Internal Medicine

Diffusing Capacity and Mortality in Chronic Obstructive Pulmonary Disease

🔗 https://t.co/F5Hqkx65hn pic.twitter.com/up0psKKE3i

— Annals of the ATS (@AnnalsATS) January 10, 2023

SR | Nonopioid pharmacological management of acute low back pain

31 Mar, 2023 | 13:27h | UTC

Nonopioid pharmacological management of acute low back pain: A level I of evidence systematic review – Journal of Orthopaedic Research

Review | Management of immune related endocrinopathies following immune checkpoint inhibitor therapy for cancer

31 Mar, 2023 | 13:23h | UTC

Diagnostic criteria and management recommendations for immune related endocrinopathies following immune checkpoint inhibitor therapy for cancer – Endocrine Connections

The Diagnosis and Management of Endocrine Side Effects of Immune Checkpoint Inhibitors – Deutsches Ärzteblatt International

Spectrum of immune checkpoint inhibitors-induced endocrinopathies in cancer patients: a scoping review of case reports – Clinical Diabetes and Endocrinology

Palliative care in the intensive care unit: not just end-of-life care

31 Mar, 2023 | 13:21h | UTC

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care – Intensive Care Research

Updated WHO Guidelines | COVID-19 boosters no longer routinely recommended for low-risk groups

30 Mar, 2023 | 14:33h | UTC

Summary: The WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) has revised its COVID-19 vaccination roadmap in light of the Omicron variant and widespread population immunity. The revised roadmap prioritizes protecting those at the highest risk of severe disease and death while maintaining resilient health systems. It introduces cost-effectiveness considerations for vaccinating lower-risk individuals, such as healthy children and adolescents, and presents revised booster dose recommendations.

Priority groups are categorized as high, medium, and low, based on factors like risk of severe disease and death. People in the high-priority group, consisting of older adults, individuals with significant comorbidities or immunocompromising conditions, pregnant persons, and frontline health workers, are advised to receive additional boosters 6 or 12 months after the last dose. The medium priority group, which includes healthy adults without comorbidities and children with comorbidities, is recommended to receive primary series and first booster doses. However, SAGE no longer routinely recommends additional boosters for this group due to limited public health gains.

For the low-priority group, encompassing healthy children and adolescents, vaccination decisions should take into account factors such as disease prevalence and cost-effectiveness. It is important to note that the public health benefits of vaccinating healthy children and adolescents are considerably lower compared to established essential vaccines for children, like rotavirus, measles, and pneumococcal conjugate vaccines.

News Release: SAGE updates COVID-19 vaccination guidance – World Health Organization

Commentaries:

No More COVID-19 Boosters for Healthy People, WHO Experts Recommend – Health Policy Watch

WHO vaccine advisers update COVID vaccine recommendations – CIDRAP

Study suggests no heightened death risk in young people with mRNA vaccines, but ChAdOx1 nCoV-19 vaccine linked to female cardiac deaths

30 Mar, 2023 | 14:28h | UTC

Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England – Nature Communications

Commentary: Expert reaction to ONS data on risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people, England: 8 December 2020 to 25 May 2022 – Science Media Centre

Commentary from the author on Twitter (thread – click for more)

Our latest @NatureComms research: Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England. Led by @Vnafilyan @kamleshkhunti @IsobelLWard et al. https://t.co/oxNdgEAflQ (1/3)

— Prof Amitava Banerjee💙 (@amibanerjee1) March 28, 2023

Opinion | ChatGPT will change Medicine

30 Mar, 2023 | 14:22h | UTC

Chat GPT will change Medicine – Vinay Prasad’s Observations and Thoughts

ChatGPT vs. NCI: analyzing the quality of cancer information on myths and misconceptions

ChatGPT has many uses. Experts explore what this means for healthcare and medical research – The Conversation

Artificial Intelligence in Medicine & ChatGPT: De-Tether the Physician – Journal of Medical Systems (if the link is paywalled, try this one)

Can artificial intelligence help for scientific writing? – Critical Care

Artificial intelligence in academic writing: a paradigm-shifting technological advance

Performance of ChatGPT on USMLE: potential for AI-assisted medical education using large language models

Perspective | ChatGPT-assisted diagnosis: is the future suddenly here?

