Editor's Choice | Page 26 of 113 | Links Medicus Content Curation & Alerts in Medicine

In this French study, the risk of cardiovascular events was similar among recipients of the bivalent Pfizer–BioNTech vaccine and the original monovalent vaccine 21 days after the booster dose. https://t.co/FUZbbsn82I pic.twitter.com/ki0FPeutNm

— NEJM (@NEJM) March 29, 2023

M-A | Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2

4 Apr, 2023 | 13:52h | UTC

Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2: a rapid review with network meta-analysis of diagnostic test accuracy studies – BMC Medicine

Accuracy of rapid point-of-care antigen-based diagnostics for SARS-CoV-2: An updated systematic review and meta-analysis with meta-regression analyzing influencing factors – PLOS Medicine

Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ

Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection – Cochrane Library

Single-arm study | Transcatheter arterialization of deep veins may help avoid amputation in chronic limb-threatening ischemia

3 Apr, 2023 | 14:03h | UTC

Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

New procedure helps patients avoid leg amputation – Vanderbilt University

PROMISE II: Flow-Diverting Procedure May Save Limbs in CLTI – TCTMD

Transcatheter Arterialization Could Revolutionize Treatment of Limb-Threatening Ischemia – HCP Live

Transcatheter Arterialization for Limb Ischemia – American College of Cardiology

Commentary on Twitter

https://twitter.com/NEJM/status/1641192272539824128

AHA Scientific Statement | Pediatric primary hypertension: An underrecognized condition

3 Apr, 2023 | 14:05h | UTC

Pediatric Primary Hypertension: An Underrecognized Condition: A Scientific Statement From the American Heart Association – Hypertension

Top Things to Know: Pediatric Primary Hypertension: An Underrecognized Condition – American Heart Association

News Release: Children with high blood pressure often become adults with high blood pressure – American Heart Association

Commentaries:

The Birth of Pediatric Primary Hypertension – American Heart Association

AHA Highlights Pediatric Hypertension in Scientific Statement – HCP Live

RCT | Comparable efficacy of cefotaxime, ceftriaxone, and ciprofloxacin in treating spontaneous bacterial peritonitis

3 Apr, 2023 | 14:01h | UTC

Summary: This multicenter, prospective, open-label, randomized controlled trial compared the efficacy of cefotaxime, ceftriaxone, and ciprofloxacin as initial treatments for spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. The study included 261 patients aged 16 to 75, with liver cirrhosis, ascites, and a polymorphonuclear cell count of >250/mm3. Researchers performed follow-up paracentesis at 48 hours to evaluate the assigned antibiotics, and assessed resolution rates at 120 and 168 hours of treatment.

The primary endpoint, resolution rates at 120 hours, showed no statistically significant difference between the groups: 67.8% for cefotaxime, 77.0% for ceftriaxone, and 73.6% for ciprofloxacin. One-month mortality rates were also similar. The study concluded that these antibiotics are equally effective as initial treatments for SBP, particularly for community-acquired infections, when administered based on response-guided therapy.

Article: Response-Guided Therapy With Cefotaxime, Ceftriaxone, or Ciprofloxacin for Spontaneous Bacterial Peritonitis: A Randomized Trial: A Validation Study of 2021 AASLD Practice Guidance for SBP – American Journal of Gastroenterology (free for a limited period)

M-A | Mediterranean & low-fat diets may reduce mortality and non-fatal MI in patients with high cardiovascular risk

3 Apr, 2023 | 13:59h | UTC

Summary: This systematic review and network meta-analysis aimed to determine the relative efficacy of different diets for preventing mortality and major cardiovascular events in patients at increased risk of cardiovascular disease. The study identified 40 randomized trials with 35,548 participants across seven dietary programs.

Moderate certainty evidence showed that Mediterranean and low-fat diets, with or without physical activity or other interventions, reduced all-cause mortality and non-fatal myocardial infarction in patients with increased cardiovascular risk. Mediterranean diet programs were also likely to reduce stroke risk.

