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Internal Medicine

Study shows increased risk of Guillain-Barré syndrome following vaccination with recombinant zoster vaccine – “an attributable risk of 3 cases per million RZV (Shingrix) doses”.

2 Nov, 2021 | 02:45h | UTC

Risk of Guillain-Barré Syndrome Following Recombinant Zoster Vaccine in Medicare Beneficiaries – JAMA Internal Medicine (free for a limited period)

Related: FDA Requires a Warning about Guillain-Barré Syndrome (GBS) be Included in the Prescribing Information for Shingrix

 

Consensus Statement: Preoperative management of gastrointestinal and pulmonary medications.

2 Nov, 2021 | 02:53h | UTC

Preoperative Management of Gastrointestinal and Pulmonary Medications: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement – Mayo Clinic Proceedings

Related articles from Mayo Clinic Proceedings:

Consensus Statement: Preoperative management of endocrine, hormonal, and urologic medications

Consensus statement: Preoperative management of opioid and nonopioid analgesics

Perioperative evaluation and management of patients with diabetes, thyroid disease, and adrenal insufficiency. Use of insulin and noninsulin diabetic medications, management of hyper and hypothyroidism, and use of stress-dose corticosteroids are some of the subjects reviewed

Review: Preoperative Cardiac Risk Assessment

Review | Perioperative cardiac risk reduction in noncardiac surgery.

Systematic Review of Perioperative Cardiac Risk Prediction Indices

Review: Perioperative venous thromboembolism prophylaxis

 

Short Review: Metronidazole-induced neurotoxicity.

2 Nov, 2021 | 02:41h | UTC

Metronidazole-induced neurotoxicity – Canadian medical Association Journal

 

Commentary on Twitter

 

Short Review: Ketamine for the treatment of acute pain.

2 Nov, 2021 | 02:43h | UTC

Ketamine for the treatment of acute pain – Canadian Medical Association Journal

 

Commentary on Twitter

 

Observational study suggests a third dose of the Pfizer COVID-19 vaccine can prevent severe COVID-19-related outcomes, compared with only two doses received at least 5 months before.

31 Oct, 2021 | 20:14h | UTC

Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study – The Lancet

Invited Commentary: Boosters appear effective, but are they always needed? – The Lancet

 

Commentaries on Twitter

 

Study shows fully vaccinated individuals can still catch SARS-CoV-2 delta variant and efficiently transmit infection in household settings, including to fully vaccinated contacts.

31 Oct, 2021 | 20:16h | UTC

Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study – The Lancet Infectious Diseases

Commentaries:

COVID vaccines effective but household transmission of delta a risk for 1 in 4 – Imperial College London

What is the vaccine effect on reducing transmission in the context of the SARS-CoV-2 delta variant? – The Lancet Infectious Diseases

CoVID-19 vaccines lower risk of infection with delta variant, but infection can still be passed on in household settings – the Lancet

COVID vaccines protect against Delta but don’t fully stop disease spread – CIDRAP

Covid: Double vaccinated can still spread virus at home – BBC

 

Commentary on Twitter

 

CDC Study: COVID-19 vaccine associated with 5 times the protection of ‘natural immunity’.

31 Oct, 2021 | 20:09h | UTC

Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19–Like Illness with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Immunity — Nine States, January–September 2021 – CDC Morbidity and Mortality Weekly Report

Commentaries:

COVID-19 vaccine gives 5 times the protection of ‘natural immunity,’ data show – CIDRAP

COVID shots more protective than past infection, study shows – Associated Press

 

Commentary on Twitter

 

Cohort Study: Among patients with ST-segment elevation myocardial infarction, a concomitant Covid-19 diagnosis is associated with increased in-hospital mortality.

31 Oct, 2021 | 20:10h | UTC

Association Between COVID-19 Diagnosis and In-Hospital Mortality in Patients Hospitalized With ST-Segment Elevation Myocardial Infarction – JAMA

Editorial: Myocardial Infarction During the COVID-19 Pandemic – JAMA

Commentary: STEMI and COVID-19 Often a Lethal Combo, Affirms Largest Study Yet – TCTMD

 

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

 

NICE Guideline | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management.

