AHA Multimodality appropriate use criteria for the detection and risk assessment of chronic coronary disease
29 May, 2023 | 11:18h | UTCCommentaries:
Commentary on Twitter
New multimodality AUC released by @ACCinTouch, key specialty & subspecialty societies, provides guidance on the appropriate use of stress testing & anatomic diagnostic procedures for risk assessment & evaluation of known or suspected CCD. https://t.co/56ewQWqW13 #JACC pic.twitter.com/WIqPyEDwfC
— JACC Journals (@JACCJournals) May 25, 2023
AHA/ASA Guideline for the management of patients with aneurysmal subarachnoid hemorrhage
29 May, 2023 | 11:16h | UTCTop Things to Know: 2023 Aneurysmal Subarachnoid Hemorrhage Guideline – American Heart Association
Commentary on Twitter
2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association https://t.co/IHZRkTR25t@American_Heart @American_Stroke @AHAScience @BrianHoh1 @drdangayach @CPDerdeyn pic.twitter.com/I2JdXnHuXp
— Stroke AHA/ASA (@StrokeAHA_ASA) May 23, 2023
RCT | Group support and skill-based learning reduce opioid use in chronic pain, but leads to no effect on pain perception
29 May, 2023 | 11:14h | UTCReducing Opioid Use for Chronic Pain With a Group-Based Intervention: A Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
News Release: New treatment helps people stop addictive opioid painkillers used for chronic pain – University of Warwick
RCT | Communication-priming intervention boosts goals-of-care discussions for seriously ill patients
29 May, 2023 | 11:12h | UTCIntervention to Promote Communication About Goals of Care for Hospitalized Patients With Serious Illness: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Conversations on Goals of Care With Hospitalized, Seriously Ill Patients – JAMA (free for a limited period)
See also: Visual Abstract
Commentary: Some Surrogate Endpoints Are Fine – By Dr John Mandrola
Cohort study | Airway-occluding mucus plugs in chest CT linked to higher mortality rates in COPD patients
29 May, 2023 | 11:10h | UTCAirway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease – JAMA (free for a limited period)
News Release: Study linking mucus plugs and COPD mortality could help save lives – Brigham and Women’s Hospital
Review | Mitigating long-term and delayed adverse events associated with cancer treatment: implications for survivorship
29 May, 2023 | 11:08h | UTCMitigating long-term and delayed adverse events associated with cancer treatment: implications for survivorship – Nature Reviews Clinical Oncology (if the link is paywalled, try this one)
Commentary on Twitter
In a Review now published online, @maryam_lustberg @NicoleKuderer @ADesaiMD @crisbergerot and @gary_lyman discuss the mitigation of long-term toxicities from cancer treatment, including financial toxicity and psychosocial needs: https://t.co/Gu08RtT0nO pic.twitter.com/OX9tUZyuY5
— NatureRevClinOncol (@NatRevClinOncol) May 25, 2023
M-A | Hydrocortisone shows no significant impact on 90-day mortality in septic shock patients
29 May, 2023 | 11:06h | UTCPatient-Level Meta-Analysis of Low-Dose Hydrocortisone in Adults with Septic Shock – NEJM Evidence
AHA Scientific Statement | Basic life support education for schoolchildren
25 May, 2023 | 11:37h | UTCNews Release: Learning to save lives can start as early as age 4, according to new scientific statement – American Heart Association
Top Things to Know: KIDS SAVE LIVES: Basic Life Support Education for Schoolchildren – American Heart Association
WHO Report | Global progress in tackling maternal and newborn deaths stalls since 2015
25 May, 2023 | 11:36h | UTCNews Release: Global progress in tackling maternal and newborn deaths stalls since 2015: UN – World Health Organization
Top studies of 2022 relevant to primary care
25 May, 2023 | 11:34h | UTCTop studies of 2022 relevant to primary care – Canadian Family Physician
Phase 2a RCT | Emodepside demonstrates superior efficacy to albendazole in treating Trichuris trichiura and Hookworm Infection
25 May, 2023 | 11:33h | UTCEmodepside for Trichuris trichiura and Hookworm Infection – New England Journal of Medicine (link to abstract – $ for full-text)
Current recommendations for the management of pediatric diabetic ketoacidosis
25 May, 2023 | 11:31h | UTC
A pragmatic approach to the management of menopause
25 May, 2023 | 11:30h | UTCA pragmatic approach to the management of menopause – Canadian Medical Association Journal
News Release: Managing menopause: Hormone therapy is back – Canadian Medical Association Journal
Consensus Statement | Pre-discharge and early post-discharge management of patients hospitalized for acute heart failure
24 May, 2023 | 13:39h | UTC
Consensus Statement | Worsening of chronic heart failure: definition, epidemiology, management and prevention
24 May, 2023 | 13:38h | UTC
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes
24 May, 2023 | 13:30h | UTC
RCT | Spironolactone enhances acne outcomes and offers a viable alternative to oral antibiotics
24 May, 2023 | 13:27h | UTCSummary: The SAFA (Spironolactone for Adult Female Acne) trial was a multicenter, phase 3, double-blind, randomized controlled trial in England and Wales and evaluated the efficacy of spironolactone for treating adult women with acne vulgaris. A total of 410 women, aged ≥18 years and suffering from facial acne for a minimum of six months, were randomly assigned to receive either 50 mg/day of spironolactone or a placebo, increasing to 100 mg/day until week 24.
The primary outcome was measured by the Acne-Specific Quality of Life (Acne-QoL) symptom subscale score at week 12 and 24. The trial demonstrated that spironolactone improved Acne-QoL scores more effectively than the placebo, particularly at week 24. Additionally, more participants in the spironolactone group reported acne improvement, and treatment success was significantly higher in this group at week 12. Mild side effects, notably headaches, were more common in the spironolactone group.