Other dietary programs generally were not superior to minimal intervention. When compared with one another, no convincing evidence was found that the Mediterranean diet was superior to the low-fat diets in preventing mortality or non-fatal myocardial infarction.

Article: Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis – The BMJ

News Release: Benefits of Mediterranean and low fat diet programmes in patients at risk of cardiovascular disease – BMJ Newsroom

Commentary: Mediterranean, Low-Fat Diets Both Good for Health: Network Meta-analysis – TCTMD

SR | Adding ultrasound to mammography increases breast cancer detection, but increases false-positives and biopsies

3 Apr, 2023 | 13:55h | UTC

Summary: The systematic review examined the effectiveness and safety of combining mammography with breast ultrasonography versus mammography alone for breast cancer screening in women at average risk. The research included one randomized controlled trial, two prospective cohort studies, and five retrospective cohort studies, involving a total of 209,207 women.

High certainty evidence from one trial indicated that combining mammography with ultrasonography led to the detection of more breast cancer cases than mammography alone (5 vs. 3 per 1000 women). However, this combination also led to a higher number of false-positive results and biopsies. For every 1000 women screened with the combined approach, 37 more received a false-positive result, and 27 more women underwent a biopsy.

Secondary analysis of the trial data revealed that in women with dense breasts, the combined screening detected more cancer cases than mammography alone, while cohort studies for women with non-dense breasts showed no statistically significant difference between the two screening methods.

The included studies did not analyze whether the higher number of detected cancers with the combined screening method resulted in lower mortality rates compared to mammography alone. Further research, including randomized controlled trials or prospective cohort studies with longer observation periods, is needed to assess the impact of the two screening interventions on morbidity and mortality.

Article: Mammography in combination with breast ultrasonography versus mammography for breast cancer screening in women at average risk – Cochrane Database of Systematic Reviews

Summary: Mammography followed by ultrasonography compared to mammography alone for breast cancer screening in women at average risk of breast cancer – Cochrane Database of Systematic Reviews

Cohort Study | Infections requiring hospitalization linked to increased short- and long-term cardiovascular risks

3 Apr, 2023 | 13:57h | UTC

Summary: The study examined the association between severe infections and the risk of cardiovascular disease in people without prior cardiovascular issues. Data from 331,683 UK Biobank participants and 271,533 Finnish participants were analyzed. Cardiovascular risk factors were measured at baseline, and infectious diseases and subsequent cardiovascular events were diagnosed through the linkage of participants to hospital and mortality registers.

Results showed that hospitalization for infection was associated with an increased risk of major cardiovascular events, regardless of the type of infection. The risk was highest during the first month after infection, with hazard ratios of 7.87 and 7.64 in the UK Biobank and Finnish cohorts, respectively. However, the risk remained elevated throughout the follow-up period, with hazard ratios of 1.47 in the UK Biobank and 1.41 in the Finnish cohort.

The study suggests that severe infections requiring hospital treatment are associated with increased risks for major cardiovascular disease events both immediately after hospitalization and in the long-term. However, it is important to note that residual confounding cannot be excluded, and further research is needed to establish causality.

Article: Severe Infection and Risk of Cardiovascular Disease: A Multicohort Study – Circulation

Commentary: Severe Infections Linked to a Variety of CV Events, Both Acute and Long-term – TCTMD

Commentary on Twitter

#OriginalResearch: In this multicohort study, hospital-treated infections associated w/ significant increase in short-term risk and modest long-term risk of major CVD events. @MikaKivimaki @nellimarikki@PyrySipila #AHAJournals https://t.co/51JSJkS6l4 pic.twitter.com/U21U2IgYCO

— Circulation (@CircAHA) March 29, 2023

Lateral flow devices maintain detection sensitivity across Alpha, Delta, and Omicron waves

3 Apr, 2023 | 13:53h | UTC

Summary: The study assessed the performance of antigen lateral flow devices (LFDs) during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic in the UK. Researchers aimed to understand LFD performance concerning changes in variant infections, vaccination, viral load, and LFD use, as well as the devices’ ability to detect infectious individuals. Paired LFD and RT-PCR test results were collected from both asymptomatic and symptomatic participants between November 2020 and March 2022.

