Internal Medicine
Meta-analysis: Among the treatment interventions to maintain abstinence from alcohol in primary care, acamprosate was the only intervention with enough evidence of benefit
26 Nov, 2020 | 08:55h | UTC
Commentary on Twitter
Acamprosate was the only intervention with enough evidence of benefit for maintaining alcohol abstinence and acceptability up to 12 months after detoxification in primary care settings, concludes new #BMJResearchhttps://t.co/K7FutIC3yd
— The BMJ (@bmj_latest) November 25, 2020
Cohort study suggests there is no need to choose first-line drug treatment for hypertension according to age and ethnicity – guidelines could be simplified
26 Nov, 2020 | 08:56h | UTCCommentary: Study questions blood pressure drug guidance based on age and ethnicity – British Medical Journal AND Laurie Tomlinson: Shining a light into medicine’s dusty corners – The BMJ Opinion AND UK’s NICE Guidelines for Hypertension Tx Based on Age, Ethnicity May Need Updating – Physician’s Weekly AND
Commentary on Twitter
Current UK guidance on drug treatment for high blood pressure, which differs depending on a patient’s age and ethnicity, could be simplified in line with other international guidelines, suggests new @bmj_latest research @SarahJoSinnott https://t.co/bWLhXoFnV4
— The BMJ (@bmj_latest) November 21, 2020
Randomized trial: Convalescent Plasma does not improve clinical status or overall mortality in severe Covid-19 pneumonia
25 Nov, 2020 | 09:17h | UTCCommentary: New trial of convalescent plasma for covid-19 falls flat, another setback for hyped treatment – Brief19
Commentary on Twitter
A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia @NEJM A well conducted RCT shows no significant differences in clinical status or overall mortality between patients treated with CP and those who received placebo. https://t.co/C6NylbO2At
— Carlos del Rio (@CarlosdelRio7) November 24, 2020
Cluster-randomized trial: Postexposure hydroxychloroquine does not prevent Covid-19 in healthy persons exposed to a PCR-positive case patient
25 Nov, 2020 | 09:15h | UTC
Commentary on Twitter
Another RCT in @NEJM of outpatient treatment with Hydroxychloroquine in high risk folks to prevent COVID transmission
No benefit
But about 10X rate of adverse events in HCQ group
Happy to keep studying HCQ
But it really doesn't look like it workshttps://t.co/9nAfir0CMX
— Ashish K. Jha, MD, MPH (@ashishkjha) November 24, 2020
With more data on its COVID-19 vaccine, Russian institute offers new evidence of success
25 Nov, 2020 | 09:13h | UTCWith more data on its COVID-19 vaccine, Russian institute offers new evidence of success – Science
Commentaries: Expert reaction to press release reporting the second interim analysis of the efficacy of the Sputnik V vaccine – Science Media Centre AND Russia says Sputnik V virus vaccine 95% effective – MedicalXpress
Latest COVID-19 guidelines come out against bamlanivimab, remdesivir
25 Nov, 2020 | 09:10h | UTCLatest COVID-19 guidelines come out against bamlanivimab, remdesivir – ACP Internist
Systematic review: Financial payments from the pharmaceutical industry is associated with more physician prescribing of the drug made by the company that they got the payments from
25 Nov, 2020 | 09:07h | UTCAre Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? A Systematic Review – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentary: Financial payments from drug industry associated with physician prescribing – American College of Physicians
Commentary from the author on Twitter (thread – click for more)
"Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing?"
Our latest on physician-industry COI is out today in @AnnalsofIM!Not to bury the lede, the answer is "yes."
