1 – Association Between Estimated Cumulative Vaccine Antigen Exposure Through the First 23 Months of Life and Non–Vaccine-Targeted Infections From 24 Through 47 Months of Age – JAMA (link to abstract – $ for full-text)
Commentaries: Vaccines won’t overload your child’s immune system—or increase their risk of other infections – Science (free) AND Too Many Too Soon? No! – Science-Based Medicine (free) AND Study finds no immune overload for US kids’ vaccine schedule – CIDRAP (free)
2 – Frequency and level of evidence used in recommendations by the National Comprehensive Cancer Network guidelines beyond approvals of the US Food and Drug Administration: retrospective observational study – The BMJ (free)
Commentaries: Vinay Prasad on the NCCN’s cancer treatment guidelines: The US system needs an audit – The BMJ Opinion (free) AND US cancer network recommending expensive drugs based on weak evidence, study finds – The Guardian (free) AND New Study Questions Evidence for NCCN Recommendations – Medscape (free registration required)
3 – Digoxin and Mortality in Patients With Atrial Fibrillation – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries: Digoxin and Mortality in Patients With Atrial Fibrillation – American College of Cardiology, Latest in Cardiology (free) AND Digoxin Associated with Higher Mortality in Patients with Atrial Fibrillation – NEJM Physician’s First Watch (free)
When available, Factor Xa inhibitors seem to be a better choice for treating these patients.
See also other recent CHEST guidelines on the management of cough in specific populations: Classification of Cough as a Symptom in Adults and Management Algorithms (free) AND Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold (free) AND Chronic Cough Due to Gastroesophageal Reflux in Adults (free) AND Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer (free) AND Cough in the athlete (free) AND Occupational and Environmental Contributions to Chronic Cough in Adults (free) AND Treatment of Unexplained Chronic Cough (free) AND Use of Management Pathways or Algorithms in Children With Chronic Cough (free) AND Management of Children With Chronic Wet Cough and Protracted Bacterial Bronchitis (free)
10 – Effect of Offering Same-Day ART vs Usual Health Facility Referral During Home-Based HIV Testing on Linkage to Care and Viral Suppression Among Adults With HIV in Lesotho: The CASCADE Randomized Clinical Trial – JAMA (free)
Editorial: The Global HIV Epidemic: What Will It Take to Get to the Finish Line? (free)
1 – Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentaries: Opioids Don’t Beat Other Medications For Chronic Pain – NPR (free) AND More Data Opioids No Better for Chronic Back, Arthritis Pain – Medscape (free registration required) AND Opioids no better than NSAIDs for chronic back or arthritis pain – Reuters (free)
2 – Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentary: One-off PSA screening for prostate cancer does not save lives – eCancer News (free)
“‘The most recognized book in all of medicine’ is also rife with hidden financial conflicts. Should Harrison’s authors be disclosing $11 million in payments from drug and device makers?” (via @caseymross see Tweet)
Source: Critical Care Reviews Newsletter
7 – Opinion: Are Hospitals Becoming Obsolete? – The New York Times (10 articles per month are free)
9 – Frailty and the management of patients with acute cardiovascular disease: A position paper from the Acute Cardiovascular Care Association – European Heart Journal: Acute Cardiovascular Care (free)
1 – Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus: A Guidance Statement Update From the American College of Physicians (free)
Commentary: Major Medical Associations Feud Over Diabetes Guidelines – NPR (free)
“Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes”
2 – Treatment of infections caused by multidrug-resistant Gram-negative bacteria: report of the British Society for Antimicrobial Chemotherapy/Healthcare Infection Society/British Infection Association Joint Working Party – Journal of Antimicrobial Chemotherapy (free) (via @ABsteward)
See original EACS Guidelines in 7 languages (all free)
In this meta-analysis of RCT testing treatments for patients with heart failure with preserved ejection fraction, only beta-blockers demonstrated reductions in all-cause and cardiovascular mortality.
