Internal Medicine
#ESCCongress – RCT: Initial hypertension treatment with a single pill with 4 drugs at quarter doses (irbesartan 37.5 mg, amlodipine 1.25 mg, indapamide 0.625 mg, and bisoprolol 2.5 mg) achieved better BP lowering vs. standard monotherapy (irbesartan 150 mg).
29 Aug, 2021 | 18:11h | UTCInitial treatment with a single pill containing quadruple combination of quarter doses of blood pressure medicines versus standard dose monotherapy in patients with hypertension (QUARTET): a phase 3, randomised, double-blind, active-controlled trial – The Lancet (link to abstract – $ for full-text)
Commentary: Quadruple UltrA-low-dose tReaTment for hypErTension – QUARTET – American College of Cardiology
#ESCCongress – RCT: Among asymptomatic patients with severe carotid stenosis, carotid surgery and stenting carry similar risks, and the long-term risk of stroke was comparable. There was no medically treated arm in this study.
29 Aug, 2021 | 18:06h | UTC
Commentary on Twitter
#ACST-2 stent CAS 🆚surgery CEA
For asymptotic carotid stenosis >= 60%https://t.co/lyLBn8C8cv
🔺No difference in death 30d MI, stroke 5 yr f/u
🔺Slight ⬆️in minor 30d strokes w Stenting but no QOL change at 6 mo
🔺no medical Rx arm
🔺both arms 1% procedural risk #ESCCongress pic.twitter.com/8ptcrstn0D— Ritu Thamman MD (@iamritu) August 29, 2021
#ESCCongress – RCT: Small benefit from systematic screening for atrial fibrillation in older adults – After a median follow-up of 6.9 y there were fewer events (stroke, embolism, bleeding, and death) in the intervention group (31·9%) vs. control group (33·0%).
29 Aug, 2021 | 18:08h | UTCClinical outcomes in systematic screening for atrial fibrillation (STROKESTOP): a multicentre, parallel group, unmasked, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
News release: Screening for atrial fibrillation could reduce risk of stroke – Karolinska Institutet
It’s not just SARS-CoV-2: Most respiratory viruses spread by aerosols.
27 Aug, 2021 | 10:18h | UTCOriginal article: Airborne transmission of respiratory viruses – Science
Commentary on Twitter (thread – click for more)
1/ AIRBORNE TRANSMISSION OF RESPIRATORY VIRUSES
A new peer-reviewed paper in @ScienceMagazine, reviewing the scientific literature on this topic. We conclude it is important not just for COVID-19, but also for other respiratory diseases such as the fluhttps://t.co/vik1deBzeB
— Prof. Jose-Luis Jimenez (@jljcolorado) August 26, 2021
[Press release – not published yet] Study shows vaccine protection wanes over time, but vaccines still offer good protection against severe disease.
27 Aug, 2021 | 10:11h | UTCPress release: Is COVID vaccine protection fading? – ZOE Covid Study
Commentaries:
Covid infection protection waning in double jabbed – BBC
Cohort study: Most COVID-19 hospital survivors had a good physical and functional recovery after 1 year of follow-up, but around half of the patients had at least one sequelae symptom.
27 Aug, 2021 | 10:13h | UTC1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study – The Lancet
Editorial: Understanding long COVID: a modern medical challenge – The Lancet
Related:
M-A: More than 50 long-term effects of COVID-19. (several articles on the subject)
New guidelines to help doctors manage long COVID patients published.
[Preprint] Observational data suggests natural immunity after a SARS-CoV-2 infection confers longer lasting and stronger protection compared to vaccine-induced immunity.
27 Aug, 2021 | 10:16h | UTC
Commentary on Twitter (thread – click for more)
https://twitter.com/andrew_croxford/status/1430799815693250562
Covid-19 vaccines flirted with perfection at first. Reality is more complicated.
27 Aug, 2021 | 10:05h | UTCCovid-19 vaccines flirted with perfection at first. Reality is more complicated – STAT
Commentary on Twitter
The mixed blessing of the 95% VE: When Pfizer & Moderna reported late last year that their Covid vaccines were highly effective, our expectations for these vaccines soared. It's time for us to get more realistic about what the vaccines can do. https://t.co/BFpje2qRmS
— Helen Branswell 🇨🇦 (@HelenBranswell) August 25, 2021
Global guideline for the diagnosis and management of rare yeast infections.
