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ACC/AHA Multimodality appropriate use criteria for the detection and risk assessment of chronic coronary disease

29 May, 2023 | 11:18h | UTC

ACC/AHA/ASE/ASNC/ASPC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2023 Multimodality Appropriate Use Criteria for the Detection and Risk Assessment of Chronic Coronary Disease – Journal of the American College of Cardiology

Commentaries:

New Multimodality AUC Address Detection and Risk Assessment of Chronic Coronary Disease – American College of Cardiology

2023 Multimodality Appropriate Use Criteria for Chronic Coronary Disease: Key Points – American College of Cardiology

 

Commentary on Twitter

 

AHA/ASA Guideline for the management of patients with aneurysmal subarachnoid hemorrhage

29 May, 2023 | 11:16h | UTC

2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association – Stroke

Top Things to Know: 2023 Aneurysmal Subarachnoid Hemorrhage Guideline – American Heart Association

 

Commentary on Twitter

 

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 | UTC

Reducing 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 | UTC

Intervention 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 | UTC

Airway-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 | UTC

Mitigating 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

 

M-A | Hydrocortisone shows no significant impact on 90-day mortality in septic shock patients

29 May, 2023 | 11:06h | UTC

Patient-Level Meta-Analysis of Low-Dose Hydrocortisone in Adults with Septic Shock – NEJM Evidence

News Release: Study examines the role of hydrocortisone in the management of adult patients with septic shock – University of California San Francisco Medical Center/News Medical

 

AHA Scientific Statement | Basic life support education for schoolchildren

25 May, 2023 | 11:37h | UTC

KIDS SAVE LIVES: Basic Life Support Education for Schoolchildren: A Narrative Review and Scientific Statement From the International Liaison Committee on Resuscitation – Circulation

News 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 | UTC

News Release: Global progress in tackling maternal and newborn deaths stalls since 2015: UN – World Health Organization

Report: Improving maternal and newborn health and survival and reducing stillbirth – Progress report 2023 – World Health Organization

 

Top studies of 2022 relevant to primary care

25 May, 2023 | 11:34h | UTC

Top 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 | UTC

Emodepside 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

Current recommendations for management of paediatric diabetic ketoacidosis – Paediatrics & Child Health

 

A pragmatic approach to the management of menopause

25 May, 2023 | 11:30h | UTC

A 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

Pre-discharge and early post-discharge management of patients hospitalized for acute heart failure: a scientific statement by the Heart Failure Association (HFA) of the ESC – European Journal of Heart Failure

 

Consensus Statement | Worsening of chronic heart failure: definition, epidemiology, management and prevention

24 May, 2023 | 13:38h | UTC

Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association (HFA) of the ESC – European Journal of Heart Failure

 

Guidelines on the diagnosis and treatment of foot infection in persons with diabetes

24 May, 2023 | 13:30h | UTC

Guidelines on the diagnosis and treatment of foot infection in persons with diabetes – International Working Group on the Diabetic Foot

 

RCT | Spironolactone enhances acne outcomes and offers a viable alternative to oral antibiotics

24 May, 2023 | 13:27h | UTC

Summary: 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.

Article: Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial – The BMJ

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 | UTC

Summary: 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.

Article: Relationship between clinic and ambulatory blood pressure and mortality: an observational cohort study in 59 124 patients – The Lancet

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 | UTC

Fake scientific papers are alarmingly common – Science

 

WHO Report | World health statistics 2023

23 May, 2023 | 13:16h | UTC

World health statistics 2023: monitoring health for the SDGs, sustainable development goals – World Health Organization

News Release: Urgent action needed to tackle stalled progress on health-related Sustainable Development Goals – World Health Organization

 

Commentary on Twitter (thread – click for more)

 

WHO Report | 152 million babies born preterm in the last decade

23 May, 2023 | 13:15h | UTC

News 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 | UTC

News 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

Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting

Biological and pathological mechanisms leading to the birth of a small vulnerable newborn

Evidence-based antenatal interventions to reduce the incidence of small vulnerable newborns and their associated poor outcomes

The ethical, economic, and developmental imperative to prevent small vulnerable newborns and stillbirths: essential actions to improve the country and global response

 

Guideline | Assessment and early management of head injury

23 May, 2023 | 13:11h | UTC

Head 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 | UTC

Single-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

Study: Giving an antibiotic to household contacts of people with leprosy slashes chances of spread – STAT

 

RCT | Tonsillectomy shown to be clinically and cost-effective in adults with recurrent acute tonsillitis

23 May, 2023 | 13:06h | UTC

Summary: 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.

Article: Conservative management versus tonsillectomy in adults with recurrent acute tonsillitis in the UK (NATTINA): a multicentre, open-label, randomised controlled trial – The Lancet

News Release: Tonsillectomy both clinically and cost effective for adults – Newcastle University

 

Commentary on Twitter

 

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