Editor's Choice
M-A | Consumption of whole vs. refined grains and risk of cardiovascular disease and all-cause mortality
20 Feb, 2023 | 12:23h | UTCSummary: This systematic review and meta-analysis of prospective cohort studies found that consuming whole grains was associated with a reduced risk of coronary heart disease, cardiovascular disease, and all-cause mortality, while consuming refined grains had no significant influence on these outcomes. Residual confounding can’t be excluded and the association found does not necessarily imply causation.
Phase 2b RCT | Ad26.RSV.preF–Respiratory Syncytial Virus preF protein vaccine is immunogenic in older adults
17 Feb, 2023 | 13:30h | UTCSummary: A phase 2b clinical trial evaluated the Ad26.RSV.preF–RSV preF protein vaccine’s efficacy, immunogenicity, and safety in preventing RSV-mediated lower respiratory tract disease in adults aged 65 years and older. The vaccine was effective in preventing the disease and immunogenic, as demonstrated by the increase in RSV A2 neutralizing antibody titers after vaccination. The vaccine was associated with higher rates of adverse events than the placebo, but most were of mild to moderate severity. The trial concluded that Ad26.RSV.preF–RSV preF protein vaccine was effective in preventing RSV-mediated lower respiratory tract disease in older adults.*
Article: Efficacy and Safety of an Ad26.RSV.preF–RSV preF Protein Vaccine in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Ad26.RSV.preF-RSV preF Protein Vaccine Immunogenic in Seniors – HealthDay
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Respiratory Syncytial Virus prefusion F protein vaccine provides protection for older adults
17 Feb, 2023 | 13:32h | UTCSummary: A phase 2b clinical trial evaluated the Ad26.RSV.preF–RSV preF protein vaccine in adults aged 65 years and older. The vaccine was effective and immunogenic, as demonstrated by the increase in RSV A2 neutralizing antibody titers after vaccination. The vaccine was associated with higher rates of adverse events than the placebo, but most were of mild to moderate severity.*
Article: Respiratory Syncytial Virus Prefusion F Protein Vaccine in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Respiratory syncytial virus causes clinically significant illness in children and adults. In a placebo-controlled trial, a prefusion stabilized F protein vaccine led to an 83% lower risk of RSV infection. https://t.co/aU9BV0LXBU pic.twitter.com/0zy1hu0VH6
— NEJM (@NEJM) February 15, 2023
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Evaluation of BNT162b2 Covid-19 vaccine in children younger than 5 years of age
17 Feb, 2023 | 13:27h | UTCSummary: The study was a combined phase 2-3 clinical trial that aimed to determine whether the BNT162b2 vaccine was safe, could elicit an immune response and was effective in preventing COVID-19 in healthy children. The trial was conducted on children aged 6 months to 11 years, with the findings presented for the 6 months to 4 years age group. The results indicated that the vaccine was safe, immunogenic, and effective in reducing the risk of symptomatic COVID-19 by 73.2% in children aged 6 months to 4 years. The vaccine was well-tolerated, and the side effects were mainly mild to moderate. The incidence of fever was similar among those who received the vaccine or a placebo.*
Article: Evaluation of BNT162b2 Covid-19 Vaccine in Children Younger than 5 Years of Age – New England Journal of Medicine (link to abstract – $ for full-text)
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Breast-conserving surgery without irradiation may be an option for older patients with early breast cancer
17 Feb, 2023 | 13:25h | UTCSummary: The article reports a phase 3 randomized trial that investigated the efficacy of omitting irradiation after breast-conserving surgery in women aged 65 years or older with hormone receptor-positive, node-negative, T1 or T2 primary breast cancer, and tumors ≤3 cm in the largest dimension, who received adjuvant endocrine therapy. A total of 1326 women were enrolled, with 658 receiving whole-breast irradiation and 668 receiving no irradiation. The results showed that the omission of radiotherapy led to an increased incidence of local breast cancer recurrence but had no negative effect on distant recurrence as the first event or overall survival. The study suggests that omission of radiotherapy could be a viable treatment option for older women with low-risk, hormone receptor–positive early breast cancer who receive adjuvant endocrine therapy.*
