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Internal Medicine

Review: Lipoprotein(a) and Cardiovascular Diseases.

29 Jul, 2021 | 10:56h | UTC

Lipoprotein(a) and Cardiovascular Diseases – JAMA (free for a limited period)

 

Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees.

28 Jul, 2021 | 10:19h | UTC

Very rare thrombosis with thrombocytopenia after second AZD1222 dose: a global safety database analysis – The Lancet

Related:

WHO Guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination to prevent coronavirus disease (COVID-19).

AHA/ASA Guidance: Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia – “No heparin products in any dose should be given.”

ISTH Interim Guidance for the Diagnosis and Treatment on Vaccine Induced Immune Thrombotic Thrombocytopenia

Case series: therapeutic plasma exchange in 3 patients with vaccine-induced immune thrombotic thrombocytopenia.

Vaccine-induced immune thrombotic thrombocytopenia (VITT) – a novel clinico-pathological entity with heterogeneous clinical presentations.

Case report: Thrombosis with Thrombocytopenia After the Messenger RNA–1273 Vaccine.

Laboratory testing for suspected COVID-19 vaccine–induced (immune) thrombotic thrombocytopenia.

Concerned about the latest AstraZeneca news? These 3 graphics help you make sense of the risk – “Two people in Australia have died from thrombosis with thrombocytopenia after 3.8 million doses of the AstraZeneca vaccine delivered”.

Case series: Adjunct immune globulin for vaccine-induced thrombotic thrombocytopenia.

Case report: Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).

[Preprint] Meta-analysis of risk of vaccine-induced immune thrombotic thrombocytopenia following ChAdOx1-S recombinant vaccine – Overall risk is 1 in 139,000; for age 65 and over, about 1 in 1,000,000; for age under 55, between 1 in 20,000 to 60,000.

Cohort study: Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S. 11 excess venous thromboembolic events per 100 000 vaccinations; 2.5 excess cerebral venous thrombosis per 100 000 vaccinations.

Case series of 12 patients with cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2.S vaccination – all women younger than 60 years, with symptoms from 6 to 15 days after vaccination

Vaccine-induced Immune Thrombotic Thrombocytopenia: Frequently Asked Questions

Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination

Editorial: SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia – “The very low prevalence of this complication of vaccination, however severe, relative to the benefits of preventing Covid-19 must be emphasized”

Case Report: Thrombotic Thrombocytopenia after Johnson & Johnson Vaccine

Papers Confirm Rare Thrombocytopenia Link to AstraZeneca Vaccine

Guidance on syndrome of Thrombosis and Thrombocytopenia occurring after coronavirus Vaccination

 

Commentary on Twitter

 

Editorial: Nine lessons learned from the Covid-19 pandemic for improving hospital care and health care delivery.

28 Jul, 2021 | 10:17h | UTC

Nine Lessons Learned From the COVID-19 Pandemic for Improving Hospital Care and Health Care Delivery – JAMA Internal Medicine

 

Household transmission of SARS-CoV-2 from children and adolescents.

28 Jul, 2021 | 10:08h | UTC

Household Transmission of SARS-CoV-2 from Children and Adolescents – New England Journal of Medicine

Related:

Effect of Vaccination on Household Transmission of SARS-CoV-2 in England – “the likelihood of household transmission was approximately 40 to 50% lower in households of index patients who had been vaccinated 21 days or more before testing positive than in households of unvaccinated index patients”.

Covid-19 vaccination prevents transmission from vaccinated to unvaccinated household members.

Study in England showed one dose of COVID-19 vaccine can cut household transmission by up to half – This protection is on top of the reduced risk of a vaccinated person developing symptomatic infection, which is around 60 to 65% after the first dose

Study: Household transmission of SARS-CoV-2 and risk factors for susceptibility and infectivity

A meta-analysis on the role of children in SARS-CoV-2 in household transmission clusters

Report: SARS-CoV-2 setting-specific transmission rates. Households showed the highest transmission rates (21.1%). Asymptomatic infections do occur but much less efficiently than symptomatic infection.

