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Family Medicine

Health and nutrition claims for infant formula: international cross sectional survey

22 Feb, 2023 | 12:31h | UTC

Health and nutrition claims for infant formula: international cross sectional survey – The BMJ

Editorial: Poorly substantiated health claims on infant formula – The BMJ

News Release: Most health claims on infant formula products seem to have little evidence – BMJ Newsroom

Commentary: Little evidence to support health claims made on formula milk – BBC

 

Commentary from one of the authors on Twitter (thread – click for more)

 


M-A | Sugar-sweetened beverage consumption and weight gain in children and adults

22 Feb, 2023 | 12:26h | UTC

Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials – American Journal of Clinical Nutrition

 


M-A | Monoclonal antibody for the prevention of respiratory syncytial virus in infants and children

22 Feb, 2023 | 12:24h | UTC

Monoclonal Antibody for the Prevention of Respiratory Syncytial Virus in Infants and Children: A Systematic Review and Network Meta-analysis – JAMA Network Open

Commentary: Study Finds 3 Monoclonal Antibodies Reduce RSV Infections in High-Risk Infants, Children – HCP Live

 

Commentary on Twitter

 


SR | Probiotics for management of functional abdominal pain disorders in children

22 Feb, 2023 | 12:20h | UTC

Probiotics for management of functional abdominal pain disorders in children – Cochrane Library

 


Podcast | Abnormal uterine bleeding pearls

22 Feb, 2023 | 12:19h | UTC

#382 Abnormal Uterine Bleeding – The Curbsiders

 


Sleep irregularity linked to subclinical markers of cardiovascular disease

21 Feb, 2023 | 11:51h | UTC

Summary: The study examined the association between sleep irregularity and subclinical markers of cardiovascular disease in a population of over 2000 participants with a mean age of 68. The participants completed 7-day wrist actigraphy that detected when they were asleep and awake. The results showed that sleep irregularity, particularly sleep duration irregularity, was associated with subclinical atherosclerosis, including high coronary artery calcium burden and abnormal ankle-brachial index. These associations persisted even after adjusting for cardiovascular disease risk factors and other sleep characteristics such as obstructive sleep apnea, sleep duration, and sleep fragmentation. While it is important to note that observational studies like this one cannot establish causation and may be subject to residual confounding, the findings suggest that promoting regular sleep schedules could be an essential aspect of lifestyle recommendations for preventing cardiovascular disease.

Article: Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis – Journal of the American Heart Association

News Release: Irregular sleeping habits may increase risk of atherosclerosis in older adults – American Heart Association

Commentaries:

Study finds chronically disrupted sleep may increase the risk for heart disease – Vanderbilt University Medical Center

Sleep Irregularity Linked to Measures of Subclinical Atherosclerosis – HealthDay

Irregular sleep may be harmful to your heart, study finds – CNN

 


Instant noodle burns common in pediatric scald injuries: Study highlights need for prevention efforts

21 Feb, 2023 | 11:50h | UTC

Summary: The study examined pediatric scald burns at the University of Chicago Burn Center between 2010 and 2020 and found that 31% of burns were attributed to instant noodles. Children with instant noodle burns were typically older, more likely to be Black/African American, and from lower socio-economic backgrounds. They were also more likely to be unsupervised at the time of the injury. While instant noodle burns were smaller and required less operative intervention than other scald burns, some still required hospitalization and were associated with complications. The study highlights the need for targeted burn prevention efforts to reduce the incidence of these common but serious injuries.

Article: Pediatric instant noodle burns: A ten-year single center retrospective study – Burns (link to abstract – $ for full-text)

Commentary: Why Instant Noodles Are a Danger to Your Kids – HealthDay

 


Review | Diagnosis and management of patients with polyneuropathy

21 Feb, 2023 | 11:40h | UTC

Diagnosis and management of patients with polyneuropathy – Canadian Medical Association Journal

 


Study finds low rates of antipsychotic medication discontinuation in older adults following infection-related hospitalization

20 Feb, 2023 | 12:25h | UTC

Summary: The study aimed to investigate discontinuation rates of antipsychotic medications (APMs) used to treat delirium due to acute hospitalization and infection in older adults. The cohort study involved 5,835 patients in the US, who were aged 65 years or older, without prior psychiatric disorders and had newly initiated an APM prescription within 30 days of an infection-related hospitalization. The study found that only 11% of new atypical APM users and 52% of new haloperidol users discontinued the medication by 30 days after initiation. The discontinuation of haloperidol and atypical APM was less likely to occur in patients with dementia and prolonged hospitalization. The findings suggest that APM discontinuation rates following infection-related hospitalization are low, especially for atypical APM, and call for effective interventions to proactively discontinue APMs when they are no longer indicated.