When compared to RT-PCR testing, the overall LFD sensitivity was 63.2%, and specificity was 99.71%. The sensitivity was higher in symptomatic participants (68.7%) than in asymptomatic participants (52.8%). The study found that increased viral load was independently associated with a higher likelihood of being LFD positive. There was no evidence of a significant difference in LFD sensitivity between the alpha and delta variants, but sensitivity increased during the omicron wave. Vaccination status did not show an independent association with LFD sensitivity.

The study concluded that LFDs can detect most SARS-CoV-2 infections across different viral variants and during vaccine roll-out, contributing to reduced transmission risk. However, LFD performance is lower in asymptomatic individuals, which should be taken into account when designing testing programs.

Article: Performance of antigen lateral flow devices in the UK during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic: a diagnostic and observational study – The Lancet Infectious Diseases

Invited Commentary: The performance of rapid antigen tests against SARS-CoV-2 variants – The Lancet Infectious Diseases

Accuracy of rapid point-of-care antigen-based diagnostics for SARS-CoV-2: An updated systematic review and meta-analysis with meta-regression analyzing influencing factors – PLOS Medicine

Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ

Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection – Cochrane Library

Assessing heart failure risk: waist-to-height ratio outperforms BMI in HFrEF patients

31 Mar, 2023 | 13:49h | UTC

Anthropometric measures and adverse outcomes in heart failure with reduced ejection fraction: revisiting the obesity paradox – European Heart Journal

Editorial: Revisiting the obesity paradox in heart failure: what is the best anthropometric index to gauge obesity? – European Heart Journal

News Release: Study shows ‘obesity paradox’ does not exist: waist-to-height ratio is a better indicator of outcomes in patients with heart failure than BMI – European Society of Cardiology

Commentary: Study Debunks Obesity Paradox in HF, Encourages BMI Alternatives – TCTMD

RCT | Early postpartum IUD placement noninferior vs. placement at 6-8 weeks for complete expulsion, but not for partial expulsion

31 Mar, 2023 | 13:48h | UTC

Early vs Interval Postpartum Intrauterine Device Placement: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

News Release: Study: Risk of IUD Expulsion in Early Postpartum Placement – UC San Diego Health

Commentary: IUD Placement at Two to Four Weeks Postpartum Noninferior – HealthDay

Placement of an intrauterine device within 48 hours after early medical abortion – a randomized controlled trial – American Journal of Obstetrics & Gynecology

Commentary on Twitter

Early IUD placement at 2 to 4 weeks postpartum compared with 6 to 8 weeks postpartum was noninferior for complete expulsion, but not partial expulsion. https://t.co/VMfWce3JJd pic.twitter.com/vdLrhCXa5Q

— JAMA (@JAMA_current) March 23, 2023

M-A | Effects of statin therapy on glycemic control and insulin resistance

31 Mar, 2023 | 13:45h | UTC

Effects of statin therapy on glycemic control and insulin resistance: A systematic review and meta-analysis – European Journal of Pharmacology

Meta-Analysis: Medications that Reduce or Increase the Risk of New Onset Diabetes

Observational Study Points to an Increased Risk of Diabetes Among Patients Using Statins

Another Observational Study Showing Association of Statin Use with Risk of New‐Onset Diabetes Mellitus

Cohort Study: Statin Use Associated with a 38% Higher Risk of Incident Type 2 Diabetes

ICU Burnout Crisis | Meta-analysis reveals over 40% prevalence in medical professionals

30 Mar, 2023 | 14:30h | UTC

High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis – Intensive Care Medicine (if the link is paywalled, try this one)

AAP Clinical Report | Physician health and wellness.

