TOP 10 Medical News Stories

Thu, November 16 – 10 Stories of The Day!

16 Nov, 2017 | 03:11h | UTC

1 – Periodic preventive health visits: a more appropriate approach to delivering preventive services – Canadian Task Force on Preventive Health Care (free)

Summary: Periodic preventive health visits: A more appropriate approach to delivering preventive services (free)

News release: Annual checkups do not result in better health outcomes, national task force reaffirms (free)

2 – Sudden Cardiac Arrest during Participation in Competitive Sports – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: Sudden Cardiac Arrest Rare During Competitive Sports – Physician’s First Watch (free) AND Cardiac arrest study in young athletes raises heart screening questions – Reuters (free) AND Cardiac Arrest Rare in Young Athletes But Tough to Predict – Health (free) AND Screening programs unlikely to prevent sudden cardiac arrest in competitive athletes – St. Michael’s Hospital, via EurekAlert (free)

3 – Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosain health care facilities – World Health Organization (free)

Commentary: WHO offers guidance on carbapenem-resistant bacteria – CIDRAP (free)

4 – CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning – Stanford ML Group (free)

“We develop an algorithm that can detect pneumonia from chest X-rays at a level exceeding practicing radiologists”

5 – The Patients vs. Paperwork Problem for Doctors – The New York Times (10 articles per month are free)

6 – World Chronic Obstructive Pulmonary Disease Day, 15 November 2017: A round up of Cochrane evidence – Evidently Cochrane (free)

7 – Comparative clinical effectiveness and cost effectiveness of endovascular strategy vopen repair for ruptured abdominal aortic aneurysm: three year results of the IMPROVE randomised trial – The BMJ (free)

Editorial: Endovascular or open repair for ruptured abdominal aortic aneurysm? (free)

Commentary: Keyhole surgery more effective than open surgery for ruptured aneurysm – MedicalXpress (free)

8 – Health Effects and Public Health Concerns of Energy Drink Consumption in the United States: A Mini-Review – Frontiers in Public Health (free)

Commentaries: Serious health risks associated with energy drinks – ScienceDaily (free)

“To curb this growing public health issue, policy makers should regulate sales and marketing towards children and adolescents and set upper limits on caffeine” (from ScienceDaily)

9 – Effects of Bariatric Surgery in Obese Patients With Hypertension: The GATEWAY Randomized Trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension) – Circulation (free)

Commentary: Bariatric Surgery Can Lead to HTN ‘Remission’ in Obese: GATEWAY – Medscape (free registration required) AND Gastric Bypass to Treat Obese Patients With Steady Hypertension – GATEWAY – American College of Cardiology, Latest in Cardiology (free)

10 – Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis – The BMJ (free)

Mon, November 20 – 10 Stories of The Day!

20 Nov, 2017 | 03:31h | UTC

1 – News release: New global commitment to end tuberculosis – World Health Organization (free)

Commentary: Global health ministers commit to end TB – CIDRAP (free)

2 – Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control – Antimicrobial Resistance & Infection Control (free)

3 – The association between paternal and adolescent depressive symptoms: evidence from two population-based cohorts – The Lancet (free)

Editorial: The effect of paternal depression on depressive symptoms in adolescent offspring (free)

Commentaries: Dads’ Depression Tied to Increased Depression Risk in Teenage Children – Physician’s First Watch (free) AND Teenage depression linked to father’s depression – University College London, via ScienceDaily (free)

4 – The High Costs of Unnecessary Care – JAMA (free)

5 – “Maybe I Will Just Send a Quick Text…” – An Examination of Drivers’ Distractions, Causes, and Potential Interventions – Frontiers in Psycology (free)

Commentaries: Young Men, Frequent Drivers Most Likely To Get Distracted While Driving – NPR (free) AND Risk of distracted driving predicted by age, gender, personality and driving frequency – MedicalXpress (free)

6 – Dog ownership and the risk of cardiovascular disease and death – a nationwide cohort study – Scientific Reports (free)

Commentaries: Dog ownership linked to lower mortality – Uppsala University, via ScienceDaily (free) AND Owning A Dog May Help Your Heart, Study Shows – Forbes (free)

7 – Bird Flu Is Spreading in Asia, Experts (Quietly) Warn – The New York Times (10 articles per month are free)

8 – Taking Care of the Physician – The New York Times (10 articles per month are free)

9 – Pearls and pitfalls in comprehensive critical care echocardiography – Critical Care (free)

10 – Validation of the Ottawa Subarachnoid Hemorrhage Rule in patients with acute headache – Canadian Medical Association Journal (free)

Commentaries: Thunderclap Headache: Ottawa Rule To Exclude Subarachnoid Bleeding – Medical Research (free) AND New tool identifies headache patients at risk of aneurysms in emergency department – CMAJ, via EurekAlert (free)

Wed, November 15 – 10 Stories of The Day!

15 Nov, 2017 | 00:52h | UTC

1 – Association of Blood Pressure Lowering With Mortality and Cardiovascular Disease Across Blood Pressure Levels: A Systematic Review and Meta-analysis – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentaries: Treating modestly high blood pressure may not boost survival odds – Reuters (free) AND No cardiovascular disease reduction with intensive blood pressure lowering treatment – Umea University, via EurekAlert (free)

“”Primary preventive BP lowering is associated with reduced risk for death and CVD if baseline SBP is 140 mm Hg or higher.” published same day as @ACCinTouch guideline w/SBP goals <130 mm Hg. Cognitive dissonance?” (RT @kennylinafp see Tweet)

2 – Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain: A Secondary Analysis of the ROMICAT-II Randomized Clinical Trial – JAMA Internal Medicine (free)

Editorial: Acute Chest Pain in the Emergency Department (free)

Commentaries: Does Clinical Evaluation Plus Noninvasive Cardiac Testing Improve Outcomes in Emergency Department Patients with Chest Pain? – The JAMA Network (free) AND Noninvasive Cardiac Testing No Better Than Clinical Eval for Low-Risk Acute Chest Pain – Physician’s First Watch (free)

“Non-invasive testing of chest pain patients in the ED – longer stay; more testing, radiation and cost; no benefit”. (RT @JAMA_current see Tweet)

3 – World Antibiotic Awareness Week, 13-19 November 2017: A round up of Cochrane evidence – Evidently Cochrane (free)

4 – Guidelines on the management of abnormal liver blood tests – Gut (free)

5 – Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among U.S. Adolescents After 2010 and Links to Increased New Media Screen Time – Clinical Psychological Science (free)

Commentaries: Increased Hours Online Correlate With An Uptick In Teen Depression, Suicidal Thoughts – NPR (free) AND Smartphones a likely culprit in the recent decline in teen mental health – STAT (free)

6 – Tinder and Grindr don’t want to talk about their role in rising STDs – VOX (free)

7 – Review: The Diagnosis of Chronic Coronary Heart Disease – Deutsches Ärzteblatt international (free)

8 – Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery – Annals of Internal Medicine (free)

Commentaries: Perioperative aspirin may improve short-term outcomes after noncardiac surgery in patients with prior PCI – ACP Internist (free) AND Aspirin can prevent heart attacks after noncardiac surgery in patients with prior PCI – University of Alberta Faculty of Medicine & Dentistry, via ScienceDaily (free) AND Aspirin Protective Against Early Death/MI in Prior PCI Patients Undergoing Noncardiac Surgery – TCTMD (free)

9 – Perinatal mortality associated with induction of labour versus expectant management in nulliparous women aged 35 years or over: An English national cohort study – PLOS Medicine (free)

Commentaries: Labor induction at 40 weeks associated with lower risk of perinatal mortality – PLOS, via ScienceDaily (free) AND Induction at Term Cuts Rates of Infant Death in Older First-Time Moms – MedPage Today (free registration required) Inducing Older Moms at 40 Weeks May Lower Stillbirth Risk – Medscape (free registration required)

10 – Effect of an Intervention to Promote Breastfeeding on Asthma, Lung Function, and Atopic Eczema at Age 16 Years: Follow-up of the PROBIT Randomized Trial – JAMA Pediatrics (free)

Commentary: Prolonged breastfeeding linked to halving of later eczema risk – OnMedica (free)

Mon, November 13 – 10 Stories of The Day!