Perspective | Generating scholarly content with ChatGPT: ethical challenges for medical publishing

ChatGPT: Will It Transform the World of Health Care? – UCSF Department of Medicine

ChatGPT and the future of medical writing (ChatGPT itself wrote this paper)

ChatGPT: five priorities for research – Nature

The path forward for ChatGPT in academia – Lumo’s Newsletter

Nonhuman “Authors” and Implications for the Integrity of Scientific Publication and Medical Knowledge – JAMA

ChatGPT is fun, but not an author – Science

Tools such as ChatGPT threaten transparent science; here are our ground rules for their use – Nature

ChatGPT listed as author on research papers: many scientists disapprove – Nature

Abstracts written by ChatGPT fool scientists

Review | Evaluation and management of hypernatremia in adults

30 Mar, 2023 | 14:20h | UTC

Evaluation and management of hypernatremia in adults: clinical perspectives – The Korean Journal of Internal Medicine

2ry analysis of a RCT | Vitamin D supplementation does not affect cognitive function in older adults

30 Mar, 2023 | 14:14h | UTC

Vitamin D supplementation and cognition—Results from analyses of the D-Health trial – Journal of the American Geriatrics Society (link to abstract – $ for full-text)

Original Study: RCT: Oral Vitamin D supplementation (60.000 IU per month) did not reduce mortality in patients 60 years or older (unscreened individuals in Australia, many without insufficiency, average 30ng/mL). Exploratory analyses pointed towards an increased risk of death from cancer.

Meta-Analysis: Vitamin D Not Effective for Cardiovascular Disease Prevention

Association between vitamin D supplementation and mortality: systematic review and meta-analysis – The BMJ

USPSTF Draft Statement: Insufficient evidence to recommend multivitamin supplements for the prevention of CVD or cancer. The statement also recommends against the use of beta-carotene (increases risk of CVD mortality and lung cancer) or vitamin E (clear evidence of no benefit)

Vitamin D, calcium, other vitamins, and supplements do not prevent cardiovascular diseases

Research: Circulating vitamin D concentration and risk of seven cancers

Research: Vitamin D and risk of total and site specific cancers

Brief Review | Acute mesenteric ischemia

30 Mar, 2023 | 13:44h | UTC

Acute mesenteric ischaemia – British Journal of Surgery

Review | Insomnia diagnosis and treatment across the lifespan

30 Mar, 2023 | 13:36h | UTC

Insomnia diagnosis and treatment across the lifespan – Journal of Family Practice

Review | How to integrate shared decision-making into your practice

30 Mar, 2023 | 13:35h | UTC

How to integrate shared decision-making into your practice – Journal of Family Practice

Study shows a slight breast cancer risk increase with progestogen-only birth control, comparable to combined oral methods

29 Mar, 2023 | 13:35h | UTC

Summary: A UK study and meta-analysis examined breast cancer risk linked to hormonal contraceptives, emphasizing progestagen-only contraceptives in premenopausal women. Utilizing a nested case-control design with the Clinical Practice Research Datalink (CPRD), a primary care database, the study included 9,498 women under 50 diagnosed with invasive breast cancer between 1996 and 2017, and 18,171 closely matched controls. The meta-analysis merged CPRD findings with 12 observational studies on progestagen-only preparations.

The results revealed that current or recent use of combined oral contraceptives, oral progestagen-only contraceptives, injectable progestagen, and progestagen intrauterine devices all led to a similar increase in breast cancer risk. The 15-year absolute excess risk associated with five years of oral combined or progestagen-only contraceptive use ranged from 8 per 100,000 users aged 16-20 to 265 per 100,000 users aged 35-39. The study concluded that both contraceptive types were linked to a slight breast cancer risk increase, and these risks must be weighed against the benefits of contraceptive use during childbearing years.