CDC Report: Transmission of SARS-COV-2 infections in households

The household secondary attack rate of SARS-CoV-2: A rapid review

 

Commentary on Twitter

 

COVID-19 and mucormycosis superinfection: the perfect storm.

28 Jul, 2021 | 10:09h | UTC

COVID-19 and mucormycosis superinfection: the perfect storm – Infection

Related:

ECMM/ISHAM recommendations for clinical management of COVID -19 associated mucormycosis in low- and middle-income countries.

The “Black Fungus” in India: The Emerging Syndemic of COVID-19–Associated Mucormycosis – careful use of antibiotics and corticosteroids and closely monitoring blood glucose levels are some of the strategies suggested by the authors.

Multicenter Epidemiologic Study of Coronavirus Disease–Associated Mucormycosis, India – Uncontrolled diabetes mellitus was the most common underlying disease; improper glucocorticoid use was independently associated with the disease.

Opinion | “Doctors have been blamed for the rise in black fungus in India, but the COVID treatment guidelines could be contributing” – improper use of antibiotics and higher than usual doses of corticosteroids may be contributing to the emergence of mucormycosis and other fungal co-infections.

What is mucormycosis, the fungal infection affecting COVID patients in India?

[Preprint] The Emergence of COVID-19 Associated Mucormycosis: Analysis of Cases From 18 Countries.

Mucormycosis: The ‘black fungus’ maiming Covid patients in India

Global Guideline for the Diagnosis and Management of Mucormycosis

 

WHO reports progress in the fight against tobacco epidemic – Highlights threats posed by new nicotine and tobacco products.

28 Jul, 2021 | 10:01h | UTC

News release: WHO reports progress in the fight against tobacco epidemic – World Health Organization

Report: WHO report on the global tobacco epidemic 2021: New and Emerging Products – World Health Organization

Commentary: While Global Tobacco Control Measures Improve, Electronic Cigarettes Evade Regulation in Many Countries – Health Policy Watch

 

Commentary on Twitter (thread – click for more)

 

Moral uncertainty: A case study of Covid-19.

28 Jul, 2021 | 10:05h | UTC

Moral uncertainty: A case study of Covid-19 – Patient Education and Counseling

 

Commentary on Twitter

https://twitter.com/trishgreenhalgh/status/1419648261661528072

 

RCT: 7 days of antibiotic therapy as good as 14 days for afebrile men with urinary tract infection.

28 Jul, 2021 | 10:03h | UTC

Effect of 7 vs 14 Days of Antibiotic Therapy on Resolution of Symptoms Among Afebrile Men With Urinary Tract Infection: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Shorter Courses of Antibiotics for Urinary Tract Infection in Men (free for a limited period)

Commentary: Study Supports Shorter Antibiotic Course for Afebrile Men With UTI – MPR

 

Commentary on Twitter

 

ESC Consensus Document: Antithrombotic therapies in aortic and peripheral arterial diseases in 2021.

28 Jul, 2021 | 09:56h | UTC

Antithrombotic therapies in aortic and peripheral arterial diseases in 2021: a consensus document from the ESC working group on aorta and peripheral vascular diseases, the ESC working group on thrombosis, and the ESC working group on cardiovascular pharmacotherapy – European Heart Journal

Key Points to remember: ESC Consensus on Antithrombotic Therapies in Aortic and Peripheral Artery Diseases – American College of Cardiology

 

Commentary on Twitter

 

CDC Report: Transmission of pan-resistant Candida auris in health care facilities.

