Internal Medicine
International guidelines for hypertension: resemblance, divergence and inconsistencies.
27 Apr, 2022 | 07:41h | UTC
Review: Use of antimicrobials for bloodstream infections in the intensive care unit.
27 Apr, 2022 | 01:34h | UTC
Covid-19: Only a quarter of patients admitted to hospital feel fully recovered after a year, study finds.
26 Apr, 2022 | 08:45h | UTCInvited Commentary: Long COVID: systemic inflammation and obesity as therapeutic targets – The Lancet Respiratory Medicine
Commentary on Twitter (thread – click for more)
PHOSP-COVID study:
– 232 (29%) of 804 pts fully recovered at 1y
– Female sex, obesity, & IMV = less likely to feel fully recovered
– inflamm mediators📈in those w/ most severe physical, mental health, & cognitive impairmentsRead it here: https://t.co/rVZuVDo4xl
— The Lancet Respiratory Medicine (@LancetRespirMed) April 25, 2022
Persistent COVID-19 symptoms in a community study of 606,434 people in England.
26 Apr, 2022 | 08:48h | UTC
Commentary on Twitter
Thirty-eight percent of participants from a community-based study of symptoms following COVID-19 reported persistent symptoms that lasted 12 weeks or more, according to an article published in @NatureComms. https://t.co/sAEutdOkSS pic.twitter.com/oCyyXGIRbk
— Nature Portfolio (@NaturePortfolio) April 20, 2022
Practice Pointer: Making decisions about radiological imaging in pregnancy.
26 Apr, 2022 | 08:44h | UTCMaking decisions about radiological imaging in pregnancy – The BMJ
Yes, relapses after Paxlovid happen — now what?
26 Apr, 2022 | 08:18h | UTCYes, Relapses After Paxlovid Happen — Now What? – HIV and ID Observations
Commentary on Twitter
Some additional thoughts about relapsing Covid19 after treatment with Paxlovid.
Bottom line — *lots* of unknowns, starting w/ how often it happens.
Looking forward to @pfizer sharing further data on the relapsing cases from their EPIC-HR study. https://t.co/1MMhqn4elw
— Paul Sax (@PaulSaxMD) April 25, 2022
M-A: Evaluation of the incremental value of a coronary artery calcium score beyond traditional cardiovascular risk assessment.
26 Apr, 2022 | 08:15h | UTCEvaluation of the Incremental Value of a Coronary Artery Calcium Score Beyond Traditional Cardiovascular Risk Assessment: A Systematic Review and Meta-analysis – JAMA Internal Medicine (free for a limited period)
Invited Commentary: Addition of Coronary Artery Calcium Scores to Primary Prevention Risk Estimation Models—Primum Non Nocere – JAMA Internal Medicine (free for a limited period)
Author Interview: Incremental Value of a Coronary Artery Calcium Score
Commentary on Twitter
Coronary artery calcium scans provide a small gain in CVD risk assessment and may have a role in selected patients. Potential harms include false positives, incidental findings, radiation, and cost. No evidence suggests that this provides clinical benefit. https://t.co/7bASFf26NF
— JAMA Internal Medicine (@JAMAInternalMed) April 25, 2022
Consensus for the treatment of tinea pedis.
26 Apr, 2022 | 08:02h | UTC
Podcast: Curing Hepatitis C.
26 Apr, 2022 | 07:47h | UTC#329 Curing Hepatitis C – The Curbsiders
Podcast: Inpatient diabetes pearls.
26 Apr, 2022 | 07:48h | UTC#330 Inpatient Diabetes with Dr. Dave Lieb – The Curbsiders
Gout in the ED: Pearls and pitfalls.
26 Apr, 2022 | 07:37h | UTCGout in the ED: Pearls and Pitfalls – emDocs
NICE Guideline | Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults.
25 Apr, 2022 | 01:11h | UTC
Cohort Study: Association of the 2020 US presidential election with hospitalizations for acute cardiovascular conditions.
