Internal Medicine | Page 49 of 487 | Links Medicus Content Curation & Alerts in Medicine

Guideline Synopsis | The use of opioids in the management of chronic pain

15 Feb, 2023 | 16:16h | UTC

Summary: The VA/DoD guideline for chronic pain management recommends non-opioid treatments, such as cognitive-behavioral and physical therapy, with opioid use reserved for specific circumstances. Mental health evaluations are emphasized, along with regular treatment reassessments. Opioid use is not recommended due to small benefits outweighed by risks, but if used, buprenorphine is suggested due to a lower risk profile. Screening for mood disorders and traumatic brain injury is also advised, although evidence for risk mitigation strategies is lacking.*

Article: The Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline – Annals of Internal Medicine

News Release: Summary of VA/DoD guidelines for management of chronic pain provides new recommendations on opioid use and mental health evaluations – American College of Physicians

Summary for patients: The Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline – Annals of Internal Medicine

Commentary: Initiation of Opioids Not Recommended for Chronic Pain – HealthDay

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

USPSTF reaffirms recommendation against serologic screening for genital herpes infection

15 Feb, 2023 | 16:17h | UTC

Summary: The US Preventive Services Task Force (USPSTF) recommends against routine screening for genital herpes infection in asymptomatic adolescents, adults, and pregnant women, as the potential harms of such screening outweigh the benefits. This recommendation is based on a systematic evaluation of the available evidence, and the USPSTF has moderate certainty in its conclusion.*

Article: Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Reaffirmation Recommendation Statement – JAMA

Evidence Report: Serologic Screening for Genital Herpes: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA

Editorials:

Reducing HSV-2 Morbidity and MortalityRoutine Serologic Screening Still Not the Best Answer – JAMA

Reaffirmed USPSTF Recommendation Against Serologic Screening for Genital Herpes: Empowering Clinicians and Reducing Potential Harm – JAMA Dermatology (free for a limited period)

Author Interview: Serologic Screening for Genital Herpes Infection – JAMA

JAMA Patient Page: Screening for Genital Herpes

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

Cohort Study | Associations between types and sources of dietary carbohydrates and cardiovascular disease risk

15 Feb, 2023 | 16:13h | UTC

Summary: This study found that the associations between carbohydrate intake and cardiovascular disease risk depend on the type and source of carbohydrates consumed, with free sugar intake being associated with higher risk of total cardiovascular disease and stroke. Fiber intake was associated with lower risk, and replacing refined grain starch and free sugars with wholegrain starch and non-free sugars may be protective for cardiovascular disease. Free sugar intake was also associated with higher triglycerides and lipoprotein subclasses. As with all observational studies, this study cannot establish causality, but rather suggests associations between carbohydrate intake and cardiovascular disease risk, and the importance of considering the quality of carbohydrates consumed for cardiovascular health.*

Article: Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants – BMC Medicine

News Release: Free sugars associated with higher risk of cardiovascular disease – BioMed Central

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

RCT | Antimicrobial therapy for 7 days is inferior to treatment for 14 days in men with febrile urinary tract infection

15 Feb, 2023 | 16:11h | UTC

Summary: This study aimed to compare the effectiveness of 7-day versus 14-day antibiotic treatment for febrile urinary tract infections in men. The multicenter randomized, double-blind, placebo-controlled non-inferiority trial enrolled 282 men from 27 centers in France. The primary endpoint was treatment success, defined as a negative urine culture, the absence of fever, and no subsequent antibiotic treatment between the end of treatment and 6 weeks after day 1. The results showed that the 14-day treatment was superior to the 7-day treatment, with a treatment success rate of 77.6% versus 55.7%, respectively. Adverse events were similar in both groups, and rectal carriage of resistant Enterobacterales did not differ. Therefore, the study concludes that treatment with ofloxacin for 7 days is inferior to 14 days for febrile UTI in men and should not be recommended.*

Article: Antimicrobial for 7 or 14 days for febrile urinary tract infection in men: a multicenter noninferiority double blind placebo-controlled, randomized clinical trial – Clinical Infectious Diseases (link to abstract – $ for full-text)

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

Cohort Study | Prevalence, outcomes and costs of a contemporary, multinational population with heart failure

15 Feb, 2023 | 15:59h | UTC

Summary: The CardioRenal and Metabolic disease (CaReMe) HF study estimated the prevalence, clinical outcomes, and costs of heart failure (HF) across 11 countries using digital healthcare systems. The study found that the prevalence of HF was 1-2%, with the most frequent comorbidities being ischemic heart disease and chronic kidney disease (CKD) stages III– V.

