Internal Medicine
Podcast | Untangling catheter associated UTIs
10 Jul, 2023 | 13:21h | UTC#402 Don’t Get Caught with a CAUTI – The Curbsiders
Podcast | Updates in addiction medicine
10 Jul, 2023 | 13:17h | UTC#401 Updates in Addiction Medicine – SGIM 2023 – The Curbsiders
Consensus Paper | Subcutaneous infusions of hydration and medication in adults
7 Jul, 2023 | 16:27h | UTC
RCT | Semont-plus maneuver yields faster recovery than Epley maneuver in posterior canal BPPV
7 Jul, 2023 | 16:26h | UTCThe Semont-Plus Maneuver or the Epley Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo: A Randomized Clinical Study – JAMA Neurology (link to abstract – $ for full-text)
See also: Visual Abstract
Videos:
Demonstration of the Semont-Plus Self-maneuver for Right Posterior Canal Canalithiasis
Semont-Plus Maneuver for Right Posterior Canal Benign Paroxysmal Positional Vertigo
Demonstration of the Epley Self-maneuver for a Right Posterior Canal Canalithiasis
Commentary: Semont-plus Meneuver Offered Faster Recovery for Benign Paroxysmal Positional Vertigo – Neurology Today
RCT | Weekly Tirzepatide outperforms placebo in weight management for type 2 diabetes patients
7 Jul, 2023 | 16:24h | UTCTirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial – The Lancet (link to abstract – $ for full-text)
Commentary: Tirzepatide triumphs in significant weight reduction for people with type 2 diabetes – News Medical
Review | Post-COVID Conditions
7 Jul, 2023 | 16:21h | UTCPost-COVID Conditions – Mayo Clinic Proceedings
Review | Management of premature ventricular complexes in the outpatient setting
7 Jul, 2023 | 16:22h | UTCManagement of Premature Ventricular Complexes in the Outpatient Setting – Mayo Clinic Proceedings
Review | Cardiovascular outcomes in patients with diabetes and kidney disease
7 Jul, 2023 | 16:13h | UTC
Review | Acute-on-chronic liver failure
7 Jul, 2023 | 16:09h | UTCAcute-on-chronic liver failure: far to go—a review – Critical Care
Related:
EASL Clinical Practice Guidelines on acute-on-chronic liver failure – Journal of Hepatology
Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU
Review | Hypereosinophilic syndrome (HES) and eosinophilic granulomatosis with polyangiitis (EGPA): two sides of the same coin
7 Jul, 2023 | 16:01h | UTCHES and EGPA: Two Sides of the Same Coin – Mayo Clinic Proceedings
ASA Consensus Guidance | Preoperative management of patients on GLP-1 agonists
5 Jul, 2023 | 01:17h | UTCCommentary: Anesthesiologists Say Ozempic, Wegovy Should Be Halted Prior to Surgery – HealthDay
RCT | Opioids not more effective than placebo for acute low back and neck pain
5 Jul, 2023 | 01:15h | UTCOpioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial – The Lancet (link to abstract – $ for full-text)
News Releases:
Opioids no more effective than placebo for acute back and neck pain – University of Sidney
Opioid pain relievers do not reduce acute lower back and neck pain, study suggests – The Lancet
Commentary from the authors: Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds – The Conversation
RCT | No statistically significant impact of vitamin D on major cardiovascular events
5 Jul, 2023 | 01:11h | UTCRelated:
2ry analysis of a RCT | Vitamin D supplementation does not affect cognitive function in older adults
Randomized Trial: Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease
Meta-Analysis: Vitamin D Not Effective for Cardiovascular Disease Prevention
Vitamin D, calcium, other vitamins, and supplements do not prevent cardiovascular diseases
Review | Pathogenesis and management of abdominal aortic aneurysm
5 Jul, 2023 | 01:07h | UTCPathogenesis and management of abdominal aortic aneurysm – European Heart Journal
See also: Visual Abstract
2023 ESH Guidelines for the management of arterial hypertension
3 Jul, 2023 | 14:34h | UTC
RCT | Weekly insulin Icodec proves effective in glucose control in insulin-naive type 2 diabetes patients
3 Jul, 2023 | 14:32h | UTCSummary: The ONWARDS 3 randomized clinical trial studied the efficacy of once-weekly insulin icodec in comparison to once-daily insulin degludec for glucose control in insulin-naive type 2 diabetes patients. The double-masked, double-dummy trial was conducted from March 2021 to June 2022 across 92 sites in 11 countries, enrolling 588 adults with type 2 diabetes. The participants were randomly divided into two groups: 294 receiving once-weekly icodec and daily placebo, and 294 receiving daily degludec and weekly placebo.
