Internal Medicine
Randomized Trial: Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation
17 Mar, 2019 | 19:10h | UTCPresented at the American College of Cardiology (ACC) 2019 Scientific Session.
Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial – JAMA (free for a limited period)
Related Study: Effect of Catheter Ablation vs Medical Therapy on Quality of Life Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial – JAMA (free for a limited period)
Video Summary: Catheter Ablation vs Drug Therapy for Patients With Atrial Fibrillation: The CABANA Trial (free)
Editorial: Catheter Ablation for Atrial Fibrillation: Lessons Learned From CABANA (free for a limited period)
Commentary: Surgery no better than medication at preventing serious complications of atrial fibrillation – NIH News Releases (free)
Related Commentary on Twitter
BREAKING: In the CABANA Trial, catheter ablation was no different from drug therapy at reducing death, disabling stroke, serious bleeding, or cardiac arrest in patients with symptomatic atrial fibrillation https://t.co/Wg0EScwrHB #ACC19 #Afib pic.twitter.com/k9CKjuQMNp
— JAMA (@JAMA_current) March 15, 2019
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease
17 Mar, 2019 | 21:48h | UTCPresented at the American College of Cardiology (ACC) 2019 Scientific Session.
Guideline Hub: Primary Prevention of Cardiovascular Disease (free resources)
Executive Summary: 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease (free PDF)
Guidelines Made Simple: A Selection of Tables and Figures (free PDF)
Summary with Key Points to Remember: 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease – American College of Cardiology (free)
Randomized Trial: Transcatheter Aortic-Valve Replacement vs. Surgical Aortic-Valve Replacement in Low-Risk Patients
17 Mar, 2019 | 19:08h | UTCPresented at the American College of Cardiology (ACC) 2019 Scientific Session.
Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients – New England Journal of Medicine (free for a limited period)
Commentary: In study, TAVR is superior to surgery for low-risk patients with aortic valve stenosis – Columbia University Irving Medical Center (free)
“”The main limitation of the study is that the current results reflect outcomes after one year, which isn’t long enough to assess the long-term durability of the replacement valve,” said Leon. “Patients in the study will be followed for at least 10 years so that we can measure their long-term outcomes and inform the medical community.” (from Columbia University)
Patient Blood Management Recommendations From the 2018 Frankfurt Consensus Conference
17 Mar, 2019 | 18:57h | UTCPatient Blood Management Recommendations From the 2018 Frankfurt Consensus Conference – JAMA (free for a limited period)
Study: Apple Watch Can Spot Atrial Fibrillation, But More Research is Needed
17 Mar, 2019 | 18:59h | UTCPresented at the American College of Cardiology (ACC) 2019 Scientific Session.
See also: Beware the hype over the Apple Watch heart app. The device could do more harm than good – STAT (free) AND Apple Watch may spot heart problem but more research needed – Associated Press (free) AND Apple Watch May Detect A-fib in the General Population, but at What Cost? – TCTMD (free)
Related: Editorial: Downsides of Detecting Atrial Fibrillation in Asymptomatic Patients (free) AND USPSTF Statement: Screening with Resting or Exercise Electrocardiography (ECG) Not Recommended (free Guideline and commentaries) AND Wearable technology to screen for atrial fibrillation: does it raise more questions than it answers? (free commentaries) AND Get Ready For A Tsunami Of ECGs (free commentaries)
Cohort Study: High Sensitivity Cardiac Troponin May Result in Misdiagnosis of Acute Myocardial Infarction
17 Mar, 2019 | 18:58h | UTCCommentaries: Evaluate Troponin Results Carefully, Researchers Warn – NEJM Journal Watch (free) AND Blood test to diagnose heart attacks is flawed, warn researchers – The BMJ (free) AND CHARIOT: 1 in 20 Hospitalized Patients Undergoing Blood Tests Have Elevated Troponin – TCTMD (free)
Related: Randomized Trial: High-Sensitivity Troponin in the Evaluation of Suspected Acute Coronary Syndrome (free study and commentaries) AND Cohort Study: The Introduction of High-sensitive Troponins Had No Impact on Survival (free study and commentaries)
