Internal Medicine
D-Dimer testing for the exclusion of pulmonary embolism has limited clinical utility among hospitalized patients with COVID-19 – most patients with or without pulmonary embolism have increased levels.
12 Oct, 2021 | 00:26h | UTCCommentary: D-Dimer Level Not Useful for Ruling Out PE in COVID-19 Patients – HealthDay
How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.
12 Oct, 2021 | 00:18h | UTCHow antiviral pill molnupiravir shot ahead in the COVID drug hunt – Nature
Related:
What we know — and don’t know — about Merck’s new Covid-19 pill.
Merck’s Covid-19 pill is great news but may not be a game-changer.
Video | A Pill For COVID? A Doctor Explains Molnupiravir.
Why easing COVID restrictions could prompt a fierce flu rebound – “As pandemic restrictions ease, other respiratory viruses are returning in unexpected ways”.
12 Oct, 2021 | 00:19h | UTCWhy easing COVID restrictions could prompt a fierce flu rebound – Nature
AHA Scientific Statement: Medication Adherence and Blood Pressure Control.
12 Oct, 2021 | 00:09h | UTCNews release: Health system crucial to improve medication adherence for people managing hypertension – American Heart Association
Top Things to Know: Medication Adherence and Blood Pressure Control – American Heart Association
Commentary: Medication Adherence – Is It Really the Patient’s Fault? – American Heart Association
Survey finds misperceptions associated with palliative care are widespread – stigma may be perpetuated by those who falsely believe they understand its meaning.
11 Oct, 2021 | 23:54h | UTCPublic knowledge and attitudes concerning palliative care – BMJ Supportive & Palliative Care
Commentary on Twitter
Public misperceptions & stigma around palliative care are significant issues even for very well developed health systems. 29% of Canadian sample believed pall care meant doctors were 'giving up'. https://t.co/gpCFwFrk8z pic.twitter.com/TZsqwdbQnt
— Richard Sullivan (@SullivanProf) October 10, 2021
Cluster RCT: An antimicrobial stewardship intervention safely reduced the use of broad-spectrum antibiotics among patients hospitalized with moderately severe community-acquired pneumonia.
11 Oct, 2021 | 23:55h | UTCNarrow-spectrum antibiotics for community-acquired pneumonia in Dutch adults (CAP-PACT): a cross-sectional, stepped-wedge, cluster-randomised, non-inferiority, antimicrobial stewardship intervention trial – The Lancet Infectious Diseases (link to abstract – $ for full-text)
RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.
10 Oct, 2021 | 21:53h | UTCInvited commentary: Anticoagulant Therapy in Patients Hospitalized With COVID-19 – JAMA Internal Medicine
Related studies (some conflicting results)
Commentary on Twitter
Thromboprophylaxis w therapeutic-dose LMWH reduced major thromboembolism and death by 32% compared with institutional standard heparin without increased major bleeding among #COVID19 inpatients with elevated D-dimers. The effect wasn't seen in ICU patients https://t.co/Wrgj2Ho5lv
— JAMA Internal Medicine (@JAMAInternalMed) October 7, 2021
Heart-inflammation risk from Pfizer COVID vaccine is very low.
10 Oct, 2021 | 21:42h | UTCHeart-inflammation risk from Pfizer COVID vaccine is very low – Nature
Original studies:
M-A: Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression.
10 Oct, 2021 | 21:34h | UTCSee calculator: PHQ-9 (Patient Health Questionnaire-9)
Commentary on Twitter
This new study investigates the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting major depression https://t.co/9WoI3MofWH
— The BMJ (@bmj_latest) October 10, 2021
ACG Clinical Guidelines: Management of Benign Anorectal Disorders
10 Oct, 2021 | 21:29h | UTC
Commentary on Twitter
🆕 2021 ACG Guidelines for Benign Anorectal Disorders 🍑🍑🍑
👉defecation disorders
👉proctalgia syndromes
👉hemorrhoids
👉anal fissures
👉fecal incontinence #GITwitter🔗 https://t.co/TeqTWjQkg1 pic.twitter.com/gEfkBsH7kn
— Carl Kay, MD (@CarlKayMD) October 8, 2021
WHO Guidance: Antigen-detection in the diagnosis of SARS-CoV-2 infection.
8 Oct, 2021 | 10:47h | UTCAntigen-detection in the diagnosis of SARS-CoV-2 infection – World Health Organization
Related infographics:
Use of antigen detection rapid diagnostic testing – World Health Organization
Diagnostic testing for SARS-CoV-2 infection – World Health Organization
Commentary on Twitter (thread – click for more)
Testing remains a critical component to the strategy to end the #COVID19 pandemic, and testing needs to be reliable, accessible, affordable, fast and linked to public health action.
So many around 🌍 have worked hard to increase testing capacities @WHOhttps://t.co/VDPdU0VK4g
— Maria Van Kerkhove (@mvankerkhove) October 7, 2021
WHO Consensus: A clinical case definition of post COVID-19 condition (Long Covid).
8 Oct, 2021 | 10:45h | UTCRelated:
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 (thread – click for more)
🆕 WHO clinical case definition for post #COVID19 condition, also called 'long COVID' https://t.co/WoiLcwsgJX pic.twitter.com/Z0olrHlWPC
— World Health Organization (WHO) (@WHO) October 7, 2021
Study shows an increased risk of Guillain-Barré Syndrome with the J&J vaccine; the estimated observed to expected rate ratio was 4.18 for the 42-day window.
8 Oct, 2021 | 10:40h | UTC
Commentary on Twitter
Study suggests a potential small but statistically significant safety concern for #GuillainBarré syndrome following receipt of the @JanssenUS #COVID19 vaccine; findings considered preliminary pending analysis of medical records to establish a definitive Dx https://t.co/yZjJVkp6BA
— JAMA (@JAMA_current) October 7, 2021
Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination.