Furthermore, the study revealed that hospital care costs were highest for cardiorenal diseases, even higher than those stemming from atherosclerotic cardiovascular diseases. This emphasizes the urgent need for improved risk management and healthcare planning for patients with HF, particularly those with cardiorenal complications.*

Article: Prevalence, outcomes and costs of a contemporary, multinational population with heart failure – Heart

News Release: Up to 2% of adults in Europe, North America, Israel likely have heart failure – BMJ Newsroom

Commentary: Multinational Study Details Contemporary Prevalence, Treatment Strategies of Heart Failure – HCP Live

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

M-A | Relative safety and effectiveness of different erythropoiesis‐stimulating agents for anemia in adults with CKD

15 Feb, 2023 | 15:58h | UTC

Summary: The article reviewed the evidence on the safety and effectiveness of different epoetin drugs in treating anemia in people with chronic kidney disease. From the available research, it is uncertain whether various epoetin medications are superior or inferior to each other in terms of the probability of requiring a blood transfusion, mortality, experiencing a heart attack or stroke, developing a clot in a fistula or dialysis vascular catheter, or the likelihood of requiring dialysis for individuals with less severe kidney disease.*

Article: Erythropoiesis‐stimulating agents for anaemia in adults with chronic kidney disease: a network meta‐analysis – Cochrane Library

Summary: The relative safety and effectiveness of different epoetin drugs for treating anaemia in people with chronic kidney disease – Cochrane Library

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

Review | Postoperative atrial fibrillation: from mechanisms to treatment

15 Feb, 2023 | 15:54h | UTC

Postoperative atrial fibrillation: from mechanisms to treatment – European Journal of Cardiology

Commentary on Twitter

Postoperative atrial fibrillation: from mechanisms to treatment https://t.co/Alpb9eFRGb @escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes pic.twitter.com/s27PGkS49X

— European Society of Cardiology Journals (@ESC_Journals) February 14, 2023

Study shows non-diabetic kidney disease is prevalent among individuals with diabetes undergoing renal biopsy

15 Feb, 2023 | 15:41h | UTC

Prevalence of non-diabetic kidney disease and inability of clinical predictors to differentiate it from diabetic kidney disease: results from a prospectively performed renal biopsy study – BMJ Open Diabetes Research & Care

Commentary: Non-Diabetic Kidney Disease Prevalent in Individuals With Type 2 Diabetes – Consultant 360

SR | Predisposing and precipitating factors associated with delirium

15 Feb, 2023 | 15:38h | UTC

Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review – JAMA Network Open

Consensus Paper | ED management of patients with alcohol intoxication, alcohol withdrawal, and alcohol use disorder

14 Feb, 2023 | 11:05h | UTC

Emergency Department Management of Patients with Alcohol Intoxication, Alcohol Withdrawal, and Alcohol Use Disorder: A White Paper Prepared for the American Academy of Emergency Medicine – The Journal of Emergency Medicine

Podcast | “Things we do for no reason” pearls

14 Feb, 2023 | 10:56h | UTC

#381 LIVE! Patient Centered Things We Do For No Reason – The Curbsiders

Single-arm study | Effects of SER-109 as an investigational microbiome therapeutic in recurrent C. difficile infection

14 Feb, 2023 | 10:47h | UTC

Summary: This was a phase 3, open-label, single-arm trial of 263 adults with recurrent Clostridioides difficile Infection (CDI). The trial aimed to evaluate the safety and rate of CDI recurrence after administration of the investigational microbiome therapeutic SER-109. The trial found that SER-109 was well tolerated and the overall rate of recurrent CDI was low, regardless of the number of prior recurrences, demographics, or diagnostic approach.

