Internal Medicine | Page 157 of 487 | Links Medicus Content Curation & Alerts in Medicine

New study challenges the idea that a coronary artery calcium score of 0 is enough for ruling out coronary stenosis in symptomatic patients, especially in young adults.

7 Nov, 2021 | 20:09h | UTC

Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients – JAMA Cardiology (link to abstract – $ for full-text)

Commentary: Zero CAC Questionable for Ruling Out Obstructive CAD in Young Adults – TCTMD

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

There has been a lot of discussion about our recent paper in JAMA Cardiology. In my opinion, much of the discussion is caused by a troublesome extrapolation of the results to the value of CAC in risk assessment in primary prevention. I will go through our findings in these tweets https://t.co/O0Rl12XYmV

— Martin Bødtker Mortensen (@MaBMortensen) November 1, 2021

NICE draft guideline recommends SGLT2 inhibitor dapagliflozin for some patients with chronic kidney disease.

7 Nov, 2021 | 20:14h | UTC

NICE recommend dapagliflozin for people with chronic kidney disease – National Institute for Health and Care Excellence

See draft guideline:

Appraisal consultation document (online commenting)

Appraisal consultation document (PDF version)

NICE Guideline: Assessment and management of chronic kidney disease.

Secondary analysis of RCT finds Dapagliflozin is safe for patients with stage 4 chronic kidney disease.

Randomized trial: Dapagliflozin in patients with chronic kidney disease

Study compares the decline in effectiveness for Moderna, Pfizer, and Janssen vaccines and consequences for mortality.

5 Nov, 2021 | 09:59h | UTC

Original study: SARS-CoV-2 vaccine protection and deaths among US veterans during 2021 – Science

News release: Breakthrough Infection Study Compares Decline in Vaccine Effectiveness and Consequences for Mortality – Public Health Institute

Commentary on Twitter

A new study of more than 780,000 United States Veterans shows that, although vaccination remains protective against #SARSCoV2 infection, protection waned as the Delta variant emerged in America.

Read more: https://t.co/8qRlKE107H #ScienceResearch pic.twitter.com/XmDQ7frIlT

— Science Magazine (@ScienceMagazine) November 4, 2021

The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first.

5 Nov, 2021 | 09:51h | UTC

The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first – NPR

Merck to allow other nations to produce new COVID-19 antiviral.

Video: Merck’s Covid pill could transform treatment. Here’s how it works.

How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.

What we know — and don’t know — about Merck’s new Covid-19 pill.

[Press release – not published yet] Merck announces oral antiviral Molnupiravir reduced the risk of hospitalization or death by approximately 50 Percent compared to placebo for patients with mild or moderate COVID-19.

Merck’s Covid-19 pill is great news but may not be a game-changer.

Video | A Pill For COVID? A Doctor Explains Molnupiravir.

Clinical Care Pathway for the Risk Stratification and Management of Patients with Nonalcoholic Fatty Liver Disease.

5 Nov, 2021 | 09:50h | UTC

Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease – Gastroenterology

News release: International experts develop Clinical Care Pathway in response to NASH epidemic – American Gastroenterology Association

Non-alcoholic fatty liver disease: A patient guideline.

State of the art review: Management of non-alcoholic fatty liver disease

M-A: Non-alcoholic fatty liver disease linked to increased risk of fatal and non-fatal cardiovascular events.

M-A: non-invasive tests for advanced fibrosis can reduce the need for biopsy in patients with non-alcoholic fatty liver disease.

Review: Dietary carbohydrates and fats in nonalcoholic fatty liver disease.

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).

5 Nov, 2021 | 09:46h | UTC

Renal Denervation for Hypertension: A Systematic Review and Meta-Analysis of Randomized, Blinded, Placebo-Controlled Trials – JACC: Cardiovascular Interventions

Commentaries:

Meta-Analysis of Renal Denervation for Hypertension – American College of Cardiology

Is Renal Denervation a Useful Strategy in BP Management? – American College of Cardiology

#ACC21 – RCT: Among patients with resistant hypertension, ultrasound renal denervation resulted in a modest improvement in systolic BP (–4.5 mm Hg) vs. sham procedure.

Meta-Analysis: Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients with Hypertension

RCT: In patients with three-vessel coronary artery disease, an FFR–guided PCI strategy was NOT noninferior to coronary bypass surgery – The 1-year incidence of the composite primary end point (death, myocardial infarction, or stroke) was 7.3% in the FFR-guided PCI group and 5.2% in the CABG group.