8 Oct, 2021 | 10:29h | UTCRelated:
Another study shows increased immune response with heterologous Oxford-AstraZeneca/mRNA vaccination.
RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.
Commentary on Twitter
As more & more countries consider adding a 3rd #COVID19 vaccine dose into their national immunisation programmes, vaccine reactogenicity will become important, especially if 3rd dose is different to first 2 doses. We need more mix-n-match booster studies 👉https://t.co/G57i9Ej7Nd
— Shamez Ladhani (@ShamezLadhani) October 7, 2021
Ivermectin: How false science created a Covid ‘miracle’ drug.
8 Oct, 2021 | 10:24h | UTCIvermectin: How false science created a Covid ‘miracle’ drug – BBC
Commentary on Twitter
Scientists evaluating ivermectin data for #COVID19
"had not found 'a single clinical trial' claiming to show that ivermectin prevented Covid deaths that did not contain 'either obvious signs of fabrication or errors so critical they invalidate the study'." https://t.co/Xndr6Q5LaS— Isaac Bogoch (@BogochIsaac) October 7, 2021
Japanese evidence-based clinical practice guidelines for Liver Cirrhosis.
8 Oct, 2021 | 10:14h | UTCEvidence-based clinical practice guidelines for Liver Cirrhosis 2020 – Journal of Gastroenterology
The German Guidelines for the treatment of anxiety disorders.
8 Oct, 2021 | 10:16h | UTC
U.S. Data: Drug-resistant Infections led to $1.9 billion in health care costs, more than 10,000 deaths among older adults in one year.
8 Oct, 2021 | 10:11h | UTCCommentaries:
Study highlights impact of antibiotic resistance on older Americans – CIDRAP
Study suggests a 30-second interval between automated office blood pressure measurements is as accurate and reliable as a 60-second interval.
8 Oct, 2021 | 10:09h | UTCImpact of 30- Versus 60-Second Time Intervals Between Automated Office Blood Pressure Measurements on Measured Blood Pressure – Hypertension (link to abstract – $ for full-text)
Commentary on Twitter
Guidelines recommend a 60-sec pause between automated office BP measures. This study indicates a 30-sec interval not only saves time but is just as accurate and reliable. @spjuraschek @therealaishak @TimAndersonMD @jenniferlcluett https://t.co/A77bvhatZq pic.twitter.com/wdrUqZDWs4
— Hypertension (@HyperAHA) October 7, 2021
Deprescribing in palliative patients with cancer: a concise review of tools and guidelines.
8 Oct, 2021 | 10:07h | UTC
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.
7 Oct, 2021 | 10:55h | UTC
Commentary on Twitter
In this 900,000-participant study in Qatar, vaccine effectiveness peaked at 77.5% in the first month after the second dose. The effectiveness fell to as low as 20% in months 5 through 7 after vaccination. #Covid19vaccine #IDTwttier https://t.co/TeDcLLftIH pic.twitter.com/pEBoxs6Hmr
— NEJM (@NEJM) October 6, 2021
Large cohort study with over 2.5 million individuals showed the incidence of myocarditis after the Pfizer vaccine was 2.13 cases per 100,000 persons.
7 Oct, 2021 | 10:51h | UTCCommentary: Studies Highlight Rarity of Myocarditis With mRNA COVID-19 Vaccines – TCTMD
Related Study: Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel – New England Journal of Medicine
Commentaries on Twitter
Among 2.5 million patients who received the BNT162b2 mRNA vaccine in a large Israeli health care system, the incidence of myocarditis at 42 days was 2.13 cases per 100,000 persons. #Covid19vaccine #IDTwitter https://t.co/EzmsaW2u4Y pic.twitter.com/P95eUm8xo9
— NEJM (@NEJM) October 6, 2021
Just out in @NEJM: Two studies on myocarditis after vaccination with Pfizer
Among 2.5 million vaccinated:
– 54 cases of myocarditis
– 94% men, median 27 y.o.
– Most cases mild, only one fulminanthttps://t.co/xGf7rtwGfr— David Juurlink (@DavidJuurlink) October 6, 2021
Study with over 5.1 million vaccinated individuals showed the incidence of myocarditis after the receipt of the Pfizer vaccine was low and more common after the second dose in young male recipients.
7 Oct, 2021 | 10:49h | UTCMyocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel – New England Journal of Medicine
Commentary: Studies Highlight Rarity of Myocarditis With mRNA COVID-19 Vaccines – TCTMD
Related study: Myocarditis after Covid-19 Vaccination in a Large Health Care Organization – New England Journal of Medicine
Commentaries on Twitter
In an Israeli Ministry of Health database, 136 cases of myocarditis were detected among 5 million vaccinated persons. #Covid19vaccine #IDTwitter https://t.co/c1wLBCq8UN pic.twitter.com/D2DAGrIuXe
— NEJM (@NEJM) October 6, 2021
Two new @NEJM reports on Pfizer vaccine related myocarditis: very rare (~2 per 100,000) and usually mild; in-depth review of 190 cases, most cases were in males 16-29 years, 2nd dosehttps://t.co/nHgxXTgQ6ohttps://t.co/pchL0VDi4b pic.twitter.com/7pUxNy36Zo
— Eric Topol (@EricTopol) October 6, 2021
RCT: Immediate drainage did not improve outcomes compared to postponed intervention in patients with infected necrotizing pancreatitis.
7 Oct, 2021 | 10:35h | UTC
Choosing Wisely: Seven things physicians and residents/patients should question in long term care.
7 Oct, 2021 | 10:31h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada