Thu, January 25 – 10 Stories of The Day!

1 – 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association (free PDF)

Commentaries: More stroke patients eligible for crucial treatments under new guidelines – American Heart Association News (free) AND More stroke patients may receive crucial treatments under new guideline – AHA/ASA Newsroom (free)

“A new guideline for treating acute ischemic stroke recommends an increased treatment window for mechanical clot removal from six hours to up to 24 hours in certain patients with clots in large vessels”. (from AHA/ASA Newsroom)

2 – Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging – New England Journal of Medicine (free)

Commentaries: Brain-scan guided emergency stroke treatment can save more lives – NIH News Releases (free) AND Study confirms late clot extraction can save brain cells of stroke victims – Reuters (free) AND New Findings Could Save Lives of More Stroke Patients – The New York Times (10 articles per month are free)

Related article: Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct – New England Journal of Medicine (link to abstract – $ for full-text)

3 – Perspectives: To Care Is Human — Collectively Confronting the Clinician-Burnout Crisis – New England Journal of Medicine (free) AND Beyond Burnout — Redesigning Care to Restore Meaning and Sanity for Physicians (free)

Related: Why Physician Burnout Is Endemic, and How Health Care Must Respond – NEJM Catalyst (free) AND Counting the costs: U.S. hospitals feeling the pain of physician burnout – Reuters (free)

4 – Association of Time to Treatment With Short-term Outcomes for Pediatric Patients With Refractory Convulsive Status Epilepticus – JAMA Neurology (free for a period)

Editorial: Time May Be of the Essence in the Treatment of Pediatric Patients With Refractory Convulsive Status Epilepticus (free)

Commentary: Delays Raise Death Risk in Kids with Status Epilepticus – MedPage Today (free registration required)

“These findings may change the perception of acute seizure and status epilepticus treatment, tentatively converting it into an extremely time-sensitive emergency that is similar to stroke or other cardiovascular events”.

5 – Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia: Evidence-based clinical practice guideline – Canadian Family Physician (free)

Related: Canadian Deprescribing Network (CaDeN) (free) AND CaDeN Deprescribing Guidelines and Algorithms (free) AND Deprescribing guidelines for the elderly – Ontario Pharmacy Evidence Network (free) AND Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline – Canadian Family Physician (free) AND 11 Drugs You Should Seriously Consider Deprescribing – Medscape Slideshow (free registration required) AND Current and future perspectives on the management of polypharmacy – BMC Family Practice (free)

6 – ECTRIMS/EAN guideline on the pharmacological treatment of people with multiple sclerosis – European Journal of Neurology (free)

7 – Guideline: Oesophago-gastric cancer: assessment and management in adults – National Institute for Health and Care Excellence (NICE) (free)

8 – Guideline: Age-related macular degeneration – National Institute for Health and Care Excellence (NICE) (free)

9 – Association Between Left Atrial Appendage Occlusion and Readmission for Thromboembolism Among Patients With Atrial Fibrillation Undergoing Concomitant Cardiac Surgery – JAMA (free)

Commentaries: Largest Study to Date Supports Surgical LAA Closure in A-fib Patients – TCTMD (free) AND Thromboembolism Less Likely With LAA Closure Added to Cardiac Surgery – MedPage Today (free registration required)

Randomized trials are needed to confirm these interesting findings. 

10 – Trends in Survival After In-Hospital Cardiac Arrest During Nights and Weekends – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentaries: Survival From In-Hospital Cardiac Arrest Improves But Still Worse on Nights and Weekends – MedicalResearch.com (free)

AND Hospital patients less likely to survive ‘off-hours’ cardiac arrest – Reuters (free) AND You are still more likely to die in a hospital on the weekend – CNN (free)

See also a recent meta-analysis showing the “weekend effect” in surgical patients