25 Apr, 2022 | 01:07h | UTCRelated:
Psychological Stress and Heart Disease: Fact or Folklore? – The American Journal of Medicine
Sudden Cardiac Death Triggered by an Earthquake – New England Journal of Medicine
Cardiovascular Events during World Cup Soccer – New England Journal of Medicine
Commentary from the author on Twitter (thread – click for more)
Found 42%⬆️in heart attacks days after 2020 US Presidential election ! Our study in 6,396,830 adults across California @JAMANetworkOpen https://t.co/4ikeNiWqkB with @MMeffordPhD & collaboration @HarvardChanSPH
Let's not underestimate the impact of emotional stress🔥on❤️
🧵 pic.twitter.com/GVohHz1iGU— Jamal Rana, MD (@JamalRanaMD) April 20, 2022
Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study.
25 Apr, 2022 | 01:00h | UTC
Commentary on Twitter
Echocardiography in #COVID19 #ICU pts, ECHO-COVID study
♥︎ systolic dysfunction in ⅓: 23% LV (similar to septic cardiomyopathy), 22.5% RV (due to P overload)
♥︎ ACP in 17% (due to hypercapnia, PE, MV)
♥︎ ACP/age associated with in-ICU mortality
📖 https://t.co/NUlAZh9hHw pic.twitter.com/t17pNolFqy— Intensive Care Medicine (@yourICM) April 21, 2022
Cohort Study: Association of cumulative blood pressure with cognitive decline, dementia, and mortality.
25 Apr, 2022 | 00:35h | UTC
Point/Counterpoint: Should asymptomatic OSA be treated in patients with significant cardiovascular disease?
25 Apr, 2022 | 00:24h | UTCPOINT: Should Asymptomatic OSA Be Treated in Patients With Significant Cardiovascular Disease? Yes – CHEST
COUNTERPOINT: Should Asymptomatic OSA Be Treated in Patients With Significant Cardiovascular Disease? No – CHEST
Anticholinergic medications and dementia: should we be worried?
25 Apr, 2022 | 00:14h | UTCCommonly-prescribed drugs and dementia: should we be worried? – Evidently Cochrane
Original Review:
Related:
How well do you know your anticholinergic (antimuscarinic) drugs? – Therapeutics Initiative
Anticholinergic drugs and risk of dementia: case-control study – The BMJ
Commentary on Twitter
Commonly-prescribed drugs & dementia: should we be worried? https://t.co/pvWxT6q48Z A @CochraneUK blog: Jodi Watt (a researcher @UofGlasgow) explores the @CochraneDCIG evidence on whether #anticholinergics might increase people’s risk of future memory problems, or even #dementia
— The Cochrane Library (@CochraneLibrary) April 22, 2022
Cohort Study: Progression to diabetes among older adults with Hemoglobin A1c–defined prediabetes was around 5% after a medium follow up of 2.3 years.
25 Apr, 2022 | 00:01h | UTCCommentaries:
How Often Does Prediabetes in Seniors Escalate to Full-Blown Disease? – MedPage Today (link to abstract – $ for full-text)
New Research Explores Diabetes Progression Rate in Older Adults with Prediabetes – HCP Livre
Related Study: Risk of Progression to Diabetes Among Older Adults With Prediabetes – JAMA Internal Medicine and Commentary: “Prediabetes” Diagnosis Less Useful in Older Patients – Johns Hopkins Bloomberg School of Public Health
Commentary on Twitter
This cohort study found that older adults with prediabetes showed higher progression to diabetes (5.3%) compared to prior studies. https://t.co/cHP7jyV7jT
— JAMA Network Open (@JAMANetworkOpen) April 21, 2022
WHO recommends highly successful COVID-19 therapy (nirmatrelvir-ritonavir) and calls for wide geographical distribution and transparency from originator.