6 – Relation of Dietary Sodium (Salt) to Blood Pressure and Its Possible Modulation by Other Dietary Factors: The INTERMAP Study – Hypertension (link to abstract – $ for full-text)
Richard Lehman reviews the latest research in the top medical journals.
9 – Summary for ED-relevant care: 2018 AHA/ASA Ischemic Stroke Updates – emDocs (free)
Original guideline: 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)
““Palliative care” had connotations of treatment withdrawal and imminent death… practicing the principles of palliative care is needed, but the term “palliative care” should be avoided or reframed”.
See related articles on this subject: Palliative care: renaming as supportive care and integration into comprehensive cancer care – CMAJ (free) AND Perceptions of palliative care among patients with advanced cancer and their caregivers (free)
2 – Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)
Commentaries: 5 Classifications of Diabetes Proposed – Physician’s First Watch (free) AND Should diabetes be divided into 5 categories to improve treatment? – Cardiovascular Business (free) AND Diabetes Consists of Five Types, Not Two, Say Researchers – Medscape (free registration required)
A free, online resource on the principles and interventions needed to reduce healthcare associated infections, with suggested control measures across different resource levels.
See also: Executive Summary
Related Guideline: Guideline for opioid therapy and chronic noncancer pain – Canadian Medical Association Journal (free)
This campaign encourages thoughtful conversation between clinicians and patients to reduce harms associated with opioid prescribing, with recommendations relevant to different specialties.
6 – New campaign: Nursing Now campaign: empowering nurses to improve global health – World Health Organization (free)
Related: Global nursing movement launches – Devex (free) AND Nursing Now campaign: raising the status of nurses – The Lancet (free registration required)
See also: Nursing Now Website
In general practice or emergency care settings, brief alcohol interventions can reduce alcohol consumption and related harm.
8 – The Challenge of Doctor-Patient Relations in the Internet Age – The New York Times (10 articles per month are free)
9 – Editorial: Escalating Inhaled Glucocorticoids to Prevent Asthma Exacerbations (free)
10 – Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance) – Journal of Clinical Oncology (link to abstract – $ for full-text)
Commentaries: Nut Consumption May Aid Colon Cancer Survival – Yale Cancer Center, via NewsWise (free) AND Nuts, Especially Tree Nuts, and Improved CRC Survival – Medscape (free registration required
A survival benefit was suggested by this observational trial.
1 – Hydrocortisone plus Fludrocortisone for Adults with Septic Shock – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Hydrocortisone-fludrocortisone cuts deaths in septic shock – The Hospitalist (free)
2 – Policy Statement: Pediatric Medication Safety in the Emergency Department – American Academy of Pediatrics (free)
Commentaries: Recommendations Issued on Reducing Pediatric Medication Errors in the ED – NEJM Physician’s First Watch (free) AND Policy statement outlines ways to improve pediatric medication safety – 2 Minute Medicine (free)
3 – Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data – The Lancet (link to abstract – $ for full-text)
This meta-analysis of randomized trials showed CABG had a mortality benefit over PCI in patients with multivessel disease, particularly those with diabetes and higher coronary complexity. There was no mortality benefit in patients with left main disease.
4 – Meta-analysis: Long-Term Outcomes of On- Versus Off-Pump Coronary Artery Bypass Grafting – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries: Long-Term Outcomes of On- vs. Off-Pump CABG – American College of Cardiology, Latest in Cardiology (free) AND Long-term survival benefit seen in on-pump vs off-pump CABG – Cardiovascular Business (free)
5 – Public Health: Tackling multiple unhealthy risk factors: Emerging lessons from practice – The King’s Fund (free PDF)
Related Guidelines and Reviews: Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline (free) AND 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines (free) AND Canadian Cardiovascular Society Guidelines for Evaluation and Management of Cardiovascular Complications of Cancer Therapy (free) AND Cardiotoxicity of anticancer treatments: Epidemiology, detection, and management – CA: A Cancer Journal for Clinicians (free)
“Despite higher operative cost, robot-assisted laparoscopic surgery does not result in statistically better treatment outcomes, with the exception of lower estimated blood loss. Operative time and total complication rate are significantly more favorable with conventional laparoscopic surgery”.