13 Nov, 2017 | 00:27h | UTC

1 – World Antibiotic Awareness Week, 13-19 November 2017 – World Health Organization (free resources)

2 – Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct – New England Journal of Medicine (free)

Editorial: A New DAWN for Imaging-Based Selection in the Treatment of Acute Stroke (free)

Commentaries: Landmark study may impact standard stroke treatment guidelines – MedicalXpress (free) AND Thrombectomy Works While Infarct Core is Small – MedPage Today (free registration required)

“DAWN data: Consider a “tissue window” rather than a “time window”” (from MedPage Today)

3 – Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: Mechanical heart valve often the safest choice – Stanford Medicine (free) AND Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement? – NEJM 360 Resident (free) AND Mechanical or Tissue Valve for AVR and MVR – American College of Cardiology, Latest in Cardiology (free) AND Mechanical Valves Show Mortality Benefit Over Biologic Valves – Medscape (free registration required) AND Heart valve replacement success may depend on age, valve type – Reuters (free)

4 – NICE Guideline: Bipolar disorder: assessment and management (free)

5 – Choice of implant combinations in total hip replacement: systematic review and network meta-analysis – The BMJ (free)

Commentary: What is the most effective type of hip implant combination for patients undergoing a hip replacement? – University of Bristol (free)

“…there is no evidence that any of the newer hip implant combinations, such as ceramic or uncemented, are better than the widely used small head metal-on-plastic cemented hip combination, which has been commonly used since the 1960s”.

6 – White Smoke From the Vatican? Not From Cigarettes – The New York Times (10 articles per month are free)

“WHO welcomes the Vatican’s decision to ban the sale of cigarettes as of next year. Tobacco kills more than 7 million people every year” (RT @WHO see Tweet)

7 – Exercise for the Prevention of Low Back Pain: Systematic Review and Meta-Analysis of Controlled Trials – American Journal of Epidemiology (link to abstract – $ for full-text)

Commentary: Exercise may help prevent low back pain or make it less severe – Reuters (free)

8 – How to survive the medical misinformation mess – European Journal of Clinical Investigation (free) (RT @RasoiniR see Tweet)

9 – Circulating vitamin D concentration and risk of seven cancers: Mendelian randomisation study – The BMJ (free)

Commentary: Vitamin D level not associated with cancer risk – Clinical Adviser (free)

“These results, in combination with previous literature, provide evidence that population-wide screening for vitamin D deficiency and subsequent widespread vitamin D supplementation should not currently be recommended as a strategy for primary cancer prevention”.

10 – Long-term Sustainability of Diabetes Prevention Approaches: A Systematic Review and Meta-analysis of Randomized Clinical Trials – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentaries: Lifestyle Modifications Slow Progression To Diabetes As Effectively As Medications – Medical Research (free) AND Lifestyle changes successfully reduce incidence of diabetes – MedicalXpress (free) AND Lifestyle changes—not medications—linked to sustained risk reduction for diabetes – Cardiovascular Business (free)

Tue, November 14 – 10 Stories of The Day!

14 Nov, 2017 | 00:47h | UTC

1 – 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults (free PDF)

2 – Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine – New England Journal of Medicine (free)

Commentaries: Neither Sodium Bicarbonate nor Oral Acetylcysteine Prevents Contrast-Induced Kidney Injury – Physician’s First Watch (free) AND PRESERVE: No Benefit from Sodium Bicarbonate, Acetylcysteine After Angiography – Medscape (free registration required)

3 – Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery – New England Journal of Medicine (free)

Commentaries: TRICS III: Restrictive Red-Cell Transfusion Noninferior to Liberal Use in Cardiac Surgery – TCTMD (free) AHA: Restrictive Blood Transfusion OK for Select Patients – MedPage Today (free registration required)

4 – Sexual Activity as a Trigger for Sudden Cardiac Arrest – Journal of The American College of Cardiology (link to abstract – $ for full-text)

Commentaries: Sex poses little risk of triggering sudden cardiac arrest – Cedars-Sinai Heart Institute, via EurekAlert (free) AND Instances of cardiac arrest after sex are low, but so are the survival rates – Cardiovascular Business (free)

5 – Comparison of Hospital Resource Use and Outcomes Among Hospitalists, Primary Care Physicians, and Other Generalists – JAMA Internal Medicine (free)

Editorial: The Costs and Benefits of Hospital Care by Primary Physicians: Continuity Counts (free)

Audio interview: Hospital Resource Use and Outcomes Among Generalist Physicians (free)

Commentaries: Study: For Inpatients, Primary Care Docs Outperform Hospitalists – MedPage Today (free registration required) AND Mortality Lower When Inpatients See Their Own PCP in Hospital – Medscape (free registration required)

6 – Review: Eosinophilic esophagitis: update on management and controversies – The BMJ (free for 2 weeks)

7 – Risks for blood clot in a vein may rise with increased TV viewing – Presented at American Heart Association’s (AHA) Scientific Sessions 2017 (free)

Commentary: More TV viewing linked to higher risk of blood clots in veins – Medical News Today (free)

8 – Nut Consumption and Risk of Cardiovascular Disease – Journal of The American College of Cardiology (free)

Commentary: Eating Regular Variety of Nuts Associated With Lower Risk of Heart Disease – American College of Cardiology (free) AND Variety of nuts tied to lower risk of heart disease – Reuters (free)

9 – Richard Lehman’s journal review, 13 November 2017 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

10 – 20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: ‘Unrelenting’: 20-Year Recurrence Risks in Breast Cancer – Medscape (free registration required) AND Breast cancer recurrence risk lingers years after treatment ends – MedicalXpress (free) AND Risk of breast cancer’s return continues long after treatment ends – Medical News Today (free)

Thu, November 9 – 10 Stories of The Day!

9 Nov, 2017 | 00:05h | UTC

1 – European guidelines on perioperative venous thromboembolism prophylaxis – European Journal of Anaesthesiology (free PDF articles):

– Editorial

– Executive Summary

– Intensive care

– Mechanical prophylaxis

– Patients with preexisting coagulation disorders and after severe perioperative bleeding

– Inferior vena cava filters

– Cardiovascular and thoracic surgery

– Neurosurgery

– Surgery in the elderly

– Surgery in the obese patient

– Surgery during pregnancy and the immediate postpartum period

– Day surgery and fast-track surgery

– Chronic treatments with antiplatelet agents

– Aspirin

2 – Vancomycin Plus Piperacillin-Tazobactam and Acute Kidney Injury in Adults: A Systematic Review and Meta-Analysis – Critical Care Medicine (link to abstract – $ for full-text)

Commentary: Vancomycin plus piperacillin-tazobactam associated with higher AKI risk – ACP Hospitalist (free)

3 – 2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure (free)

4 – Clinical Practice Guideline of Korean Diabetes Association (free articles):

– Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017

– Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus

– Monotherapy in Patients with Type 2 Diabetes Mellitus

– Combination Therapy of Oral Hypoglycemic Agents in Patients with Type 2 Diabetes Mellitus

5 – 2017 Multimodality Appropriate Use Criteria for Noninvasive Cardiac Imaging: Expert Consensus of the Asian Society of Cardiovascular Imaging – Korean Journal of Cardiology (free)

6 – Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research – The Lancet Neurology (free registration required)

7 – Being overweight or obese is linked with heart disease even without other metabolic risk factors – NIHR Signal (free)

Original article: Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis – European Heart Journal (free)

8 – Receipt of Warnings Regarding Potentially Impairing Prescription Medications and Associated Risk Perceptions in a National Sample of U.S. Drivers – Journal of Studies on Alcohol and Drugs (free)

Commentaries: Drivers not always told about their prescriptions’ potentially impairing effects – ACP Internist (free) AND Many People Prescribed Drugs That Could Impair Driving Aren’t Warned About Risk – Physician’s First Watch (free)

9 – Cardiovascular Effects of Long‐Term Exposure to Air Pollution: A Population‐Based Study With 900 845 Person‐Years of Follow‐up – Journal of The American Heart Association (free)

Commentaries: Air pollution as great a risk as hypertension, obesity, diabetes for CVD – Cardiovascular Business (free)

10 – Pulse oximetry screening for critical congenital heart defects: a European consensus statement – The Lancet Child & Adolescent Health (free)

Commentaries: All babies in Europe should be screened for heart defects at birth – OnMedica (free) AND Call for Europe-wide screening of babies for heart defects – MedicalXpress (free)

Fri, November 10 – 10 Stories of The Day!