Article: Antipsychotic Medication Use Among Older Adults Following Infection-Related Hospitalization – JAMA Network Open

 


RCT | Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease

20 Feb, 2023 | 12:27h | UTC

Summary: The article reports on a randomized trial that compared the effects of alternate-day fasting (ADF) combined with exercise, fasting alone, or exercise alone in adults with obesity and non-alcoholic fatty liver disease (NAFLD). After three months, the combination of ADF and exercise significantly reduced intrahepatic triglyceride content, body weight, fat mass, waist circumference, and alanine transaminase levels compared to the control group. The intervention seems promising for patients with fatty liver disease who want to improve their health without using medications.

Article: Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease: A randomized controlled trial – Cell Metabolism (link to abstract – $ for full-text)

News Release: Alternate-day fasting could be a good option for patients with fatty liver disease – University of Illinois Chicago

 


M-A | Consumption of whole vs. refined grains and risk of cardiovascular disease and all-cause mortality

20 Feb, 2023 | 12:23h | UTC

Summary: 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.

Article: Consumption of whole grains and refined grains and associated risk of cardiovascular disease events and all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies – American Journal of Clinical Nutrition

Related: Cohort Study | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk

 


M-A | Soluble fiber supplementation and serum lipid profile

20 Feb, 2023 | 12:18h | UTC

Summary: The article presents the results of a systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) that evaluated the effect of soluble fiber supplementation on blood lipid parameters in adults. The review included 181 RCTs with 220 treatment arms and 14,505 participants. The meta-analysis found that soluble fiber supplementation significantly reduced LDL cholesterol, total cholesterol, triglycerides, and apolipoprotein B concentrations. The article suggests that increasing fiber intake using soluble fiber supplementation could be an effective intervention in the prevention and management of dyslipidemia, and consequently may contribute to the risk reduction of cardiovascular diseases. However, the article also notes that because of the high between-study heterogeneity and publication bias, the findings should be interpreted cautiously.

Article: Soluble Fiber Supplementation and Serum Lipid Profile: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials – Advances in Nutrition

 


RCT | Evaluation of BNT162b2 Covid-19 vaccine in children younger than 5 years of age

17 Feb, 2023 | 13:27h | UTC

Summary: 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.

 


M-A | Aspirin with or without statin in individuals without atherosclerotic CVD across risk categories

17 Feb, 2023 | 13:22h | UTC

Summary: 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.*

Article: Aspirin With or Without Statin in Individuals Without Atherosclerotic Cardiovascular Disease Across Risk Categories – JACC: Advances

 

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

 


M-A | Efficacy and safety of drugs for gastroparesis

17 Feb, 2023 | 13:05h | UTC

Efficacy and Safety of Drugs for Gastroparesis: Systematic Review and Network Meta-analysis – Gastroenterology

Commentaries:

Review finds only two efficacious medications to treat gastroparesis – ACP Gastroenterology

Two drug classes appear effective for gastroparesis treatment – MDedge

 

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

 


SR | Antipsychotic exposure is an independent risk factor for breast cancer

17 Feb, 2023 | 12:41h | UTC

Antipsychotic exposure is an independent risk factor for breast cancer: A systematic review of epidemiological evidence – Frontiers in Oncology

Related: Large observational study suggests prolactin-increasing antipsychotics are associated with increased risk of breast cancer (OR=1.56 for over 5 years of exposure); prolactin-sparing antipsychotics (including clozapine, quetiapine, or aripiprazole), on the other hand, were not associated with increased risk.