M-A | Physicians suffering burnout are twice as likely to be involved in patient safety incidents.

Systematic Review | Predictors of burnout among healthcare providers.

Prevalence of burnout among GPs: a systematic review and meta-analysis – British Journal of General Practice

Physician Well-being 2.0: Where Are We and Where Are We Going? – Mayo Clinic Proceedings

Consensus Study – Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being – National Academies of Medicine

Assessment of Risk Factors for Suicide Among US Health Care Professionals

Beyond Burnout: Docs Decry ‘Moral Injury’ From Financial Pressures of Health Care

Hospital administration response to physician stress and burnout – Journal of Hospital Practice

Opinion: It’s Time to Talk About Physician Burnout and Moral Injury

Systematic Review: Effect of Organization-Directed Workplace Interventions on Physician Burnout

The 3 Causes Of Physician Burnout (And Why There’s No Simple Solution) – Forbes

Physician Burnout: A Global Crisis

The Burnout Crisis in American Medicine – The Atlantic

To Combat Physician Burnout and Improve Care, Fix the Electronic Health Record – Harvard Business Review

Physician burnout costs up to $17B a year, task force says – HealthcareDive

Systematic Review: Prevalence of Burnout Among Physicians

Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis – International Journal of Environmental Research and Public Health

Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction

Commentary on Twitter

High-level burnout in adult ICUs physicians & nurses, SR/MA
➡️ prevalence > 40% in all #ICU HCWs, 41% physicians/44% nurses
➡️ #COVID19? ⬆️ burnout only in nurses
Preventive/therapeutic measures to improve well-being crucial as a consensual definitio.
🖇️ https://t.co/kUcZ7P9iqz pic.twitter.com/owqC1W5yLu

— Intensive Care Medicine (@yourICM) March 28, 2023

Updated WHO Guidelines | COVID-19 boosters no longer routinely recommended for low-risk groups

30 Mar, 2023 | 14:33h | UTC

Summary: The WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) has revised its COVID-19 vaccination roadmap in light of the Omicron variant and widespread population immunity. The revised roadmap prioritizes protecting those at the highest risk of severe disease and death while maintaining resilient health systems. It introduces cost-effectiveness considerations for vaccinating lower-risk individuals, such as healthy children and adolescents, and presents revised booster dose recommendations.

Priority groups are categorized as high, medium, and low, based on factors like risk of severe disease and death. People in the high-priority group, consisting of older adults, individuals with significant comorbidities or immunocompromising conditions, pregnant persons, and frontline health workers, are advised to receive additional boosters 6 or 12 months after the last dose. The medium priority group, which includes healthy adults without comorbidities and children with comorbidities, is recommended to receive primary series and first booster doses. However, SAGE no longer routinely recommends additional boosters for this group due to limited public health gains.

For the low-priority group, encompassing healthy children and adolescents, vaccination decisions should take into account factors such as disease prevalence and cost-effectiveness. It is important to note that the public health benefits of vaccinating healthy children and adolescents are considerably lower compared to established essential vaccines for children, like rotavirus, measles, and pneumococcal conjugate vaccines.

News Release: SAGE updates COVID-19 vaccination guidance – World Health Organization

Commentaries:

No More COVID-19 Boosters for Healthy People, WHO Experts Recommend – Health Policy Watch

WHO vaccine advisers update COVID vaccine recommendations – CIDRAP

Study suggests no heightened death risk in young people with mRNA vaccines, but ChAdOx1 nCoV-19 vaccine linked to female cardiac deaths

30 Mar, 2023 | 14:28h | UTC

Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England – Nature Communications

Commentary: Expert reaction to ONS data on risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people, England: 8 December 2020 to 25 May 2022 – Science Media Centre