28 Jul, 2021 | 09:59h | UTC

Notes from the Field: Transmission of Pan-Resistant and Echinocandin-Resistant Candida auris in Health Care Facilities ― Texas and the District of Columbia, January–April 2021 – CDC Morbidity and Mortality Weekly Report

Commentaries:

CDC reports two outbreaks of pan-resistant Candida auris – CIDRAP

U.S. sees first cases of dangerous fungus resistant to all drugs in untreated people – STAT

Related:

Case reports: Multidrug-resistant Candida auris infections in critically ill Covid-19 patients

Candida auris: A Review of Recommendations for Detection and Control in Healthcare Settings

Global Epidemiology of Emerging Candida Auris (reviews and commentaries on the subject)

The superbug Candida auris is giving rise to warnings — and big questions – STAT

Candida Auris – “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy” (reviews and commentaries on the subject)

 

Commentaries on Twitter

 

Review: Anabolic Therapy for Osteoporosis.

28 Jul, 2021 | 09:48h | UTC

Anabolic Therapy for Osteoporosis – JAMA (free for a limited period)

Author interview: Anabolic Therapy for Osteoporosis

 

Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management.

28 Jul, 2021 | 09:44h | UTC

Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management – European Respiratory Review

 

The use and impact of monoclonal antibody biologics during pregnancy.

28 Jul, 2021 | 09:43h | UTC

The use and impact of monoclonal antibody biologics during pregnancy – Canadian Medical Association Journal

 

Review: Long covid—mechanisms, risk factors, and management.

27 Jul, 2021 | 03:52h | UTC

Long covid—mechanisms, risk factors, and management – The BMJ

 

Commentary on Twitter

 

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

27 Jul, 2021 | 03:48h | UTC

Immunogenicity and reactogenicity of heterologous ChAdOx1 nCoV-19/mRNA vaccination – Nature Medicine

Commentary: A ‘mix and match’ approach to SARS-CoV-2 vaccination – Nature Medicine

Related:

WHO warns against mixing and matching COVID vaccines.

Germany issues world’s strongest recommendation for mixing Covid-19 vaccines.

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”.

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

 

Commentary on Twitter

 

[Preprint] Covid-19: Longer interval between Covid-19 Pfizer vaccine doses boosts immunity.

27 Jul, 2021 | 03:50h | UTC

News release: Longer interval between Covid-19 Pfizer vaccine doses boosts immunity – Newcastle University

Original Study (preprint): Sustained T cell immunity, protection and boosting using extended dosing intervals of BNT162b2 mRNA vaccine

Commentaries:

Commentary: Covid-19: Longer interval between Pfizer doses results in higher antibody levels, research finds – BMJ

Expert reaction to preprint from PITCH study looking at interval between two Pfizer vaccine doses, and antibody and T-cell responses – Science Media Centre

Related:

Debate: Should we delay second vaccine doses to give one dose of the Covid-19 vaccine to more people? (several texts on the subject)

 

Safety evaluation of the second dose of mRNA COVID-19 vaccines in patients with immediate reactions to the first dose.

27 Jul, 2021 | 03:42h | UTC

Safety Evaluation of the Second Dose of Messenger RNA COVID-19 Vaccines in Patients With Immediate Reactions to the First Dose – JAMA Internal Medicine

Commentaries:

Second COVID-19 mRNA vaccine dose found safe following allergic reactions to first dose – Massachusetts General Hospital

No anaphylaxis after second dose of mRNA COVID vaccine, study finds – CIDRAP

 

Commentary on Twitter

 

[Preprint] Test-negative case-control study: Effectiveness of Oxford-AstraZeneca vaccine in older people during SARS-CoV-2 Gamma variant transmission in Brazil – Adjusted effectiveness was 77.9% for symptomatic Covid-19, 87.6% against hospitalization, and 93.6% against death.

27 Jul, 2021 | 03:41h | UTC

Effectiveness of the ChAdOx1 vaccine in the elderly during SARS-CoV-2 Gamma variant transmission in Brazil – medRxiv

 

Commentary on Twitter (thread – click for more)

https://twitter.com/MHitchingsEpi/status/1418599162795360260

 

[Preprint] Test-negative case-control study: Effectiveness of CoronaVac vaccine in older people during SARS-CoV-2 Gamma variant transmission in Brazil – Adjusted vaccine effectiveness was 41.6% for symptomatic Covid-19, 59.0% against hospitalizations and 71.4% against deaths.

