Editor's Choice
SR | Ultrasound‐guided arterial cannulation in the pediatric population
7 Mar, 2023 | 13:15h | UTCSummary:
This updated systematic review analyzed nine randomized controlled trials comparing ultrasound guidance to traditional methods of locating arteries for cannulation, such as palpation and Doppler auditory assistance.
The review found that ultrasound guidance probably improves first-attempt success rates, reduces the risk of complications such as hematoma formation, improves success rates within two attempts and the overall rate of successful cannulation, and reduces the number of attempts and duration of the cannulation procedure.
However, the review also notes that the evidence is only of moderate certainty due to the inability to mask the doctors performing the cannulation and the limited number of children studied. More research is needed to confirm the benefits of ultrasound guidance for arterial cannulation in different age groups of children.
Article: Ultrasound‐guided arterial cannulation in the paediatric population – Cochrane Library
Summary: Ultrasound use for insertion of arterial catheters in children – Cochrane Library
RCT | Study finds both one-food and six-food elimination diets are effective initial options for eosinophilic esophagitis
7 Mar, 2023 | 13:17h | UTCSummary:
The article describes a multicenter randomized trial that compared the effectiveness of a one-food elimination diet (1FED – eliminating animal milk) versus a six-food elimination diet (6FED – eliminating animal milk, wheat, egg, soy, fish and shellfish, and peanut and tree nuts) for treating eosinophilic esophagitis in adults.
The study found that both diets were equally effective at achieving histological remission, although the 6FED resulted in a higher proportion of patients achieving complete remission. Patients who did not achieve histological remission with the 1FED could proceed to the 6FED, and 43% had histological remission. For those without response to the 6FED, topical fluticasone propionate induced remission in 82%.
Overall, the study suggests that eliminating animal milk alone is an acceptable initial dietary therapy for eosinophilic esophagitis.
Article: One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial – The Lancet Gastroenterology & Hepatology (link to abstract – $ for full-text)
News Release: Forgoing one food treats eosinophilic esophagitis as well as excluding six – National Institutes of Health
Related: M-A | Efficacy of elimination diets in eosinophilic esophagitis
Commentary on Twitter
New research – Kliewer et al – One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial https://t.co/Tpm0EPPfx0#EoE #GItwitter #RareDiseaseDay #CEGIR pic.twitter.com/iUcqIt9Pg5
— The Lancet Gastroenterology & Hepatology (@LancetGastroHep) February 28, 2023
Myocarditis or pericarditis events after BNT162b2 vaccination in individuals aged 12 to 17 years in Ontario, Canada
7 Mar, 2023 | 13:13h | UTCSummary:
A population-based cohort study was conducted to estimate the incidence of reported myocarditis or pericarditis after BNT162b2 vaccination in adolescents aged 12 to 17 years in Ontario, Canada, and to describe the clinical information associated with these events. The study analyzed data from 1.65 million doses of BNT162b2 vaccinations administered between December 14, 2020, and November 21, 2021.
According to the study, 77 adolescents were reported to have developed myocarditis or pericarditis after receiving the vaccine, and there was a greater occurrence of these events among those aged 16 to 17 years compared to those aged 12 to 15 years. Additionally, adolescents with shorter intervals between vaccine doses had a higher incidence of myocarditis or pericarditis.
Most cases of myocarditis and pericarditis were mild, and the adolescents required either no treatment or were treated conservatively with nonsteroidal anti-inflammatory drugs.
Perspective | Artificial intelligence in medicine & ChatGPT: de-tether the physician
7 Mar, 2023 | 13:10h | UTCArtificial Intelligence in Medicine & ChatGPT: De-Tether the Physician – Journal of Medical Systems (if the link is paywalled, try this one)
Related:
Can artificial intelligence help for scientific writing? – Critical Care
Artificial intelligence in academic writing: a paradigm-shifting technological advance
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
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
ChatGPT has many uses. Experts explore what this means for healthcare and medical research
7 Mar, 2023 | 13:11h | UTCRelated:
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
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
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
Review | Acquired disorders of hypomagnesemia
7 Mar, 2023 | 13:09h | UTCAcquired Disorders of Hypomagnesemia – Mayo Clinic Proceedings
CDC Interim Guidance | Treatment considerations for severe manifestations of Mpox
7 Mar, 2023 | 13:08h | UTCCommentary: CDC recommendations and clinical considerations for the treatment of severe Mpox – News Medical
Update on current contraceptive options | A case-based discussion of efficacy, eligibility, and use
7 Mar, 2023 | 13:06h | UTC
Report | Economic impact of overweight and obesity to surpass $4 trillion by 2035
6 Mar, 2023 | 14:32h | UTCSummary:
A recent report from the World Obesity Federation has issued a warning that the number of people worldwide suffering from overweight or obesity could increase significantly by 2035, surpassing the 50% mark. The report, called the World Obesity Atlas 2023, also highlights the significant economic impact of this trend, estimating that the cost of overweight and obesity could reach $4.32tn annually by 2035, equivalent to almost 3% of the global GDP.