31 Oct, 2021 | 20:03h | UTC

Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management – National Institute for Health and Care Excellence

Commentaries:

Chronic fatigue syndrome advice scraps exercise therapy – BBC

ME exercise therapy guidance scrapped by health watchdog Nice – The Guardian

 

Cardiovascular clinical examination: the need for an evidence-based approach.

31 Oct, 2021 | 19:57h | UTC

Cardiovascular clinical examination: the need for an evidence-based approach – European Heart Journal

 

Commentary on Twitter

 

Study suggests smoking cessation, but not reduction, is associated with reduced risk of cardiovascular disease.

31 Oct, 2021 | 19:59h | UTC

Smoking cessation, but not reduction, reduces cardiovascular disease incidence – European Heart Journal (link to abstract – $ for full-text)

 

Commentary on Twitter

 

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

29 Oct, 2021 | 10:20h | UTC

Update to post-acute sequelae of SARS-CoV-2 infection: Caring for the ‘long-haulers’ – Cleveland Clinic Journal of Medicine

Related:

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)

 

Review: How I manage a patient with MRSA bacteremia.

31 Oct, 2021 | 19:54h | UTC

How I manage a patient with MRSA bacteraemia – Clinical Microbiology and Infection

 

The effectiveness of the AstraZeneca vaccine in older adults during SARS-CoV-2 Gamma variant circulation in São Paulo was 77.9% against symptomatic Covid-19, 87.6% against hospitalization, and 93.6% against death.

29 Oct, 2021 | 10:25h | UTC

Effectiveness of ChAdOx1 vaccine in older adults during SARS-CoV-2 Gamma variant circulation in São Paulo – Nature Medicine

 

Commentary on Twitter (thread – click for more)

https://twitter.com/MHitchingsEpi/status/1453779176826105857

 

2021 AHA/ACC Guideline for the Evaluation and Diagnosis of Chest Pain.

29 Oct, 2021 | 09:57h | UTC

2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines – Journal of the American College of Cardiology

Executive Summary: 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain – Journal of the American College of Cardiology

News Release: First-Ever Guideline Focused Solely on Chest Pain Evaluation, Diagnosis Released

Guideline Hub: Guideline for the Evaluation and Diagnosis of Chest Pain

Key Points: 2021 AHA/ACC Chest Pain Guideline – American College of Cardiology

Commentary: New Chest Pain Guidelines Out at Last: Most Tests Have a Role – TCTMD

 

Commentary on Twitter (thread – click for more)

 

Systematic Review: GLP-1 receptor agonists and SGLT-2 inhibitors are likely to reduce the risk of death from cardiovascular disease and death from any cause in people with both diabetes and established cardiovascular disease.

29 Oct, 2021 | 09:52h | UTC

Dipeptidyl peptidase‐4 inhibitors, glucagon‐like peptide 1 receptor agonists and sodium‐glucose co‐transporter‐2 inhibitors for people with cardiovascular disease: a network meta‐analysis – Cochrane Library

Summary: The effects of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors for people with cardiovascular disease – Cochrane Library

 

Commentary on Twitter

 

Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis.

29 Oct, 2021 | 09:49h | UTC

Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis – Intensive Care Medicine

 

Commentary on Twitter

 

Stimulant prescription linked to increased short-term risks of cardiovascular events in older adults.

29 Oct, 2021 | 09:47h | UTC

Assessment of Stimulant Use and Cardiovascular Event Risks Among Older Adults – JAMA Network Open

Commentaries:

Use of stimulants in older adults associated with higher risk for cardiovascular events in first month – University of Toronto

Stimulants Linked to Early Risk of CV Events in Elderly – TCTMD

Stimulants May Pose Short-Term Cardiovascular Risks in Older Adults – Psychiatric News Alert

 

RCT: Early treatment of Covid-19 with SARS-CoV-2 neutralizing antibody Sotrovimab is associated with reduced risk of hospitalization.

28 Oct, 2021 | 10:20h | UTC

Early Treatment for Covid-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab – New England Journal of Medicine

 

Commentary on Twitter

 

RCT: Early treatment with fluvoxamine reduced the risk of emergency care and hospitalization among patients with COVID-19.