10 Nov, 2017 | 00:45h | UTC

1 – Book: Major Infectious Diseases: Disease Control Priorities, Third Edition (free)

Press Release: Disease Control Priorities, 3rd Edition Launches Major Infectious Diseases Volume (free)

Previous volumes: 1 – Essential Surgery / 2 – Reproductive, Maternal, Newborn, and Child Health / 3 – Cancer / 4 – Mental, Neurological, and Substance Use Disorders / 5 – Injury Prevention and Environmental Health (all free)

2 – Inflammatory Bowel Disease, 4th Edition – Australian Guidelines for General Practitioners and Physicians (free PDF)

Source: Gastroenterology Research Review Australia

3 – Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial- The BMJ (free)

Editorial: Antibiotics or NSAIDs for uncomplicated urinary tract infection? (free)

Commentary: NSAID Compared to Antibiotic for Symptomatic Treatment of UTI – MPR (free)

4 – Regeneration of the entire human epidermis using transgenic stem cells – Nature (link to abstract – $ for full-text)

Commentaries: A Dying Boy Gets a New, Gene-Corrected Skin – The Atlantic (free) Gene Therapy Creates Replacement Skin to Save a Dying Boy – The New York Times (10 articles per month are free) AND ‘Extraordinary’ tale: Stem cells heal a young boy’s lethal skin disease – STAT (free) AND Scientists grow replacement skin for boy suffering devastating genetic disorder – The Guardian (free) Boy with rare disease gets brand new skin with gene therapy – Associated Press (free)

5 – International variations in primary care physician consultation time: a systematic review of 67 countries – BMJ Open (free)

Commentary: Primary care consultations last less than 5 minutes for half the world’s population – BMJ, via ScienceDaily (free)

“Global assessment of the length of doctor visits (primary care): range of 48 seconds to 22 minutes” (RT @EricTopol see Tweet)

6 – The case against hospital beds – Politico (free)

7 – Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa – Gates Open Research (free)

8 – Medications That Cause Dry Mouth As an Adverse Effect in Older People: A Systematic Review and Metaanalysis – Journal of The American Geriatrics Society (free)

Commentaries: Dry mouth symptoms can be side effect of certain medications for older adults – American Geriatrics Society, via EurekAlert (free) AND Certain medication use associated with dry mouth in older adults – Clinical Advisor (free)

9 – Coronary Artery Calcium Score for Long-term Risk Classification in Individuals With Type 2 Diabetes and Metabolic Syndrome From the Multi-Ethnic Study of Atherosclerosis – JAMA (free)

Commentaries: Risk Classification by CAC Score in Diabetes and Metabolic Syndrome – American College of Cardiology, Latest in Cardiology (free) AND CAC Score Aids in CVD Risk Prediction in Diabetes – MedPage Today (free registration required)

10 – Viewpoint: Placebo Effect of the Heart – The Atlantic (free)

See original ORBITA trial and commentaries in our November 3rd issue (see #1)

Wed, November 8 – 10 Stories of The Day!

8 Nov, 2017 | 01:20h | UTC

1 – News Release and Summary: More Cardiac Arrest Victims Could Survive with Dispatcher CPR Instruction, Rescue Breaths for Children (free)

See Guidelines: 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary (free PDF) AND 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality (free PDF) AND 2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality (free PDF)

Top Ten Things to Know: AHA Focused Update on Adult and Pediatric Basic Life Support and CPR Quality (free PDF)

2 – WHO guidelines on use of medically important antimicrobials in food-producing animals – World Health Organization (free)

News release: Stop using antibiotics in healthy animals to prevent the spread of antibiotic resistance (free)

Commentaries: WHO calls for restrictions on use of antibiotics in food animal production – STAT (free) AND WHO Moves to Contain Superbugs on the Farm – Scientific American (free) WHO calls for an end to antibiotic use in healthy animals – CIDRAP (free)

3 – Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients – The Lancet (free)

Commentaries: Tranexamic acid: is it about time? – The Lancet (free) Rapid use of blood drug could save thousands of lives, study finds – The Guardian (free) AND Severely bleeding patients must receive lifesaving drug within minutes, not hours – London School of Hygiene & Tropical Medicine, via EurekAlert (free)

4 – Draft Recommendation Statement: Osteoporosis to Prevent Fractures: Screening – U.S. Preventive Services Task Force (free)

Commentary: New USPSTF Draft Recommendations for Osteoporosis Screening – Medscape (free registration required)

5 – Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentaries: No Significant Difference in Pain Relief for Opioids vs Non-Opioid Analgesics for Treating Arm or Leg Pain – The JAMA Network (free) AND Acetaminophen plus Ibuprofen Noninferior to Low-Dose Oral Opioids for Acute Extremity Pain – Journal Watch (free)

6 – Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis – JAMA (link to abstract – $ for full-text)

Commentaries: Exercise, Vision Testing and Osteoporosis Evaluation Are Keys To Fall Prevention – Medical Research (free) AND Exercise may be best intervention to prevent falls among elderly, according to new study – MedicalXpress (free) AND Adding other therapy to exercise may be best for fall prevention – Reuters (free) AND How to Prevent Falls in Older Adults – Consumer Reports (free)

7 – Alcohol and Cancer: A Statement of the American Society of Clinical Oncology – Journal of Clinical Oncology (free)

Commentaries: Cancer Doctors Cite Risks of Drinking Alcohol – The New York Times (10 articles per month are free) AND Cutting back on alcohol can prevent cancers: experts – Reuters (free) ASCO links alcohol to cancer, calls for reduced consumption – eCancer News (free)

8 – The Growing Value of Digital Health: Evidence and Impact on Human Health and the Healthcare System – IQVIA Institute (free)

Commentary: Study Names Top Apps for Patients to Manage Illnesses – Medscape (free registration required)

“An impressive, in-depth report on digital health, shows how the field is taking hold” (RT @EricTopol see Tweet)

9 – Clinical Guidelines Synopsis: Screening for Chronic Obstructive Pulmonary Disease – JAMA (free)

Original Guideline: GOLD 2017 Global Strategy for the Diagnosis, Management and Prevention of COPD (free PDF)

10 – Projecting the impact of a nationwide school plain water access intervention on childhood obesity: a cost–benefit analysis – Pediatric Obesity (link to abstract – $ for full-text)

Commentaries: Making water available to school chilren at lunch may save $13B in health costs – UPI (free) AND Serving water with school lunches could curb obesity, save billions – Cardiovascular Business (free) AND Serving water with school lunches could prevent child, adult obesity: study – MedicalXpress (free)

Tue, November 7 – 10 Stories of The Day!

7 Nov, 2017 | 00:06h | UTC

1 – The Burden of Group B Streptococcus Worldwide for Pregnant Women, Stillbirths, and Children – Clinical Infectious Diseases Supplement (free articles)

Commentaries: Group B Streptococcus infection causes an estimated 150,000 preventable stillbirths and infant deaths every year – London School of Hygiene & Tropical Medicine (free) AND Streptococcus vaccine ‘could prevent over 100,000 baby deaths worldwide’ – The Guardian (free)

2 – Effectiveness of β-Lactam Monotherapy vs Macrolide Combination Therapy for Children Hospitalized With Pneumonia – JAMA Pediatrics (link to abstract – $ for full-text)

Commentaries: Study: Azithromycin overprescribed for kids’ pneumonia – CIDRAP (free) AND Vanderbilt study shows azithromycin overprescribed for childhood pneumonia – Vanderbilt University Medical Center, via EurekAlert (free)

3 – Position Paper: Patient Safety in the Office-Based Practice Setting – American College of Physicians (free PDF)

Commentaries: ACP says patient safety must be improved in office-based practice setting – American College of Physicians, via EurekAlert (free) AND ACP: Recommendations for Improving Patient Safety in Ambulatory Settings – MPR (free)

4 – Debate: the case for and against screening for breast cancer with mammography:

The case for mammography: Routine mammograms do save lives: The Science – The Conversation (free)

The case against mammography: Routine mammograms do not save lives: The research is clear – The Conversation (free)

Related: Make Screening Mammography Personal, Say the French – Medscape (free registration required)

“The debate over breast cancer screening continues, with disagreements about the start age, frequency, mortality effect, overdiagnosis, and overtreatment” (from Medscape)

5 – ORBITA: Another clinical trial demonstrating the need for sham controls in surgical trials – Science-Based Medicine (free) (via @gorskon)

6 – Viewpoint: Advance Directives for Dementia: Meeting a Unique Challenge – JAMA (free)

7 – Richard Lehman’s journal reviews, 6 November 2017 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

8 – Last Month in Oncology with Dr. Bishal Gyawali: October 2017 – eCancer News (free)

9 – Association of Warfarin Use With Lower Overall Cancer Incidence Among Patients Older Than 50 Years – JAMA Internal Medicine (free)

“In this population-based cohort study of 1.256.725 persons, there was a significantly lower age- and sex-adjusted incidence rate ratio of cancer among warfarin users vs nonusers”.