The primary endpoint was the change in Hemoglobin A1c (HbA1c) from baseline to week 26. Insulin icodec showed a noninferior HbA1c change from the baseline (-1.6 percentage points) compared to insulin degludec (-1.4 percentage points) and demonstrated confirmed statistical superiority. However, the trial showed a higher rate of combined level 2 (clinically significant) or level 3 (severe) hypoglycemic events in the insulin icodec group than in the insulin degludec group, despite the overall low rates in both groups. There was no significant difference in weight changes between the two groups.
The study concluded that once-weekly insulin icodec demonstrated superior HbA1c reduction compared to once-daily degludec after 26 weeks of treatment in insulin-naive type 2 diabetes patients. The convenience of once-weekly administration should be considered against the slightly higher absolute risk of hypoglycemia. The study’s limitations include its short duration (26 weeks) and a lack of data on sustained effects, patient-reported outcomes, and continuous glucose monitoring.
Article: Once-Weekly Insulin Icodec vs Once-Daily Insulin Degludec in Adults With Insulin-Naive Type 2 Diabetes: The ONWARDS 3 Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
See also: Visual Abstract
Related Study: Weekly Icodec versus Daily Glargine U100 in Type 2 Diabetes without Previous Insulin – New England Journal of Medicine (link to abstract – $ for full-text)
Open-label RCT | Weekly insulin Icodec proves noninferior to daily Glargine in type 2 diabetes
3 Jul, 2023 | 14:23h | UTCWeekly Icodec versus Daily Glargine U100 in Type 2 Diabetes without Previous Insulin – New England Journal of Medicine (link to abstract – $ for full-text)
Related Study: Once-Weekly Insulin Icodec vs Once-Daily Insulin Degludec in Adults With Insulin-Naive Type 2 Diabetes: The ONWARDS 3 Randomized Clinical Trial – JAMA (free for a limited period)
USPSTF Recommendations | Screen for anxiety disorders in adults, including pregnant and postpartum women
30 Jun, 2023 | 15:03h | UTCEditorial: Are There Reasons to Fear Anxiety Screening? – JAMA
Evidence Report: Anxiety Screening: Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA
Patient Page: Screening for Anxiety Disorders in Adults – JAMA
Author Interview: USPSTF Recommendations: Screening for Depression and Suicide Risk in Adults, and Screening for Anxiety Disorders in Adults – JAMA
From NAFLD to MASLD | New consensus changes fatty liver disease terminology to avoid stigmatization
30 Jun, 2023 | 15:01h | UTCA multi-society Delphi consensus statement on new fatty liver disease nomenclature – Hepatology
Commentary on Twitter
Big news in the field of Hepatology
In 1980, Jurgen Ludwig and his colleagues at Mayo Clinic, identified a severe type of fatty liver disease in people who did not drink signficant amounts of alcohol. The disease was more common in women, most patients were obese and suffered… pic.twitter.com/aAq2vneIov
— TheLiverDoc (@theliverdr) June 25, 2023
Consensus Statement 2023 Update | Timing of elective surgery and risk assessment after SARS-CoV-2 infection
30 Jun, 2023 | 15:00h | UTCTiming of elective surgery and risk assessment after SARS-CoV-2 infection: 2023 update – Anaesthesia
Commentary on Twitter
?"In most circumstances, surgery should proceed unless risk assessment indicates that the risk of proceeding exceeds the risk of delay."@Assoc_Anaes @RCoANews @UkFssa @RCSnews @elboghdadly @doctimcook @justin_kua @NigelMercer @rmoonesinghe
?https://t.co/gfjymze0oi pic.twitter.com/D8bEfAHBD7
— ??????????? (@Anaes_Journal) June 20, 2023
Phase 2 RCT | FGF21 analogue Pegozafermin treatment leads to improvement in NASH fibrosis
30 Jun, 2023 | 14:58h | UTCSummary: In a phase 2b, multicenter, double-blind, randomized, placebo-controlled trial, the fibroblast growth factor 21 (FGF21) analogue pegozafermin was examined for its efficacy and safety in treating patients with biopsy-confirmed noncirrhotic nonalcoholic steatohepatitis (NASH). A total of 222 patients with moderate or severe fibrosis (stage F2 or F3) were assigned to receive either subcutaneous pegozafermin at varying doses or a placebo. The primary endpoints were an improvement in fibrosis and resolution of NASH without worsening of fibrosis at 24 weeks.
