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Internal Medicine

Heterologous AstraZeneca/Pfizer vaccination seems to be associated with increased effectiveness against Covid-19 compared to homologous Pfizer/Pfizer vaccination.

27 Oct, 2021 | 01:44h | UTC

Immunogenicity and efficacy of heterologous ChadOx1/BNT162b2 vaccination – 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.

 

Commentary on Twitter

 

COVID super-immunity: one of the pandemic’s great puzzles – “People who have previously recovered from COVID-19 have a stronger immune response after being vaccinated than those who have never been infected. Scientists are trying to find out why”.

27 Oct, 2021 | 01:41h | UTC

COVID super-immunity: one of the pandemic’s great puzzles – Nature

 

UEG Consensus on Functional Dyspepsia.

27 Oct, 2021 | 01:32h | UTC

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia – UEG Journal

 

RCT: In critically ill patients, an individualized glucose control targeting an ICU patient’s pre-admission usual glycemia did not demonstrate a survival benefit compared to conventional glucose control (targeting glycemia below 180 mg/dL).

27 Oct, 2021 | 01:17h | UTC

Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study—a randomized clinical trial – Intensive Care Medicine

Editorial: The goal of personalized glucose control in the critically ill remains elusive – Intensive Care Medicine

 

Anticoagulants and diabetes agents are among the most frequent causes of emergency department visits attributed to medication harms.

27 Oct, 2021 | 01:15h | UTC

US Emergency Department Visits Attributed to Medication Harms, 2017-2019 – JAMA (link to abstract – $ for full-text)

Commentaries:

Number of emergency room visits for medication harms increases with age – MedicalResearch.com

Blood thinners, diabetes meds among top causes of drug-related ER visits – UPI

 

Systematic Review: Antibiotics for the treatment of COVID‐19 – “We are certain that risk of death in hospitalized COVID‐19 patients is not reduced by treatment with azithromycin after 28 days”.

26 Oct, 2021 | 02:07h | UTC

Antibiotics for the treatment of COVID‐19 – Cochrane Library

 

Commentary on Twitter

 

Case Series: Toxic effects from ivermectin use associated with prevention and treatment of Covid-19.

26 Oct, 2021 | 02:02h | UTC

Toxic Effects from Ivermectin Use Associated with Prevention and Treatment of Covid-19 – New England Journal of Medicine

 

Infection with Covid-19 carries a much higher risk of developing neurological complications than Covid-19 vaccines.

26 Oct, 2021 | 02:04h | UTC

News Release: Infection with Covid-19 carries a much higher risk of developing neurological complications than a vaccine, says new study – University of Nottingham

Original Study: Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection – Nature Medicine

Commentaries:

Covid: Vaccine study links virus to rare neurological illness – BBC

Expert reaction to study looking at rare neurological complications after SARS-CoV-2 infection and COVID-19 vaccination – Science Media Centre

 

Commentary on Twitter

 

Cohort Study: Bacterial Superinfection Pneumonia in Patients Mechanically Ventilated for COVID-19 Pneumonia – “Bacterial superinfection within 48 hours of intubation was detected in 21 percent of patients”.

26 Oct, 2021 | 01:59h | UTC

Bacterial Superinfection Pneumonia in Patients Mechanically Ventilated for COVID-19 Pneumonia – American Journal of Respiratory and Critical Care Medicine

Commentary: Potential Overuse of Antibiotics Found in Patients with Severe COVID-19 Pneumonia – American Thoracic Society

 

Commentary on Twitter

 

COVID: how worried should we be about the new AY.4.2 lineage of the coronavirus?

26 Oct, 2021 | 02:01h | UTC

COVID: how worried should we be about the new AY.4.2 lineage of the coronavirus? – The Conversation

 

What It Means To Be Fully Vaccinated.

26 Oct, 2021 | 01:57h | UTC

What It Means To Be Fully Vaccinated – Think Global Health

 

Adult-Onset Type 1 Diabetes: Current Understanding and Challenges.

26 Oct, 2021 | 01:47h | UTC

Adult-Onset Type 1 Diabetes: Current Understanding and Challenges – Diabetes Care

Related:

ADA Consensus Report: The Management of Type 1 Diabetes in Adults.

Guideline: ADA 2021 Standards of Medical Care in Diabetes

 

Consensus and algorithm on the diagnosis and management of Cushing’s disease: a guideline update.

26 Oct, 2021 | 01:49h | UTC

Consensus on diagnosis and management of Cushing’s disease: a guideline update – The Lancet Diabetes & Endocrinology (free registration required)

Related:

Meta-Analysis: Effectiveness of Medical Treatment for Cushing’s Syndrome

COVID-19 and Cushing’s Syndrome Recommendations

Practice recommendations for the management of the most common forms of secondary hypertension, including primary aldosteronism, renovascular hypertension, pheochromocytoma, Cushing’s syndrome, and sleep apnea

 

Commentary on Twitter

 

Review: Thoracic involvement and imaging patterns in IgG4-related disease.