Source: Medscape (free registration required)
“Cognitive enhancers in general have minimal effects on cognition according to minimal clinically important difference and global ratings. The drugs appear safe, but this must be interpreted cautiously because trial participants may have less comorbidity and fewer adverse effects than those treated with these drugs in clinical practice”.
Commentary: EHR Time Exceeds Patient Face Time in Family Practice Visits – Medscape (free registration required)
Related: Care-Centered Clinical Documentation in the Digital Environment: Solutions to Alleviate Burnout – National Academy of Medicine (free) AND Date Night with the EHR – NEJM Catalyst (free) AND Why Physician Burnout Is Endemic, and How Health Care Must Respond – NEJM Catalyst (free) AND Putting Patients First by Reducing Administrative Tasks in Health Care: A Position Paper of the American College of Physicians(free)
“Self-monitoring, with or without telemonitoring, when used by general practitioners to titrate antihypertensive medication in individuals with poorly controlled blood pressure, leads to significantly lower blood pressure than titration guided by clinic readings”.
Editorial: Treatment or surveillance for CIN2? (free)
Commentaries: Treatment or surveillance for CIN2: when less is more – The BMJ Opinion (free) AND Some irregular cervical lesions could be monitored rather that treated immediately – OnMedica (free) AND Regular monitoring rather than immediate treatment justified for some cervical lesions – EurekAlert (free)
4 – Association of Varicose Veins With Incident Venous Thromboembolism and Peripheral Artery Disease – JAMA (link to abstract – $ for full-text)
Commentaries: Patients with varicose veins at greater risk for thrombosis, other vascular diseases – Cardiovascular Business (free) AND Varicose Veins Linked to Greater Risk for VTE, PAD – NEJM Physician’s First Watch (free) AND Varicose Veins May Increase Likelihood of Blood Clots – Physician’s Weekly (free)
5 – Sex Differences in the Association Between Measures of General and Central Adiposity and the Risk of Myocardial Infarction: Results From the UK Biobank – Journal of the American Heart Association (free for a limited period)
Related Systematic Review: Identifying older adults at risk of harm following elective surgery: a systematic review and meta-analysis – BMC Medicine (free) AND Commentary: Age itself is not a risk factor for complications after surgery among older patients – OnMedica (free)
Related guideline: Social anxiety disorder: recognition, assessment and treatment – NICE (free) AND Summary: Recognition, assessment and treatment of social anxiety disorder: summary of NICE guidance – The BMJ (free)
“Intravenous devices known as PICCs should be reserved for long-term use, but a new study shows 1 in 4 are used for 5 days or less” (from ScienceDaily)
9 – Real-World Effectiveness of Pharmacologic Treatments for the Prevention of Rehospitalization in a Finnish Nationwide Cohort of Patients With Bipolar Disorder – JAMA Psychiatry (link to abstract – $ for full-text)
Editorial: Enthusiasm and Skepticism About Using National Registers to Analyze Psychotropic Drug Outcomes (free for a limited period)
Commentaries: Lithium treatment for bipolar disorder linked to lowest risk of rehospitalization – Karolinska Institutet, via EurekAlert (free) AND Lithium Top Choice for Preventing Bipolar Rehospitalization – MedPage Today (free registration required)
Related study: Effectiveness of maintenance therapy of lithium vs other mood stabilizers in monotherapy and in combinations: a systematic review of evidence from observational studies – Bipolar Disorders (free)
These observational studies suggest Lithium may be a better choice for treating these patients, but long-term randomized controlled trials are needed to clarify this issue (see editorial).