28 Oct, 2021 | 10:22h | UTC

Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial – The Lancet Global Health

Commentaries:

Expert reaction to study looking at fluvoxamine as a COVID-19 treatment in high-risk outpatients with early-diagnosed COVID-19 – Science Media Centre

The TOGETHER Trial: COVID-19 and Fluvoxamine Take Two – REBEL EM

The antidepressant fluvoxamine can keep COVID-19 patients out of the hospital – ScienceNews

Related:

[Preprint] RCT: Fluvoxamine reduced the risk for ER visits and hospitalization among patients with Covid-19.

Opinion | Could this be our first effective, inexpensive, widely available outpatient treatment for COVID-19? (It’s fluvoxamine).

Preliminary study shows fluvoxamine may reduce clinical deterioration in outpatients with symptomatic COVID-19

 

Commentary on Twitter

 

Brain fog can persist for months after COVID diagnosis.

28 Oct, 2021 | 10:13h | UTC

Assessment of Cognitive Function in Patients After COVID-19 Infection – JAMA Network Open

Commentaries:

Brain fog can persist 8 months after COVID diagnosis – CIDRAP

Brain fog in Covid-19 patients can persist for months, even in those who were not hospitalized, study finds – CNN

 

ESC Consensus Document | Frailty in cardiology: definition, assessment and clinical implications for general cardiology.

28 Oct, 2021 | 09:59h | UTC

Frailty in cardiology: definition, assessment and clinical implications for general cardiology. A consensus document of the Council for Cardiology Practice (CCP), Association for Acute Cardio Vascular Care (ACVC), Association of Cardiovascular Nursing and Allied Professions (ACNAP), European Association of Preventive Cardiology (EAPC), European Heart Rhythm Association (EHRA), Council on Valvular Heart Diseases (VHD), Council on Hypertension (CHT), Council of Cardio-Oncology (CCO), Working Group (WG) Aorta and Peripheral Vascular Diseases, WG e-Cardiology, WG Thrombosis, of the European Society of Cardiology, European Primary Care Cardiology Society (EPCCS) – European Journal of Preventive Cardiology

 

Review: Genome sequencing as a diagnostic test.

28 Oct, 2021 | 09:42h | UTC

Genome sequencing as a diagnostic test – Canadian Medical Association Journal

 

Breakthrough infections occur in those with lower antibody levels.

27 Oct, 2021 | 01:45h | UTC

Breakthrough Infections Occur in Those with Lower Antibody Levels, Israeli Study Shows – NIH Director’s Blog

Original study: Covid-19 Breakthrough Infections in Vaccinated Health Care Workers – New England Journal of Medicine

 

Mix-and-match COVID vaccines ace the effectiveness test – “No need for brand loyalty”.

27 Oct, 2021 | 01:42h | UTC

Mix-and-match COVID vaccines ace the effectiveness test – Nature

Related:

Cohort Study: The effectiveness of heterologous AstraZeneca (AZ)/mRNA prime-boost vaccination was more significant (68%) compared to the effectiveness of homologous AZ/AZ vaccination (50%) against symptomatic Covid-19 infection in Sweden.

Should You Mix and Match Your Booster Shot?

Study evaluated several heterologous SARS-CoV-2 vaccine regimens; no efficacy data but there was increased antibody production on study days 15 and 29 after booster shots from Moderna and Pfizer.

A primer on what we know about mixing and matching Covid vaccines.

Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination.

RCT: Safety and immunogenicity of heterologous vs. homologous prime-boost schedules with an adenoviral vectored and mRNA COVID-19 vaccine.

Another study shows increased immune response with heterologous Oxford-AstraZeneca/mRNA vaccination.

Heterologous Oxford–AstraZeneca and Moderna Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

Heterologous Oxford–AstraZeneca and BioNTech/Pfizer Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

[Preprint] Mixing Covid jabs has good immune response, study finds – “The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system”.

Phase 2 RCT: Immunogenicity and reactogenicity of a Pfizer-BioNTech booster in patients that have received a single dose of AstraZeneca vaccine – “BNT162b2 (Pfizer) given as a second dose in individuals prime vaccinated with ChAdOx1-S (AstraZeneca) induced a robust immune response, with an acceptable and manageable reactogenicity profile”.

Lab study shows heterologous AstraZeneca/Pfizer vaccination produces strong immune response against SARS-CoV-2 Delta variant.

Lab study shows a heterologous AstraZeneca + Pfizer immunization strategy provides stronger immunogenicity against Covid compared to homologous AZ + AZ or Pfizer + Pfizer strategies.

RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.

 

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