10 – The Value of Preoperative Assessment Before Noncardiac Surgery in the Era of Value-Based Care – Circulation (free)

Mon, November 6 – 10 Stories of The Day!

6 Nov, 2017 | 00:03h | UTC

1 – European Guidelines for treatment of HIV-positive adults – European AIDS Clinical Society (free)

Commentary: New EACS treatment guidelines – Aidsmap (free) AND EACS updates HIV guidelines for adults – Healio (free registration required)

2 – Effect of Sertraline on Depressive Symptoms in Patients With Chronic Kidney Disease Without Dialysis Dependence: The CAST Randomized Clinical Trial – JAMA (free)

Editorial: Treating Depression in Patients With Advanced CKD: Beyond the Generalizability Frontier (free)

Commentary: Standard Antidepressant May Not Help Patients with Chronic Kidney Disease – UT Southwestern Medical Center, via NewsWise (free)

“Not only doesn’t help treat moderate depression, sertraline causes worse nausea (NNH=8) & diarrhea (NNH=10)” (RT @AnilMakam see Tweet 1 and Tweet 2)

3 – Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza season – American Journal of Infection Control (free)

Commentaries: 4 in 10 healthcare professionals work when they’re sick, risking patients – HealthCare Finance (free) AND Four in 10 Healthcare Personnel Work While Sick – Medscape (free registration required) AND Four in 10 HCPs Work While Experiencing Flu-Like Illness, Says Survey – MPR (free)

4 – Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition – The Lancet (free registration required)

5 – Testing for chronic hepatitis B and C: a global perspective – BMC Infectious Diseases (free)

6 – Frequent sugar-sweetened beverage consumption and the onset of cardiometabolic diseases: cause for concern? – Journal of the Endocrine Society (free)

Commentaries: Just two sugary drinks per week may raise type 2 diabetes risk – Medical News Today (free) AND Sugar-sweetened drinks raise risk of diabetes, metabolic syndrome – The Endocrine Society, via EurekAlert (free)

7 – Choosing Wisely: Twenty Things Physicians and Patients Should Question – American Society for Clinical Pathology (free)

Commentary: More Lab Tests Deemed Inappropriate – Medscape (free registration required)

See more on the Choosing Wisely initiative in our April 5 issue (see #6)

8 – What We Know About Tuberculosis Transmission: An Overview – The Journal of Infectious Diseases (free) (RT @greg_folkers see Tweet)

9 – Fiber Intake and Survival After Colorectal Cancer Diagnosis – JAMA Oncology (free)

Commentaries: Is Eating Fiber After Colorectal Cancer Diagnosis Associated with Lower Death Risk? – The JAMA Network (free) AND Higher Fiber Intake After Colorectal Cancer Diagnosis Tied to Improved Survival – Physician’s First Watch (free)

10 – Glucocorticosteroids for people with alcoholic hepatitis – Cochrane Library (free)

Original article: Glucocorticosteroids for people with alcoholic hepatitis – Cochrane Library (link to abstract – $ for full-text)

“We found no evidence of a difference between glucocorticosteroids and placebo or no intervention on all-cause mortality, health-related quality of life, and serious adverse events during treatment”.

Fri, November 3 – 10 Stories of The Day!

3 Nov, 2017 | 02:08h | UTC

1 – Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial – The Lancet (link to abstract – $ for full-text)

Commentaries: Small Trial Raises Big Concerns That PCI In Stable Angina Is Just A Placebo – Cardiobrief (free) AND Diving Deep Into The ORBITA Trial – Cardiobrief (free) AND ‘Unbelievable’: Heart Stents Fail to Ease Chest Pain – The New York Times (10 articles per month are free) AND ORBITA: PCI Offers No Symptom Improvement Over Sham Procedure – TCTMD (free)

2 – Balanced Crystalloids vs Saline for Critically Ill Adults – American College of Chest Physicians Annual Meeting (free abstract)

Commentaries: Landmark Trials Deliver Evidence to Rethink Saline Use – Medscape (free registration required) AND Saline on the Ropes? Studies find balanced crystalloid fluids safer – MedPage Today (free registration required)

3 – Familial hypercholesterolaemia: identification and management – NICE Guideline (free)

News release: Inherited risk of high cholesterol should be identified and treated as early as possible, NICE says in updated guidance (free)

4 – Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (free PDF)

Commentary: Intracranial Hemorrhage After Stroke Thrombolysis: More Questions Than Answers (free)

Top Ten Things to Know: Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke (free PDF)

Slide Set: Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in AIS (free PDF)

5 – Cancer incidence and mortality among young adults aged 20–39 years worldwide in 2012: a population-based study – The Lancet Oncology (free)

Commentaries: Reducing the global cancer burden among young adults – The Lancet Oncology (free) AND Global burden of cancer among young adults aged 20–39 years – eCancer News (free) AND Cancer in Young Adults Disproportionately Affects Women – Medical Research (free)

6 – A ‘smart’ approach to performance drugs – ACP Internist (free)

6 – Seeing is Believing: Using Visual Abstracts to Disseminate Scientific Research – The American Journal of Gastroenterology (free)

7 – Opinion: Drug company sales reps should be banned from hospitals – STAT (free)

8 – Australia ends insurance subsidies for naturopathy, homeopathy, and more – Science-Based Medicine (free)

9 – Untreatable Gonorrhea Is Rapidly Spreading. Here’s What You Need to Know – TIME Health (free)

10 – Adolescent Childbirth Is Associated With Greater Framingham Risk Scores for Cardiovascular Disease Among Participants of the IMIAS (International Mobility in Aging Study) – Journal of The American Heart Association (free)

News release: Teen childbirth linked to increased risk for heart disease (free)

Commentaries: Teen childbirth linked to increased cardiovascular risk decades later – Cardiovascular Business (free) AND Study finds link between increased cardiovascular diseases and teen childbirth – News Medical (free)

Wed, November 1 – 10 Stories of The Day!

1 Nov, 2017 | 00:01h | UTC

1 – Lancet Countdown: Traking Progress on Health and Climate Change (free infographics, video and other resources)

Report: The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health (free registration required)

Commentaries: Health impacts of climate change already felt today – Imperial College London (free) AND How Climate Change Is Already Affecting Health, Spreading Disease – NPR Goats and Soda (free) AND Climate change already bringing disease, air pollution and heatwaves – The Guardian (free) AND Climate change isn’t just hurting the planet – it’s a public health emergency – The Guardian (free)

2 – Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study – Gut (link to abstract – $ for full-text)

Commentaries: Acid reflux drug linked to more than doubled risk of stomach cancer – study – The Guardian (free) AND Gastric Cancer Risk Doubled With Long-term PPI Use – Medscape (free registration required) AND PPI Use After H. pylori Eradication Therapy Tied to Increased Risk for Gastric Cancer – Physician’s First Watch (free)

3 – Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden – BMJ Open (free)

“Among 797 067 individuals on maintenance PPI therapy, the SIR of gastric cancer was over threefold increased (SIR=3.38, 95% CI 3.23 to 3.53)”.

4 – Review: Point of Care Ultrasound: An Overview – American College of Cardiology, Latest in Cardiology (free)

5 – 25th UEG (United European Gastroenterology) Week: Long-term aspirin use reduces the incidence of digestive cancers by up to 47% (free)

Commentaries: Long-Term Aspirin Use May Reduce Cancer Risk, Study Finds – Forbes (free) AND Aspirin slashes risk of gastrointestinal cancer – Medical News Today (free)

6 – Joint statement for the diagnosis, management, and prevention of chronic obstructive pulmonary disease for Gulf Cooperation Council countries and Middle East–North Africa region, 2017 – International Journal of Chronic Obstructive Pulmonary Disease (free)

7 – Mefloquine for preventing malaria during travel to endemic areas – Cochrane Library (free)

News release: Can mefloquine prevent malaria during travel to areas where the disease is widespread? (free)

Commentary: Cochrane review provides clarity about safety of mefloquine for preventing malaria in travelers – News Medical (free)

8 – Enjoyment of Spicy Flavor Enhances Central Salty-Taste Perception and Reduces Salt Intake and Blood Pressure – Hypertension (free)

Commentary: Can spicy foods curb salt cravings or lower blood pressure? – Reuters (free) AND Need to cut down on salt? Try something spicy instead – Medical News Today (free)

9 – Economic impact of palliative care among elderly cancer patients – presented at: 2017 Palliative and Supportive Care in Oncology Symposium (free abstract)

Commentaries: Palliative Care Associated With Decreased Costs For Patients With Advanced Cancer – Oncology Nurse Advisor (free) AND Early Palliative Care Is Key Driver in Reducing Costs – Medscape (free registration required)

10 – Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report (free PDF)

Thu, November 2 – 10 Stories of The Day!