Article: Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
For many older breast cancer patients, study finds radiation doesn’t affect survival – STAT
Do Older Patients Need Radiation Rx After Breast Cancer Surgery? – HealthDay
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
M-A | Financial toxicity among patients with breast cancer worldwide
17 Feb, 2023 | 13:20h | UTCCommentary: Breast Cancer Treatment Is Associated With Financial Toxicity Worldwide, Study Finds – AJMC
Related:
Not Just Nausea And Vomiting: Cancer Docs Now Worry About ‘Financial Toxicity’ – WBUR
Financial Toxicity and Cancer Treatment (PDQ®) – National Institute of Cancer
Commentary on Twitter
Financial toxicity for patients with breast cancer (pooled): 78% in LMICs and 35% in HICs; much higher than other health conditions, including other cancers. Policies to address this huge burden are critical to improve financial and health outcomes. https://t.co/eaB7nCvurU
— JAMA Network Open (@JAMANetworkOpen) February 9, 2023
M-A | Aspirin with or without statin in individuals without atherosclerotic CVD across risk categories
17 Feb, 2023 | 13:22h | UTCSummary: This meta-analysis examined the effects of aspirin in adults without atherosclerotic cardiovascular disease (ASCVD), stratified by statin use across different ASCVD risks. The analysis found that aspirin reduced myocardial infarction but increased major bleeding, and was not associated with total or cardiovascular survival benefits. In adults without ASCVD, concomitant statin appeared to significantly reduce absolute risk reduction for MI associated with aspirin without influencing bleeding risk. The study highlights that the risk-benefit equilibrium may be tilted towards more harm for primary prevention, and that the expected absolute risk of major bleeding exceeds absolute MI benefits by aspirin for every level of ASCVD risk. The findings have implications for the use of aspirin in those already on statin therapy for primary ASCVD prevention.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Perspective | Choosing the right path toward polio eradication
17 Feb, 2023 | 13:18h | UTCChoosing the Right Path toward Polio Eradication – New England Journal of Medicine
M-A | Association between antimicrobial stewardship programs and antibiotic use globally
16 Feb, 2023 | 15:21h | UTCCommentaries:
Antimicrobial Stewardship Programs Beneficial for Cutting Antibiotic Use – HealthDay
RCT | Rivaroxaban shows promise compared to Enoxaparin in the acute phase of an acute coronary syndrome
16 Feb, 2023 | 15:20h | UTCInvited Commentary: Rivaroxaban for Patients With Acute Coronary Syndromes—Where Do We Stand? – JAMA Network Open
Commentary on Twitter
The H-REPLACE RCT: short-term rivaroxaban (5mg 2x/day) was noninferior to enoxaparin in safety + efficacy during 6-month follow-up among patients with acute coronary syndrome who missed the primary reperfusion window and before selective revascularization. https://t.co/TIHOwGSWjJ
— JAMA Network Open (@JAMANetworkOpen) February 10, 2023
Guideline | Diagnosis and management of subarachnoid hemorrhage caused by a ruptured aneurysm
16 Feb, 2023 | 15:23h | UTC
RCT | Laser treatment does not improve sexual dysfunction in survivors of breast cancer
16 Feb, 2023 | 15:19h | UTCInvited commentary: Genitourinary Syndrome of Menopause and the False Promise of Vaginal Laser Therapy – JAMA Network Open
Related:
RCT | Laser no better than sham treatment for genitourinary syndrome of menopause
M-A | Carbon dioxide laser vs. vaginal estrogen for genitourinary syndrome of menopause.
Perspective: From vaginal laser treatment to spa breaks – it’s the great menopause gold rush.
