Internal Medicine
Sleep irregularity linked to subclinical markers of cardiovascular disease
21 Feb, 2023 | 11:51h | UTCSummary: The study examined the association between sleep irregularity and subclinical markers of cardiovascular disease in a population of over 2000 participants with a mean age of 68. The participants completed 7-day wrist actigraphy that detected when they were asleep and awake. The results showed that sleep irregularity, particularly sleep duration irregularity, was associated with subclinical atherosclerosis, including high coronary artery calcium burden and abnormal ankle-brachial index. These associations persisted even after adjusting for cardiovascular disease risk factors and other sleep characteristics such as obstructive sleep apnea, sleep duration, and sleep fragmentation. While it is important to note that observational studies like this one cannot establish causation and may be subject to residual confounding, the findings suggest that promoting regular sleep schedules could be an essential aspect of lifestyle recommendations for preventing cardiovascular disease.
News Release: Irregular sleeping habits may increase risk of atherosclerosis in older adults – American Heart Association
Commentaries:
Sleep Irregularity Linked to Measures of Subclinical Atherosclerosis – HealthDay
Irregular sleep may be harmful to your heart, study finds – CNN
Guideline Synopsis | Management of thoracic aortic dissection
21 Feb, 2023 | 11:48h | UTCManagement of Thoracic Aortic Dissection – JAMA (free for a limited period)
Original Guidelines:
Consensus Statement | Renal denervation in the management of hypertension in adults
21 Feb, 2023 | 11:45h | UTC
Cohort Study | One third of patients hospitalized with Covid-19 persist with lung abnormalities after 2 years
21 Feb, 2023 | 11:47h | UTCSummary: The study aimed to assess changes in chest CT abnormalities and pulmonary function in patients two years after recovery from SARS-CoV-2 infection. The prospective study followed 144 participants discharged from the hospital after SARS-CoV-2 infection between January 15 and March 10, 2020. The participants underwent serial chest CT scans and pulmonary function tests at 6 months, 12 months, and 2 years after symptom onset. The study found that 39% of participants had persistent interstitial lung abnormalities at 2 years, and this was associated with respiratory symptoms and decreased diffusion pulmonary function.
Editorial: Radiologic Findings after COVID-19 and the Correlation with Lung Function – Radiology
Commentaries:
Post-COVID-19 CT scans show lung abnormalities persist two years later – News Medical
COVID’s aftermath: Persistent organ damage at 1 year, lung abnormalities at 2 – CIDRAP
Review | How to manage coagulopathies in critically ill patients
21 Feb, 2023 | 11:43h | UTCHow to manage coagulopathies in critically ill patients – Intensive Care Medicine
Commentary on Twitter
Coagulopathies severe/frequent complication in #ICU: how to manage??
🩸 hemorrhagic coagulopathies: non‑malignant & malignant
🩸 thrombotic c.: sepsis‑induced & solid cancer‑associated
🩸 managing hemorrhagic c.
🩸(preventing &) managing thrombotic c.
🖇️ https://t.co/CKqzT7dcoH pic.twitter.com/SvpPNf0oGO— Intensive Care Medicine (@yourICM) February 18, 2023
Review | Diagnosis and management of patients with polyneuropathy
21 Feb, 2023 | 11:40h | UTCDiagnosis and management of patients with polyneuropathy – Canadian Medical Association Journal
Study finds low rates of antipsychotic medication discontinuation in older adults following infection-related hospitalization
20 Feb, 2023 | 12:25h | UTCSummary: The study aimed to investigate discontinuation rates of antipsychotic medications (APMs) used to treat delirium due to acute hospitalization and infection in older adults. The cohort study involved 5,835 patients in the US, who were aged 65 years or older, without prior psychiatric disorders and had newly initiated an APM prescription within 30 days of an infection-related hospitalization. The study found that only 11% of new atypical APM users and 52% of new haloperidol users discontinued the medication by 30 days after initiation. The discontinuation of haloperidol and atypical APM was less likely to occur in patients with dementia and prolonged hospitalization. The findings suggest that APM discontinuation rates following infection-related hospitalization are low, especially for atypical APM, and call for effective interventions to proactively discontinue APMs when they are no longer indicated.