(By ChatGPT, reviewed and edited)

Article: Safety and Tolerability of SER-109 as an Investigational Microbiome Therapeutic in Adults With Recurrent Clostridioides difficile Infection: A Phase 3, Open-Label, Single-Arm Trial – JAMA Network Open

Commentary: Phase 3 trial provides more positive data for recurrent C diff microbiome drug – CIDRAP

Post-trial follow-up | Microbiome therapeutic SER-109 through 24 weeks for recurrent Clostridioides difficile infection.

Cohort study | Epidemiology and outcomes of hospital-acquired bloodstream infections in ICU patients

14 Feb, 2023 | 10:44h | UTC

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study – Intensive Care Medicine (if the link is paywalled, try this one)

Commentary on Twitter

Hospital‑acquired bloodstream infections in #ICU, @EuroBact2
🧫mainly due to Gram -, widespread carbapenem resistant, DTR pathogens
🧫resistance associated w longer delays to adequate ABT therapy
At day-28
🧫mortality 37%
🧫16.1% discharged alive from 🏥
🖇️https://t.co/0T4FK2mxc5 pic.twitter.com/e0u50hMKqO

— Intensive Care Medicine (@yourICM) February 11, 2023

Cohort Study | Global epidemiology of carbapenem-resistant Pseudomonas aeruginosa and associated carbapenemases

14 Feb, 2023 | 10:43h | UTC

Global epidemiology and clinical outcomes of carbapenem-resistant Pseudomonas aeruginosa and associated carbapenemases (POP): a prospective cohort study – The Lancet Microbe

M-A | Prevalence of ocular candidiasis and Candida endophthalmitis in patients with candidemia

14 Feb, 2023 | 10:43h | UTC

Prevalence of ocular candidiasis and Candida endophthalmitis in patients with candidemia: A systematic review and meta-analysis – Clinical Infectious Diseases

Commentary on Twitter

Prevalence of ocular candidiasis and Candida endophthalmitis in patients with candidemia: A systematic review and meta-analysis

✅ Just Accepted
🆓 Freely Available
🔗 https://t.co/a8SYDUM8UH pic.twitter.com/L5niNTVIUd

— Clinical Infectious Diseases (@CIDJournal) February 9, 2023

Review | Anisocoria in the ED: pathophysiology, evaluation, and management

14 Feb, 2023 | 10:41h | UTC

Anisocoria in the ED: Pathophysiology, Evaluation, and Management – emDocs

Takayasu Arteritis | JACC Focus Seminar

14 Feb, 2023 | 10:39h | UTC

Takayasu Arteritis: JACC Focus Seminar 3/4 – Journal of the American College of Cardiology

2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis – Annals of the Rheumatic Diseases

2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis – Arthritis & Rheumatology

Retrospective Study | Outcomes of percutaneous intervention in patients with Takayasu arteritis

14 Feb, 2023 | 10:38h | UTC

Outcomes of Percutaneous Intervention in Patients With Takayasu Arteritis – Journal of the American College of Cardiology

Commentary: Percutaneous Intervention in Patients With Takayasu Arteritis – Journal of the American College of Cardiology

2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis – Annals of the Rheumatic Diseases

2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis – Arthritis & Rheumatology

Recommended adult immunization schedule, United States, 2023

13 Feb, 2023 | 13:06h | UTC

Commentary: Recommended 2023 Adult Immunization Schedule Published – HealthDay

Commentary on Twitter

The 2023 #ACIP schedule is out now with important changes to #COVID19 and pneumococcal vaccines, including recommendations for adults who have previously received PCV13 and PPSV23: https://t.co/QeErLZJFuZ pic.twitter.com/BR6aa1kNKi

— Annals of Int Med (@AnnalsofIM) February 10, 2023

Perspective | Five new realities in critical care for patients with cancer

13 Feb, 2023 | 12:53h | UTC

Five new realities in critical care for patients with cancer – Intensive Care Medicine

Consensus Conference: Critically ill cancer patient’s resuscitation.

