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Internal Medicine

Systematic Review: Renal denervation may have a modest effect in improving 24h ambulatory blood pressure monitoring (reduction in SBP by 5.29 mmHg and DBP by 3.75 mmHg) but does not improve major cardiovascular outcomes and renal function.

24 Nov, 2021 | 08:33h | UTC

Summary: Renal denervation for improving outcomes in individuals with resistant hypertension – Cochrane Library

Original Review: Renal denervation for resistant hypertension – Cochrane Library

Related: M-A: Renal denervation for hypertension is associated with a modest reduction in ambulatory blood pressure control (3.61 mm Hg reduction in ambulatory systolic BP and 1.85 mm Hg reduction in ambulatory diastolic BP).

 

Commentary on Twitter

https://twitter.com/CochraneHTN/status/1462979551558995971

 

Chest Pain: Who needs additional testing beyond ECG and Troponin?

24 Nov, 2021 | 08:28h | UTC

Chest Pain: Who Needs Additional Testing Beyond ECG and Troponin? – JACC: Case Reports

 

RCT: A brief 5:2 diet advice resulted in similar weight loss at one year vs. a standard multicomponent weight-management advice (-2.6kg vs. -1.9kg, p = 0.37).

24 Nov, 2021 | 08:29h | UTC

A randomised controlled trial of the 5:2 diet – PLOS One

News Release: Brief 5:2 diet advice is as effective as traditional GP advice, but people like it better, according to new study – Queen Mary University of London

Commentary: Fasting 2 days a week can help obese people keep off the weight with modest results, study finds – CNN

 

A prospective cohort study showed a 3.1% risk for recurrent venous thromboembolism at 90 days in patients with subsegmental pulmonary embolism managed without anticoagulation.

24 Nov, 2021 | 08:31h | UTC

Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation: A Multicenter Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

 

Commentary on Twitter

 

Review: A Road Map of the Axial Spondyloarthritis Continuum.

24 Nov, 2021 | 08:27h | UTC

A Road Map of the Axial Spondyloarthritis Continuum – Mayo Clinic Proceedings

 

Review: Prevention and treatment of atrial fibrillation via risk factor modification.

24 Nov, 2021 | 08:25h | UTC

Prevention and Treatment of Atrial Fibrillation via Risk Factor Modification – American Journal of Cardiology

 

Systematic Review: Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery.

24 Nov, 2021 | 08:22h | UTC

Summary: Selective serotonin reuptake inhibitors for stroke recovery – Cochrane Library

Original Article: Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery – Cochrane Library

Related:

RCT: Routine treatment with fluoxetine does not reduce the incidence of depression after stroke.

[Abstract Only] Randomized trial: Fluoxetine does not improve functional recovery after acute stroke

Randomized Trial: Effects of Fluoxetine on Functional Outcomes After Acute Stroke

 

Commentary on Twitter

 

[Preprint] Systematic Review: Duration of Effectiveness of Vaccines Against SARS-CoV-2 Infection and COVID-19 Disease – “effectiveness against COVID-19 severe disease remained high (>70%) in most studies in the six months after full vaccination, although it did decrease some (on average, 8-10 percentage points) between one and six months after full vaccination”.

23 Nov, 2021 | 08:57h | UTC

Duration of Effectiveness of Vaccines Against SARS-CoV-2 Infection and COVID-19 Disease: Results of a Systematic Review and Meta-Regression – Preprints with The Lancet – SSRN

Related:

Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine.

China’s COVID vaccines have been crucial — now immunity is waning.

[Preprint] Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – “Vaccine protection declined by mid-August 2021, decreasing from 91.9% in March to 53.9%”.

Observational study in Qatar showed the effectiveness of Pfizer vaccine against any SARS-CoV-2 infection dropped to 20% in months 5 through 7 after the second dose, but effectiveness against severe Covid-19 remained high.

Cohort study: Pfizer vaccine effectiveness against any infections declined from 88% during the first month after full vaccination to 47% after 5 months. Vaccine effectiveness against hospital admissions remained high; 87% within 1 month, and 88% at 5 months after full vaccination, with no significant waning.

Editorial | Covid-19 vaccination: evidence of waning immunity is overstated.

COVID vaccine immunity is waning — how much does that matter? – “As debates about booster shots heat up, what’s known about the duration of vaccine-based immunity is still evolving”.

COVID vaccine effects wane over time but still prevent death and severe illness.

Perspective | What we actually know about waning immunity.

Another study shows Pfizer mRNA vaccine immunity is reduced over time.

[Press release – not published yet] Study shows vaccine protection wanes over time, but vaccines still offer good protection against severe disease.