10 – Beta-blocker Therapy and Clinical Outcomes in Patients with Moderate COPD and Heightened Cardiovascular Risk: An Observational Sub-study of SUMMIT – Annals of the American Thoracic Society (link to abstract – $ for full-text)
Commentary: Beta-blockers may not change COPD lung function – Univadis (free registration required)
Related review and meta-analysis: Beta-blockers in patients with chronic obstructive disease and coexistent cardiac illnesses – COPD Research and Practice (free) AND Beta-blocker use and COPD mortality: a systematic review and meta-analysis – BMC Pulmonary Medicine (free)
Related observational studies: β-Blockers in COPD: A Cohort Study From the TONADO Research Program – CHEST (free) AND Effect of β blockers in treatment of chronic obstructive pulmonary disease: a retrospective cohort study – The BMJ (free)
“Balanced crystalloids may be superior to saline in critically ill patients — but not in patients hospitalized outside an ICU” (from Physician’s First Watch)
Commentary: Bystander defibrillator use tied to better cardiac arrest outcomes – Reuters (free)
Related articles: The Effects of Public Access Defibrillation on Survival After Out-of-Hospital Cardiac Arrest: A Systematic Review of Observational Studies – Circulation (link to abstract – $ for full-text) AND Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest – New England Journal of Medicine (Link to abstract – $ for full-text)
3 – Medical Education: Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians – Annals of Internal Medicine (free)
4 – 2018 consensus of the Taiwan Society of Cardiology and the Diabetes Association of Republic of China (Taiwan) on the pharmacological management of patients with type 2 diabetes and cardiovascular diseases – Journal of the Chinese Medical Association (free)
“For a typical lunch with an intake of 600 calories, such as a slice of pizza and a soft drink, labelling may reduce the energy content of food purchased by about 8% (48 calories)”
Commentaries: Bariatric Surgery Associated With Reduced Need For Diabetes Medications at Six Years – MedicalResearch (free) AND Roughly Half of Obese Patients Who Have Bariatric Surgery Are Off Type 2 Diabetes Meds at 6 Years – TCTMD (free)
See related studies on the long-term effects of Bariatric Surgery in our January 17th issue (see #1, #2 and #3)
See original FDA statement on National Toxicology Program draft report on Bisphenol A (free) AND Endocrine Society Experts Express Concern with FDA Statement on BPA Safety – Endocrine Society, via NewsWise (free)
Source: Critical Care Reviews Newsletter
Related guidelines: 2017 European Society of Cardiology focused update on dual antiplatelet therapy in coronary artery disease (free) AND 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease (free)
2 – Guidelines for Adolescent Depression in Primary Care – American Academy of Pediatrics
Part II. Treatment and Ongoing Management (free)
Commentary: Pediatricians Call For Universal Depression Screening For Teens – NPR (free)
Source: Critical Care Reviews Newsletter
News release: Responding to inflight medical emergencies can be stressful for doctors – CMAJ News (free)
5 – Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: results from the German prospective, multicentre FITT-STEMI trial – European Heart Journal (free)
Commentaries: 3% rise in deaths for every 10 min delay in restoring blood flow after heart attack – OnMedica (free) AND Treatment Delay and Mortality in STEMI With Shock – American College of Cardiology, Latest in Cardiology (free)
Original article: Interventions for paracetamol (acetaminophen) overdose – Cochrane Library (link to abstract – $ for full-text)
Richard Lehman reviews the latest research in the top medical journals.