RCT | Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease
20 Feb, 2023 | 12:27h | UTCSummary: The article reports on a randomized trial that compared the effects of alternate-day fasting (ADF) combined with exercise, fasting alone, or exercise alone in adults with obesity and non-alcoholic fatty liver disease (NAFLD). After three months, the combination of ADF and exercise significantly reduced intrahepatic triglyceride content, body weight, fat mass, waist circumference, and alanine transaminase levels compared to the control group. The intervention seems promising for patients with fatty liver disease who want to improve their health without using medications.
Article: Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease: A randomized controlled trial – Cell Metabolism (link to abstract – $ for full-text)
News Release: Alternate-day fasting could be a good option for patients with fatty liver disease – University of Illinois Chicago
M-A | Consumption of whole vs. refined grains and risk of cardiovascular disease and all-cause mortality
20 Feb, 2023 | 12:23h | UTCSummary: This systematic review and meta-analysis of prospective cohort studies found that consuming whole grains was associated with a reduced risk of coronary heart disease, cardiovascular disease, and all-cause mortality, while consuming refined grains had no significant influence on these outcomes. Residual confounding can’t be excluded and the association found does not necessarily imply causation.
Review | Neurological complications of sepsis
20 Feb, 2023 | 12:16h | UTCSummary: This article covers the latest developments in the prevention, diagnosis, and treatment of sepsis-associated encephalopathy (SAE) and ICU-acquired weakness (ICUAW). SAE diagnosis is clinical with supporting EEG and neuroimaging. Treatment involves early identification and treatment of infections and organ dysfunction. ICUAW is due to an overlap between critical illness polyneuropathy, critical illness myopathy, and muscle disuse atrophy. It affects all limbs and respiratory muscles and is associated with prolonged hospital stay, increased costs, and both short and long-term mortality. Recovery is typical in weeks or months, but severe cases may result in persistent functional impairments for ICU survivors.
Article: Neurological complications of sepsis – Current Opinion in Critical Care
M-A | Soluble fiber supplementation and serum lipid profile
20 Feb, 2023 | 12:18h | UTCSummary: The article presents the results of a systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) that evaluated the effect of soluble fiber supplementation on blood lipid parameters in adults. The review included 181 RCTs with 220 treatment arms and 14,505 participants. The meta-analysis found that soluble fiber supplementation significantly reduced LDL cholesterol, total cholesterol, triglycerides, and apolipoprotein B concentrations. The article suggests that increasing fiber intake using soluble fiber supplementation could be an effective intervention in the prevention and management of dyslipidemia, and consequently may contribute to the risk reduction of cardiovascular diseases. However, the article also notes that because of the high between-study heterogeneity and publication bias, the findings should be interpreted cautiously.