2 Nov, 2017 | 01:08h | UTC

1 – The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases – Hepatology (free)

2 – The Care of Children With Congenital Heart Disease in Their Primary Medical Home – Pediatrics (free)

3 – Glaucoma: diagnosis and management – NICE Guideline (free)

News release: People at a low risk of developing glaucoma can avoid unnecessary referral, says NICE (free)

4 – Overdiagnosis and disease labels: the case of polycystic ovary syndrome – STAT (free)

Related: Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome? – The BMJ (link to summary – $ for full-text)

5 – Bacteria Can Evolve Resistance to Drugs Before Those Drugs Are Used – The Atlantic (free)

6 – What I’ve learned from 547 doctor suicides – Pamela Wible, via KevinMd.com (free)

7 – Mortality lower with prolonged vs. short-term IV infusion of antipseudomonal beta-lactams – ACP Hospitalist (free)

Original article: Prolonged versus short-term intravenous infusion of antipseudomonal β-lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials – The Lancet Infectious Diseases (link to abstract – $ for full-text)

8 – Updated WHO recommendation on intravenous tranexamic acid for the treatment of post-partum haemorrhage – The Lancet Global Health (free)

9 – Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy – NIHR Signal (free)

Original article: Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia – New England Journal of Medicine (link to abstract – $ for full-text)

10 – Vaginal cleansing before caesarean delivery reduces risk of infections – NIHR signal (free)

Original article: Vaginal Cleansing Before Cesarean Delivery: A Systematic Review and Meta-analysis – Obstetrics & Gynecology (link to abstract – $ for full-text)

Mon, October 30 – 10 Stories of The Day!

30 Oct, 2017 | 01:22h | UTC

1 – Book: Injury Prevention and Environmental Health – Disease Control Priorities, Third Edition (free)

Press Release: Disease Control Priorities, 3rd Edition Launches Volume on Injury Prevention & Environmental Health (free)

Previous volumes: 1 – Essential Surgery / 2 – Reproductive, Maternal, Newborn, and Child Health / 3 – Cancer / 4 – Mental, Neurological, and Substance Use Disorders

2 – NICE Guideline: Sinusitis (acute): antimicrobial prescribing (free)

News release: Antibiotics should not be used to treat the majority of sinus infections, NICE says (free)

3 – NICE Guideline: Cystic fibrosis: diagnosis and management (free)

News release: People with cystic fibrosis could be monitored through phone or video messaging, says NICE (free)

4 – NICE Guideline: Cataracts in adults: management (free)

News release: Take a patient-centred approach to treating cataracts, says NICE (free)

5 – KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors – Transplantation (free)

News release: KDIGO Guidelines on Living Kidney Donors: A Call for A Paradigm Shift (free)

6 – Influence of pharmaceutical marketing on Medicare prescriptions in the District of Columbia – PLOS One (free)

Commentaries: The More Lavish the Gifts to Doctors, the Costlier the Drugs They Prescribe – The New York Times (10 articles per month are free) AND Study finds even small gifts from pharma companies change prescribing habits – FierceHealthcare (free) AND Pharma gifts to providers result in more branded, expensive prescriptions – Georgetown University Medical Center, via EurekAlert (free)

7 – Why we need better evidence – Centre for Evidence-Based Medicine, University of Oxford (free)

“20 fundamental problems with the production of evidence” (RT @CochraneUK see Tweet)

8 – Viewpoint: The Evolution of Patient Diagnosis: From Art to Digital Data-Driven Science – JAMA (free)

9 – Review: Acute Management of Pulmonary Embolism – American College of Cardiology, Latest in Cardiology (free)

10 – Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbα antagonism: a single-centre propensity-matched cohort study and a randomised study – The Lancet (link to abstract – $ for full-text)

Commentaries: Why Heart Surgery May be Better in the Afternoon – Scientific American (free) AND Afternoon heart surgery has lower risk of complications, study suggests – The Guardian (free) AND Aortic Valve Replacement: Afternoon Surgery Linked to Fewer Adverse Events – Physician’s First Watch (free)

Tue, October 31 – 10 Stories of The Day!

31 Oct, 2017 | 00:51h | UTC

1 – Global tuberculosis report 2017 – World Health Organization (free PDF)

News release: WHO report signals urgent need for greater political commitment to end tuberculosis (free)

Commentaries: Tuberculosis world’s top infectious killer; UN health agency calls for political action to stop spread – UN News Center (free) AND Pandemic alert: Tuberculosis is world’s No. 1 infectious killer – CNBC (free) Despite progress, WHO paints ‘grim’ picture of global TB – CIDRAP (free)

2 – 2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (free PDF)

News release: Societies Detail Treatment for Patients With Ventricular Arrhythmias (free)

See also: Executive summary (free PDF) AND Top Ten Things to Know (free PDF) AND Slide Set (free PDF)

3 – PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock – New England Journal of Medicine (free)

Editorial: Back to the Future in Cardiogenic Shock — Initial PCI of the Culprit Lesion Only (free)

Commentaries: CULPRIT-SHOCK Disputes Benefit of Immediate Multivessel PCI in Patients With Cardiogenic Shock – TCTMD (free) AND CULPRIT-SHOCK: Culprit Lesion Only PCI Vs. Immediate Multivessel PCI in Cardiogenic Shock – American College of Cardiology, Latest in Cardiology (free)

4 – Prenatal Exposure to Acetaminophen and Risk of ADHD – Pediatrics (free)

Commentaries: An Association Between Prenatal Acetaminophen Use and ADHD: The Benefits of Large Data Sets – Pediatrics (free) AND Long-term Acetaminophen Use in Pregnancy and ADHD – 2 Minute Medicine (free) AND Study links acetaminophen in pregnancy to ADHD, but experts question results – CNN (free)

5 – Policy Statement: Cord Blood Banking for Potential Future Transplantation – American Academy of Pediatrics (free)

News release: Updated policy reaffirms value of public over private cord blood banks (free)

Commentaries: Pediatrics Group Updates Recommendations on Cord Blood Banking – Physician’s First Watch (free)

6 – Duration of Breastfeeding and Risk of SIDS: An Individual Participant Data Meta-analysis – Pediatrics (link to abstract – $ for full-text)

Commentary: Breastfeeding for two months halves risk of SIDS – University of Virginia Health System, via ScienceDaily (free)

7 – Is there a conflict of interest behind your cancer diagnosis? – STAT (free)

8 – Richard Lehman’s journal reviews, 30 October 2017 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

9 – Electronic cigarette use and smoking initiation among youth: a longitudinal cohort study – Canadian Medical Association Journal (free)

Commentary: E-cigarette use by high school students linked to cigarette smoking – ScienceDaily (free)

10 – Review: So you think it is sepsis: considerations beyond lung and urine in the sick patient without a source – emDocs (free)

Fri, October 27 – 10 Stories of The Day!

27 Oct, 2017 | 00:22h | UTC

1 – Screening for Lung Cancer: CHEST Guideline and Expert Panel Report – American College of Chest Physicians (free)

News release: American College of Chest Physicians unveils new lung cancer screening guidelines at CHEST 2017 (free)

2 – Guideline: Responding to children and adolescents who have been sexually abused – World Health Organization (free)

News release: Responding to children and adolescents who have been sexually abused (free)

3 – Payments by US pharmaceutical and medical device manufacturers to US medical journal editors: retrospective observational study – The BMJ (free)

“Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journals should consider the potential impact of such payments on public trust in published research”.

4 – Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis – The BMJ (free)

“Women with antithrombin, protein C, or protein S deficiency or with homozygous factor V Leiden should be considered for antepartum or postpartum thrombosis prophylaxis, or both”.

