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Internal Medicine

WHO Report: Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic.

15 Oct, 2021 | 02:30h | UTC

Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic – World Health Organization

Report: Global tuberculosis report 2021

Commentary: Tuberculosis deaths rise for 1st time in years, due to COVID – Associated Press

 

Commentary on Twitter (thread – click for more)

 

Former CDC director: Low sodium salt could save millions of lives.

15 Oct, 2021 | 02:27h | UTC

Former CDC director: Low sodium salt could save millions of lives – CNN

Related:

Is salt good for you after all? The evidence says no.

#ESCCongress – Cluster RCT: Among patients at increased risk for stroke, salt substitution (75% sodium chloride and 25% potassium chloride by mass) reduced the rates of stroke, major cardiovascular events, and death from any cause.

Systematic Review: Altered dietary salt intake for people with chronic kidney disease.

New WHO benchmarks help countries reduce salt intake and save lives.

RCT: Reduced-sodium added-potassium salt substitute reduces blood pressure in hypertensive patients

Potassium Enriched Salt Substitution Could Prevent a Large Number of Cardiovascular Deaths

Meta-Analysis: Effect of Reduction in Dietary Sodium on Blood Pressure Levels

Cluster Randomized Trial: Effect of Salt Substitution on Community-wide Blood Pressure and Hypertension Incidence

 

Systematic Review: There is not enough evidence from randomized trials to inform about the effects of additional antihypertensive drugs in patients with hypertension‐induced left ventricular hypertrophy.

15 Oct, 2021 | 02:20h | UTC

Pharmacotherapy for hypertension‐induced left ventricular hypertrophy – Cochrane Library

Summary: What are the main benefits and risks of drugs for reducing blood pressure in the treatment of people with thickening of the heart muscle caused by high blood pressure? – Cochrane Library

 

Commentary on Twitter

 

Meta-analysis of cohort studies: High intake of fatty acid in nuts, seeds and plant oils linked to lower risk of death.

15 Oct, 2021 | 02:22h | UTC

News release: High intake of fatty acid in nuts, seeds and plant oils linked to lower risk of death – The BMJ

Original study: Dietary intake and biomarkers of alpha linolenic acid and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of cohort studies – The BMJ

Commentaries:

Current evidence on dietary intakes of fatty acids and mortality – The BMJ

Expert reaction to systematic review and meta-analysis on consumption of dietary fatty acids (alpha linolenic acid) and risk of death – Science Media Centre

Related: Total dietary fat intake, fat quality, and health outcomes: A scoping review of systematic reviews of prospective studies.

 

Commentary on Twitter

 

Autoimmune encephalitis–related seizures and epilepsy: diagnostic and therapeutic approaches.

15 Oct, 2021 | 02:08h | UTC

Autoimmune Encephalitis–Related Seizures and Epilepsy: Diagnostic and Therapeutic Approaches – Mayo Clinic Proceedings

 

Commentary on Twitter

 

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

14 Oct, 2021 | 10:15h | UTC

Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review – JAMA Network Open

Commentaries:

Most COVID-19 survivors have symptoms 6 months on, review finds – CIDRAP

Expert reaction to systematic review on rates of postacute sequelae of SARS-CoV-2 infection (PASC) – Science Media Centre

How many people get ‘long COVID’? More than half, researchers find – Penn State

Related:

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)

 

Commentary on Twitter

 

[Preprint] In RCT with 29,949 participants, the Novavax vaccine demonstrated high overall efficacy (>90%) for the prevention of Covid-19, and all moderate-to-severe cases occurred in placebo recipients.

14 Oct, 2021 | 10:17h | UTC

Efficacy and Safety of NVX-CoV2373 in Adults in the United States and Mexico – medRxiv

Commentary: Novel vaccine demonstrates high efficacy for prevention of COVID-19 – News Medical

Related:

RCT: Novavax vaccine conferred 89.7% protection against symptomatic SARS-CoV-2 infection and 100% protection against hospitalizations or deaths.

Opinion | The mRNA vaccines are extraordinary, but Novavax is even better.