Commentary on Twitter
The LIGHT Trial RCT: Vaginal laser therapy does not improve sexual dysfunction/genitourinary syndrome of menopause in breast cancer survivors receiving aromatase inhibitors when added to first line therapy based on moisturizers and vibrator stimulation. https://t.co/jdVDgHe9HC
— JAMA Network Open (@JAMANetworkOpen) February 10, 2023
Regulations on palliative sedation: an international survey across eight European countries
16 Feb, 2023 | 15:17h | UTC
RCT | Adjuvant nivolumab plus ipilimumab not better than placebo for localized renal cell carcinoma after nephrectomy
16 Feb, 2023 | 15:15h | UTCAdjuvant nivolumab plus ipilimumab versus placebo for localised renal cell carcinoma after nephrectomy (CheckMate 914): a double-blind, randomised, phase 3 trial – The Lancet (link to abstract – $ for full-text)
Hidden harms of indoor air pollution — five steps to expose them
16 Feb, 2023 | 15:13h | UTCHidden harms of indoor air pollution — five steps to expose them – Nature
Commentary on Twitter
Dirty outdoor air might grab the headlines, but learning how pollutants inside buildings form, accumulate and affect our health is equally crucial, argue Alastair Lewis, Deborah Jenkins and @CMO_England in a @Nature Comment article. https://t.co/C8MrWEwfE2
— Nature Portfolio (@NaturePortfolio) February 8, 2023
Excess mortality among US physicians during the COVID-19 pandemic
16 Feb, 2023 | 15:14h | UTCExcess Mortality Among US Physicians During the COVID-19 Pandemic – JAMA Internal Medicine
Commentaries:
More than 600 US doctors died than expected early in COVID pandemic – CIDRAP
Hundreds of U.S. Doctors Lost Their Lives During Pandemic – HealthDay
Commentary on Twitter
From March 2020 to December 2021, US physicians experienced over 600 more deaths than expected, but substantially fewer than the US general population. Older physicians who provide direct patient care were at the highest risk. https://t.co/7Un0h7VC8X
— JAMA Internal Medicine (@JAMAInternalMed) February 8, 2023
Rare, overlooked, or underappreciated causes of recurrent abdominal pain: a primer for gastroenterologists
16 Feb, 2023 | 15:12h | UTC
Commentary from the author on Twitter
Our paper in @AGA_CGH looking at Rare, Overlooked, or Underappreciated Causes of Recurrent Abdominal Pain: A Primer for Gastroenterologists
Thanks to @umfoodoc @dbrennerGIMD and my mentor #DrBrandt @MonteGastro for including me in this important work https://t.co/91MKLqvgLy pic.twitter.com/HcHiRehhNI
— Marc Fenster (@Marcfenster1) September 28, 2022
M-A | Blood pressure lowering effects of B-blockers as add-on or combination therapy
16 Feb, 2023 | 15:10h | UTC
Guideline Synopsis | The use of opioids in the management of chronic pain
15 Feb, 2023 | 16:16h | UTCSummary: The VA/DoD guideline for chronic pain management recommends non-opioid treatments, such as cognitive-behavioral and physical therapy, with opioid use reserved for specific circumstances. Mental health evaluations are emphasized, along with regular treatment reassessments. Opioid use is not recommended due to small benefits outweighed by risks, but if used, buprenorphine is suggested due to a lower risk profile. Screening for mood disorders and traumatic brain injury is also advised, although evidence for risk mitigation strategies is lacking.*
Commentary: Initiation of Opioids Not Recommended for Chronic Pain – HealthDay
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
USPSTF reaffirms recommendation against serologic screening for genital herpes infection
15 Feb, 2023 | 16:17h | UTCSummary: The US Preventive Services Task Force (USPSTF) recommends against routine screening for genital herpes infection in asymptomatic adolescents, adults, and pregnant women, as the potential harms of such screening outweigh the benefits. This recommendation is based on a systematic evaluation of the available evidence, and the USPSTF has moderate certainty in its conclusion.*
Evidence Report: Serologic Screening for Genital Herpes: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA
Editorials:
Reducing HSV-2 Morbidity and MortalityRoutine Serologic Screening Still Not the Best Answer – JAMA
Reaffirmed USPSTF Recommendation Against Serologic Screening for Genital Herpes: Empowering Clinicians and Reducing Potential Harm – JAMA Dermatology (free for a limited period)
Author Interview: Serologic Screening for Genital Herpes Infection – JAMA
JAMA Patient Page: Screening for Genital Herpes
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
AHA Statement | Optimizing prepregnancy cardiovascular health improves outcomes for pregnant women, offspring
15 Feb, 2023 | 16:14h | UTCSummary: This statement highlights the need to optimize cardiovascular health before pregnancy to reduce the risk for adverse pregnancy outcomes and cardiovascular disease in mothers and children. It emphasizes the role of clinicians in promoting early cardiovascular health, clinical trials to investigate interventions, and the use of a life course framework to monitor health. By targeting cardiovascular health before pregnancy, interventions can improve health outcomes across generations.*