The report also identifies two groups that are particularly at risk: children and individuals from lower-income countries. Childhood obesity is a growing concern, as the report predicts it could double by 2035. Additionally, lower-income countries face a rapid increase in obesity prevalence, with nine out of 10 countries with the greatest expected increases in obesity coming from low or lower-middle income countries.
Report: World Obesity Atlas 2023
News release: Economic impact of overweight and obesity to surpass $4 trillion by 2035
Commentary: Report: Obesity could cost the world over $4 trillion a year by 2035 – STAT
Related:
Report: Tenfold increase in childhood and adolescent obesity in four decades
Global cost of obesity-related illness to hit $1.2tn a year from 2025
The Lancet Series: The Double Burden of Malnutrition
BTS Clinical Guidance | Aspiration pneumonia
6 Mar, 2023 | 14:36h | UTCBTS clinical statement on aspiration pneumonia – Thorax
BTS Clinical Guidance | Prevention and management of community-acquired pneumonia in people with learning disability
6 Mar, 2023 | 14:34h | UTC
#ACC23 – RCT | Transcatheter repair for patients with tricuspid regurgitation
6 Mar, 2023 | 14:29h | UTCTranscatheter Repair for Patients with Tricuspid Regurgitation – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
The TRILUMINATE Transcatheter Tricuspid Repair Trial: Positive but No Benefit? – Medscape (recommended reading – free registration required)
TRILUMINATE Pivotal: TEER With the TriClip Benefits Patients With Severe TR – TCTMD
Commentary on Twitter
In the TRILUMINATE trial, patients with tricuspid regurgitation who were treated with transcatheter edge-to-edge repair had more favorable clinical outcomes at 1 year than did patients who received medical therapy. Full trial results: https://t.co/ZWObb9Xl6T #ACC23/#WCCardio pic.twitter.com/O2E9QSumpQ
— NEJM (@NEJM) March 4, 2023
RCT | Hydrochlorothiazide is not effective for the prevention of kidney-stone recurrence
6 Mar, 2023 | 14:26h | UTCSummary:
This study aimed to assess the effectiveness of hydrochlorothiazide, a thiazide diuretic, in preventing the recurrence of calcium-containing kidney stones. The trial randomly assigned 416 patients with recurrent kidney stones to receive hydrochlorothiazide at a dose of 12.5 mg, 25 mg, or 50 mg once daily, or a placebo once daily, and followed them for a median of 2.9 years.
The results showed that the incidence of kidney stone recurrence did not differ significantly between the hydrochlorothiazide and placebo groups, regardless of the dose. Furthermore, patients who received hydrochlorothiazide were more likely to experience side effects such as hypokalemia, gout, new-onset diabetes mellitus, skin allergy, and a plasma creatinine level exceeding 150% of the baseline level.
Therefore, the effectiveness of hydrochlorothiazide in preventing kidney stone recurrence may be limited, and the common practice of prescribing it for these patients should be reevaluated.
Article: Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence – New England Journal of Medicine (link to abstract – $ for full-text)
Video Summary: Hydrochlorothiazide and Kidney-Stone Recurrence | NEJM
Commentary: Hydrochlorothiazide and Prevention of Kidney Stones – NEJM Resident 360
#ACC23 – RCT | Five-year follow-up after transcatheter repair of secondary mitral regurgitation
6 Mar, 2023 | 14:28h | UTCFive-Year Follow-up after Transcatheter Repair of Secondary Mitral Regurgitation – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
COAPT at 5 Years: MitraClip Still Ahead, but Deaths and Crossovers Cast Shadows – TCTMD
Commentary on Twitter
Transcatheter repair of secondary mitral regurgitation for heart failure was associated with a lower rate of hospitalization for heart failure and lower all-cause mortality than medical therapy at 5 years of follow-up.