(Press release – not published yet) Novavax COVID-19 vaccine demonstrates 90% overall efficacy and 100% protection against moderate and severe disease.

RCT: Novavax vaccine is 49.4% effective against B.1.351 SARS-CoV-2 variant.

[Press release – not published yet] Novavax reports 96% efficacy against original strain of COVID-19, 86% efficacy against B.1.1.7 variant, and 55% efficacy against B1.351 variant

New COVID-19 vaccines: here’s how the promising Novavax and Johnson & Johnson jabs work

Covid-19: Novavax vaccine efficacy is 86% against UK variant and 60% against South African variant

 

Commentary on Twitter

 

Home Hemodialysis: Core Curriculum 2021.

14 Oct, 2021 | 09:55h | UTC

Home Hemodialysis: Core Curriculum 2021 – American Journal of Kidney Diseases

 

Commentary on Twitter

 

Podcast with Dr Walter Willett: CardioNutrition – Why are findings from prospective, epidemiologic cohort studies important in informing dietary recommendations?

14 Oct, 2021 | 09:49h | UTC

ACC CardiaCast: CardioNutrition – Why Are Findings From Prospective, Epidemiologic Cohort Studies Important In Informing Dietary Recommendations? – American College of Cardiology

 

Commentary on Twitter

 

Survey finds patients undergoing medical imaging procedures have overall limited knowledge about medical radiation.

14 Oct, 2021 | 09:46h | UTC

Patient Perceptions and Knowledge of Ionizing Radiation From Medical Imaging – JAMA Network Open

Invited commentary: It Is Time to Inform Patients of Medical Imaging Risks – JAMA Network Open

 

Podcast: Acute Pain Management for the Hospitalist.

14 Oct, 2021 | 09:47h | UTC

#299 Acute Pain Management for the Hospitalist – The Curbsiders

 

WHO advisers recommend 3rd COVID vaccine dose for highest-risk groups.

13 Oct, 2021 | 01:48h | UTC

WHO advisers recommend 3rd COVID vaccine dose for highest-risk groups – CIDRAP

See also: WHO advises additional COVID shot for immunocompromised people – Reuters

 

Real-world data show that filters clean COVID-causing virus from air.

13 Oct, 2021 | 01:43h | UTC

Real-world data show that filters clean COVID-causing virus from air – Nature

Original article: The removal of airborne SARS-CoV-2 and other microbial bioaerosols by air filtration on COVID-19 surge units – medRxiv

 

Commentary on Twitter

 

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

13 Oct, 2021 | 01:44h | UTC

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

Related:

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.

 

USPSTF draft statement revises previous guidance and now recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults aged 60 years or older.

13 Oct, 2021 | 01:36h | UTC

USPSTF Draft Recommendation Statement: Aspirin Use to Prevent Cardiovascular Disease – U.S. Preventive Services Task Force

Commentaries:

Advice shifting on aspirin use for preventing heart attacks – Associated Press

Taking aspirin to prevent heart attack may cause more harm than good, task force says – NPR

Related Randomized Trials:

Randomized Trial: Aspirin for Primary Prevention of Cardiovascular Disease

Randomized Trial: Effects of Aspirin for Primary Prevention in Persons with Diabetes

Randomized Trial: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly

Related Meta-Analysis:

Meta-Analysis: Association of Aspirin Use for Primary Prevention with Cardiovascular Events and Bleeding Events

Meta-Analysis: Efficacy and Safety of Aspirin for Primary Prevention of Cardiovascular Events

Aspirin for primary prevention of cardiovascular disease: a meta-analysis with a particular focus on subgroups – BMC Medicine

Related Opinions:

Aspirin for Primary Prevention: Is This the End of the Road?

Evidence evolving on aspirin as prevention – ACP Internist

 

Commentary on Twitter

 

M-A: Frequency of Neurologic Manifestations in COVID-19 – up to one-third of patients (89% hospitalized) experienced at least one neurological manifestation.

13 Oct, 2021 | 01:40h | UTC

Frequency of Neurologic Manifestations in COVID-19: A Systematic Review and Meta-analysis – Neurology

 

Consensus Guidance: Hyperkalemia management in the emergency department.