26 Oct, 2021 | 01:22h | UTC

Thoracic involvement and imaging patterns in IgG4-related disease – European Respiratory Review

 

Commentary on Twitter

 

Opinion | COVID STEROID-2: Double the steroid, double the fun? – “Dexamethasone 6 mg/day alone is likely suboptimal for most patients with severe COVID pneumonia. Dexamethasone 12 mg/day may provide a reasonable intensity of immunomodulation”.

25 Oct, 2021 | 00:01h | UTC

COVID STEROID-2: Double the steroid, double the fun? – PulmCrit

Original study: RCT: In adults with Covid-19 and severe hypoxemia, 12 mg vs. 6 mg of Dexamethasone did not result in a statistically significant difference in the number of days alive without life support.

 

Commentary on Twitter

 

Review: Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity?

25 Oct, 2021 | 00:03h | UTC

Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity? – The Lancet Respiratory Medicine

 

Commentary on Twitter

 

Review: Cardiac involvement in the long-term implications of COVID-19.

24 Oct, 2021 | 23:59h | UTC

Cardiac involvement in the long-term implications of COVID-19 – Nature Reviews Cardiology

 

Guideline: Transfusion strategies in bleeding critically ill adults.

24 Oct, 2021 | 23:47h | UTC

Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine – Intensive Care Medicine

 

Commentary on Twitter

 

RCT: The association of Varenicline and Nicotine patch was not better than Varenicline alone to increase smoking abstinence; there was also no difference between 24-week vs. 12-week treatment courses in abstinence rates.

24 Oct, 2021 | 23:45h | UTC

Effects of Combined Varenicline With Nicotine Patch and of Extended Treatment Duration on Smoking Cessation: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Is There a Role for Combined Use of Varenicline and Nicotine Patch or Extended Treatment Duration to Enhance Smoking Cessation? – JAMA (free for a limited period)

Commentary: Varenicline Combo, Extension No Better for Quitting Smoking – HealthDay

 

Commentary on Twitter

 

Middle-aged and older women are being diagnosed with Takotsubo Syndrome more frequently, up to 10 times more often, than younger women or men of any age.

24 Oct, 2021 | 23:43h | UTC

Sex‐ and Age‐Based Temporal Trends in Takotsubo Syndrome Incidence in the United States – Journal of the American Heart Association

News release: Broken heart syndrome is on the rise, especially among older women – American Heart Association

Commentary: ‘Broken heart’ syndrome is on the rise in women – Cedars-Sinai Medical Center

Related:

International Expert Consensus Document on Takotsubo Syndrome

International Registry: 16.6% of Patients with Takotsubo Syndrome Have Underlying Malignancy

Systematic Review: Long-Term Prognosis and Outcome Predictors in Takotsubo Syndrome

Cohort Study: Hospital Readmission Following Takotsubo Syndrome

 

The cost-effectiveness of cefazolin compared to anti-staphylococcal penicillins for the treatment of methicillin-sensitive Staphylococcus aureus bacteremia.

24 Oct, 2021 | 23:41h | UTC

The cost-effectiveness of cefazolin compared to anti-staphylococcal penicillins for the treatment of methicillin-sensitive Staphylococcus aureus bacteremia – Open Forum of Infectious Diseases

Related:

Meta-Analysis: Cefazolin vs. Anti-staphylococcal Penicillins for the Treatment of Staphylococcus aureus Bacteremia

Meta-Analysis: Cefazolin vs. Antistaphylococcal Penicillins for MSSA Bacteremia

 

Commentaries on Twitter

 

M-A: In patients with Staphylococcus aureus bacteremia, combination therapy does not reduce mortality and is associated with increased risks of adverse events.

24 Oct, 2021 | 23:42h | UTC

The Effect of Combination Therapy on Mortality and Adverse Events in Patients with Staphylococcus aureus Bacteraemia: A Systematic Review and Meta-analysis of Randomized Controlled Trials – Infectious Diseases and Therapy

 

Perspective | The flawed science of antibody testing for SARS-CoV-2 immunity.

22 Oct, 2021 | 10:30h | UTC

The Flawed Science of Antibody Testing for SARS-CoV-2 Immunity – JAMA

 

[Press release – not published yet] A phase 3 trial with more than 10,000 participants showed a booster dose of the Pfizer/BioNTech vaccine had an efficacy of 95.6% against disease; there were 5 cases in the booster group and 109 cases in the non-boosted group, not classified according to severity.

22 Oct, 2021 | 10:34h | UTC

Pfizer and BioNTech Announce Phase 3 Trial Data Showing High Efficacy of a Booster Dose of Their COVID-19 Vaccine

Commentary: Booster dose of Pfizer/BioNTech coronavirus vaccine shows 95.6% efficacy in Phase 3 trial, companies say – CNN

 

Commentaries on Twitter

 

RCT: In adults with Covid-19 and severe hypoxemia, 12 mg vs. 6 mg of Dexamethasone did not result in a statistically significant difference in the number of days alive without life support.

22 Oct, 2021 | 10:32h | UTC

Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia: The COVID STEROID 2 Randomized Trial – JAMA

Editorial: Glucocorticoid Dose in COVID-19: Lessons for Clinical Trials During a Pandemic – JAMA

 

Commentary on Twitter

 

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