Internal Medicine
Antibiotic stewardship reduces the incidence of antibiotic-resistant bacteria
20 Jun, 2017 | 12:41h | UTCEffect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis – The Lancet Infectious Diseases (link to abstract – $ for full-text)
Commentaries: Antibiotic Stewardship Programs Linked to Lower Rates of Drug-Resistant Infections – Physician’s First Watch (free) AND Review ties stewardship to sharp drop in resistant bacteria – CIDRAP (free)
Richard Lehman’s weekly review of medical journals
20 Jun, 2017 | 12:26h | UTCRichard Lehman’s weekly review of medical journals, 19 June 2017 – The BMJ Blogs (free)
Why overtreatment and overdiagnosis can be bad for your health
20 Jun, 2017 | 12:19h | UTCWhy overtreatment and overdiagnosis can be bad for your health – CBC Radio (free text and audio)
See more on the Choosing Wisely initiative in our April 5 issue, see #6.
“Choosing Wisely on CBC Sunday about overdiagnosis & importance of speaking with your doc about tests/treatments” (RT @ChooseWiselyCA see Tweet)
Who Should Assess the Needs of and Care for a Dementia Patient’s Caregiver?
20 Jun, 2017 | 12:20h | UTCWho Should Assess the Needs of and Care for a Dementia Patient’s Caregiver? – AMA Journal of Ethics (free)
“Physicians have an obligation to check in on dementia patients’ caregivers, and provide support if necessary” (RT @JournalofEthics see Tweet)
ACR Thyroid Imaging and Reporting
20 Jun, 2017 | 12:09h | UTCACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee – Journal of the American College of Radiology (free, and legal, PDF via Unpawall)
Commentary: New ultrasound scoring system for thyroid nodules to reduce unnecessary biopsies – University of Alabama at Birmingham, via EurekAlert (free)
Incretin based treatments and mortality in patients with type 2 diabetes
20 Jun, 2017 | 12:06h | UTC“The current evidence provides no support for the hypothesis that incretin based treatment increases all-cause mortality in patients with type 2 diabetes”
Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association
19 Jun, 2017 | 13:00h | UTCDietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association (free PDF)
Invited Commentary: Trimming the Fat on Diet Recommendations for a Healthy Heart: Emphasis on Eating Patterns over Dietary Restrictions (free)
Top Ten Things to Know: Dietary Fats and Cardiovascular Disease: A Presidential Advisory from the American Heart Association (free PDF)
AHA News: Advisory: Replacing saturated fat with healthier fat could lower cardiovascular risks (free)
News release: Replacing saturated fat with healthier fat may lower cholesterol as well as drugs in context of a healthy diet (free)
AHA no longer recommends decreasing total fat, but to replace saturated fats with polyunsaturated or monounsaturated fats. “Replacing saturated fat with healthier fat in the diet lowers cardiovascular disease risk as much as cholesterol-lowering statin drugs”
Comparison of sputum collection methods for tuberculosis diagnosis
19 Jun, 2017 | 13:01h | UTCInvited commentary: Remembering the basics: interventions to improve sputum collection for tuberculosis diagnosis (free)
Pooled sputum collection (sputum that was pooled from each spontaneous expectoration into the same sputum container over a period of several hours) increased the diagnostic performance of smear microscopy 1.6 times and the delivery of standardized instruction emphasizing the difference between sputum and saliva (verbally or visually) increased the odds of a positive microscopy result 1.4 times. “The effect of these simple, inexpensive strategies on diagnostic performance was similar to that of the relatively expensive GeneXpert MTB/RIF test, which, in the largest published studies, increased the odds of diagnosing tuberculosis by 1.3–1.5 times”
Evolocumab for Treatment of High Cholesterol: Clinical Effectiveness
19 Jun, 2017 | 12:55h | UTCEvolocumab for Treatment of High Cholesterol: Clinical Effectiveness (free PDF) (RT @AnilMakam see Tweet 1, Tweet 2, Tweet 3 and Tweet 4)
News release: Institute for Clinical and Economic Review’s “New Evidence Update” on PCKS9 Inhibitors Highlights Lack of Mortality Benefit With Evolocumab (free)
Lack of mortality benefit in a recent large trial is highlighted in this updated review. Se more on the FOURIER trial and commentaries in our March 20th issue, see #2.
Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels
19 Jun, 2017 | 12:59h | UTCRacial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Glycation of Hemoglobin Differs by Race – Physician’s Briefing (free) AND Hemoglobin A1c Overestimates Average Glucose in Blacks – Medscape (free registration required) AND Why a key diabetes test may work differently depending on your race – CNN (free)
In this study with 104 black patients and 104 white patients with type 1 diabetes, HbA1c values in black persons were 0.4 percentage points higher than those in white persons for a given mean glucose concentration.