13 Oct, 2021 | 01:34h | UTC

Hyperkalemia management in the emergency department: An expert panel consensus – Journal of the American College of Emergency Physicians Open

Related: Review: Clinical Management of Hyperkalemia. Classification and monitoring, when to reinitiate RAASi therapy, use oral K+-binding agents, and more

Podcast: Hyperkalemia, Diet, K+ Binders, Exercise

Hyperkalemia: Pathophysiology, Risk Factors and Consequence

Hyperkalemia: Pathophysiology, Risk Factors and Consequence (several articles)

 

ACR Announces New Appropriateness Criteria for Diagnostic Exams.

13 Oct, 2021 | 01:32h | UTC

American College of Radiology Announces New Appropriateness Criteria – Medical Device News Magazine

New Guidance: ACR Appropriateness Criteria

 

RCT: Laser treatment not better than sham treatment on symptom severity in women with postmenopausal vaginal symptoms.

13 Oct, 2021 | 01:30h | UTC

Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial – JAMA (free for a limited period)

News release: This laser is supposed to rejuvenate vaginal tissue. But scientists say it’s no better than a placebo – University of New South Wales

Editorial: Time for a “Pause” on the Use of Vaginal Laser (free for a limited period)

Author Interview: Effect of Carbon Dioxide Laser vs Sham Therapy on Women With Postmenopausal Vaginal Symptoms

Commentary: Vagina lasering for postmenopausal women ‘may be placebo’ – The Guardian

 

Commentary on Twitter

 

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018.

13 Oct, 2021 | 01:21h | UTC

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018 – Nature Medicine

Invited commentary: Anemia in women — an intractable problem that requires innovative solutions – Nature Medicine

 

RCT: FODMAPs, but not gluten, elicit modest symptoms of irritable bowel syndrome.

13 Oct, 2021 | 01:25h | UTC

FODMAPs, but not gluten, elicit modest symptoms of irritable bowel syndrome: a double-blind, placebo-controlled, randomized three-way crossover trial – American Journal of Clinical Nutrition

 

Commentary on Twitter

 

M-A: Omega-3 fatty acids supplementation is associated with increased risk of atrial fibrillation.

13 Oct, 2021 | 01:27h | UTC

Effect of Long-Term Marine Omega-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis – Circulation (link to abstract – $ for full-text)

Related:

M-A: Omega-3 fatty acids supplementation increases the risk of atrial fibrillation in patients with lipid disorders.

More data suggests no cardiovascular benefit from Omega-3 supplementation – secondary analysis of STRENGHT trial did not show an association between achieved Omega-3 fatty acid levels and major adverse cardiovascular outcomes in patients with high cardiovascular risk.

RCT: Omega-3 supplements do not reduce cardiovascular events in elderly patients after myocardial infarction

#AHA20 – Randomized trial: High-dose Omega-3 fatty acids did not reduce the risk of cardiac events in patients at high cardiovascular risk

Meta-Analysis of Randomized Trials: Little Benefit from Omega-3 Intake to Reduce Cardiovascular Disease Risk

 

Commentary on Twitter

 

Review: Optimal diet for cardiovascular and planetary health.

13 Oct, 2021 | 01:22h | UTC

Optimal diet for cardiovascular and planetary health – Heart

 

M-A: New pharmacologic agents (Ditans and Gepants) are not as good as triptans for treating migraines.

13 Oct, 2021 | 01:17h | UTC

Comparison of New Pharmacologic Agents With Triptans for Treatment of Migraine: A Systematic Review and Meta-analysis – JAMA Network Open

Commentary: Migraine: Older Drugs May Be Best Bet for Lessening Pain – Physician’s Weekly

 

Commentary on Twitter

 

RCT: No benefit from antithrombotic therapy (aspirin or apixaban) in outpatients with clinically stable symptomatic COVID-19.

12 Oct, 2021 | 00:28h | UTC

Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial – JAMA

Editorial: Antithrombotic Therapy for Outpatients With COVID-19: Implications for Clinical Practice and Future Research – JAMA

 

Commentary on Twitter

 

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