Article: Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis – PLOS Medicine

News Release: Study finds similar association of progestogen-only and combined hormonal contraceptives with breast cancer risk – PLOS

Commentary: Expert reaction to study looking at the association between hormonal contraceptive use and breast cancer incidence – Science Media Centre

M-A | Limited evidence for analgesic effectiveness in acute low back pain treatment

29 Mar, 2023 | 13:32h | UTC

Summary: The objective of this systematic review and network meta-analysis was to assess the effectiveness and safety of various analgesic medicines for treating acute non-specific low back pain. After examining 98 randomized controlled trials with over 15,000 participants, the study found that the quality of evidence for the effectiveness and safety of these medications is low or very low.

Some analgesic medicines showed potential in reducing pain intensity, but the evidence was limited due to trial risk of bias and imprecision in effect estimates. Furthermore, certain medications might increase the risk of adverse events during treatment, with evidence ranging from moderate to very low confidence.

Given the lack of high-quality evidence, clinicians and patients are advised to be cautious when using analgesic medicines for acute non-specific low back pain. More robust head-to-head comparison trials are needed to provide clearer guidance on the best course of treatment.

Article: Comparative effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain: systematic review and network meta-analysis – The BMJ

News Release: Study finds “considerable uncertainty” around effectiveness and safety of analgesics for low back pain – BMJ Newsroom

Commentary from the author on Twitter (thread – click for more)

Out today in @bmj_latest.

We found “considerable uncertainty” around the effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain.

Available at https://t.co/PeOmEOeJyJ

Thread 🧵 pic.twitter.com/T8YDNGhhME

— Michael Wewege, PhD (@mawewege) March 22, 2023

Review | Cerebrovascular manifestations of SARS-CoV-2

29 Mar, 2023 | 13:29h | UTC

Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review – Current Treatment Options in Neurology

M-A | Aggressive IV hydration may increase mortality risk in severe acute pancreatitis

29 Mar, 2023 | 13:26h | UTC

Summary: This systematic review and meta-analysis investigated the outcomes of aggressive and non-aggressive intravenous hydration in patients with severe and non-severe acute pancreatitis (AP). The study included nine randomized controlled trials with a total of 953 participants.

The findings revealed that aggressive intravenous hydration significantly increased mortality risk in severe AP cases, and fluid-related complication risk in both severe and non-severe AP cases. However, the study has some limitations, as only one study with 249 participants was judged to have a low risk of bias in all domains, while the remaining eight studies had non-low risk of bias, raising concerns about the reliability of the findings.

Despite these concerns, the findings still suggest that more conservative intravenous fluid resuscitation protocols for AP may be preferable. Further research with more rigorous study designs is needed to provide robust evidence on the effectiveness of different intravenous hydration strategies in treating acute pancreatitis.

Article: Comparison of clinical outcomes between aggressive and non-aggressive intravenous hydration for acute pancreatitis: a systematic review and meta-analysis – Critical Care

Commentary on Twitter

5 commonly-used creatinine-based equations provided different eGFR estimates in older adults in Sweden. BIS equation outperformed others in predicting 15-year mortality, but its accuracy was reduced in subgroups of low muscle mass and high age. https://t.co/DOJmp4HzZn

— JAMA Network Open (@JAMANetworkOpen) March 23, 2023

A syndrome-specific antibiotic stewardship intervention reduced antipseudomonal antibiotic use in diabetic foot infections

29 Mar, 2023 | 13:10h | UTC

Impact of a syndrome-specific antibiotic stewardship intervention on antipseudomonal antibiotic use in inpatient diabetic foot infection management – Antimicrobial Stewardship & Healthcare Epidemiology

Study shows clinical instability and severity are predictors for psychiatric hospitalization

M-A | Incidence and prognostic role of pleural effusion in patients with pulmonary embolism

SR | Etiologies of vertigo in the elderly

Cohort Study | Subclinical coronary atherosclerosis and risk for myocardial infarction

Review | Exercise in octogenarians: how much is too little?

Cohort Study | Diffusing capacity strongly predicts all-cause mortality in individuals with COPD