Commentary from the author on Twitter (thread – click for more)

Our latest @NatureComms research: Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England. Led by @Vnafilyan @kamleshkhunti @IsobelLWard et al. https://t.co/oxNdgEAflQ (1/3)

— Prof Amitava Banerjee💙 (@amibanerjee1) March 28, 2023

Opinion | ChatGPT will change Medicine

30 Mar, 2023 | 14:22h | UTC

Chat GPT will change Medicine – Vinay Prasad’s Observations and Thoughts

ChatGPT vs. NCI: analyzing the quality of cancer information on myths and misconceptions

ChatGPT has many uses. Experts explore what this means for healthcare and medical research – The Conversation

Artificial Intelligence in Medicine & ChatGPT: De-Tether the Physician – Journal of Medical Systems (if the link is paywalled, try this one)

Can artificial intelligence help for scientific writing? – Critical Care

Artificial intelligence in academic writing: a paradigm-shifting technological advance

Performance of ChatGPT on USMLE: potential for AI-assisted medical education using large language models

Perspective | ChatGPT-assisted diagnosis: is the future suddenly here?

Perspective | Generating scholarly content with ChatGPT: ethical challenges for medical publishing

ChatGPT: Will It Transform the World of Health Care? – UCSF Department of Medicine

ChatGPT and the future of medical writing (ChatGPT itself wrote this paper)

ChatGPT: five priorities for research – Nature

The path forward for ChatGPT in academia – Lumo’s Newsletter

Nonhuman “Authors” and Implications for the Integrity of Scientific Publication and Medical Knowledge – JAMA

ChatGPT is fun, but not an author – Science

Tools such as ChatGPT threaten transparent science; here are our ground rules for their use – Nature

ChatGPT listed as author on research papers: many scientists disapprove – Nature

Abstracts written by ChatGPT fool scientists

Study shows a slight breast cancer risk increase with progestogen-only birth control, comparable to combined oral methods

29 Mar, 2023 | 13:35h | UTC

Summary: A UK study and meta-analysis examined breast cancer risk linked to hormonal contraceptives, emphasizing progestagen-only contraceptives in premenopausal women. Utilizing a nested case-control design with the Clinical Practice Research Datalink (CPRD), a primary care database, the study included 9,498 women under 50 diagnosed with invasive breast cancer between 1996 and 2017, and 18,171 closely matched controls. The meta-analysis merged CPRD findings with 12 observational studies on progestagen-only preparations.

The results revealed that current or recent use of combined oral contraceptives, oral progestagen-only contraceptives, injectable progestagen, and progestagen intrauterine devices all led to a similar increase in breast cancer risk. The 15-year absolute excess risk associated with five years of oral combined or progestagen-only contraceptive use ranged from 8 per 100,000 users aged 16-20 to 265 per 100,000 users aged 35-39. The study concluded that both contraceptive types were linked to a slight breast cancer risk increase, and these risks must be weighed against the benefits of contraceptive use during childbearing years.

Article: Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis – PLOS Medicine

News Release: Study finds similar association of progestogen-only and combined hormonal contraceptives with breast cancer risk – PLOS

Commentary: Expert reaction to study looking at the association between hormonal contraceptive use and breast cancer incidence – Science Media Centre

M-A | Limited evidence for analgesic effectiveness in acute low back pain treatment

29 Mar, 2023 | 13:32h | UTC

Summary: The objective of this systematic review and network meta-analysis was to assess the effectiveness and safety of various analgesic medicines for treating acute non-specific low back pain. After examining 98 randomized controlled trials with over 15,000 participants, the study found that the quality of evidence for the effectiveness and safety of these medications is low or very low.

Some analgesic medicines showed potential in reducing pain intensity, but the evidence was limited due to trial risk of bias and imprecision in effect estimates. Furthermore, certain medications might increase the risk of adverse events during treatment, with evidence ranging from moderate to very low confidence.