The results showed that a larger percentage of patients receiving pegozafermin met the criteria for fibrosis improvement and NASH resolution compared to those receiving placebo. The most significant improvements were observed in the 44-mg pegozafermin group, with 27% showing fibrosis improvement and 26% meeting NASH resolution criteria, compared to 7% and 2% in the placebo group, respectively. Adverse events were mainly gastrointestinal and included nausea and diarrhea. These findings support the progression of pegozafermin into phase 3 development.
Article: Randomized, Controlled Trial of the FGF21 Analogue Pegozafermin in NASH – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Late breaking at #EASLCongress: In this phase 2b, placebo-controlled trial involving patients with nonalcoholic steatohepatitis, pegozafermin, a long-acting glycopegylated FGF21 analogue, reduced fibrosis at 24 weeks. Full results by @drloomba et al.: https://t.co/mfRRrV2yX2
— NEJM (@NEJM) June 24, 2023
M-A | Metoclopramide effective in acute migraine relief, comparable to most active drugs, superior to placebo
30 Jun, 2023 | 14:51h | UTC
M-A | Interventions using wearable activity trackers to improve patient physical activity in adults who are hospitalized
30 Jun, 2023 | 14:46h | UTCAuthor Interview: Wearable Activity Trackers to Improve Physical Activity and Outcomes – JAMA
News Release: Wearable activity trackers accelerate hospital patient recovery – University of South Australia
Update on transfusion-related acute lung injury: an overview of its pathogenesis and management
30 Jun, 2023 | 14:31h | UTC
Post hoc analysis | Low-dose aspirin linked to increased risk of anemia in older adults
29 Jun, 2023 | 14:06h | UTCSummary: In a post hoc analysis of the ASPREE randomized controlled trial, the impact of daily low-dose aspirin on anemia, hemoglobin, and serum ferritin concentrations in elderly individuals was investigated. The study included 19,114 community-dwelling individuals aged 70 years and older (or ≥65 years for Black and Hispanic individuals) from Australia and the United States.
Findings reveal an increased incidence of anemia in the aspirin group compared to the placebo group (51.2 events versus 42.9 events per 1000 person-years, respectively). This correlates to a 20% increase in risk (hazard ratio, 1.20 [95% CI, 1.12 to 1.29]). Hemoglobin concentrations displayed a more pronounced decline in the aspirin group by 0.6 g/L per 5 years. Additionally, among participants with ferritin measures, the aspirin group exhibited a greater prevalence of ferritin levels less than 45 µg/L at year 3 and overall decline in ferritin by 11.5%. The study found similar results even in the absence of major bleeding.
This research underscores the risk of anemia and decline in ferritin in otherwise healthy older adults taking low-dose aspirin, highlighting the need for periodic monitoring of hemoglobin levels. However, the study lacked data on the causes of anemia, indicating the need for further research.
Article: Effect of Low-Dose Aspirin Versus Placebo on Incidence of Anemia in the Elderly: A Secondary Analysis of the Aspirin in Reducing Events in the Elderly Trial – Annals of Internal Medicine (link to abstract – $ for full-text)
News Release: Low-dose aspirin may increase anaemia risk in healthy older adults: study – Monash University
Commentaries:
Aspirin Use Ups Risk of Anemia in Elderly Patients: ASPREE – TCTMD
Low-dose aspirin associated with 20% increase in risk of anemia among older adults – ACP Internist
Original Study: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly – New England Journal of Medicine