Family Medicine
Study identifies outpatient procedures associated with increased risk of myocardial infarction
16 Mar, 2023 | 13:11h | UTCRisk of myocardial infarction after invasive outpatient procedures – Heart
RCT | Patient-reported outcomes 12 years after different treatments for localized prostate cancer
15 Mar, 2023 | 15:24h | UTCSummary: The article reports on a study that evaluated patient-reported outcomes of 1,643 participants in the ProtecT trial over a period of 7 to 12 years to assess the long-term functional and quality-of-life impacts of prostatectomy, radiotherapy with neoadjuvant androgen deprivation, and active monitoring for localized prostate cancer detected by PSA screening.
The study found that generic quality-of-life scores were similar among the randomized groups over 7 to 12 years. However, although the prostatectomy group had a lower incidence of nocturia, they showed a higher incidence of urinary incontinence and sexual dysfunction compared to the radiotherapy and active monitoring groups. The radiotherapy group had a higher incidence of fecal leakage compared to the other groups.
The study provides evidence that helps patients and their clinicians assess the trade-offs between treatment harms and benefits and make better-informed treatment decisions.
Article: Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment – NEJM Evidence
Original Study: RCT | Localized prostate cancer treatment options have similar 15-year survival outcomes
Cohort Study | Risk of interpersonal violence during and after pregnancy among people with schizophrenia
16 Mar, 2023 | 12:56h | UTCNews Release: Pregnant people with schizophrenia have threefold risk of interpersonal violence – Canadian Medical Association Journal
Updated recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission
15 Mar, 2023 | 15:22h | UTC
Review | Diagnosis and management of endometriosis
15 Mar, 2023 | 15:19h | UTCDiagnosis and management of endometriosis – Canadian Medical Association Journal
Review | Heart failure with preserved ejection fraction
15 Mar, 2023 | 15:18h | UTCHeart Failure With Preserved Ejection Fraction: A Review – JAMA (free for a limited period)
Author Interview: Diagnosis and Treatment of Heart Failure with Preserved Ejection Fraction – JAMA
SR | Yoga may improve frailty markers in older adults
15 Mar, 2023 | 15:08h | UTCEffect of Yoga on Frailty in Older Adults: A Systematic Review – Annals of Internal Medicine (link to abstract – $ for full-text)
Annals Video Summary: Effect of Yoga on Frailty in Older Adults: A Systematic Review
News Release: Yoga may help to prevent frailty in older adults – American College of Physicians
Deprescribing strategies for opioids and benzodiazepines with emphasis on concurrent use: a scoping review
15 Mar, 2023 | 15:06h | UTCRelated:
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
Review | MRI image features with an evident relation to low back pain
15 Mar, 2023 | 15:01h | UTC
Cohort Study | Higher ultra-processed food consumption linked to increased cancer incidence and mortality
15 Mar, 2023 | 14:48h | UTCNews Release: Ultra-processed foods may be linked to increased risk of cancer – Imperial College London
Related:
Scanxiety among adults with cancer: a scoping review to guide research and interventions
14 Mar, 2023 | 13:55h | UTCSummary: The article presents a scoping review of existing literature on scanxiety, which refers to the anxiety and distress experienced by cancer patients before and after medical imaging scans. The authors identified and synthesized findings from 36 articles on scanxiety among adults diagnosed with current or prior cancer.
The authors observed that scanxiety is a prevalent issue throughout the cancer continuum and may be linked to various factors related to the procedure itself or the uncertainty surrounding the possible outcomes of the scans.
The waiting period between the scan procedure and receipt of the results was described as particularly stressful, with participants reporting feeling overwhelmed by negative thoughts and fears about the potential outcomes of the scan. Some participants even found it difficult to focus on daily activities or responsibilities during this time.
The authors suggest that implementing supportive measures during scan experiences, including examining the waiting period between scans and scan results, could enhance the well-being for individuals with cancer who are going through different stages of treatment.