22 Apr, 2022 | 09:36h | UTCSee also:
A living WHO guideline on drugs for covid-19 – The BMJ
Therapeutics and COVID-19: living guideline – World Health Organization
Related:
Commentary on Twitter
🔥 Our latest @WHO living guidance on drugs for #COVID19, with new recommendations for nirmatrelvir-ritonavir & updated recommendation for remdesivir in non-severe illness.@bmj_latest: https://t.co/KuJjwzeTPV@WHO: https://t.co/n3iQx3pdmY
@theMAGICapp: https://t.co/dA7YYzeAZ1 pic.twitter.com/LvAhJf70UY
— Arnav Agarwal (@ArnavAgarwalMD) April 21, 2022
UK drug regulator advises patients and doctors against the use of Pregabalin during pregnancy due to a possible increased risk of congenital malformations.
22 Apr, 2022 | 09:31h | UTCSee also: Pregabalin and risks in pregnancy – Medicines and Healthcare products Regulatory Agency
Source: Avoid prescribing pregabalin during pregnancy if possible, says UK drug regulator – The BMJ ($)
Commentary on Twitter
The Medicines and Healthcare Products Regulatory Agency (@MHRAgovuk) has strengthened its warning about avoiding pregabalin during pregnancy after new data showed an increased risk of major congenital malformations associated with the drug https://t.co/ghGvqCqA0C
— The BMJ (@bmj_latest) April 22, 2022
One-year follow-up of a RCT: In ICU patients with severe hypoxemia, there was no difference in long-term mortality and health-related quality of life with lower vs. higher oxygenation targets.
22 Apr, 2022 | 09:32h | UTCOriginal Study: Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure – New England Journal of Medicine
Commentary on Twitter
Lower (8 kPa) vs higher oxygenation (12 kPa) targets: no longterm survival benefit nor HRQoL improvement at 1y in #ICU pts with severe hypoxaemia (HOT-ICU trial cohort). Substantial impairments in several EQ-5D-5L dimensions in survivors in both groups.
🖇️ https://t.co/P48Cd5sIWK pic.twitter.com/JBFEIqDdcB— Intensive Care Medicine (@yourICM) April 20, 2022
RCT: Calorie restriction combined with time-restricted eating (eating from 8:00 am to 4:00 pm) did not significantly decrease weight loss compared to calorie restriction alone at 12 months (net difference, −1.8 kg; 95% CI, −4.0 to 0.4; P=0.11).
21 Apr, 2022 | 10:31h | UTCCalorie Restriction with or without Time-Restricted Eating in Weight Loss- New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Time-Restricted Eating No Better Than Cutting Calories for Obesity – HealthDay
Commentary on Twitter
As compared with calorie restriction, time-restricted eating does not produce additional benefits with regard to reduction of body weight, body fat, and metabolic risk factors. https://t.co/Ygx4zbC6QP pic.twitter.com/TGE5Pva3yS
— NEJM (@NEJM) April 20, 2022
[News release – not published yet] New guidelines from WHO recommend a simpler, safer treatment for cryptococcal disease in people living with HIV.
21 Apr, 2022 | 10:28h | UTCRelated Study: Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis – New England Journal of Medicine (link to abstract – $ for full-text)
Cohort study: COVID-19 infection granted patients strong and long-lasting protection from reinfection.
21 Apr, 2022 | 10:20h | UTCNews Release: COVID-19 infection granted patients strong and long-lasting protection from reinfection – Providence Health & Services
Original Study: Rates of COVID-19 Among Unvaccinated Adults With Prior COVID-19 – JAMA Network Open
Commentary: COVID-19 infection may offer similar immunity as vaccination – CIDRAP
Commentary on Twitter
This US cohort study found that unvaccinated individuals with prior symptomatic #COVID19 had 85% lower risk against recurrent COVID-19 compared to unvaccinated individuals without prior infection, for up to 9 months, through November, 2021. https://t.co/1qHCFmGqXG
— JAMA Network Open (@JAMANetworkOpen) April 20, 2022
SARS-CoV-2 vaccination and myocarditis in a Nordic cohort study of 23 million residents.
21 Apr, 2022 | 10:23h | UTCEditorial: Communicating the Benefits of Vaccination in Light of Potential Risks