Studies: COVID vaccine protection waning against infection but not hospitalization.

 

Populational study in France did not show an increased incidence of acute myocardial infarction, stroke, and pulmonary embolism following the Pfizer vaccine.

23 Nov, 2021 | 08:51h | UTC

Myocardial Infarction, Stroke, and Pulmonary Embolism After BNT162b2 mRNA COVID-19 Vaccine in People Aged 75 Years or Older – JAMA

 

M-A: Colchicine doesn’t lessen COVID-19 severity or stave off risk of death.

23 Nov, 2021 | 08:55h | UTC

News release: Gout drug colchicine doesn’t lessen COVID-19 severity or stave off risk of death – BMJ

Original Study: Efficacy and safety of colchicine in COVID-19: a meta-analysis of randomised controlled trials – RMD Open

Related:

RECOVERY Trial: In patients admitted to hospital with COVID-19, Colchicine did not reduce 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death.

[Preprint] PRINCIPLE RCT: Colchicine does not improve time to recovery in outpatients with Covid-19 at higher risk of complications.

COLCORONA RCT: Colchicine for community-treated patients with COVID-19 – findings suggest it may lower death and hospital admission rates, but further studies are required.

[Preprint] RECOVERY Trial: Colchicine does not improve outcomes in patients admitted to hospital with COVID-19.

 

ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease.

23 Nov, 2021 | 08:40h | UTC

ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease – American Journal of Gastroenterology

 

Commentary on Twitter (thread – click for more)

 

In a survey of about 27,600 U.S. individuals, 18.5% of adults with hypertension used medications that may raise blood pressure; the most commonly reported classes were antidepressants, nonsteroidal anti-inflammatory drugs, steroids, and estrogens.

23 Nov, 2021 | 08:33h | UTC

Prevalence of Medications That May Raise Blood Pressure Among Adults With Hypertension in the United States – JAMA Internal Medicine (free for a limited period)

 

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

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.

23 Nov, 2021 | 08:45h | UTC

IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections – Infectious Diseases Society of America

 

Commentary on Twitter

 

Antibiotic Awareness: a round-up of Cochrane evidence.

23 Nov, 2021 | 08:23h | UTC

Antibiotic Awareness: a round-up of Cochrane evidence – Cochrane Library

 

Commentary on Twitter

 

M-A: Current evidence does not support intensive blood pressure reduction as a preventive strategy for cognitive decline and dementia.

23 Nov, 2021 | 08:26h | UTC

Evaluation of Intensive vs Standard Blood Pressure Reduction and Association With Cognitive Decline and Dementia: A Systematic Review and Meta-analysis – JAMA Network Open

 

Commentary on Twitter

 

United States FDA clears COVID vaccine boosters for all adults over 18 – Pfizer & Moderna 6 months after second jab.

21 Nov, 2021 | 23:17h | UTC

United States FDA Clears COVID Vaccine Boosters for All Adults Over 18 – Pfizer & Moderna 6 Months After Second Jab – Health Policy Watch

See also:

FDA expands emergency authorization for Covid-19 booster shots to all adults – STAT

FDA, CDC advisors approve COVID boosters for all US adults – CIDRAP

FDA Approves Both Pfizer, Moderna Boosters for All Adults – HealthDay

 

EuGMS Guidance: Management of post-acute COVID-19 patients in geriatric rehabilitation.

21 Nov, 2021 | 23:14h | UTC

Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance – European Geriatric Medicine

Related:

Addressing Post-COVID Symptoms: A Guide for Primary Care Physicians.

Global surveillance, research, and collaboration needed to improve understanding and management of long COVID.

Provocative study suggests that persistent physical symptoms after COVID-19 infection may be associated more with the belief in having been infected with SARS-CoV-2 than with having laboratory-confirmed COVID-19 infection.

Update to post-acute sequelae of SARS-CoV-2 infection: Caring for the ‘long-haulers’.

Systematic Review: Short-term and long-term rates of postacute sequelae of SARS-CoV-2 infection.

WHO Consensus: A clinical case definition of post COVID-19 condition (Long Covid).

Characterizing long COVID: a living systematic review.

Long Covid – The illness narratives.

New guidelines to help doctors manage long COVID patients published.

M-A: More than 50 long-term effects of COVID-19. (several articles on the subject)

 

Recent updates in antimicrobial stewardship in outpatient parenteral antimicrobial therapy.