Commentaries: FDA: Antibiotic Linked to Increased Risk of Death in Heart Disease Patients – MPR (free) AND FDA: Clarithromycin Risks Persist in Patients With CAD – TCTMD (free) FDA Alert: Clarithromycin Risky in Patients With Heart Disease – Medscape (free registration required)
Related guidelines: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline: Treatment of Idiopathic Pulmonary Fibrosis (free) AND German Guideline for Idiopathic Pulmonary Fibrosis – Update on Pharmacological Therapies 2017 – Pneumologie (free) AND Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines – European Respiratory Review (free) AND Idiopathic pulmonary fibrosis in adults: diagnosis and management – NICE (free)
10 – Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentaries: Pulmonary Embolism Rule-out Criteria non-inferior to usual care for patients at low-risk for pulmonary embolism – 2 Minute Medicine (free) AND EM Nerd-The Case of the Diagnostic Absurdity (free) AND Using PERC & Sending Home Pulmonary Emboli For Fun and Profit – Emergency Literature of Note (free)
Commentary and summary: New Guideline for Management of Alcoholic Liver Disease – NEJM Journal Watch (free for a limited period)
3 – Prediction of cardiovascular risk factors from retinal fundus photographs via deep learning – Nature Biomedical Engineering (link to abstract – $ for full-text) (via @EricTopol see Very interesting Tweet)
Commentaries: Assessing Cardiovascular Risk Factors with Computer Vision – Google Research Blog (free) AND Google’s new AI algorithm predicts heart disease by looking at your eyes – TheVerge (free) AND Combination of AI, eye images could predict cardiovascular disease – Cardiovascular Business (free) AND It’s All in the Eyes: Google AI Calculates Cardiovascular Risk From Retinal Images – Medium (free)
4 – Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update – Journal of Clinical Oncology (free)
Related guidelines: Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) (free) AND Management of febrile neutropaenia: ESMO Clinical Practice Guidelines (free) AND Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update (free)
“Countries like Italy and Australia are tired of measles outbreaks — so they’re moving to fine anti-vaccine parents”.
Related: The Future of Peer Review – Scientific American (free) AND Peer review is a black box. Let’s open it up – STAT News (free) AND Exposing peer review – Research Information (free) AND Researchers debate whether journals should publish signed peer reviews – Science (free) AND The peer-review system for academic papers is badly in need of repair – The Conversation (free)
Related: Updated WHO Recommendation on Tranexamic Acid for the Treatment of Postpartum Haemorrhage (free PDF) AND Early use of tranexamic acid reduces bleeding more effectively – NIHR Signal (free) AND 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)
Commentary: Spironolactone bests clonidine as fourth drug for resistant hypertension – Univadis (free registration required)
Commentaries: Maternal vaccination during pregnancy not associated with infant hospitalization, mortality – 2 Minute Medicine (free) AND Getting Recommended Vaccines During Pregnancy Doesn’t Lead to Harm in Infants – Physician’s First Watch (free)
See also: Commentary: Spontaneous Coronary Artery Dissection: Making strides, long journey ahead! (free) AND Top Ten Things to Know (free PDF)
2 – Diagnosis and Treatment of Neurocysticercosis: 2017 Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH) – Clinical Infectious Diseases (free)
3 – Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis – The Lancet (free)
Commentaries: More data, more answers: picking the optimal antidepressant – The Lancet (free) AND All antidepressants are more efficacious than placebo – OnMedica (free) AND Expert reaction to largest review of antidepressants – Science Media Centre (free) AND Antidepressants can help adults with major depression – The Mental Elf (free)
Commentaries: New rotavirus vaccine to curb child deaths in developing countries – New Zealand Doctor (free) AND Researchers successfully develop a rotavirus vaccine which could benefit millions of children – MedicalXpress (free)
6 – The Origin of Spousal Resemblance for Alcohol Use Disorder – JAMA Psychiatry (link to abstract – $ for full-text)
Commentaries: For Better or Worse: Risk of Alcohol Use Disorder Rises When Spouse is Diagnosed – Psychiatric News Alert (free) AND Spouses have strong influence on risk for alcohol abuse – Reuters (free)
Commentaries: Women Who Clean at Home or Work Face Increased Lung Function Decline – American Thoracic Society, via NewsWise (free) AND Cleaning Chemicals ‘Likely Cause Substantial Damage To Women’s Lungs’, Study Finds – Huffpost (free) AND Cleaning at home or work linked to faster lung function decline in women – Univadis (free registration required)
8 – Perspective: Our Other Prescription Drug Problem – New England Journal of Medicine (free)
Related opinion: Benzodiazepines: our other prescription drug epidemic – STAT (free)
10 – Robot-assisted radical prostatectomy vs laparoscopic and open retropubic radical prostatectomy: functional outcomes 18 months after diagnosis from a national cohort study in England – British Journal of Cancer (free)
Related Cochrane Review with similar results: Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer – Cochrane Library (free)