Family Medicine
SR | Zinc supplementation for preventing mortality, morbidity, and growth failure in children aged 6 months to 12 years
6 Apr, 2023 | 13:06h | UTC
WHO Report | 1 in 6 people globally affected by infertility
5 Apr, 2023 | 13:47h | UTCNews Release: 1 in 6 people globally affected by infertility – World Health Organization
Report: Infertility Prevalence Estimates, 1990–2021 – World Health Organization
Key facts: Infertility – World Health Organization
Commentaries:
Infertility affects a ‘staggering’ 1 in 6 people worldwide, WHO says – CNN
One in six people worldwide affected by infertility, WHO reports – The Guardian
Commentary on Twitter (thread – click for more)
Around 1 in 6 people is affected by infertility in their lifetime: ? WHO research.
This shows an urgent need to increase access to affordable, high-quality fertility care https://t.co/od9QQ9Qjvj pic.twitter.com/R8JtezT0kZ
— World Health Organization (WHO) (@WHO) April 4, 2023
ACC/AHA blood pressure categories | Systematic review of adverse pregnancy outcomes in early pregnancy
6 Apr, 2023 | 12:53h | UTC
Commentary on Twitter
American College of Cardiology and American Heart Association blood pressure categories—a systematic review of the relationship with adverse pregnancy outcomes in the first half of pregnancy https://t.co/n3jWFLVYg5 pic.twitter.com/QzaWRyY4n5
— AJOG (@AJOG_thegray) March 31, 2023
M-A | Impact of antihypertensive therapy on maternal & neonatal outcomes in mild-moderate pregnancy hypertension
6 Apr, 2023 | 12:51h | UTC
Cohort Study | Pregnancy glucose intolerance, even below diabetes criteria, linked to increased risk of type 2 diabetes
5 Apr, 2023 | 13:42h | UTCGlucose intolerance in pregnancy and risk of early-onset type 2 diabetes: a population-based cohort study – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)
Review | Diagnosis and treatment of acute myocarditis
5 Apr, 2023 | 13:40h | UTCDiagnosis and Treatment of Acute Myocarditis: A Review – JAMA (free for a limited period)
Review | Comprehensive care of women with genetic predisposition to breast and ovarian cancer
5 Apr, 2023 | 13:32h | UTC
M-A | Vaginal swab outperforms urine for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis
5 Apr, 2023 | 13:23h | UTC
Consensus Paper | Definition and criteria for diagnosing cesarean scar disorder
5 Apr, 2023 | 12:51h | UTCDefinition and Criteria for Diagnosing Cesarean Scar Disorder – JAMA Network Open
Pharmacotherapy of obesity: an update on the available medications and drugs under investigation
5 Apr, 2023 | 12:50h | UTC
M-A | Efficacy of flash glucose monitoring in type 1 and type 2 diabetes
5 Apr, 2023 | 12:46h | UTC
RCT | Mindfulness therapy proves more effective and affordable than cognitive behavioral therapy for depression
4 Apr, 2023 | 14:04h | UTCSummary: The LIGHTMind Randomized Clinical Trial studied 410 adults with mild to moderate depression, comparing the clinical effectiveness and cost-effectiveness of practitioner-supported mindfulness-based cognitive therapy self-help (MBCT-SH) to practitioner-supported cognitive behavioral therapy self-help (CBT-SH). The trial provided participants with either an MBCT-SH or CBT-SH workbook and six support sessions with a trained practitioner. Depressive symptom severity was measured using the Patient Health Questionnaire (PHQ-9) score at 16 weeks after randomization.
Results showed that MBCT-SH led to significantly greater reductions in depressive symptoms and was more cost-effective than CBT-SH. The between-group difference was 1.5 PHQ-9 points, and MBCT-SH cost health services £526 ($631) less per participant over a 42-week follow-up period. A substantial portion of this cost difference was due to additional face-to-face individual psychological therapy accessed by CBT-SH participants outside of the study intervention.
The trial concluded that offering practitioner-supported MBCT-SH for mild to moderate depression could improve outcomes and save money compared to CBT-SH. To translate these findings into practice, proper training and supervision for practitioners delivering MBCT-SH are necessary. Future research should focus on corroborating and extending these findings, exploring factors contributing to MBCT-SH’s relative effectiveness, and examining potential barriers and facilitators for successful implementation in routine clinical practice.
Commentary:
Mindfulness better than CBT for treating depression, study finds – The Guardian
Practitioner-Supported Mindfulness-Based Cognitive Therapy Aids Depression – HealthDay
Commentary on Twitter
Practitioner-supported mindfulness-based cognitive therapy self-help for mild-moderate depression is clinically- and cost-effective compared to currently recommended practitioner-support CBT self-help. https://t.co/H23AfwiO7X pic.twitter.com/xTHzYG4oqg
— JAMA Psychiatry (@JAMAPsych) March 22, 2023
RCT | No significant fracture reduction from monthly 60,000 IU vitamin D3 supplementation
4 Apr, 2023 | 13:58h | UTCThe effect of monthly vitamin D supplementation on fractures: a tertiary outcome from the population-based, double-blind, randomised, placebo-controlled D-Health trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)
Related:
RCT | Supplemental Vitamin D does not reduce incident fractures in midlife and older adults.