27 Aug, 2021 | 09:08h | UTC
Commentary on Twitter
The @eurconfmedmycol did it again!
The 4⃣th One World🌍- One Guideline is published!
This time for the Diagnosis and Management of RARE YEAST Infections
Free access🔗https://t.co/1QSanohMsk @TheLancetInfDis@CornelyOliver @neleshg @ASMicrobiology @ISHAM_Mycology @martinhoenigl pic.twitter.com/DEnS09MnDS— Rosanne Sprute (@RosanneSprute) August 20, 2021
Review: How to approach a patient with difficult-to-treat IBS.
27 Aug, 2021 | 09:00h | UTCHow to Approach a Patient with Difficult-to-Treat IBS – Gastroenterology (free for a limited period)
Commentary on Twitter
Happy to share 📰 on “How to Approach a Patient with Difficult to Treat IBS” in @AGA_Gastro.
Diagnostic algorithm, practical tips, meds & doses. Based on scientific data & what I've learned caring for #IBS pts for many years.
Free for next 50 days 👉 https://t.co/pHKvJuhZtg
— Lin Chang (@LinChangMD) August 25, 2021
A review of the epidemiology, pathophysiology, and efficacy of anti-diabetic drugs used in the treatment of nonalcoholic fatty liver disease.
27 Aug, 2021 | 08:59h | UTC
Revisiting treatment options for depressed patients with generalized anxiety disorder.
27 Aug, 2021 | 08:52h | UTC
In a large cohort study including 807,413 surgeries, many noncardiac surgeries, previously categorized as elevated cardiac risk, were found to be low cardiac risk.
27 Aug, 2021 | 08:29h | UTC
Commentary on Twitter
Nothing really new here. Confirmed increasing MACE with interm/high risk surgery vs low risk (all <1% MI/death). Argues for reassessing risk category for various procedures, usually to a lower category (laparoscopic, GU,Gyn,ortho other than TJR/hip Fx). https://t.co/x0DXaiCHuL
— Steven Cohn, MD (@preopconsult) August 21, 2021
Large Observational study shows Pfizer Covid vaccine is mostly safe but is associated with increased risk of myocarditis, adenopathy, appendicitis, and herpes zoster.
26 Aug, 2021 | 09:16h | UTCCommentaries on Twitter
For those who still believe getting Covid-19 is less risky than taking the vaccine, take a look at this chart from an observational study of nearly 1 million people in Israel. The risk of these conditions is much higher in those infected than vaccinated.https://t.co/Io08oFYRqW pic.twitter.com/57hOaoT5wQ
— Benjy Renton (@bhrenton) August 25, 2021
(thread from the author – click for more)
1/
Vaccine safety: We compared excess adverse events after #COVID19 vaccination (Pfizer-BioNTech) and after documented #SARSCoV2 infection.https://t.co/PNyCTqkq0tTake-home message: Low excess risk of adverse events after vaccination, higher after infection.
Some thoughts👇 pic.twitter.com/pbpJwCRd3D
— Miguel Hernán (@_MiguelHernan) August 25, 2021
WHO Guide | Support for rehabilitation: self-management after COVID-19-related illness.
26 Aug, 2021 | 09:21h | UTC
Commentary on Twitter
The World Health Organisation have just published: Support for rehabilitation: self-management after COVID-19-related illness, 2nd ed. Written by the Leeds Rehabilitation team. Accessed from https://t.co/Ep4KG2FTiQ Will be in all European languages soon.
— Derick Wade (@derickwaderehab) August 25, 2021
COVID vaccines show no signs of harming fertility or sexual function.
26 Aug, 2021 | 09:12h | UTCCOVID Vaccines Show No Signs of Harming Fertility or Sexual Function – Scientific American
Related: Study: Sperm parameters not changed before and after COVID-19 mRNA vaccination.
Johnson & Johnson booster shot prompts large increase in immune response, company says.