M-A | Aspirin with or without statin in individuals without atherosclerotic CVD across risk categories
17 Feb, 2023 | 13:22h | UTCSummary: This meta-analysis examined the effects of aspirin in adults without atherosclerotic cardiovascular disease (ASCVD), stratified by statin use across different ASCVD risks. The analysis found that aspirin reduced myocardial infarction but increased major bleeding, and was not associated with total or cardiovascular survival benefits. In adults without ASCVD, concomitant statin appeared to significantly reduce absolute risk reduction for MI associated with aspirin without influencing bleeding risk. The study highlights that the risk-benefit equilibrium may be tilted towards more harm for primary prevention, and that the expected absolute risk of major bleeding exceeds absolute MI benefits by aspirin for every level of ASCVD risk. The findings have implications for the use of aspirin in those already on statin therapy for primary ASCVD prevention.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Retrospective Cohort | High burden of premature ventricular complex linked to increased risk of new‐onset atrial fibrillation
17 Feb, 2023 | 13:12h | UTCSummary: The study investigated whether a high burden of premature ventricular complex (PVC) is associated with an increased risk of new-onset atrial fibrillation (AF). The study analyzed the daily burden of PVC using the 24-hour Holter ECG and medical record databases of a single hospital in Taiwan. Patients with high PVC burden were at a higher risk of new-onset AF compared to those with low PVC burden.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
M-A | Efficacy and safety of drugs for gastroparesis
17 Feb, 2023 | 13:05h | UTCCommentaries:
Review finds only two efficacious medications to treat gastroparesis – ACP Gastroenterology
Two drug classes appear effective for gastroparesis treatment – MDedge
Commentary from the author on Twitter (thread – click for more)
Our latest (and definitely last!) paper of 2022 is now published online in @AGA_Gastro and is a network meta-analysis of drugs in gastroparesis:https://t.co/kpz8nH6ekT
— Alexander Ford (@alex_ford12399) December 26, 2022
Review | Contemporary pharmacotherapies for nontuberculosis mycobacterial infections
17 Feb, 2023 | 13:03h | UTC
M-A | Global status of azithromycin and erythromycin resistance rates in Neisseria gonorrhoeae
17 Feb, 2023 | 12:58h | UTC
Case Reports | Seventeen cases of daptomycin-induced eosinophilic pneumonia in bone and joint infections
17 Feb, 2023 | 12:54h | UTC
RCT | Home high-flow nasal cannula oxygen therapy for stable hypercapnic COPD
17 Feb, 2023 | 12:53h | UTC
Acute pain management pearls: a focused review for the hospital clinician
17 Feb, 2023 | 12:42h | UTCAcute Pain Management Pearls: A Focused Review for the Hospital Clinician – Healthcare
Regulations on palliative sedation: an international survey across eight European countries
16 Feb, 2023 | 15:17h | UTC
Rare, overlooked, or underappreciated causes of recurrent abdominal pain: a primer for gastroenterologists
16 Feb, 2023 | 15:12h | UTC
Commentary from the author on Twitter
Our paper in @AGA_CGH looking at Rare, Overlooked, or Underappreciated Causes of Recurrent Abdominal Pain: A Primer for Gastroenterologists
Thanks to @umfoodoc @dbrennerGIMD and my mentor #DrBrandt @MonteGastro for including me in this important work https://t.co/91MKLqvgLy pic.twitter.com/HcHiRehhNI
— Marc Fenster (@Marcfenster1) September 28, 2022
M-A | Blood pressure lowering effects of B-blockers as add-on or combination therapy
16 Feb, 2023 | 15:10h | UTC
RCT | Orlistat and a low-carb diet show promising results for the treatment of Metabolic-Associated Fatty Liver Disease
16 Feb, 2023 | 15:07h | UTCSummary: The study aimed to compare the effects of orlistat or a high-protein/lower-carbohydrate diet with a control diet in Asian patients with obesity and metabolic-associated fatty liver disease (MAFLD) over 24 weeks. The primary endpoint was the relative change in liver fat content (LFC) assessed by MRI-PDFF. A total of 118 patients were randomly assigned to the control group, orlistat group, or experimental diet group. All three groups demonstrated improvement in liver steatosis at week 24, with the orlistat group and the experimental diet group both showing a significant decrease in LFC compared to the control group.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
M-A | Worldwide prevalence of antibiotic-associated Stevens-Johnson syndrome and toxic epidermal necrolysis
16 Feb, 2023 | 15:04h | UTCSummary: The article examined the prevalence Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) associated with antibiotics worldwide. The analysis included 38 studies involving 2,917 patients, which showed that 28% of SJS/TEN cases were associated with antibiotics. Among antibiotic-associated SJS/TEN, the sulfonamide class was associated with 32% of cases, followed by penicillins, cephalosporins, fluoroquinolones, and macrolides.
Article: Worldwide Prevalence of Antibiotic-Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Meta-analysis – JAMA Dermatology (free for a limited period)
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Review | Female genital tuberculosis
16 Feb, 2023 | 14:42h | UTCFemale Genital Tuberculosis – Open Forum Infectious Diseases