Raising awareness for time-limited trial discussion upon ICU triage and admission.

Trends in clinical profiles, organ support use and outcomes of patients with cancer requiring unplanned ICU admission: a multicenter cohort study

Commentary on Twitter

New realities in critical care for pts with cancer
1️⃣ serious illness no longer means end of life
2️⃣ novel cancer therapies: changing outcomes but creating new diseases
3️⃣ take fresh look at ARF
4️⃣ goals of care & time‑limited trial
5️⃣ look beyond #ICU
📖 https://t.co/ZRNQD6AMIw pic.twitter.com/5QoYVSq5Br

— Intensive Care Medicine (@yourICM) February 10, 2023

RCT | A deprescribing intervention reduced medication burden among older adults in post-acute care

13 Feb, 2023 | 12:50h | UTC

Deprescribing Medications Among Older Adults From End of Hospitalization Through Postacute Care: A Shed-MEDS Randomized Clinical Trial – JAMA Internal Medicine (free for a limited period)

Achieving sustainable healthcare through deprescribing of unnecessary medications: making sense of the evidence – Cochrane Library

Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis – Health Technology Assessment

Barriers and facilitators to deprescribing of cardiovascular medications: a systematic review – BMJ Open

A National Modified Delphi Consensus Process to Prioritize Experiences and Interventions for Antipsychotic Medication Deprescribing Among Adult Patients With Critical Illness – Critical Care Explorations

Deprescribing proton pump inhibitors – Australian Journal of General Practice

Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis – Age and Ageing

Optimizing Medication Use in Older Adults With Rheumatic Musculoskeletal Diseases: Deprescribing as an Approach When Less May Be More – ACP Open Rheumatology

Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy – European Heart Journal – Cardiovascular Pharmacotherapy

Deprescribing in Older Adults with Cardiovascular Disease – Journal of the American College of Cardiology

Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology

Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports

How-to guide for medication reviews in older adults with cancer: A Young International Society of Geriatric Oncology and Nursing & Allied Health Interest Group initiative – Journal of Geriatric Oncology

Deprescribing in Palliative Cancer Care – Life

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360

Process evaluation of implementation strategies to reduce potentially inappropriate medication prescribing in older population: A scoping review – Research in Social and Administrative Pharmacy

AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review – Gastroenterology

Development of a Metric to Detect and Decrease Low-Value Prescribing in Older Adults – JAMA Network Open

The MedSafer Study—Electronic Decision Support for Deprescribing in Hospitalized Older Adults: A Cluster Randomized Clinical Trial – JAMA Internal Medicine

Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models – Drugs & Aging

Deprescribing in palliative patients with cancer: a concise review of tools and guidelines – Supportive Care in Cancer

Prescribing practices, patterns, and potential harms in patients receiving palliative care: A systematic scoping review – Exploratory Research in Clinical and Social Pharmacy

A narrative review of evidence to guide deprescribing among older adults – Journal of General and Family Medicine

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens – The Lancet Health Longevity

Polypharmacy Management in Older Patients – Mayo Clinic Proceedings

Psychopharmacological Treatment in Older People: Avoiding Drug Interactions and Polypharmacy – Deutsches Ärzteblatt international

Eliminating Medication Overload: A National Action Plan – Lown Institute

International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): Position Statement and 10 Recommendations for Action – Drugs & Aging

Common ED Medication Errors: Polypharmacy – emDocs

Current and future perspectives on the management of polypharmacy – BMC Family Practice

Routine deprescribing of chronic medications to combat polypharmacy – Therapeutic Advances in Drug Safety

Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international

Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety

Commentary on Twitter

A randomized trial of patient-centered #deprescribing in the acute care setting reduced medication burden by 14% among older hospitalized patients that needed ongoing post-acute care. https://t.co/FJf53O00Cv #ShedMEDS #polypharmacy #LessIsMore #Geriatrics

— JAMA Internal Medicine (@JAMAInternalMed) February 9, 2023