Related Commentary on Twitter
This study found that the true 99th centile of high sensitivity cardiac troponin for a general hospital population was not consistent with the manufacturer's recommended upper limit of normal #BMJResearch @NickCurzen https://t.co/IQy62VenOx
— The BMJ (@bmj_latest) March 15, 2019
Cohort Study: Associations of Dietary Cholesterol or Egg Consumption with Incident Cardiovascular Disease and Mortality
17 Mar, 2019 | 18:50h | UTCAssociations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality – JAMA (free for a limited period)
Commentaries: Are Eggs Good Or Bad? How You Should Interpret This Latest Study – Forbes (free) AND Are eggs good or bad for you? New research rekindles the debate – STAT (free) AND Eggs are bad – then good – then bad again? What gives? – Diet Doctor (free)
Related Commentary on Twitter
Disagrees with several notable papers:
In NHS & HPFS, eggs not assoc w MI or stroke. https://t.co/F1OcIr0GjZ
In China Kadoorie study, eggs assoc w LOWER risk of CVD.https://t.co/MX6NTPfdhJ
Meta analysis: eggs assoc w LOWER stroke, no assoc w MI.https://t.co/UOFLKBw8dv https://t.co/oX6I6uvXaa
— Andrew Mente (@ToYourHealth101) March 15, 2019
NICE Guideline: Delirium Prevention, Diagnosis and Management
15 Mar, 2019 | 04:25h | UTCDelirium: prevention, diagnosis and management – National Institute for Health and Care Excellence (free)
Related: SIGN Guideline: Risk Reduction and Management of Delirium (free)
Randomized Trial: 9-month Treatment for Multi-drug Resistant TB is as Effective as 24-month Treatment
15 Mar, 2019 | 04:17h | UTCA Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: STREAM trial final results show 9-month treatment for multi-drug resistant TB is as effective as 24-month treatment – University College London (free) AND Trial data support shorter drug-resistant TB regimen – CIDRAP (free)
American Geriatrics Society Guiding Principles on the Care of Older Adults with Multimorbidity
15 Mar, 2019 | 03:01h | UTCNews Release: AGS releases new action steps to guide care for older adults with multiple chronic illnesses – American Geriatrics Society (free)
Cohort Study: Systolic Blood Pressure and Cognitive Decline in Older Adults with Hypertension
15 Mar, 2019 | 02:41h | UTCCommentary: Lower BP Linked to Cognitive Decline in Frail Elderly – Medscape (free registration required)
Related: Cohort Study: Control of Blood Pressure and Risk of Mortality in a Cohort of Older Adults (link to abstract and commentary)
SIGN Guideline: Risk Reduction and Management of Delirium
14 Mar, 2019 | 00:52h | UTCRisk reduction and management of delirium – Scottish Intercollegiate Guidelines Network (SIGN) (free guideline and summary)
News Release: First delirium clinical guidelines for Scotland published on World Delirium Awareness Day (free)
Pro/Con Debate: Should Asymptomatic Patients with Moderate-to-severe OSA be Treated?
14 Mar, 2019 | 00:43h | UTCPro: should asymptomatic patients with moderate-to-severe OSA be treated? – Breathe (free)
Con: should asymptomatic patients with moderate-to-severe OSA be treated? – Breathe (free)
Related: Obstructive Sleep Apnea in Cardiovascular Disease: A Review of the Literature and Proposed Multidisciplinary Clinical Management Strategy (free reviews) AND Positive airway pressure doesn’t reduce cardiovascular events and death in adults with sleep apnea (link to abstract and commentaries)
Evidence Evolving on Aspirin as Prevention
13 Mar, 2019 | 06:04h | UTCEvidence evolving on aspirin as prevention – ACP Internist (free)
Related: Randomized Trial: Aspirin for Primary Prevention of Cardiovascular Disease (link to abstract and commentaries) AND Randomized Trial: Effects of Aspirin for Primary Prevention in Persons with Diabetes (link to abstract and commentaries) AND Randomized Trial: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly (link to abstract and commentaries) AND Meta-Analysis: Association of Aspirin Use for Primary Prevention with Cardiovascular Events and Bleeding Events (link to abstract and commentaries)
“In patients who have not had a prior cardiovascular event, aspirin’s protective effects are modest and may not necessarily outweigh its potential downsides (namely, risk of bleeding and hemorrhagic stroke).”
Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment
13 Mar, 2019 | 05:52h | UTC
Podcast: Cirrhosis TIPS for Acute Complications
13 Mar, 2019 | 03:45h | UTC#142 Cirrhosis TIPS for Acute Complications – The Curbsiders Internal Medicine Podcast (free)
See also: Episode List
Meta-Analysis: Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults
12 Mar, 2019 | 02:49h | UTCAdults with an acute respiratory infection who have normal vital signs (temperature < 37,8 / respiratory rate < 20 / heart rate < 100) and a normal pulmonary examination are very unlikely to have CAP.
Systematic Review: Physical Maneuvers as a Preventive Intervention to Manage Vasovagal Syncope
12 Mar, 2019 | 02:47h | UTCRelated: 2018 ESC Guidelines for the diagnosis and management of syncope (free) AND 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (free) AND Review: The Management of Vasovagal Syncope (free)
AHA Statement on Cardiorenal Syndrome – Classification, Pathophysiology, Diagnosis, and Treatment Strategies
12 Mar, 2019 | 02:52h | UTCCommentary: The Heart-Kidney, Kidney-Heart Connection and Our Improving Understanding of a Complex and Intimate Relationship – American Heart Association (free)
Top Things to Know: Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies – American Heart Association (free)
Viewpoint: Reexamining Recommendations for Treatment of Hypercholesterolemia in Older Adults
12 Mar, 2019 | 02:46h | UTCReexamining Recommendations for Treatment of Hypercholesterolemia in Older Adults – JAMA (free for a limited period)
“This Viewpoint discusses the 2018 ACC/AHA cholesterol management guideline recommendation to consider statin treatment in adults aged >75 years with LDL levels 70-189 mg/dL, arguing that trial evidence does not support it…”
Three Neglected Numbers in the CBC: The RDW, MPV, and NRBC count
12 Mar, 2019 | 02:43h | UTCReview: Three neglected numbers in the CBC: The RDW, MPV, and NRBC count – Cleveland Clinic Journal of Medicine (free)
Christopher Martyn’s Research Reviews, 11 March 2019
12 Mar, 2019 | 02:42h | UTCChristopher Martyn’s research reviews, 11 March 2019 – The BMJ Opinion (free)
Christopher Martyn reviews the latest research from the top medical journals.
Laboratory Tests in Rheumatology: A Rational Approach
11 Mar, 2019 | 03:43h | UTCLaboratory tests in rheumatology: A rational approach – Cleveland Clinical Journal of Medicine (free)
Source: Hospital Medicine Virtual Journal Club
Overdiagnosis of Pulmonary Embolism: Definition, Causes and Implications
11 Mar, 2019 | 03:47h | UTCOverdiagnosis of pulmonary embolism: definition, causes and implications – Breathe (free)
Related: Time Trends in Pulmonary Embolism in the United States: Evidence of Overdiagnosis – JAMA Internal Medicine (free)
Study: E-Cigarettes Linked to Increased Risk of Heart Attacks, Coronary Artery Disease and Depression
11 Mar, 2019 | 03:37h | UTCCommentaries: E-cigarettes linked to heart attacks, coronary artery disease and depression – American College of Cardiology (free) AND E-cigarettes raise risk of heart attacks, strokes, depression, study says – UPI (free) AND e-Cigarettes Boost Heart Attack Risk, Emotional Stress, Findings Show – AJMC (free)