26 Aug, 2021 | 09:14h | UTCJohnson & Johnson booster shot prompts large increase in immune response, company says – CNN
News release: Johnson & Johnson Announces Data to Support Boosting its Single-Shot COVID-19 Vaccine
The long-term sequelae of COVID-19: an international consensus on research priorities for patients with pre-existing and new-onset airways disease.
26 Aug, 2021 | 08:59h | UTCInvited commentary: Charting a course for the management of long COVID
Related: M-A: More than 50 long-term effects of COVID-19. (several articles on the subject)
Commentary on Twitter
NEW Position Paper—The long-term sequelae of #COVID19: an international consensus on research priorities for patients with pre-existing and new-onset airways disease
From the International COVID-19 Airways Diseases Group https://t.co/QAoUhzbYtb pic.twitter.com/jj4rxEGyzC
— The Lancet Respiratory Medicine (@LancetRespirMed) August 18, 2021
New guidelines to help doctors manage long COVID patients published.
26 Aug, 2021 | 09:01h | UTCNew guidelines to help doctors manage long COVID patients published – Imperial College London
Original article: Recommendations for the recognition, diagnosis, and management of long covid: A Delphi study – British Journal of General Practice
Related: M-A: More than 50 long-term effects of COVID-19. (several articles on the subject)
New WHO Guideline for the pharmacological treatment of hypertension in adults.
26 Aug, 2021 | 08:57h | UTCGuideline for the pharmacological treatment of hypertension in adults – World Health Organization
Commentary on Twitter (thread – click for more)
The number of adults aged 30-79 living with #hypertension has doubled from 650 million to 1.28 billion since 1990, according to a 🆕 comprehensive global 🌎🌍🌏 analysis of trends in hypertension prevalence, detection, treatment and control.
👉 https://t.co/MI48CX2kEO pic.twitter.com/ARpS8uipeY
— World Health Organization (WHO) (@WHO) August 25, 2021
WHO: More than 700 million people with untreated hypertension – Number of people living with hypertension has doubled to 1.28 billion since 1990.
26 Aug, 2021 | 08:54h | UTCMore than 700 million people with untreated hypertension – World Health Organization
Commentary on Twitter (thread – click for more)
The number of adults aged 30-79 living with #hypertension has doubled from 650 million to 1.28 billion since 1990, according to a 🆕 comprehensive global 🌎🌍🌏 analysis of trends in hypertension prevalence, detection, treatment and control.
👉 https://t.co/MI48CX2kEO pic.twitter.com/ARpS8uipeY
— World Health Organization (WHO) (@WHO) August 25, 2021
M-A of randomized trials: Effectiveness of the modified Valsalva maneuver in adults with supraventricular – “The meta-analysis demonstrated a significantly higher success rate for reconversion to sinus rhythm when using the modified VM compared to the standard VM in patients with an SVT (odds ratio = 4.36; 95% confidence interval, 3.30–5.76; P < 0.001)”.
26 Aug, 2021 | 08:51h | UTCEffectiveness of the modified Valsalva manoeuvre in adults with supraventricular tachycardia: a systematic review and meta-analysis – European Journal of Emergency Medicine (link to abstract – $ for full-text)
Related: Randomized Trial: Standard Valsalva vs. Modified Valsalva for Cardioversion of SVT (studies and commentaries on the subject)
Video: Modified Valsalva manoeuvre for supraventricular tachycardia – The Lancet
International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines.
26 Aug, 2021 | 08:52h | UTC
Expert analysis: Ideal Aspirin Dose for Secondary Prevention in Patients with ASCVD – “A lower-dose aspirin strategy is best for most patients with ASCVD given similar effectiveness, bleeding risk, and overall better adherence”.
26 Aug, 2021 | 08:42h | UTCIdeal Aspirin Dose for Secondary Prevention in Patients With ASCVD – American College of Cardiology
Observational study suggests there is no need to provide a germ-free diet (neutropenic diet) for neutropenic high-risk patients with cancer.
26 Aug, 2021 | 08:45h | UTC
Related commentary on Twitter
🔥🔥 Dietary restriction meaningless in high-risk patients with cancer. Stop the tradition and restore patient autonomy & #QoL @jvehreschildgm1 @EricTopol @HallekMichael @mjvehreschild
Free download here https://t.co/n7NlE6RcQ7— Oliver Cornely (@CornelyOliver) August 14, 2021