Article: Scanxiety among Adults with Cancer: A Scoping Review to Guide Research and Interventions – Cancers
SR | Environmental interventions can reduce falls in high-risk older adults
14 Mar, 2023 | 13:58h | UTCSummary: Falls and fall-related injuries are common among older adults and can have serious consequences, such as restricting activity or institutionalization. The Cochrane review aimed to assess the effects of environmental interventions, such as fall-hazard reduction, assistive technology, home modifications, and education, on preventing falls in older adults living in the community.
The review included 22 randomized controlled trials from 10 countries involving 8,463 community-residing older people. The study found that home fall-hazard interventions, which involve evaluating potential fall hazards and implementing safety adaptations or behavioral strategies, can reduce the rate of falls by 26% and the number of people who experience one or more falls by 11% in people at a higher risk of falling.
On the other hand, the study did not find any evidence of a decrease in the rate of falls when the interventions were not targeted toward individuals at higher risk. Additionally, the study suggests that these interventions are unlikely to have a significant impact on health-related quality of life, and there may be little or no difference in the risk of fall-related fractures, hospitalizations due to falls, or the rate of falls that require medical attention.
Summary: Reducing fall hazards within the environment – Cochrane Library
Commentary: Preventing falls in older people: new evidence on what helps – Evidently Cochrane
M-A | Ionizing radiation and cardiovascular disease
14 Mar, 2023 | 13:49h | UTCIonising radiation and cardiovascular disease: systematic review and meta-analysis – The BMJ
News Release: Low dose radiation linked to increased lifetime risk of heart disease – BMJ Newsroom
Review | Orthostatic tachycardia after covid-19
14 Mar, 2023 | 13:48h | UTCOrthostatic tachycardia after covid-19 – The BMJ
Commentary: Key steps for diagnosis and management of orthostatic tachycardia after COVID-19 – News Medical
Review | Pathogenesis, epidemiology and control of Group A Streptococcus infection
14 Mar, 2023 | 13:38h | UTC
Commentary on Twitter
NEW📢🎉Pathogenesis, epidemiology and control of Group A Streptococcus infectionhttps://t.co/XFSKQrTe1P
Brouwer & co. summarize the epidemiological and clinical features of Group A Streptococcus infection, and the molecular mechanisms of GAS virulence and drug resistance. pic.twitter.com/qm23YgnKlg
— Nature Reviews Microbiology (@NatureRevMicro) March 10, 2023
Adolescent substance use | Objective assessment with hair analysis nearly doubled the estimated prevalence based on self-reported data
14 Mar, 2023 | 13:34h | UTCNews Release: Hair analysis shows child drug use could be twice as high as we think – Taylor & Francis Group
CDC recommends HBV screening at least once in a lifetime for all adults aged ≥18 years
13 Mar, 2023 | 15:14h | UTCSummary: The Centers for Disease Control and Prevention (CDC) has issued new recommendations for screening and testing for hepatitis B virus (HBV) infection in the US.
The recommendations include screening for HBV infection at least once in a lifetime for adults aged ≥18 years and more frequent testing for persons at increased risk for HBV infection. The risk groups include:
- Persons incarcerated or formerly incarcerated in jail, prison, or other detention settings.
- Persons with a history of sexually transmitted infections or multiple sex partners.
- Persons with a history of hepatitis C virus infection.
The CDC recommends using the triple panel (HBsAg, anti-HBs, and total anti-HBc) for initial screening to help identify persons who have an active HBV infection, have resolved infection and might be susceptible to reactivation, are susceptible and need vaccination, or are vaccinated.
Commentaries:
Universal Adult Hepatitis B Screening and Vaccination as the Path to Elimination – JAMA
CDC recommends hepatitis B screening for all adults – CIDRAP
CDC Recommends Universal Screening for Hepatitis B Virus – HCP Live
Commentary on Twitter
CDC recommends that all adults get tested for #HepatitisB at least once in their life. Ask your doctor if you’ve been tested. Learn more: https://t.co/kLBZyQYZtQ @CDCMMWR pic.twitter.com/EBkQ9s4MsQ
— CDC (@CDCgov) March 9, 2023
RCT | Localized prostate cancer treatment options have similar 15-year survival outcomes
13 Mar, 2023 | 15:12h | UTCSummary: The study followed 1643 men diagnosed with localized prostate cancer (diagnosed by screening with PSA) in the United Kingdom between 1999 and 2009 who were randomly assigned to receive active monitoring, prostatectomy, or radiotherapy.