The findings from the SAFA trial highlight spironolactone’s effectiveness, safety, and tolerability in treating adult women with acne vulgaris, suggesting it is a viable alternative to long-term antibiotic treatments. Future research is proposed on higher initial dosages of spironolactone, and its effects on different subgroups like patients with different ages, body mass index, and ethnicity.
Editorial: What do we know about prescribing spironolactone for acne? – The BMJ
News Release: Non-antibiotic treatment for women with persistent acne shown to be effective – University of Southhampton
Cohort Study | Ambulatory blood pressure more predictive of mortality than clinic blood pressure
24 May, 2023 | 13:19h | UTCSummary: This cohort study analyzed the relationship between clinic and ambulatory blood pressure with mortality. The study utilized data from March 2004 to December 2014, sourced from the Spanish Ambulatory Blood Pressure Registry, which included 59,124 patients from 223 primary care centers across all regions of Spain. Patients were monitored until their date of death or until December 31, 2019.
During a median follow-up of 9.7 years, 7174 (12.1%) patients died, including 2361 (4.0%) due to cardiovascular causes. Findings revealed J-shaped associations for several blood pressure measures. Notably, 24-hour systolic blood pressure had a stronger association with all-cause death (HR 1.41 per 1 SD increment [95% CI 1.36–1.47]) than clinic systolic blood pressure. When adjusted for clinic blood pressure, the association between 24-hour blood pressure and all-cause death remained strong (HR 1.43 [95% CI 1.37–1.49]). Night-time systolic blood pressure was found to be the most predictive of all-cause and cardiovascular death.
The findings imply that ambulatory blood pressure, particularly night-time blood pressure, is more informative about the risk of all-cause death and cardiovascular death than clinic blood pressure. Masked hypertension and sustained hypertension were associated with increased mortality risks, but not white-coat hypertension. These results emphasize the importance of ambulatory blood pressure monitoring in hypertension management and risk prediction. Future research should focus on potential causes and strategies to control night-time blood pressure effectively, considering its substantial association with death risk.
Commentary: Tight Link Between Ambulatory BP and Mortality Affirmed in Revamped Analysis – TCTMD
Perspective | Fake scientific papers are alarmingly common
24 May, 2023 | 13:18h | UTCFake scientific papers are alarmingly common – Science
WHO Report | World health statistics 2023
23 May, 2023 | 13:16h | UTCNews Release: Urgent action needed to tackle stalled progress on health-related Sustainable Development Goals – World Health Organization
Commentary on Twitter (thread – click for more)
📌World Health Statistics 2023 report is out.
It is WHO’s ‘annual check-up on the state of the world’s health’.
⏩New figures on the impact of the #COVID19 pandemic
⏩Latest statistics on progress towards health-related Sustainable Development Goals.
🔗https://t.co/ESpUv3mEh4 pic.twitter.com/i0zrsy0IdH— World Health Organization (WHO) (@WHO) May 19, 2023
WHO Report | 152 million babies born preterm in the last decade
23 May, 2023 | 13:15h | UTCNews Release: 152 million babies born preterm in the last decade – World Health Organization
Report: Born too soon: decade of action on preterm birth – World Health Organization
The Lancet Series | Small vulnerable newborns
23 May, 2023 | 13:13h | UTCNews Release: An estimated 1 million stillbirths and newborn baby deaths could be prevented each year with low-cost solutions – Lancet
Homepage: Small vulnerable newborns – The Lancet (free registration required for all articles)
Small vulnerable newborns—big potential for impact
Biological and pathological mechanisms leading to the birth of a small vulnerable newborn
Guideline | Assessment and early management of head injury
23 May, 2023 | 13:11h | UTCHead injury: assessment and early management – NICE
Commentary: NICE head injury guidelines 2023: Now who do we scan? – St Emilyn’s
Cluster RCT | Single-dose rifapentine reduces 4-year leprosy incidence in household contacts
23 May, 2023 | 13:09h | UTCSingle-Dose Rifapentine in Household Contacts of Patients with Leprosy – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary:
Tuberculosis drug shows protective effect against leprosy – CIDRAP
RCT | Tonsillectomy shown to be clinically and cost-effective in adults with recurrent acute tonsillitis
23 May, 2023 | 13:06h | UTCSummary: The NATTINA trial, a pragmatic multicentre, open-label, randomized controlled study, sought to compare the clinical and cost-effectiveness of conservative management versus tonsillectomy in adults with recurrent acute tonsillitis. Conducted across 27 UK hospitals, 453 participants aged 16 or older were randomly assigned to either undergo immediate tonsillectomy or receive standard non-surgical care.
The main finding was that participants in the immediate tonsillectomy group had fewer days of sore throat over a 24-month period than those in the conservative management group (median 23 vs. 30 days). After adjusting for site and baseline severity, the incident rate ratio of total sore throat days in the immediate tonsillectomy group was significantly lower than in the conservative management group (0.53, 95% CI 0.43 to 0.65, p < 0.0001). The most common adverse event related to tonsillectomy was bleeding, which occurred in 19% of participants.
The NATTINA trial is the largest to date assessing the clinical and cost-effectiveness of tonsillectomy in adults. The results indicate that immediate tonsillectomy is clinically effective and cost-effective for recurrent acute tonsillitis. However, patients should weigh the benefits of fewer sore throat days against the risks of surgery.
News Release: Tonsillectomy both clinically and cost effective for adults – Newcastle University
Commentary on Twitter
Compared with conservative management, immediate tonsillectomy is clinically effective and cost-effective in adults with recurrent acute #tonsillitis, suggests trial. https://t.co/LvSjn6XUx0 pic.twitter.com/yKzH9RqY5J
— The Lancet (@TheLancet) May 18, 2023