News Release: Does risk for heart disease start before birth? – American Heart Association
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Cohort Study | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk
15 Feb, 2023 | 16:13h | UTCSummary: This study found that the associations between carbohydrate intake and cardiovascular disease risk depend on the type and source of carbohydrates consumed, with free sugar intake being associated with higher risk of total cardiovascular disease and stroke. Fiber intake was associated with lower risk, and replacing refined grain starch and free sugars with wholegrain starch and non-free sugars may be protective for cardiovascular disease. Free sugar intake was also associated with higher triglycerides and lipoprotein subclasses. As with all observational studies, this study cannot establish causality, but rather suggests associations between carbohydrate intake and cardiovascular disease risk, and the importance of considering the quality of carbohydrates consumed for cardiovascular health.*
News Release: Free sugars associated with higher risk of cardiovascular disease – BioMed Central
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Effect of low-concentration atropine eyedrops vs. placebo on myopia incidence in children
15 Feb, 2023 | 16:09h | UTCSummary: The study aimed to evaluate the efficacy of low-concentration atropine eyedrops at 0.05% and 0.01% concentration for delaying the onset of myopia in children. The randomized, placebo-controlled, double-masked trial enrolled 474 nonmyopic children aged 4 through 9 years. Participants were assigned to 0.05% atropine, 0.01% atropine, and placebo groups and had eyedrops applied once nightly in both eyes over 2 years. The results showed that the 0.05% atropine eyedrops resulted in a significantly lower incidence of myopia and a lower percentage of participants with fast myopic shift at 2 years compared with placebo. However, there was no significant difference between 0.01% atropine and placebo. More research is necessary to replicate the results, determine whether this approach delays or prevents myopia, and evaluate its long-term safety.*
Article: Effect of Low-Concentration Atropine Eyedrops vs Placebo on Myopia Incidence in Children: The LAMP2 Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Delaying the Onset of Nearsightedness – JAMA (free for a limited period)
Commentaries:
Atropine Eyedrops Associated With Lower Incidence of Myopia, Myopic Shift – AJMC
Low-Concentration Atropine Eyedrops Linked to Lower Myopia Incidence in Children – HCP Live
0.05 Percent Atropine Eye Drops Result in Lower Incidence of Myopia – HealthDay
Commentary on Twitter
Among children aged 4 to 9 years without #myopia, nightly use of 0.05% atropine eyedrops compared with placebo resulted in a significantly lower incidence of myopia and lower percentage of participants with fast myopic shift at 2 years. https://t.co/XUjnPVGVad pic.twitter.com/4iZa4Iek76
— JAMA (@JAMA_current) February 14, 2023
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Antimicrobial therapy for 7 days is inferior to treatment for 14 days in men with febrile urinary tract infection
15 Feb, 2023 | 16:11h | UTCSummary: This study aimed to compare the effectiveness of 7-day versus 14-day antibiotic treatment for febrile urinary tract infections in men. The multicenter randomized, double-blind, placebo-controlled non-inferiority trial enrolled 282 men from 27 centers in France. The primary endpoint was treatment success, defined as a negative urine culture, the absence of fever, and no subsequent antibiotic treatment between the end of treatment and 6 weeks after day 1. The results showed that the 14-day treatment was superior to the 7-day treatment, with a treatment success rate of 77.6% versus 55.7%, respectively. Adverse events were similar in both groups, and rectal carriage of resistant Enterobacterales did not differ. Therefore, the study concludes that treatment with ofloxacin for 7 days is inferior to 14 days for febrile UTI in men and should not be recommended.*
Article: Antimicrobial for 7 or 14 days for febrile urinary tract infection in men: a multicenter noninferiority double blind placebo-controlled, randomized clinical trial – Clinical Infectious Diseases (link to abstract – $ for full-text)
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Opinion | Platform trials: the future of medical research?
15 Feb, 2023 | 16:07h | UTCPlatform trials: the future of medical research? – The Lancet Respiratory Medicine
Commentary on Twitter
"The COVID-19 pandemic has shown the amazing things that can come out of a truly pragmatic clinical trial."
NEW Spotlight—Platform trials: the future of medical research?
Read more here: https://t.co/VPxg7JmAov
— The Lancet Respiratory Medicine (@LancetRespirMed) February 10, 2023