 


Rare, overlooked, or underappreciated causes of recurrent abdominal pain: a primer for gastroenterologists

16 Feb, 2023 | 15:12h | UTC

Rare, Overlooked, or Underappreciated Causes of Recurrent Abdominal Pain: A Primer for Gastroenterologists – Clinical Gastroenterology and Hepatology

 

Commentary from the author on Twitter

 


M-A | Blood pressure lowering effects of B-blockers as add-on or combination therapy

16 Feb, 2023 | 15:10h | UTC

Blood pressure lowering effects of β-blockers as add-on or combination therapy: A meta-analysis of randomized controlled trials – Journal of Clinical Hypertension

Related: Diverse pharmacological properties, trial results, comorbidity prescribing and neural pathophysiology suggest European hypertension guideline downgrading of beta-blockers is not justified – Blood Pressure

 


RCT | Orlistat and a low-carb diet show promising results for the treatment of Metabolic-Associated Fatty Liver Disease

16 Feb, 2023 | 15:07h | UTC

Summary: The study aimed to compare the effects of orlistat or a high-protein/lower-carbohydrate diet with a control diet in Asian patients with obesity and metabolic-associated fatty liver disease (MAFLD) over 24 weeks. The primary endpoint was the relative change in liver fat content (LFC) assessed by MRI-PDFF. A total of 118 patients were randomly assigned to the control group, orlistat group, or experimental diet group. All three groups demonstrated improvement in liver steatosis at week 24, with the orlistat group and the experimental diet group both showing a significant decrease in LFC compared to the control group.*

Article: Treatment of Obesity and Metabolic-Associated Fatty Liver Disease with a Diet or Orlistat: A Randomized Controlled Trial – American Journal of Clinical Nutrition

Commentary: The efficiency of lifestyle intervention, orlistat, and experimental diet therapy in patients with obesity and metabolic-associated fatty liver disease – News Medical

 

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

 


10-year follow-up on preterm prelabor rupture of membranes: induced labor vs. expectant management childhood outcomes

16 Feb, 2023 | 15:05h | UTC

Summary: This study aimed to compare the long-term outcomes of children born after singleton pregnancies complicated by preterm prelabor rupture of membranes and managed by induction of labor vs. expectant management in RCTs undergone between 2007 and 2011. The study assessed the children’s cognition, motor function, and behavior as the primary outcomes. It found that expectant management did not improve long-term outcomes compared to induction of labor for children born after pregnancies with preterm prelabor (between 34 0/7 and 36 6/7 weeks of pregnancy) rupture of membranes. The confidence in the results of this follow-up study is diminished because only 35% of the children who participated in the original trials participated in the follow-up study.

Article: Childhood outcomes after induction of labor or expectant management for preterm prelabor rupture of membranes: a 10-year follow-up of the PPROMEXIL trials – American Journal of Obstetrics & Gynecology

 

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

 


Pediatric edible cannabis exposures and acute toxicity in the US: 2017–2021

16 Feb, 2023 | 15:00h | UTC

Pediatric Edible Cannabis Exposures and Acute Toxicity: 2017–2021 – Pediatrics

Commentaries:

The Number of American Kids Eating Cannabis Has Surged Dramatically – Science Alert

2017 to 2021 Saw Increase in Pediatric Edible Cannabis Exposure – HealthDay

 


Guideline Synopsis | The use of opioids in the management of chronic pain

15 Feb, 2023 | 16:16h | UTC

Summary: 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.*

Article: The Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline – Annals of Internal Medicine

News Release: Summary of VA/DoD guidelines for management of chronic pain provides new recommendations on opioid use and mental health evaluations – American College of Physicians

Summary for patients: The Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline – Annals of Internal Medicine

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 | UTC

Summary: 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.*

Article: Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Reaffirmation Recommendation Statement – JAMA

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 | UTC

Summary: 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.*

Article: Optimizing Prepregnancy Cardiovascular Health to Improve Outcomes in Pregnant and Postpartum Individuals and Offspring: A Scientific Statement From the American Heart Association – Circulation

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 | UTC

Summary: 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.*

Article: Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants – BMC Medicine

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.

 


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