Full COAPT trial: https://t.co/rcJ6RQEMAX #ACC23/#WCCardio pic.twitter.com/sM8R50oaBq
— NEJM (@NEJM) March 5, 2023
RCT | Antipsychotic association seems better than antidepressant switch in treatment-resistant geriatric depression
6 Mar, 2023 | 14:23h | UTCSummary:
This open-label randomized trial compared the benefits and risks of augmenting therapy vs. switching antidepressants in older adults with treatment-resistant depression. In the first step, 619 patients were randomly assigned to augmentation of existing antidepressant medication with aripiprazole (an antipsychotic), augmentation with bupropion, or a switch from existing antidepressant medication to bupropion. In step 2, 248 patients who did not benefit from or were ineligible for step 1 were randomly assigned to augmentation with lithium or a switch to nortriptyline.
The aripiprazole-augmentation group showed significant improvement in well-being compared to the switch-to-bupropion group. Remission occurred in 28.9% of patients in the aripiprazole-augmentation group, 28.2% in the bupropion-augmentation group, and 19.3% in the switch-to-bupropion group. In step 2, similar remission rates occurred in the lithium-augmentation group (18.9%) and the switch-to-nortriptyline group (21.5%).
Article: Antidepressant Augmentation versus Switch in Treatment-Resistant Geriatric Depression – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
#AAGPAM23: In a pragmatic trial involving older persons with treatment-resistant depression, augmentation of existing antidepressants with aripiprazole was better than augmentation with bupropion or a switch to bupropion. Full results of the OPTIMUM trial: https://t.co/2OPOxH67Qx pic.twitter.com/g0AtrYGhKV
— NEJM (@NEJM) March 3, 2023
Cluster RCT | Effectiveness of a non-physician community health-care provider-led intensive BP intervention vs. usual care on CVD
6 Mar, 2023 | 14:20h | UTCSummary:
The study evaluated the effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention on cardiovascular disease compared to usual care. The trial randomly assigned 326 villages to the intervention or usual care, and recruited individuals aged at least 40 years with hypertension. Trained non-physician community health-care providers initiated and titrated antihypertensive medications according to a simple stepped-care protocol and delivered health coaching for patients in the intervention group during the 36-month follow-up.
The study found that the intervention effectively reduced the risk of cardiovascular disease and all-cause death. There was a significant reduction in systolic blood pressure (23.1 mm Hg) and diastolic blood pressure (9.9 mm Hg) in the intervention group compared to the usual care group, with an increased risk of hypotension in the intervention group.
Article: Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trial – The Lancet (link to abstract – $ for full-text)
Related:
Cohort Study: Impact of Community Based Screening for Hypertension in Older Adults
Randomized Trial: Community-Based Interventions to Improve Cardiovascular Risk in High-Risk Patients
Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops
Perspective | Why functional neurological disorder is not feigning or malingering
6 Mar, 2023 | 14:17h | UTCWhy functional neurological disorder is not feigning or malingering – Nature Reviews Neurology (free for a limited period)
Perspective | Diagnostic stewardship to prevent diagnostic error
6 Mar, 2023 | 14:18h | UTCDiagnostic Stewardship to Prevent Diagnostic Error – JAMA (free for a limited period)
Commentary on Twitter
This #Viewpoint discusses diagnostic stewardship and its uses and challenges in preventing diagnostic error. https://t.co/VtiqHsrlwU pic.twitter.com/Q0VVOPCrF2
— JAMA (@JAMA_current) March 2, 2023
ACG Guideline | Diagnosis and management of biliary strictures
3 Mar, 2023 | 14:13h | UTC
Estimates and projections of the global economic cost of 29 cancers in 204 countries and territories from 2020 to 2050
3 Mar, 2023 | 14:09h | UTCSummary: The study aimed to estimate the global economic cost and distribution of 29 cancers in 204 countries and territories from 2020 to 2050. The study’s findings suggest that the global economic cost of cancers from 2020 to 2050 is estimated at $25.2 trillion. The five cancers with the highest financial costs are tracheal, bronchus, and lung cancer; colon and rectum cancer; breast cancer; liver cancer; and leukemia. China and the US face the highest economic costs, and the financial and health burdens are distributed unequally across countries, world regions, and country income groups.