Thread to follow.https://t.co/2lfAjWSQuq
1/— Aaron Mitchell (@TheWonkologist) November 24, 2020
Randomized trial: Prednisone is an effective short-term preventive therapy in patients with episodic cluster headache
25 Nov, 2020 | 09:01h | UTCSafety and efficacy of prednisone versus placebo in short-term prevention of episodic cluster headache: a multicentre, double-blind, randomised controlled trial – The Lancet Neurology (link to abstract – $ for full-text)
Commentary from the author on Twitter
Finally published online! After countless years and a lot of work our study on prednisone for the treatment of episodic cluster headache. Thanks to all the many people that were involved in this study, Very proud!!! #PredCH #Clusterheadachehttps://t.co/d88TUWTY5i
— Mark Obermann (@ProfObermann) November 25, 2020
Randomized trial: Colorectal cancer screening with repeated fecal immunochemical tests detects more colorectal cancer and advanced adenomas compared to screening sigmoidoscopy
25 Nov, 2020 | 09:05h | UTCColorectal cancer screening with repeated fecal immunochemical test versus sigmoidoscopy: baseline results from a randomized trial – Gastroenterology (link to abstract – $ for full-text)
USPSTF Statement recommends regular behavioral counseling on healthy diet and physical activity to prevent cardiovascular disease
25 Nov, 2020 | 08:59h | UTCAuthor interview: Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors
JAMA Patient Page: Counseling on Healthy Diet and Physical Activity to Prevent Cardiovascular Disease
Diagnosis, management, and pathophysiology of arterial and venous thrombosis in COVID-19
24 Nov, 2020 | 09:34h | UTCDiagnosis, Management, and Pathophysiology of Arterial and Venous Thrombosis in COVID-19 – JAMA
Commentary on Twitter
Arterial and venous thrombosis are common in #COVID19, especially in critically ill patients. Thromboprophylaxis should be considered for all hospitalized patients with COVID-19 in the absence of contraindications https://t.co/sjqL7MqGLX
— JAMA (@JAMA_current) November 23, 2020
Data show hospitalized Covid-19 patients are surviving at higher rates, but surge in cases could roll back gains
24 Nov, 2020 | 09:25h | UTC
Podcast: Diabetes Triple Distilled. Pitfalls of A1c testing, different guidelines for A1C targets, when and how to use the newer medications such as SGLT-2 inhibitors and GLP-1 agonists, and more
24 Nov, 2020 | 09:03h | UTC#243 Diabetes Triple Distilled – The Curbsiders Internal Medicine Podcast
Covid-19: Oxford University vaccine shows 70% protection
23 Nov, 2020 | 09:54h | UTCCovid-19: Oxford University vaccine shows 70% protection – BBC
News release: Oxford University breakthrough on global COVID-19 vaccine
Commentary on Twitter
Today marks an important milestone in the fight against #COVID19. Interim data show the #OxfordVaccine is 70.4% effective, & tests on two dose regimens show that it could be 90%, moving us one step closer to supplying it at low cost around the world>> https://t.co/fnHnKSqftT pic.twitter.com/2KYXPxFNz1
— University of Oxford (@UniofOxford) November 23, 2020
Meta-analysis: SARSCoV2 most contagious within the first 5 days of symptom onset
23 Nov, 2020 | 09:53h | UTCCommentaries: COVID-19 most contagious in first 5 days of illness, study finds – CIDRAP AND Infectiousness peaks early in COVID-19 patients, emphasising the need to rapidly isolate cases – The Lancet AND Covid-19 carriers ‘most infectious earlier on’ – BBC
Commentary on Twitter (thread – click for more)
Our systematic review and meta-analysis on #SARSCoV2, #SARSCoV & #MERSCoV viral load dynamics, duration of viral shedding & infectiousness out now in @LancetMicrobe 👇@mugecevik @silverfoxdoc @CVRinfo @UofGlasgow @Infection_StAnd https://t.co/Tac3A2RR3E
— Antonia Ho (@DrToniHo) November 20, 2020
A proposed framework and timeline of the spectrum of disease due to SARS-CoV-2 infection: Illness beyond acute infection and public health implications
23 Nov, 2020 | 09:48h | UTC
Commentary on Twitter
The #COVID19 response focuses on acute illness, but accumulating evidence shows morbidity beyond acute infection, with at least 2 other periods of illness: a rare postacute hyperinflammatory illness, and late inflammatory/viral sequelae https://t.co/mrf8WDxKY4 @jtsylee @CDCgov
— JAMA (@JAMA_current) November 19, 2020
Updated WHO guideline on drugs for Covid-19 rejects Remdesivir and strongly recommends Corticosteroids for patients with severe and critical disease
20 Nov, 2020 | 08:51h | UTCA living WHO guideline on drugs for covid-19 – The BMJ
Commentary: WHO Guideline Development Group advises against use of remdesivir for COVID-19 – British Medical Journal
Commentary on Twitter
Today the @WHO rejects Remdesivir for #COVID19.
The same drug the @US_FDA gave a full approval.