23 Nov, 2021 | 08:15h | UTC

Recent Updates in Antimicrobial Stewardship in Outpatient Parenteral Antimicrobial Therapy – Current Infectious Disease Reports

 

Non-invasive respiratory support in the management of acute COVID-19 pneumonia: considerations for clinical practice and priorities for research – “The two randomized controlled trials indicate superiority of non-invasive ventilation over high-flow nasal oxygen in reducing the need for intubation”.

21 Nov, 2021 | 23:15h | UTC

Non-invasive respiratory support in the management of acute COVID-19 pneumonia: considerations for clinical practice and priorities for research – The Lancet Respiratory Medicine

Related: [Preprint] RCT: non-invasive respiratory strategies in acute respiratory failure in patients with COVID-19 – CPAP reduced the composite outcome of intubation or death within 30 days; high-flow nasal oxygenation was not associated with better outcomes.

 

Commentary on Twitter

 

M-A: Convalescent plasma does not reduce mortality in COVID-19.

21 Nov, 2021 | 23:09h | UTC

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials – BMC Infectious Diseases

Related:

RCT: Another study shows convalescent plasma does not improve outcomes in critically ill patients with Covid-19.

RCT: Convalescent plasma does not improve outcomes and may be harmful to hospitalized patients with COVID-19.

NIH study shows no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms.

M-A: Convalescent plasma is safe but does not improve outcomes in the treatment of COVID-19.

RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.

 

Estimation of SARS-CoV-2 infection fatality rate by age and comorbidity status using antibody screening of blood donors during the COVID-19 epidemic in Denmark – “The IFR was low for people younger than 51 years without comorbidity during the two waves (combined IFR = 3.36 per 100,000 infections)”.

21 Nov, 2021 | 23:12h | UTC

Estimation of SARS-CoV-2 infection fatality rate by age and comorbidity status using antibody screening of blood donors during the COVID-19 epidemic in Denmark – The Journal of Infectious Diseases

 

Commentary on Twitter

 

Consensus Statement: U.S. Multi-Society Task Force on Colorectal Cancer now suggests average-risk CRC screening begins at age 45.

21 Nov, 2021 | 23:01h | UTC

Updates on Age to Start and Stop Colorectal Cancer Screening: Recommendations From the U.S. Multi-Society Task Force on Colorectal Cancer – Gastroenterology

News release: US Multi-Society Task Force on colorectal cancer releases updated screening recommendations - American Gastroenterological Association

Related:

State of the Art Review: Screening and prevention of colorectal cancer.

USPSTF Statement: Start colorectal cancer screening at 45 years for most patients.

ACG Clinical Guidelines: Start colorectal cancer screening at 45

 

Overdiagnosis: it’s official – the term is now included in the medical subject headings (MeSH) vocabulary.

21 Nov, 2021 | 22:53h | UTC

Overdiagnosis: it’s official – The BMJ

Related:

Overdiagnosis: what it is and what it isn’t – BMJ Evidence Based Medicine

Overdiagnosis across medical disciplines: a scoping review – The BMJ Open

Too much medical care: bad for you, bad for health care systems – STAT News

Screening: How overdiagnosis and other harms can undermine the benefits – Health News Review

Overdiagnosis: causes and consequences in primary health care – Canadian Family Physician

Five warning signs of overdiagnosis – The Conversation

What is overdiagnosed cancer? And why does it matter? – Croakey

Blame rising cancer overdiagnosis on ‘irrational exuberance’ for early detection – STAT

Preventing overdiagnosis and the harms of too much sport and exercise medicine – British Journal of Sports Medicine

Study shows that current definitions of chronic kidney disease overestimate the CKD burden in older individuals and results in overdiagnosis.

Opinion | More kids are being diagnosed with ADHD for borderline (yet challenging) behaviors. Our new research shows why that’s a worry

A food allergy epidemic… or just another case of overdiagnosis?

An epidemic of overdiagnosis: Melanoma diagnoses sky rocket

 

Clinical Guideline Highlights for the Hospitalist: Management of Upper Gastrointestinal and Ulcer Bleeding.

21 Nov, 2021 | 22:44h | UTC

Clinical Guideline Highlights for the Hospitalist: Management of Upper Gastrointestinal and Ulcer Bleeding – Journal of Hospital Medicine (free for a limited period)

Original Guideline: ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding – RBC transfusion at a threshold of 7 g/dL; Erythromycin infusion is suggested before endoscopy; and endoscopy is suggested within 24 hours after presentation.

 

RECOVERY Trial: Aspirin as an add-on therapy did not reduce mortality in patients hospitalized with COVID-19.

19 Nov, 2021 | 11:01h | UTC

Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial – The Lancet

Invited Commentary: Studying the coagulopathy of COVID-19 – The Lancet

 

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

 

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