Contrary to prior studies, new research finds no heightened postoperative risk after a recent covid-19 infection
4 Apr, 2023 | 13:54h | UTCCommentaries:
COVID infection within 60 days not tied to adverse postsurgical outcomes – CIDRAP
Adverse Postoperative Outcomes Not Increased With Recent COVID-19 – HealthDay
Related:
ASA and APSF statement on perioperative testing for the COVID-19 virus.
Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery
BJS commission on surgery and perioperative care post-COVID-19.
ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.
Position statement: Perioperative management of post-COVID-19 surgical patients.
M-A | Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2
4 Apr, 2023 | 13:52h | UTCRelated:
Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ
RCT | Vitamin D supplementation shows no significant impact on psoriasis severity
4 Apr, 2023 | 13:51h | UTCSummary: In a randomized, double-blind, placebo-controlled clinical trial involving 122 participants with plaque psoriasis, researchers investigated the effects of vitamin D supplementation on psoriasis severity during winter. Participants received either vitamin D (cholecalciferol, 100,000 IU loading dose followed by 20,000 IU/week) or a placebo for four months. The primary outcome was Psoriasis Area Severity Index (PASI) scores, with secondary outcomes including Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores.
The study found no significant difference in PASI scores or secondary outcomes between the two groups. The results suggest that vitamin D supplementation does not affect psoriasis severity. However, low baseline severity scores and a lower than expected increase in 25-hydroxyvitamin D levels in the intervention group may have influenced the findings, indicating that further research may be needed to account for these factors.
Article: Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels: A Randomized Clinical Trial – JAMA Dermatology (free for a limited period)
Commentary on Twitter
This RCT, performed in North-Norway, found no measurable effect of vitamin D supplementation on psoriasis severity during winter. Low baseline severity, & lower-than-expected rise in 25(OH)D levels in intervention group, may have affected the results. https://t.co/ip17uFQsgM
— JAMA Dermatology (@JAMADerm) March 29, 2023
M-A | No significant health benefits found for low-volume alcohol intake
4 Apr, 2023 | 13:48h | UTCSummary: This systematic review and meta-analysis aimed to investigate the association between alcohol use and all-cause mortality, taking into account potential sources of bias. The study analyzed data from 107 cohort studies published between January 1980 and July 2021, which included 4,838,825 participants and 425,564 deaths.
The study found no significant reductions in all-cause mortality risk for drinkers who consumed less than 25 grams of ethanol per day compared to lifetime nondrinkers. However, there was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams per day and male drinkers who drank 45 or more grams per day.
The analysis highlighted the importance of controlling for former drinker bias and misclassification errors and found sex differences in the risk of all-cause mortality.
In conclusion, the updated meta-analysis found no significantly reduced risk of all-cause mortality associated with low-volume alcohol consumption after adjusting for potential confounding factors. The study recommends that future longitudinal studies in this field should attempt to minimize lifetime selection biases by not including former and occasional drinkers in the reference group and by using younger cohorts at baseline.
Commentary: Drinking Alcohol Brings No Health Benefits, Study Finds – HealthDay
Related:
Prioritising action on alcohol for health and development – The BMJ
Cohort study | Younger stroke survivors show elevated cancer risk for up to 8 years
4 Apr, 2023 | 13:46h | UTCSummary: In this cohort study, 390,398 patients aged 15 years or older in the Netherlands, without a history of cancer and with a first-ever ischemic stroke or intracerebral hemorrhage (ICH), were analyzed between January 1, 1998, and January 1, 2019. The primary outcome was the cumulative incidence of first-ever cancer after the index stroke, stratified by stroke subtype, age, and sex, compared with age-, sex-, and calendar year-matched peers from the general population.
The findings revealed that, in the first year after a stroke, patients aged 15 to 49 years had a 3- to 5-fold increased risk of cancer compared to individuals without a stroke. In contrast, the risk was only slightly elevated for patients aged 50 years or older. The cancer risk remained elevated for up to 8 years after an ischemic stroke and 6 years after an ICH in the younger age group, with the highest risks observed for lung cancer, gastrointestinal cancer, and hematologic cancer.
The findings may be confounded by shared risk factors, such as smoking. Alternatively, the increased cancer risk may have a causal mechanism between cancer and stroke, possibly related to the hypercoagulable state induced by cancer. However, the study design does not allow for conclusions about causal mechanisms, and the researchers called for further studies investigating the usefulness of cancer screening after a stroke.
Cross-sectional study | Association between sodium intake and coronary and carotid atherosclerosis
4 Apr, 2023 | 13:42h | UTCEditorial: Dietary salt intake and atherosclerosis: an area not fully explored – European Heart Journal Open
News Release: High salt diet associated with hardened arteries even in people with normal blood pressure – European Society of Cardiology
Cochrane Library | Hearing conditions: evidence, experience and resources
4 Apr, 2023 | 13:36h | UTCHearing conditions: evidence, experience and resources – Evidently Cochrane
Two FITs better than one: enhancing diagnostic performance for colorectal cancer in symptomatic populations
4 Apr, 2023 | 13:32h | UTC
Cohort Study | Preoperative depression has minimal impact on 5-year bariatric surgery outcomes
4 Apr, 2023 | 13:23h | UTC
AHA Scientific Statement | Pediatric primary hypertension: An underrecognized condition
3 Apr, 2023 | 14:05h | UTCTop 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
M-A | Mediterranean & low-fat diets may reduce mortality and non-fatal MI in patients with high cardiovascular risk
3 Apr, 2023 | 13:59h | UTCSummary: 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.
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 | UTCSummary: 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.