News Release: The price of cancer – International Institute for Applied Systems Analysis
Commentary on Twitter
The estimated global economic cost of cancers in 2020–2050 is $25.2 trillion, or $2,857 per capita. Global efforts to curb the health and economic burden of cancers are urgently warranted. https://t.co/xAMOGX3Dtl
— JAMA Oncology (@JAMAOnc) February 23, 2023
Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews
3 Mar, 2023 | 14:11h | UTCSummary: This umbrella review summarized the evidence on the effects of physical activity interventions on symptoms of depression, anxiety, and psychological distress in adult populations. The study included 97 systematic reviews comprising 1039 randomized controlled trials and 128,119 participants. The results showed that physical activity had medium effects on depression, anxiety, and psychological distress compared to usual care across all populations. Higher-intensity physical activity was associated with greater improvements in symptoms, and the effectiveness of physical activity interventions diminished with longer-duration interventions. The authors concluded that physical activity is highly beneficial for improving symptoms of depression, anxiety, and distress in a wide range of adult populations, including those with mental health disorders and chronic diseases, and should be a mainstay approach in their management.
Article: Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews – British Journal of Sports Medicine (link to abstract – $ for full-text)
News Release: Exercise more effective than medicines to manage mental health – University of South Australia
Commentary from the authors: Exercise is even more effective than counselling or medication for depression. But how much do you need? – The Conversation
Commentary on Twitter
📣 Effectiveness of #PhysicalActivity for improving depression, anxiety and distress: an overview of #SystematicReviews 🔎📄#KeyPoints:
🧠Higher intensity = greater improvements 🏋️♂️
🧠 Effect diminished with longer duration interventions 📉👉 https://t.co/UJRRFVz7eG pic.twitter.com/5JT9xEVMsa
— British Journal of Sports Medicine (BJSM) (@BJSM_BMJ) February 19, 2023
An overview of systematic reviews and meta-analyses on the effect of medication interventions targeting polypharmacy for frail older adults
3 Mar, 2023 | 14:07h | UTCSummary: This overview of published systematic reviews examined the effectiveness of medication reviews on managing polypharmacy in frail older adults. The overview identified 10 systematic reviews, which included 154 studies. Medication reviews were the most common intervention, and the evidence suggests that they help reduce inappropriate medication use in frail older adults, but their impact on frailty scores and hospital admission is unclear. Pharmacist-led medication interventions were the most common, reducing inappropriate prescriptions in various settings. Tools, such as clinical decision-making computer support tools, were also found to be effective. The evidence quality ranged from moderate to critically low, highlighting the need for further research to establish if interventions directed at polypharmacy could have an impact on frailty syndromes.
Related:
RCT | A deprescribing intervention reduced medication burden among older adults in post-acute care
Deprescribing proton pump inhibitors – Australian Journal of General Practice
Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports
Deprescribing in Palliative Cancer Care – Life
Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360
Polypharmacy Management in Older Patients – Mayo Clinic Proceedings
Eliminating Medication Overload: A National Action Plan – Lown Institute
Common ED Medication Errors: Polypharmacy – emDocs
Current and future perspectives on the management of polypharmacy – BMC Family Practice
Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international
Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety
Perspective | The other long Covid: the pandemic took young people’s present. What will it do to their future?
3 Mar, 2023 | 14:05h | UTC
RCT | Reducing social media use improves appearance and weight esteem in youth with emotional distress
3 Mar, 2023 | 14:04h | UTCSummary: The article discusses a randomized controlled trial conducted on 220 participants aged 17-25 to examine the effects of reducing smartphone social media use (SMU) on appearance and weight esteem in youth with emotional distress. The participants were divided into an intervention group (limited to 1 hr/day SMU) and a control group (unrestricted SMU). The study found that reducing SMU improved appearance and weight esteem in the intervention group, while the control group showed no significant change. The authors concluded that reducing SMU may be a feasible and effective method of improving body image in a vulnerable youth population and should be evaluated as a potential component in treating body image-related disturbances. It is worth noting, however, that the impossibility of blinding participants and the subjective nature of the endpoints make it difficult to draw definitive conclusions on the subject.
News Release: Reducing social media use significantly improves body image in teens, young adults – American Psychological Association
Commentary: How to help young people limit screen time — and feel better about how they look – NPR
The European guideline on management of major bleeding and coagulopathy following trauma
2 Mar, 2023 | 13:04h | UTC