5 Nov, 2021 | 09:49h | UTC

Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery – New England Journal of Medicine

Commentaries:

FAME 3: PCI Fails to Demonstrate Noninferiority to Surgery in Three-Vessel CAD – TCTMD

FAME 3: FFR-Guided PCI vs. CABG in Patients With Three-Vessel CAD – American College of Cardiology

Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3 – FAME 3 – American College of Cardiology

Commentary on Twitter

In this trial, patients with three-vessel coronary artery disease, PCI guided by assessment of fractional flow reserve was not noninferior to CABG with respect to the composite end point of death, myocardial infarction, stroke, or repeat revascularization. https://t.co/uYZGZWub0T pic.twitter.com/zsghs2SlsA

— NEJM (@NEJM) November 4, 2021

Cluster RCT: In older adults with advanced cancer, a geriatric assessment program reduced the toxic effects of cancer treatment.

5 Nov, 2021 | 09:48h | UTC

Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised study – The Lancet

News Release: Less Chemotherapy, Personalized Care: Wilmot Study Reinforces Major Strides in Geriatric Oncology – University of Rochester Medical Center

RCT: A geriatric assessment–driven intervention can reduce chemotherapy-related toxic effects in older adults with cancer.

Perspective: A Cancer Care Approach Tailored to The Elderly May Have Better Results

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

https://twitter.com/rochgerionc/status/1456046017766375425

Observational study showed J&J single shot vaccine had an effectiveness of 74% against symptomatic Covid-19.

4 Nov, 2021 | 10:08h | UTC

Analysis of the Effectiveness of the Ad26.COV2.S Adenoviral Vector Vaccine for Preventing COVID-19 – JAMA Network Open

Commentaries:

Single-Dose Ad26.COV2.S Vaccine—Room for Improvement – JAMA Network Open

Real-world study shows J&J COVID-19 vaccine 74% effective – CIDRAP

J&J COVID-19 Vaccine: FDA recommends booster shot for all adults aged 18 and older at least two months following initial vaccination with the single-shot vaccine.

[Press release – not published yet] J&J says booster shot at two months provided 75% protection against moderate to severe COVID-19 globally and 94% of such cases in the U.S.

CDC Report: Moderna’s vaccine associated with greater effectiveness (93%) against Covid-19 hospitalization compared to Pfizer (88%) and J&J (71%) vaccines.

[Preprint] Observational study finds single-dose Johnson & Johnson vaccine is 76.7% effective in preventing SARS-CoV-2 infection

RCT: Single-Dose Johnson & Johnson Vaccine has 85% efficacy against severe/critical Covid-19 and maintains efficacy against variant B.1.351

Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain.

5 Nov, 2021 | 09:44h | UTC

Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain – Journal of Hospital Medicine

Large observational study suggests Tramadol is associated with increased risk of adverse outcomes compared to Codeine.

Tramadol: Where do we go from here? – “Tramadol’s unpredictability, unique potential harms, and lack of advantage over other opioids or NSAIDs are now well recognized”.

Cohort Study: Chronic Use of Tramadol After Acute Pain Episode

CDC Guidance: Immunocompromised may need a fourth Covid-19 shot.

4 Nov, 2021 | 10:06h | UTC

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States – Centers for Disease Control and Prevention

Commentaries:

Immunocompromised may need a fourth Covid-19 shot, CDC says – CNN

Some immunocompromised people can receive a 4th Covid shot, CDC says – NBC News

The USPSTF draft statement recommends against screening for chronic obstructive pulmonary disease in asymptomatic adults.

4 Nov, 2021 | 09:56h | UTC

Chronic Obstructive Pulmonary Disease: Screening – U.S. Preventive Services Task Force

Commentary: USPSTF Still Advises Against COPD Screening for Asymptomatic Adults – HealthDay

ASH Guideline issued a conditional recommendation against routine use of outpatient anticoagulant prophylaxis in patients with COVID-19 being discharged from the hospital.

4 Nov, 2021 | 10:03h | UTC

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: July 2021 update on post-discharge thromboprophylaxis – Blood Advances

M-A: Zinc might help to stave off respiratory infection symptoms and cut illness duration – “But quality of evidence variable, and no clarity on optimal formulation or dose”.

4 Nov, 2021 | 09:53h | UTC

News Release: Zinc might help to stave off respiratory infection symptoms and cut illness duration – BMJ

Original Study: Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials – BMJ Open

Commentary on Twitter

A zinc supplement might help stave off the symptoms of respiratory tract infections, such as coughing, congestion, and sore throat, and cut illness duration, suggests a pooled analysis of the available evidence, published in @BMJ_Open https://t.co/Nq5KadAw5y

— BMJ Group (@bmj_company) November 2, 2021

Review: Lower carbohydrate diets for adults with type 2 diabetes.