EULAR/EFORT recommendations for the management of fragility fractures
19 Jun, 2017 | 12:54h | UTC
Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty
19 Jun, 2017 | 12:57h | UTCPress release: New Guideline Aims to Reduce Infections in Total Hip & Knee Replacement Patients (free)
Commentaries: New medication guidelines for rheumatic disease patients having joint replacement – Hospital for Special Surgery, via EurekAlert (free) AND New Guidelines Issued on Antirheumatic Drugs for Patients Undergoing Knee or Hip Replacement – Physician’s First Watch (free)
Why are doctors killing themselves
19 Jun, 2017 | 12:55h | UTCWhy are doctors killing themselves? – by Anne Malatt, via MJA Insight (free)
Related: Why are doctors plagued by depression and suicide? A crisis comes into focus – STAT News (free)
PSA Test for Prostate Cancer
19 Jun, 2017 | 12:50h | UTCOpinion: Why I Won’t Get a PSA Test for Prostate Cancer – Scientific American (free)
Guidelines for the Chronic Use of Opioid Analgesics
19 Jun, 2017 | 12:50h | UTCGuidelines for the Chronic Use of Opioid Analgesics – Federation of State Medical Boards (FSMB) (free PDF)
Commentary: Chronic Pain Opioid Guidelines Updated for State Medical Boards – Medscape (free registration required)
Hundreds died while taking an arthritis drug, but nobody alerted patients
19 Jun, 2017 | 12:47h | UTC
Managing epilepsy in women of childbearing age
19 Jun, 2017 | 12:45h | UTC
Pain and Opioids in Cancer Care: Benefits, Risks, and Alternatives
16 Jun, 2017 | 01:24h | UTCPain and Opioids in Cancer Care: Benefits, Risks, and Alternatives – 2017 ASCO Educational Book (free)
Chronic Myeloid Leukemia: What Every Practitioner Needs to Know in 2017
16 Jun, 2017 | 01:26h | UTCChronic Myeloid Leukemia: What Every Practitioner Needs to Know in 2017 – 2017 ASCO Educational Book (free)
American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question
16 Jun, 2017 | 00:59h | UTCNew Choosing Wisely List: American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question (free)
See more on the Choosing Wisely initiative in our April 5 issue, see #6.
“Great choosing wisely list from @ASHPOfficial. Great doctoring tips for physicians & trainees” (RT @AnilMakam see Tweet)
Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events
15 Jun, 2017 | 00:47h | UTCInvited commentary: Preventing major gastrointestinal bleeding in elderly patients (free)
Commentaries: Aspirin Bleeding Risk in Over 75s Higher Than Thought – Medscape (free registration required) AND Aspirin linked to higher risk of serious bleeding in the elderly – Reuters Health News (free)
In this cohort, the risk of major bleeding increased sharply in patients above 75 years.
Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction
15 Jun, 2017 | 00:50h | UTCNon–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction – Journal of The American College of Cardiology (link to abstract – $ for full-text)
Commentary: NOAC Doses: Just Stick to the Label – MedPage Today (free registration required)
“Among the 1,473 patients with a renal indication for dose reduction, 43.0% were potentially overdosed, which was associated with a higher risk of major bleeding”
Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex for Iron-Deficiency Anemia
15 Jun, 2017 | 00:48h | UTCEffect of Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex on Hemoglobin Concentration in Young Children With Nutritional Iron-Deficiency Anemia: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
The JAMA Network – For the Media: Treating Nutritional Iron-Deficiency Anemia in Children (free)
Commentaries: Ferrous Sulfate Drops Tied to Higher Hemoglobin Increases in Kids with Anemia – Physician’s First Watch (free) AND Traditional treatment is better for iron-deficiency anaemia in children – OnMedica (free) AND Ferrous Sulfate Effective for Iron-Deficiency Anemia in Kids – Medscape (free registration required)
Researchers expected that Iron Polysaccharide Complex would restore hemoglobin more effectively, because it is designed to be tolerated better, but the proportion of infants and children with a complete resolution of iron-deficiency anemia was higher in the ferrous sulfate group (29 percent vs 6 percent).
Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes
14 Jun, 2017 | 00:43h | UTCCommentary: CANVAS: Canagliflozin Reduces CV Events, but at Cost of Amputations – Medscape (free registration required)
Patients treated with canagliflozin had a lower risk of cardiovascular events than those who received placebo but a greater risk of amputation and fractures. The benefits and harms were likely small. See interesting commentaries on the trade-offs by @AnilMakam, see Tweet 1; Tweet 2; Tweet 3; Tweet 4; Tweet 5; Tweet 6; Tweet 7; Tweet 8; and Tweet 9.
Association of Adverse Events With Antibiotic Use in Hospitalized Patients
14 Jun, 2017 | 00:41h | UTCAssociation of Adverse Events With Antibiotic Use in Hospitalized Patients – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentary: Antibiotic-Associated Adverse Events Common – Medscape (free registration required)
“20% of hospitalized patients receiving antibiotics had adverse drug event. Of those, 20% of regimens inappropriate” (RT @PeterPronovost see Tweet)