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Infectious Diseases (all articles)

RCT: Propafenone leads to quicker sinus rhythm restoration than amiodarone in supraventricular arrhythmias related to septic shock

1 Oct, 2023 | 15:19h | UTC

Study Design & Population: The research was a two-center, prospective, controlled parallel-group, double-blind trial involving 209 septic shock patients who had new-onset supraventricular arrhythmia and a left ventricular ejection fraction above 35%. Patients were randomized to receive either intravenous propafenone (70 mg bolus followed by 400–840 mg/24 h) or amiodarone (300 mg bolus followed by 600–1800 mg/24 h).

Main Findings: The primary outcomes focused on the proportion of patients in sinus rhythm 24 hours post-infusion, time to the first sinus rhythm restoration, and arrhythmia recurrence rates. No significant difference was observed in 24-hour sinus rhythm rates between the propafenone (72.8%) and amiodarone (67.3%) groups (p=0.4). Time to the first rhythm restoration was significantly shorter for the propafenone group (median 3.7 hours) compared to the amiodarone group (median 7.3 hours, p=0.02). Recurrence of arrhythmia was notably lower in the propafenone group (52%) than in the amiodarone group (76%, p<0.001). In the subgroup of patients with a dilated left atrium, amiodarone appeared to be more effective.

Implications & Limitations: The study suggests that while propafenone doesn’t offer better rhythm control at 24 hours compared to amiodarone, it does provide faster cardioversion and fewer arrhythmia recurrences, especially in patients with a non-dilated left atrium. No significant differences were observed in clinical outcomes, such as ICU or long-term mortality, between propafenone and amiodarone in the trial. Limitations include potential underpowering of the study and the inability to fully account for the impact of multiple covariates involved in the complex therapy of septic shock.

Article: Balik, M., Maly, M., Brozek, T. et al. Propafenone versus amiodarone for supraventricular arrhythmias in septic shock: a randomised controlled trial. Intensive Care Med (2023)

 

Commentary on Twitter:

 


M-A | Most dengue infections are asymptomatic and could significantly contribute to the transmission of the disease

9 Aug, 2023 | 15:21h | UTC

Global prevalence of asymptomatic dengue infections – a systematic review and meta-analysis – International Journal of Infectious Diseases

 


Review | Artificial intelligence, machine learning and deep learning: Potential resources for the infection clinician

9 Aug, 2023 | 15:18h | UTC

Artificial intelligence, machine learning and deep learning: Potential resources for the infection clinician – Journal of Infection

 


M-A | Percutaneous catheter drainage superior to needle aspiration for liver abscess treatment success

9 Aug, 2023 | 15:12h | UTC

Percutaneous catheter drainage versus percutaneous needle aspiration for liver abscess: a systematic review, meta-analysis and trial sequential analysis – BMJ Open

 


Multinational Study | No correlation between Covid-19 and onset of type 1 diabetes in children

8 Aug, 2023 | 13:32h | UTC

SARS-CoV-2 — No Increased Islet Autoimmunity or Type 1 Diabetes in Teens – New England Journal of Medicine

 


M-A | The global prevalence of human fascioliasis

8 Aug, 2023 | 13:10h | UTC

The global prevalence of human fascioliasis: a systematic review and meta-analysis – Therapeutic Advances in Infectious Disease

 


Perspective | Cardiac device infection: removing barriers to timely and adequate treatment

4 Aug, 2023 | 11:54h | UTC

Cardiac device infection: removing barriers to timely and adequate treatment – European Heart Journal

 


Position Paper | Perioperative antibiotic prophylaxis in skin surgery

3 Aug, 2023 | 13:39h | UTC

Perioperative antibiotic prophylaxis in skin surgery – Position paper of the Antibiotic Stewardship working group of the German Society for Dermatologic Surgery (DGDC) – Journal of the German Society of Dermatology

Part 1: Procedure- and patient-related risk factors

Part 2: Special indications and situations

 


RCT | Early oral antibiotic switch in low-risk neutropenic sepsis shows mixed results

3 Aug, 2023 | 13:15h | UTC

Early switch to oral antibiotic therapy in patients with low risk neutropenic sepsis (EASI-SWITCH): A randomized non-inferiority trial – Clinical Microbiology and Infection

 


Consensus Paper | Diagnosis and management of infective endocarditis in adults

1 Aug, 2023 | 14:34h | UTC

Guidelines for Diagnosis and Management of Infective Endocarditis in Adults: A WikiGuidelines Group Consensus Statement – JAMA Network Open

 


Opinion | Bad science needs to be called out: the medical profession loses trust when bad studies are used to promote policy

1 Aug, 2023 | 14:29h | UTC

Bad Science Needs to Be Called Out – Sensible Medicine

Related: Did Republicans die more during the pandemic bc they didn’t get the vax? – By Dr. Vinay Prassad

Original Study: Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic – JAMA Internal Medicine

 


Critical Appraisal | Did Republicans die more during the pandemic bc they didn’t get the vax?