4 Nov, 2021 | 09:55h | UTC

Lower carbohydrate diets for adults with type 2 diabetes – British Journal of Nutrition

Meta-analysis of randomized trials: patients adhering to a low carbohydrate diet for six months may experience remission of diabetes without adverse consequences

Low carbohydrate diet: Insights from a general practice service in patients with type 2 diabetes

Position Statement on Low-Carbohydrate Diets for Adults with Diabetes

Low Carbohydrate Diets for Diabetes: A Review of the Clinical Effectiveness and Guidelines

Systematic Review: Low‐carbohydrate Diets for Type 2 Diabetes Management

Practical Guide: Adapting Diabetes Medication for Low Carbohydrate Management of Type 2 Diabetes

Observational Study: Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet

Study: Dietary Carbohydrate Restriction Improves Metabolic Syndrome Independent of Weight Loss

Research: Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes

A national HPV vaccination program in England was associated with an estimated reduction in cervical cancer rates of 87% for those offered the vaccine at age 12–13 years.

4 Nov, 2021 | 09:58h | UTC

The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study – The Lancet

Nationwide cohort study in Sweden shows HPV vaccination linked to reduced risk of invasive cervical cancer

CDC: 92% of Human Papillomavirus–Attributable Cancers can be Targeted by HPV Vaccination

Meta-Analysis: Population-level Impact of HPV Vaccination Programs

Commentary on Twitter

NEW—Cervical cancer rates 87% lower in women offered vaccination against human papillomavirus (#HPV) between ages 12-13 than in previous generations, English study confirms.

First direct evidence of cervical cancer prevention using bivalent vaccine: https://t.co/HdQbGIKxZp pic.twitter.com/PMFermHGOv

— The Lancet (@TheLancet) November 3, 2021

Spontaneous coronary artery dissection: Principles of management.

4 Nov, 2021 | 09:52h | UTC

Spontaneous coronary artery dissection: Principles of management – Cleveland Clinic Journal of Medicine

Spontaneous Coronary Artery Dissection: Pitfalls of Angiographic Diagnosis and an Approach to Ambiguous Cases.

Spontaneous Coronary Artery Dissection: Clinical Considerations in Diagnosis and Treatment

Review: Spontaneous Coronary Artery Dissections and Associated Predisposing Factors

Study: Natural History of Spontaneous Coronary Artery Dissection

Spontaneous Coronary Artery Dissection: An Often Unrecognized Cause of Acute Coronary Syndrome

ESC position paper on spontaneous coronary artery dissection

Guideline: Spontaneous Coronary Artery Dissection

Study: Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence

Short Review: Cardiac injury in Covid-19.

3 Nov, 2021 | 10:04h | UTC

Cardiac injury in COVID-19 – Intensive Care Medicine

Commentary on Twitter

Myocardial injury in #COVID19, many potential mechanisms:
🫀myocardial DO2/VO2 imbalance
🫀ARDS & MV
🫀cytokine storm
🫀direct viral lesion.
Variable clinical presentations, with high complications rates, mortality & risk of long-term cardiac impairment.https://t.co/wxPDDrtEoY pic.twitter.com/vOx1B4cwY2

— Intensive Care Medicine (@yourICM) November 2, 2021

Review: The role of chest imaging in the diagnosis, management, and monitoring of Covid-19.

3 Nov, 2021 | 10:05h | UTC

The role of chest imaging in the diagnosis, management, and monitoring of coronavirus disease 2019 (COVID-19) – Insights into Imaging

AHA Scientific Statement: 2021 Dietary Guidance to Improve Cardiovascular Health.

3 Nov, 2021 | 10:00h | UTC

2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association – Circulation

News release: New look at nutrition research identifies 10 features of a heart-healthy eating pattern – American Heart Association

Top Things to Know: 2021 Dietary Guidance to Improve Cardiovascular Health – American Heart Association

Commentaries:

‘Balance’ is the key word in new dietary guidance for heart health – American Heart Association

The new American Heart Association dietary guidance to improve population-level cardiometabolic health: moving toward a heart-healthy food environment – American Heart Association

Commentary on Twitter

CHOOSE MINIMALLY PROCESSED FOODS INSTEAD OF ULTRA-PROCESSED FOODS is one of the 10 evidence-based dietary pattern recommendations in the new excellent 2021 American Heart Association Scientific Statement on Dietary Guidance to Improve Cardiovascular Healthhttps://t.co/YgtDKz05EP

— Carlos A. Monteiro (@CMonteiro_USP) November 2, 2021

Review: Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation.

3 Nov, 2021 | 09:45h | UTC

Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation – Nature Reviews Gastroenterology & Hepatology

Commentary on Twitter

New content online: Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation https://t.co/sWd1Vs6N2c pic.twitter.com/XZo8ETzhEl

— Nature Reviews Gastroenterology & Hepatology (@NatRevGastroHep) November 2, 2021