5 – Regular antibiotics for preventing pneumococcal infection in young children with sickle cell disease – Cochrane Library (free)

Original article: Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease – Cochrane Library (link to abstract – $ for full-text)

Source: EvidenceAlerts

6 – World leaders rehearse for a pandemic that will come ‘sooner than we expect’ – The Washington Post (free)

7 – Perspective: HIV Drug Resistance: An Emerging Threat to Epidemic Control – New England Journal of Medicine (free)

8 – Terbinafine is probably first choice oral drug for fungal toenail infection – NIHR Signal (free)

Original article: Oral antifungal medication for toenail onychomycosis – Cochrane Library (free)

9 – Clinical guidelines for the prevention and treatment of osteoporosis: summary statements and recommendations from the Italian Society for Orthopaedics and Traumatology – Journal of Orthopaedics and Traumatology (free)

10 – Austrian consensus guidelines on the management and treatment of portal hypertension (Billroth III) – Wiener klinische Wochenschrift (free)

Tue, October 24 – 10 Stories of The Day!

24 Oct, 2017 | 00:51h | UTC

1 – Guideline: Hepatitis B (chronic): diagnosis and management – National Institute for Health and Care Excellence (free)

2 – British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD) – Thorax (free)

3 – A toolkit for reducing repetitive routine blood draws in hospitals – Choosing Wisely Canada (free PDF)

News release: Toolkit: Pause the Draws (free)

4 – Policy Statement: Infection Prevention and Control in Pediatric Ambulatory Settings – American Academy of Pediatrics (free)

News release: Updated policy offers guidance on infection prevention, control in ambulatory settings (free)

Commentaries: Pediatrician’s New Germ-Control Advice: Bring Your Own Toys (10 articles per month are free) AND AAP: Hygiene, isolation protocols critical for infection control in pediatric office – Healio (free registration required)

5 – Clinical Report: Sexual and Reproductive Health Care Services in the Pediatric Setting – American Academy of Pediatrics (free)

News release: Pediatricians have key role in providing sexual, reproductive health care services (free)

6 – Incidence, Demographics, and Clinical Characteristics of Diabetes of the Exocrine Pancreas (Type 3c): A Retrospective Cohort Study – Diabetes Care (link to abstract – $ for full-text)

Commentary: Newly-identified third type of diabetes is being wrongly diagnosed as type 2 – The Conversation (free)

“Diabetes of the exocrine pancreas is frequently labeled type 2 diabetes but has worse glycemic control and a markedly greater requirement for insulin”.

7 – Concussion in adolescence and risk of multiple sclerosis – Annals of Neurology (link to abstract – $ for full-text)

Commentaries: Concussions in Teenagers Tied to Multiple Sclerosis Risk – The New York Times (10 articles per month are free) AND Teenage concussion linked to later risk of MS – Medical News Today (free)

8 – Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands – BMC Pregnancy and Childbirth (free)

9 – Clinical Management of Insomnia Disorder – JAMA (free)

“Cognitive Behavior Therapy for insomnia is recommended as 1st-line Tx; pharmacotherapy, if used, should be on a short-term basis” (RT @JAMAInternalMed see Tweet)

10 – Review: The challenge of Takotsubo syndrome: heterogeneity of clinical features – Swiss Medical Weekly (free)

Thu, October 26 – 10 Stories of The Day!

26 Oct, 2017 | 00:29h | UTC

1 – Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries – The Lancet Global Health (free)

Commentaries: Antenatal multiple micronutrient supplementation: benefits beyond iron-folic acid alone – The Lancet Global Health (free) AND Multiple micronutrient supplements to mothers improve survival for newborn girls – Harvard School of Public health (free)

Related systematic review: Multiple-micronutrient supplementation for women during pregnancy – Cochrane Library (free summary)

2 – Less dementia with oral anticoagulation in atrial fibrillation – European Heart Journal (free)

Commentaries: Blood-thinning drugs appear to protect against dementia in AF patients – OnMedica (free) AND Blood-thinning drugs ‘can reduce risk of dementia by up to 48%’ – The Guardian (free) AND Oral Anticoagulants Tied to Less Dementia in Patients with Atrial Fibrillation – Physician’s First Watch (free)

3 – Surgery for Drug-Resistant Epilepsy in Children – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: First test of anti-epilepsy surgeries in children shows dramatic benefit – Reuters (free) AND Surgery Cuts Seizures in Drug-Resistant Epilepsy – MedPage Today (free registration required)

4 – Guideline: Long-Acting Reversible Contraception: Implants and Intrauterine Devices – American College of Obstetricians and Gynecologists (free)

News release: LARC and Reproductive Choice (free)

Commentary: New Guidelines on LARC Released by ACOG – Medscape (free registration required)

5 – Review: The Practice and Implications of Finding Fluid During Point-of-Care Ultrasonography – JAMA Internal Medicine (free)

Related JAMA Video: Finding Fluid With Point-of-Care Ultrasonography (free)

6 – Depression and mortality in a longitudinal study: 1952–2011 – Canadian Medical Association Journal (free)

Commentaries: Depression strongly linked to higher long-term risk of early death for both women, men – ScienceDaily (free) AND Depression raises risk of early death – Medical News Today (free) AND Depression tied to shorter lifespan – Reuters (free)

7 – Is It Possible to Predict the Next Pandemic? – The Atlantic (free)

“Large initiatives are underway to pinpoint the next big viral threats—but some virologists believe the task is too hard”.

8 – Prognostic Effect and Longitudinal Hemodynamic Assessment of Borderline Pulmonary Hypertension – JAMA Internal Medicine (free)

Commentary: Borderline Pulmonary Hypertension Tied to Mortality Risk – MedPage Today (free registration required)

9 – Here’s Why Vaccines Are So Crucial – National Geographic Magazine (free) (via @filiamd)

10 – Aerosol delivery during invasive mechanical ventilation: a systematic review – Critical Care (free)

Wed, October 25 – 10 Stories of The Day!

25 Oct, 2017 | 00:19h | UTC

1 – Statin use and risk of developing diabetes: results from the Diabetes Prevention Program – BMJ Open Diabetes Research & Care (free)

Commentaries: Statins increase the risk of developing diabetes in at-risk people – Medical News Today (free) AND Statin use link to heightened type 2 diabetes risk in some people – OnMedica (free)

2 – Synopsis of the 2017 U.S. Department of Veterans Affairs/U.S. Department of Defense Clinical Practice Guideline: Management of Type 2 Diabetes Mellitus – Annals of Internal Medicine (free)

3 – Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review – The Lancet Global Health (free)

Commentary: New research highlights worldwide risk of HIV, Hepatitis C epidemics – University of New South Wales, via ScienceDaily (free)

4 – Effect of Robotic-Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients Undergoing Resection for Rectal Cancer: The ROLARR Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentaries: Comparison of Outcomes for Robotic-Assisted vs Laparoscopic Surgical Procedures – The JAMA Network (free) AND Robotic docs can boost surgery time and cost – Science News (free) AND Robot-assisted surgery for kidney removal associated with longer operating times, higher cost – Stanford Medicine (free) AND Robotic-assisted surgery: more expensive, but not always more effective – Reuters (free)

5 – Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms – Scientific Reports (free)

Other Commentaries: Magic mushrooms ‘reboot’ brain in depressed people – study – The Guardian (free) AND Magic mushrooms can ‘reset’ depressed brain – BBC News (free)

6 – Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association – Circulation (free PDF)

News releases: African Americans live shorter lives due to heart disease and stroke – AHA / ASA Newsroom (free) AND New report raises concerns about the cardiovascular health of African-Americans – AHA News (free)

Commentaries: Blacks Face Higher Mortality from Heart Disease, Stroke – Cardiobrief (free) AND Heart health disparities take toll on African-Americans – Reuters (free)

7 – A baby with a disease gene or no baby at all: Genetic testing of embryos creates an ethical morass – STAT (free)

8 – Richard Lehman’s journal review, 23 October 2017 – The BMJ Opinion (free)

Richard Lehman’s weekly review of medical journals.

9 – Protection of the house against Chagas disease, dengue, leishmaniasis, and lymphatic filariasis: a systematic review – The Lancet Infectious Diseases (free registration required)

10 – Head position after acute stroke does not affect disability outcomes – NIHR Signal (free)

Original article: Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke – The New England Journal of Medicine (link to abstract – $ for full-text)

Mon, October 23 – 10 Stories of The Day!