1 Aug, 2023 | 14:28h | UTC

Did Republicans die more during the pandemic bc they didn’t get the vax? – By Dr. Vinay Prassad

Related: Bad Science Needs to Be Called Out – Sensible Medicine

Original Study: Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic – JAMA Internal Medicine

 


M-A | Updated evidence supports incisional negative pressure wound therapy for surgical site infection prevention

1 Aug, 2023 | 14:15h | UTC

Incisional negative pressure wound therapy for the prevention of surgical site infection: an up-to-date meta-analysis and trial sequential analysis – eClinicalMedicine

 


Opinion Video | Critical analysis of the data behind Covid-19 booster shots

31 Jul, 2023 | 14:40h | UTC

“FLAWED Booster data was used by FDA for Mass Vax Campaign & We PROVE it in our new PAPER” – YouTube Video by Dr Vinay Prassad

Original Publication: Correspondence | Potential “healthy vaccinee bias” in a study of BNT162b2 vaccine against Covid-19

 


RCT | Bictegravir regimen noninferior to dolutegravir regimen in HIV-1, HBV co-infection treatment

31 Jul, 2023 | 14:00h | UTC

Bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir, emtricitabine, and tenofovir disoproxil fumarate for initial treatment of HIV-1 and hepatitis B coinfection (ALLIANCE): a double-blind, multicentre, randomised controlled, phase 3 non-inferiority trial – The Lancet HIV (free registration required)

 


RCT | Limited antibiotic efficacy in children with sinusitis lacking nasopharyngeal pathogens

27 Jul, 2023 | 13:08h | UTC

Identifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Acute Bacterial Sinusitis: Limitations of Test-Based Treatment – JAMA (free for a limited period)

News Release: Bacterial testing in kids with sinusitis could slash antibiotic use – University of Pittsburgh

Commentary: Trial suggests bacterial test could reduce antibiotics in kids with sinusitis – CIDRAP

 

Commentary on Twitter

 


Cohort Study | 9.9% of patients acquire C. difficile carriage in healthcare facilities, most do not develop clinical infection

27 Jul, 2023 | 13:01h | UTC

Natural History of Clostridioides difficile Colonization and Infection Following New Acquisition of Carriage in Healthcare Settings: A Prospective Cohort Study – Clinical Infectious Diseases

 


RCT | Pitavastatin effective in the primary prevention of cardiovascular disease in HIV-infected individuals

26 Jul, 2023 | 13:35h | UTC

Pitavastatin to Prevent Cardiovascular Disease in HIV Infection – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

Pitavastatin lowers risk of cardiovascular events in people living with HIV – Aidsmap

Statins reduce cardiovascular risk in people living with HIV, new global study finds – STAT

Pitavastatin Cuts MACE in HIV-Infected Patients: REPRIEVE – TCTMD

 

Commentary on Twitter

 


Mitigating neurological, cognitive, and psychiatric sequelae of COVID-19-related critical illness

26 Jul, 2023 | 13:28h | UTC

Mitigating neurological, cognitive, and psychiatric sequelae of COVID-19-related critical illness – The Lancet Respiratory Medicine

 


Systematic Review | Monocyte distribution width as a diagnostic marker for infection

26 Jul, 2023 | 13:26h | UTC

Monocyte Distribution Width as a Diagnostic Marker for Infection – CHEST

Related: Comparison of the Diagnostic Accuracies of Monocyte Distribution Width, Procalcitonin, and C-Reactive Protein for Sepsis: A Systematic Review and Meta-Analysis – Critical Care Medicine

 

Commentary on Twitter

 


Global, regional, and national burden of meningitis and its etiologies, 1990–2019

25 Jul, 2023 | 13:55h | UTC

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 – The Lancet Neurology

 

Commentary on Twitter

 


Consensus Paper | Urinary tract infections in pregnant individuals

25 Jul, 2023 | 13:53h | UTC

Urinary Tract Infections in Pregnant Individuals – Obstetrics & Gynecology

 


Cohort Study | Examining patient demographics, microbiology, and mortality in infectious endocarditis after TAVI

25 Jul, 2023 | 13:48h | UTC

Patient characteristics, microbiology, and mortality of infective endocarditis after transcatheter aortic valve implantation – Clinical Infectious Diseases

 


New WHO guidance on the role of HIV viral suppression in improving individual health and reducing transmission

24 Jul, 2023 | 13:17h | UTC

News Release: New WHO guidance on HIV viral suppression and scientific updates released at IAS 2023 – World Health Organization

WHO Guidance: The role of HIV viral suppression in improving individual health and reducing transmission – Word Health Organization

Related WHO Guidelines:

WHO recommends optimizing HIV testing services – World Health Organization

Primary health care and HIV: convergent actions – World Health Organization

 


Systematic Review | Low-level HIV viremia (below 1000 copies/mL) linked to minimal sexual transmission risk

24 Jul, 2023 | 13:15h | UTC

The risk of sexual transmission of HIV in individuals with low-level HIV viraemia – The Lancet

Editorial: HIV is sexually untransmittable when viral load is undetectable – The Lancet

Related: Study: Growing Acceptability of “Undetectable = Untransmittable” but Widespread Misunderstanding of HIV Transmission Risk Persists (several texts on the subject)

 

Commentary on Twitter

 


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