Given the lack of high-quality evidence, clinicians and patients are advised to be cautious when using analgesic medicines for acute non-specific low back pain. More robust head-to-head comparison trials are needed to provide clearer guidance on the best course of treatment.

Article: Comparative effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain: systematic review and network meta-analysis – The BMJ

News Release: Study finds “considerable uncertainty” around effectiveness and safety of analgesics for low back pain – BMJ Newsroom

Commentary from the author on Twitter (thread – click for more)

Out today in @bmj_latest.

We found “considerable uncertainty” around the effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain.

Available at https://t.co/PeOmEOeJyJ

Thread 🧵 pic.twitter.com/T8YDNGhhME

— Michael Wewege, PhD (@mawewege) March 22, 2023

Review | Cerebrovascular manifestations of SARS-CoV-2

29 Mar, 2023 | 13:29h | UTC

Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review – Current Treatment Options in Neurology

Alcohol minimum unit pricing in Scotland led to substantial decrease in alcohol-attributable deaths and hospitalizations

29 Mar, 2023 | 13:28h | UTC

Evaluating the impact of alcohol minimum unit pricing on deaths and hospitalisations in Scotland: a controlled interrupted time series study – The Lancet

News Release: Minimum unit pricing for alcohol associated with a 13% decrease in deaths from alcohol consumption in Scotland – Lancet

Commentaries:

Expert reaction to study looking at alcohol-related deaths and hospitalisations in Scotland since the minimum unit pricing for alcohol policy was introduced – Science Media Centre

Minimum pricing averts alcohol deaths, study claims – BBC

Scotland’s minimum pricing linked to 13% drop in alcohol-related deaths, study finds – The Guardian

Commentary on Twitter (thread – click for more)

Minimum unit pricing for #alcohol was introduced in Scotland in 2018 (50p per unit) with the aim of reducing alcohol consumption in the heaviest drinkers.

A new study analyses the impact of the policy on alcohol-specific hospitalisations and deaths. https://t.co/ehoHjbc8lw

— The Lancet (@TheLancet) March 21, 2023

AHA Scientific Statement | Interpreting incidentally identified variants in genes associated with heritable cardiovascular disease

28 Mar, 2023 | 15:12h | UTC

Interpreting Incidentally Identified Variants in Genes Associated With Heritable Cardiovascular Disease: A Scientific Statement From the American Heart Association – Circulation: Genomic and Precision Medicine

News Release: Genetic tests unexpectedly find genes linked to heart disease — now what? – AHA Newsroom

CDC report reveals escalating Candida auris transmission and resistance in the US

28 Mar, 2023 | 15:10h | UTC

Worsening Spread of Candida auris in the United States, 2019 to 2021 – Annals of Internal Medicine

News Release: Increasing Threat of Spread of Antimicrobial-resistant Fungus in Healthcare Facilities – Centers for Disease Control and Prevention

Commentaries:

CDC reports dramatic increase in US Candida auris cases – CIDRAP

Cases and transmission of highly contagious fungal infections see dramatic increase between 2019 and 2021 – American College of Physicians

An emerging fungal threat spread at an alarming rate in US health care facilities, study says – CNN

Case reports: Multidrug-resistant Candida auris infections in critically ill Covid-19 patients

Candida auris: A Review of Recommendations for Detection and Control in Healthcare Settings

Global Epidemiology of Emerging Candida Auris (reviews and commentaries on the subject)

The superbug Candida auris is giving rise to warnings — and big questions – STAT

Candida Auris – “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy” (reviews and commentaries on the subject)

Commentary on Twitter

New Annals of Internal Medicine study finds cases of deadly fungus, Candida auris, rose drastically between 2019 and 2021. Increase included treatment resistant strains: https://t.co/J3SkmfWDr5 @CDCgov pic.twitter.com/ZJBRqMIOy1

— Annals of Int Med (@AnnalsofIM) March 21, 2023