23 Oct, 2017 | 00:28h | UTC

1 – Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis – The Lancet Global Health (free)

Invited commentary: Global causes of vision loss in 2015: are we on track to achieve the Vision 2020 target? (free)

2 – Upright versus lying down position in second stage of labour in nulliparous women with low dose epidural: BUMPES randomised controlled trial – The BMJ (free)

Commentaries: During Labor, Lie Down – The New York Times (10 articles per month are free) AND Normal birth more likely when lying down in late stages, post epidural – OnMedica (free)

3 – Summary with 10 key points to remember: Thrombophilia Testing and Venous Thrombosis – American College of Cardiology, Latest in Cardiology (free)

Original article: Thrombophilia Testing and Venous Thrombosis – New England Journal of Medicine (link to abstract – $ for full-text)

4 – Is gene editing ethical? – Medical News Today (free)

Related Position Statement: Human Germline Genome Editing – American Society of Human Genetics (free) AND Commentary: 11 Organizations Urge Cautious but Proactive Approach to Gene Editing (free)

5 – Trial Evaluating Ambulatory Therapy of Travelers’ Diarrhea (TrEAT TD) Study: A Randomized Controlled Trial Comparing 3 Single-Dose Antibiotic Regimens With Loperamide – Clinical Infectious Diseases (link to abstract – $ for full-text)

Commentary: Azithromycin, levofloxacin, rifaximin all effective for travelers diarrhea – Healio (free registration required)

6 – Literature review: the economic costs of lung disease and the cost effectiveness of policy and service interventions – British Lung Foundation and British Thoracic Society (free PDF)

News release: New report identifies the most cost effective NHS activities and programmes to improve lung health – British Thoracic Society (free)

Source: Most cost effective treatments for lung disease identified – The BMJ News ($)

“The most cost effective treatments are: patient education and self management for asthma; stop smoking support for chronic obstructive pulmonary disease (COPD); vaccination programmes for pneumonia; and awareness campaigns for lung cancer” (from The BMJ).

7 – Walking in Relation to Mortality in a Large Prospective Cohort of Older U.S. Adults – American Journal of Preventive Medicine (free)

Commentaries: Regular Walking, Even if Minimal, Tied to Lower Death Risk – Medscape (free registration required) AND Study finds even regular walking can lower mortality risk – UPI (free)

8 – Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management – Mayo Clinic Proceedings (free)

Commentary: Docs Call Attention to Women Piling on Pounds in Midlife – Medscape (free registration required)

9 – Carefully managed antibiotic use could halve antibiotic-resistant infections – NIHR Signal (free)

Original article: Effect 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)

10 – Placing wet gauze on babies’ tummies speeds up urine collection – NIHR Signal (free)

Original article: Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial – The BMJ (free)

Thu, October 19 – 10 Stories of The Day!

19 Oct, 2017 | 00:01h | UTC

1 – 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation – Journal of The American College of Cardiology (free)

Commentaries: Expert Consensus Decision Pathway for Management of Mitral Regurgitation – American College of Cardiology, Latest in Cardiology (free) AND ACC Recommends ‘Structured Approach’ to Mitral Regurgitation – MedPage Today (free registration required)

2 – Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association – Circulation (free PDF)

Commentaries: 12 key points to remember: Standards for Inpatient Electrocardiographic Monitoring – American College of Cardiology, Latest in Cardiology (free) AND AHA updates practice standards for electrocardiographic monitoring – ACP Hospitalist (free)

3 – Dark chocolate is now a health food. Here’s how that happened – VOX (free)

“Big Chocolate’s investment in health science was a marketing masterstroke…” Interesting tale by @juliaoftoronto (RT @hildabast see Tweet)

4 – Long-term antibiotics likely to reduce risk of recurrent cellulitis – NIHR Signal (free)

Original article: Interventions for the prevention of recurrent erysipelas and cellulitis – Cochrane Library (link to abstract – $ for full-text)

5 – Comparing the Outcomes of Adults With Enterobacteriaceae Bacteremia Receiving Short-Course Versus Prolonged-Course Antibiotic Therapy in a Multicenter, Propensity Score–Matched Cohort – Clinical Infectious Diseases (link to abstract – $ for full-text)

Commentary: Short course of antibiotics worked as well as long for Enterobacteriaceae bacteremia – ACP Hospitalist (free)

6 – Report: Opportunities for Organ Donor Intervention Research: Saving Lives by Improving the Quality and Quantity of Organs for Transplantation (2017) – National Academies Press (free PDF)

7 – Short and Long Term Complications of In Utero Exposure to Lamotrigine – British Journal of Clinical Pharmacology (free PDF)

News release: Study Finds Epilepsy Drug to Be Safe During Pregnancy – Wiley (free)

Source: Study finds lamotrigine to be safe during pregnancy – The BMJ Research News ($)

8 – Richard Lehman’s journal review, 17 October 2017 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

9 – Association of Patient Frailty With Increased Morbidity After Common Ambulatory General Surgery Operations – JAMA Surgery (link to abstract – $ for full-text)

Commentaries: Frailty Associated With Increased Risk of Complications Following Common, Outpatient Operations – The JAMA Network (free) AND Frailty tied to higher risk of complications with common surgeries – Reuters (free) AND Frailty linked to higher rate of perioperative morbidity – OnMedica (free)

10 – 25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium – Mayo Clinic Proceedings (free)

Commentaries: Excessive Exercise May Harm The Heart, Study Suggests – Forbes (free) AND Physically active white men at high risk for plaque buildup in arteries – ScienceDaily (free)

Wed, October 18 – 10 Stories of The Day!

18 Oct, 2017 | 00:15h | UTC

1 – Guideline: 2017 Appropriate Use Criteria for the Treatment of Patients With Severe Aortic Stenosis (free)

Commentaries: 2017 AUC for Management of Severe Aortic Stenosis – American College of Cardiology, Latest in Cardiology (free) AND First Appropriate Use Criteria Issued for Severe Aortic Stenosis – Medpage Today (free registration required)

2 – Association of Blood Transfusion From Female Donors With and Without a History of Pregnancy With Mortality Among Male and Female Transfusion Recipients – JAMA (link to abstract – $ for full-text)

Commentaries: Blood Boundaries: Should Transfusions Be Matched by Sex? – Scientific American (free) AND Are transfusions harmful to men if the blood comes from women who have been pregnant? – STAT (free) AND Receipt of Blood Transfusion From Previously Pregnant Donor Associated with Increased Risk of Death Among Male Recipients – The JAMA Network (free)

3 – Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients—A Systematic Review and Meta-Analysis – Antibiotics (free)

Antibiotic-associated diarrhea ocurred in 8.0% of the probiotic group compared to 17.7% in the control group. The number needed to treat (NNT) to prevent one case of diarrhea was 11 (95% CI 6 to 13).

4 – Approach to recurrent fever in childhood – Canadian medical Association Journal (free)

5 – Comparative safety of direct oral anticoagulants and warfarin in venous thromboembolism: multicentre, population based, observational study – The BMJ (free)

Commentary: New Anticoagulants Not Linked To Excess Bleeding Rates – Cardiobrief (free)

6 – How Low to Go With Glucose, Cholesterol, and Blood Pressure in Primary Prevention of CVD – Journal of The American College of Cardiology (free)

Summary with 12 key points to remember: Glucose, Cholesterol, BP Targets for CVD Risk Factors – American College of Cardiology, Latest in Cardiology (free)

7 – Omega-6 fatty acid biomarkers and incident type 2 diabetes: pooled analysis of individual-level data for 39 740 adults from 20 prospective cohort studies – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)

Commentaries: Omega-6 fats may help prevent type 2 diabetes – George Institute for Global Health (free) AND Eating More Nuts Could Protect Against Type 2 Diabetes – Medscape (free registration required) AND Omega-6 could lower type 2 diabetes risk by 35 percent – Medical News Today (free)

8 – The oncologic burden of hepatitis C virus infection: A clinical perspective – CA: A Cancer Journal for Clinicians (free)

9 – Recommendations for Prevention and Control of Influenza in Children, 2017 – 2018 – American Academy of Pediatrics (free)

Commentary: 2017-2018 recommendations for pediatric influenza vaccination – Clinical Advisor (free) AND Fall Weather Headed Your Way? Time For Flu Shots – NPR (free)

10 – Individual support of nurses using electronic medicine monitors can improve HIV treatment – NIHR Signal (free)

Original article: Effectiveness and cost-effectiveness of a nurse-delivered intervention to improve adherence to treatment for HIV: a pragmatic, multicentre, open-label, randomised clinical trial – The Lancet Infectious Diseases (free)

Fri, October 20 – 10 Stories of The Day!