After a median follow-up of 15 years, the study found that while prostatectomy and radiotherapy decreased metastasis, local progression, and the need for long-term androgen deprivation therapy, death from prostate cancer was low regardless of the treatment assigned, with 17 deaths (3.1%) in the active-monitoring group, 12 deaths (2.2%) in the prostatectomy group, and 16 (2.9%) deaths in the radiotherapy group (P=0.53). Additionally, the study found that overall deaths were similar between the groups.
The authors suggest that the choice of therapy for localized prostate cancer involves weighing the benefits and harms associated with each treatment option.
Article: Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Delaying treatment for localised prostate cancer does not increase mortality risk, trial shows – University of Bristol
Commentary on Twitter
Presented at #EAU23: In men with prostate cancer on PSA screening, radical treatments led to half the incidence of metastasis and local progression as active monitoring without affecting disease-specific or overall survival (ProtecT trial) https://t.co/G2ABkMkyJg #oncology pic.twitter.com/s2Va08Fpxj
— NEJM (@NEJM) March 11, 2023
Review | Commonly missed findings on chest radiographs: causes and consequences
13 Mar, 2023 | 15:07h | UTCCommonly Missed Findings on Chest Radiographs: Causes and Consequences – CHEST (free for a limited period)
See also: Reducing Errors Resulting From Commonly Missed Chest Radiography Findings – CHEST (free for a limited period)
Review | Reducing errors resulting from commonly missed chest radiography findings
13 Mar, 2023 | 15:06h | UTCReducing Errors Resulting From Commonly Missed Chest Radiography Findings – CHEST (free for a limited period)
See also: Commonly Missed Findings on Chest Radiographs: Causes and Consequences – CHEST (free for a limited period)
M-A | Strength of association between comorbidities and asthma
13 Mar, 2023 | 15:01h | UTCSummary: The study investigated the strength of association between comorbidities and asthma, as the presence of comorbidities is related to poor asthma outcomes. A comprehensive literature search was conducted for observational studies reporting data on comorbidities in asthma and nonasthma populations.
A total of 5,493,776 subjects were analyzed, and several comorbidities were found to be strongly or very strongly associated with asthma and severe asthma, including allergic conjunctivitis, allergic rhinitis, bronchiectasis, hypertensive cardiomyopathy, nasal congestion, COPD, and other chronic respiratory diseases.
The study supports the relevance of individualized strategies for disease management that look beyond asthma and suggests a comprehensive approach should be used to assess whether poor symptom control is related to uncontrolled asthma or other underlying comorbidities.
Decrease in hospitalizations and liver failure after FDA mandate limiting paracetamol dosage in prescription opioid combinations.
13 Mar, 2023 | 14:45h | UTCAssociation of FDA Mandate Limiting Acetaminophen (Paracetamol) in Prescription Combination Opioid Products and Subsequent Hospitalizations and Acute Liver Failure – JAMA (free for a limited period)
Editorial: Moving the Needle to Reduce Acetaminophen (Paracetamol) Hepatotoxicity – JAMA (free for a limited period)
Author Interview: Limiting Acetaminophen in Prescription Combination Opioid Products – JAMA
Video Summary: Acetaminophen (Paracetamol) and Acute Liver Failure – JAMA
Commentary on Twitter
The @US_FDA mandate to limit acetaminophen to 325 mg/tablet in prescription combination acetaminophen and opioid medications was associated with a decline in hospitalizations involving acetaminophen and opioid toxicity. https://t.co/6tdqFAI4hG
— JAMA (@JAMA_current) March 7, 2023
WHO urges countries to implement comprehensive sodium reduction policies to combat cardiovascular disease
10 Mar, 2023 | 14:43h | UTCSummary:
A new report from the World Health Organization (WHO) has shown that the world needs to catch up to achieve its global target of reducing sodium intake by 30% by 2025. The report highlights that only 5% of WHO member states have mandatory and comprehensive sodium reduction policies.