Because the @WHO reviewed all the data and made the right call.https://t.co/u7GKTRlf37@bmj_latest pic.twitter.com/kVwmDnJRCz— Eric Topol (@EricTopol) November 20, 2020
Systematic review: Ultra-long‐acting insulins provide modest benefit compared to NPH insulin for Type 2 DM, resulting in reduced risk of hypoglycemia but no difference in HbA1c
23 Nov, 2020 | 09:45h | UTC
Systematic review: Interventions for breathlessness in patients with advanced cancer
23 Nov, 2020 | 09:43h | UTCFull report: Interventions for breathlessness in patients with advanced cancer
Evidence Summary: Interventions for breathlessness in patients with advanced cancer
Randomized trial suggesting mask use does not protect the wearer from Covid-19 sparks controversy
20 Nov, 2020 | 08:48h | UTCEditorials: Of Masks and Methods AND The Role of Masks in Mitigating the SARS-CoV-2 Pandemic: Another Piece of the Puzzle
Commentaries: Expert reaction to paper using an RCT to assess mask use as a public health measure to help control SARS-CoV-2 spread (DANMASK-19) – Science Media Centre AND Here’s How to Think About the Danish Mask Study – MedPage Today AND Lead Researcher Behind Controversial Danish Study Says You Should Still Wear A Mask – Forbes AND Denmark trial measures effectiveness of adding a mask recommendation to other public health measures for preventing SARS-CoV-2 infection – ACP Newsroom
“questioning why a top medical journal would publish a large randomized trial on an important issue is absolutely antithetical to science. Of course they should, so we may all read and debate it” (via @VPrasadMDMPH see Tweet)
Commentaries on Twitter (threads – click for more)
Not perfect, nor confirmatory, but a good enough study to modulate the probability of a large self-efficacy from masks. Study powered to a 50% RRR, correctly concluded that it does not reduce infection by 50%. A negative study is negative only for the effect size it was powered https://t.co/aDPxRoIuqS
— Luis Correia (@LuisCLCorreia) November 19, 2020
So, The Big Mask study has been published, and I thought rather than expound on what the results DID show (everyone's doing that), I might point out a few things that they DIDN'T show 1/n pic.twitter.com/zG4jtXQVVq
— Health Nerd (@GidMK) November 18, 2020
Older adults with COVID-19 commonly present to the ED with delirium
20 Nov, 2020 | 08:46h | UTCDelirium in Older Patients With COVID-19 Presenting to the Emergency Department – JAMA Network Open
Commentaries: Delirium could signal Covid-19 infection in older adults, study finds – STAT AND Delirium fairly common in older COVID-19 patients – CIDRAP AND Delirium is first symptom for many elderly COVID-19 patients – UPI
Commentary on Twitter
In older ED patients w/ COVID-19 only 56% had a fever, 51% SOB & 50% cough. 28% had delirium & one third of delirious pts lacked typical symptoms. In the ED delirium may the only symptom of #COVID19. @sharon_inouye @ACEPNow @GeriatricEDNews @AGEM_SAEM @JAMANetworkOpen pic.twitter.com/MxjSTx3Ffi
— Maura Kennedy (@MauraKennedyMD) November 19, 2020
Evaluating COVID risk on planes, trains and automobiles
20 Nov, 2020 | 08:45h | UTCEvaluating COVID Risk on Planes, Trains and Automobiles – Scientific American
Systematic review: Routine laboratory tests are not useful for accurately ruling in or ruling out COVID-19 on their own
20 Nov, 2020 | 08:42h | UTCRoutine laboratory testing to determine if a patient has COVID‐19 – Cochrane Library
Summary: Routine laboratory testing to determine if a patient has COVID‐19 – Cochrane Library
Opinion: Improving care for heart failure with reduced ejection fraction—a potential polypill-based strategy
20 Nov, 2020 | 08:37h | UTC
Pfizer and BioNTech to submit Covid-19 vaccine data to FDA as full results show 95% efficacy
19 Nov, 2020 | 09:36h | UTCPfizer and BioNTech to submit Covid-19 vaccine data to FDA as full results show 95% efficacy – STAT
News release: Pfizer and Biontech conclude phase 3 study of Covid-19 vaccine candidate, meeting all primary efficacy endpoints
Commentaries: ‘Incredible milestone for science.’ Pfizer and BioNTech update their promising COVID-19 vaccine result – Science AND Pfizer: COVID-19 shot 95% effective, seeking clearance soon – Associated Press AND Expert reaction to announcement by Pfizer that they have concluded the Phase III study of their COVID-19 vaccine candidate after demonstrating 95% efficacy – Science Media Centre AND Covid vaccine: Pfizer says ‘94% effective in over-65s’ – BBC