20 Oct, 2017 | 01:31h | UTC

1 – Levels & Trends in Child Mortality – UNICEF (free PDF)

News release: Levels and Trends in Child Mortality (free)

Commentaries: 7,000 newborns die every day, despite steady decrease in under-five mortality, new report says – The World Bank (free) AND New child mortality estimates show that 15,000 children died every day in 2016 – The World Bank (free) AND ‘Unconscionable’: 7,000 babies die daily despite record low for child mortality – The Guardian (free)

2 – Report: The Lancet Commission on pollution and health (Report, Executive Summary, Video, Audio and Comments – free registration required)

Commentaries: Report: Pollution Kills 3 Times More than AIDS, TB And Malaria Combined – NPR (free) AND Pollution linked to one in six deaths – BBC (free)

3 – 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea (free)

Commentary: New diarrhea guidelines stress implications of molecular tests – CIDRAP (free)

4 – Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology (free)

5 – Elevated blood pressure and risk of mitral regurgitation: A longitudinal cohort study of 5.5 million United Kingdom adults – PLOS Medicine (free)

Commentaries: High Blood Pressure Is a Risk Factor For Mitral Regurgitation – Medical Research (free) AND High Blood Pressure May Raise Mitral Regurgitation Risk – TCTMD (free) AND Inevitable or preventable? High blood pressure linked to mitral regurgitation – Cardiovascular Business (free)

6 – High-flow oxygen via nasal cannulae in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis – Systematic Reviews (free)

“In patients with acute hypoxemic respiratory failure HFNC was not associated with a difference in mortality compared to Noninvasive ventilation or standard oxygen”

7 – Imaging Studies Offer New Insights Into Inflammation In CV Disease – Cardiobrief (free)

Original article: Colchicine Therapy and Plaque Stabilization in Patients With Acute Coronary Syndrome – Journal of The American College of Cardiology (link to abstract – $ for full-text)

“Preliminary evidence that colchicine may reduce coronary plaque”.

8 – Evidence-based guidelines for supportive care of patients with Ebola virus disease – The Lancet (free)

Commentaries: New Ebola guidelines address immediate supportive care – CIDRAP (free)

9 – Update: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection – MMWR / CDC (free)

Commentaries: CDC Offers New Guidance on Diagnosing and Managing Zika in Infants – Physician’s First Watch (free)

10 – A Highly Pathogenic Avian H7N9 Influenza Virus Isolated from A Human Is Lethal in Some Ferrets Infected via Respiratory Droplets – Cell Host Microbe (free)

Commentaries: H7N9 study finds virus poised to become more lethal, resistant to treatment – CIDRAP (free) AND H7N9 influenza is both lethal and transmissible in animal model for flu – University of Wisconsin–Madison (free) AND Will the World’s Most Worrying Flu Virus Go Pandemic? – The Atlantic (free)

Mon, October 16 – 10 Stories of The Day!

16 Oct, 2017 | 01:32h | UTC

1 – The Revised Declaration of Geneva: A Modern-Day Physician’s Pledge – JAMA (free)

2 – Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report (free registration required)

Commentaries: A milestone for palliative care and pain relief – The Lancet (free registration required) AND Millions die suffering amid global opioid gap, report says – STAT (free) AND More than 25 million people dying in agony without morphine every year – The Guardian (free)

3 – Guideline: Assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition – World Health Organization (free) (RT @equitylist see Tweet)

News release: WHO releases guidelines to address overweight and obesity in children (free)

4 – Long Sleeves on Doctors’ White Coats May Spread Germs – Scientific American (free)

Related guideline: Healthcare Personnel Attire in Non-Operating-Room Settings – Infection Control and Hospital Epidemiology (free) AND Commentaries: Goodbye to the Doctor’s White Coat? – The New York Times (10 articles per month are free) AND New infection control recommendations could make white coats obsolete – ScienceDaily (free) AND Should Doctors Still Be Allowed to Wear White Coats? You Decide – HIV and ID Observations (free)

5 – Draft Recommendation Statement: Skin Cancer Prevention: Behavioral Counseling – U.S. Preventive Services Task Force (free)

Commentary: USPSTF Draft Statement Recommends Sun-Safe Behavioral Counseling for More Fair-Skinned Youth – Physician’s First Watch (free)

6 – Blood pressure targets in people with cardiovascular disease – Cochrane Library (free)

7 – Testing blood procalcitonin levels to decide when to start and stop antibiotics in adults with acute respiratory tract infections – Cochrane Library (free)

Original Article: Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections – Cochrane Library (link to abstract – $ for full-text)

“the use of procalcitonin to guide initiation and duration of antibiotic treatment results in lower risks of mortality, lower antibiotic consumption, and lower risk for antibiotic-related side effects”.

8 – 2017 EACTS Guidelines on perioperative medication in adult cardiac surgery – European Journal of Cardio-Thoracic Surgery (free)

Source: Critical Care Reviews Newsletter (free)

9 – Antibiotic susceptibility testing in less than 30 min using direct single-cell imaging – Proceedings of the National Academy of Sciences (free)

Commentary: Rapid Test for Antibiotic Susceptibility – JAMA (free)

10 – Older people with acute coronary syndromes may benefit from routine invasive therapy – NIHR Signal (free)

Original article: Revascularisation compared with initial medical therapy for non-ST-elevation acute coronary syndromes in the elderly: a meta-analysis – Heart (link to abstract – $ for full-text)

Tue, October 17 – 10 Stories of The Day!

17 Oct, 2017 | 01:34h | UTC

1 – Association of History of Gestational Diabetes With Long-term Cardiovascular Disease Risk in a Large Prospective Cohort of US Women – JAMA Internal Medicine (free)

Commentaries: CVD Risk for Women Rises After Gestational Diabetes – TCTMD (free) AND Does Gestational Diabetes Per Se Up Long-Term Cardiovascular Risk? – Medscape (free registration required) AND Gestational Diabetes Raises Heart Attack, Stroke Risk, NIH Study Finds – AJMC (free)

2 – Association of Antidepressant Medications With Incident Type 2 Diabetes Among Medicaid-Insured Youths – JAMA Pediatrics (link to abstract – $ for full-text)

Commentaries: Antidepressant Use in Youth Tied to Increased Diabetes Risk – Physician’s First Watch (free)

3 – State of The Art Review: Why and how to step down chronic asthma drugs – The BMJ (free)

4 – Clinical Use of a Home Sleep Apnea Test: An American Academy of Sleep Medicine Position Statement (free)

News release: AASM releases position statement on home sleep apnea testing (free)

Commentaries: AASM: Position Statement on Home Sleep Apnea Testing – MPR (free) AND Sleep Medicine Academy Releases Statements on Home Apnea Testing – Physician’s First Watch (free)

5 – Sex Differences and Similarities in Atrial Fibrillation Epidemiology, Risk Factors, and Mortality in Community Cohorts: Results From the BiomarCaRE Consortium (Biomarker for Cardiovascular Risk Assessment in Europe) – Circulation (link to abstract – $ for full-text)

Commentaries: A-fib strikes men a decade earlier than women – Medical News Today (free) And AHA: Men develop AFib a decade before women do; BMI linked to increased risk – Cardiovascular Business (free)

6 – Modelled Cost-Effectiveness of a Package Size Cap and a Kilojoule Reduction Intervention to Reduce Energy Intake from Sugar-Sweetened Beverages in Australia – Nutrients (free)

Commentaries: Cutting sugar in soft drinks would save 155,000 lives and $8 billion: experts – The Age (free) AND Study spells out huge health benefits by cutting back sugar in sugary drinks – University of New South Wales, Sidney (free)

7 – We may soon have our first $1 million drug. Who will pay for it? And how? – STAT (free)

8 – Long-term Outcomes of Multiple Arterial Coronary Artery Bypass Grafting: A Population-Based Study of Patients in British Columbia, Canada – JAMA Cardiology (free)

Commentaries: Study: Triple-Vessel CABG Strategy Matters in the Long Run – MedPage Today (free registration required)

In patients with multivessel disease who are undergoing coronary artery bypass grafting, multiple arterial grafting (MAG) is associated with reduced mortality, repeated revascularization, myocardial infarction, and heart failure when compared with left internal thoracic artery (LITA) supplemented by saphenous vein grafts (LITA+SVG).

9 – 2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery (free)

10 – Gastric acid suppression promotes alcoholic liver disease by inducing overgrowth of intestinal Enterococcus – Nature Communications (free)

Commentaries: Proton pump inhibitors linked to liver disease, researchers find – The Pharmaceutical Journal (free) AND Liver disease risk may be heightened by gastric acid drugs – Medical News Today (free) AND Common acid reflux medications promote chronic liver disease – EurekAlert (free)

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