27 Jul, 2021 | 03:39h | UTC

Effectiveness of the CoronaVac vaccine in the elderly population during a Gamma variant-associated epidemic of COVID-19 in Brazil: A test-negative case-control study – medRxiv

 

Commentary on Twitter (thread – click for more)

https://twitter.com/MHitchingsEpi/status/1418599162795360260

 

NICE Guideline | Clostridioides difficile infection: antimicrobial prescribing.

27 Jul, 2021 | 03:34h | UTC

Clostridioides difficile infection: antimicrobial prescribing – National Institute for Health and Care Excellence

Infographic: Clostridioides difficile infection: antimicrobial prescribing

Related:

IDSA 2021 focused update guidelines on the management of Clostridioides difficile infection in adults.

ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections.

Prevention of Clostridioides difficile in hospitals: A position paper of the International Society for Infectious Diseases

Review | My Treatment Approach to Clostridioides difficile Infection.

 

CoronaVac vaccine: its results are patchy, but the world can’t ignore its usefulness.

27 Jul, 2021 | 03:38h | UTC

CoronaVac vaccine: its results are patchy, but the world can’t ignore its usefulness – The Conversation

Related:

RCT: CoronaVac showed efficacy of 83.5% for preventing symptomatic SARS-CoV-2 infection.

Prospective national cohort in Chile showed CoronaVac effectiveness was 65.9% for symptomatic Covid-19, 87.5% for hospitalization, 90.3% for ICU admission, and 86.3% for death.

Phase 1/2 RCT: CoronaVac is well tolerated and safe and induces strong humoral responses in children and adolescents aged 3–17 years.

Perspective | Are Chinese COVID vaccines underperforming? a dearth of real-life studies leaves unanswered questions.

WHO approval of Chinese CoronaVac COVID vaccine will be crucial to curbing pandemic.

Brazilian town experiment shows mass vaccination can wipe out COVID-19.

WHO validates Sinovac-CoronaVac COVID-19 vaccine for emergency use and issues interim policy recommendations.

[Press release – not published yet] The city of Serrana in Brazil has seen a 95% drop in Covid-19 deaths after almost all adults were vaccinated with Chinese CoronaVac – The findings suggest the pandemic can be controlled after 75% of people are fully vaccinated.

[Not published yet] Observational study in Uruguay found CoronaVac reduced mortality by 97 percent – “In people who had received two doses, it reduced infection with the coronavirus by 57 percent and intensive care admissions by 95 percent”.

 

Review: A pathophysiological compass to personalize antianginal drug treatment.

27 Jul, 2021 | 03:27h | UTC

A pathophysiological compass to personalize antianginal drug treatment – Nature Reviews Cardiology (free for a limited period)

 

Commentary on Twitter

 

Systematic review: Compression bandages or stockings vs. no compression for treating venous leg ulcers.

27 Jul, 2021 | 03:31h | UTC

Compression bandages or stockings versus no compression for treating venous leg ulcers – Cochrane Library

Summary: Compression bandages or stockings versus no compression for treating venous leg ulcers – Cochrane Library

 

Cluster RCT: Effectiveness of a tailored intervention to reduce antibiotics for urinary tract infections in nursing home residents.

27 Jul, 2021 | 03:25h | UTC

Effectiveness of a tailored intervention to reduce antibiotics for urinary tract infections in nursing home residents: a cluster, randomised controlled trial – The Lancet Infectious Diseases (link to abstract – $ for full-text)

 

Commentary on Twitter

 

Research provides vital insights about excess coffee consumption and brain health.

27 Jul, 2021 | 03:28h | UTC

Commentary: Research provides vital insights about excess coffee consumption and brain health – University of South Australia/ News Medical

Original study: High coffee consumption, brain volume and risk of dementia and stroke – Nutritional Neuroscience (link to abstract – $ for full-text)

 

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