Sodium, found in table salt and other condiments, increases the risk of heart disease, stroke, and premature death when eaten in excess. Implementing highly cost-effective sodium reduction policies could save an estimated seven million lives globally by 2030.
WHO suggests a number of policies, such as reducing the amount of sodium in food products, introducing front-of-pack labeling, launching mass media campaigns, and enforcing public policies related to food service and sales.
The report urges member states to implement sodium intake reduction policies without delay, and calls on food manufacturers to set ambitious targets for sodium reduction in their products.
Article: WHO global report on sodium intake reduction – World Health Organization
News Release: Massive efforts needed to reduce salt intake and protect lives – World Health Organization
Related:
Adding salt to foods and hazard of premature mortality – European Heart Journal
New WHO benchmarks help countries reduce salt intake and save lives – World Health Organization
WHO global sodium benchmarks for different food categories – World Health Organization
Commentary on Twitter
Eating too much salt is one of the top risk factors for heart disease, stroke, and death.
WHO’s first global report on sodium intake reduction shows only 5% of WHO Member States are protected by mandatory and comprehensive sodium reduction policies👉https://t.co/hiocdiXUiy pic.twitter.com/NXSv0oe7fn
— World Health Organization (WHO) (@WHO) March 9, 2023
RCT | Treat-to-target strategy is noninferior to high-intensity statin therapy in patients with coronary artery disease
10 Mar, 2023 | 14:44h | UTCSummary: This randomized, multicenter, noninferiority trial in South Korea enrolled 4,400 patients with known coronary artery disease. Patients were randomly assigned to one of two groups: a treat-to-target group and a high-intensity statin group.
The treat-to-target group received moderate or high-intensity statins and titrated their medication to achieve an LDL-C goal of 50-70 mg/dL, while the high-intensity statin group received rosuvastatin 20 mg or atorvastatin 40 mg. The primary endpoint was a 3-year composite of death, myocardial infarction, stroke, or coronary revascularization.
The study found that the primary endpoint occurred in 8.1% of the treat-to-target group and 8.7% of the high-intensity statin group, indicating that the treat-to-target strategy was noninferior to the high-intensity statin strategy.
Overall, the results of this study indicate that a treat-to-target strategy could be an appropriate substitute for high-intensity statin therapy in patients with coronary artery disease. This approach enables a personalized treatment plan that accounts for variations in individual drug response to statin therapy.
Article: Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial – JAMA (free for a limited period)
Commentaries:
Not all patients with coronary artery disease require high intensity statins – MedicalResearch.com
Commentary on Twitter
Among patients with coronary artery disease, a treat-to-target LDL-C strategy was noninferior to a high-intensity statin strategy for major clinical outcomes. https://t.co/Orv8IeF4Gv #ACC23 #WCCardio pic.twitter.com/NVEEJfQYfJ
— JAMA (@JAMA_current) March 6, 2023
RCT | Cannabidiol oil not effective for post-ureteroscopy pain control
10 Mar, 2023 | 14:34h | UTCSummary: The study evaluated the effect of cannabidiol oil on pain control and opioid usage in patients undergoing ureteroscopy with stent placement for urinary stone disease. Ninety patients were randomized 1:1 to receive either placebo or 20mg of cannabidiol oil daily for 3 days postoperatively.
Results showed no difference between CBD oil and placebo in reducing pain scores, opioid usage, or stent-related symptoms. The study suggests that despite the availability of numerous analgesic agents, stent symptoms continue to be bothersome for most patients, and further research is needed to find effective non-opioid alternatives for pain management in this setting.
Article: Effect of Cannabidiol Oil on Post-ureteroscopy Pain for Urinary Calculi: A Randomized, Double-blind, Placebo-controlled Trial – The Journal of Urology (free for a limited period)