Open access

Fri, September 1 – 10 Stories of The Day!

1Sep
2017

 

1 – Public Health Guideline: Vitamin D: supplement use in specific population groups – National Institute for Health and Care Excellence (NICE) (free)

“Only test vitamin D status if someone has symptoms of deficiency or is at very high risk”

 

2 – Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis – Heart (free)

Commentary: Heart Failure with Preserved Ejection Fraction: Treatments Compared – MPR (free)

Source: ACP Journal Wise ($)

This study suggests a reduction in all-cause mortality with beta-blocker therapy in patients with heart failure with preserved ejection fraction. The authors recommend further trials to confirm the benefits of beta-blockers in this patient group.

 

3 – Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis – JAMA Surgery (free)

Commentaries: Acupuncture, Electrotherapy after Knee Replacement Associated with Reduced and Delayed Opioid Use – The JAMA Network (free) AND Electrotherapy, Acupuncture Tied to Less Opioid Use After Knee Arthroscopy – Medscape (free registration required) AND Meta-Analysis: Electrotherapy, Acupuncture May Help Reduce Opioid Use After Knee Arthroplasty – Physician’s First Watch (free)

 

4 – Original articles: Cost-Effectiveness of Intensive versus Standard Blood-Pressure Control – New England Journal of Medicine (link to abstract – $ for full-text) AND Effect of Intensive Blood-Pressure Treatment on Patient-Reported Outcomes – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: Analyses from SPRINT examine cost-effectiveness, patient-reported outcomes with intensive BP control – ACP Internist (free) AND Intensive BP Management Well Tolerated, Cost-effective: SPRINT – Medscape (free registration required) AND Can SPRINT Be Used To Inform Hypertension Treatment? – Cardiobrief (free)

Be sure to measure the patient’s blood pressure in the same way it was done in the SPRINT trial before adopting this study results in clinical practice (see Cardiobrief commentary)

 

5 – Natural History and Tumor Volume Kinetics of Papillary Thyroid Cancers During Active Surveillance – JAMA Otolaryngology Head & Neck Surgery (free for a week)

Author interview: Natural History and Tumor Volume Kinetics of Papillary Thyroid Cancers (free audio)

Commentaries: Findings Support Use of Active Surveillance for Low-Risk Papillary Thyroid Cancer – The JAMA Network (free) AND Many People Can Delay Treatment For Thyroid Cancer, Study Finds – NPR (free)

 

6 – How should we deal with non-culprit lesions during a STEMI? A mid-night conundrum – Evidently Cochrane (free)

Original article: Complete versus culprit-only revascularisation in ST elevation myocardial infarction with multi-vessel disease – Cochrane Library (link to abstract – $ for full-text)

 

7 – Preventing Teen Suicide: What Does the Evidence Shows – The New York Times (10 articles per month are free)

Related Guideline: Preventing Suicide: A Technical Package of Policy, Programs, and Practices – Centers for Disease Control and Prevention (free PDF)

 

8 – Low molecular weight heparin for prevention of venous thromboembolism in patients with lower-limb immobilization – Cochrane Library (link to abstract – $ for full-text)

“Moderate-quality evidence showed that the use of LMWH in outpatients reduced DVT when immobilization of the lower limb was required, when compared with no prophylaxis or placebo”. 

 

9 – Pembrolizumab versus ipilimumab for advanced melanoma: final overall survival results of a multicentre, randomised, open-label phase 3 study (KEYNOTE-006) – The Lancet (link to abstract – $ for full-text)

Commentary: Pembrolizumab Prolongs Overall Survival Compared With Ipilimumab in Melanoma – Cancer Therapy Advisor (free)

Source: Richard Lehman’s journal review (free)

 

10 – Impact of Obesity on Intensive Care Unit Resource Utilization After Cardiac Operations – The Annals of Thoracic Surgery (link to abstract – $ for full-text)

Commentaries: Obese cardiac patients a drain on ICU resources – Cardiovascular Business (free) AND Obese Cardiac Surgery Patients a Burden on ICU Resources – TCTMD (free) AND Post–Cardiac Surgery ICU Usage Rises With Increasing Obesity – Medscape (free registration required)

 

Thu, August 31 – 10 Stories of The Day!

31Aug
2017

 

1 – Comparison of recommendations for screening mammography using CISNET models – Cancer (link to abstract – $ for full-text)

Commentaries: Three questions to ask about calls to widen breast cancer screening – The Conversation (free) AND Comparison of Screening Recommendations for Mammography – ASCO Post (free)

Canadian Task Force on Preventive Health Care: Risks & Benefits, Age 40–49 (free) AND Risks & Benefits, Age 50–69 (free) AND Risks & Benefits, Age 70–74 (free) AND Full Guideline and Resources (free)

This article had a lot of attention from the media and suggests an annual screening starting at age 40 would prevent more breast cancer deaths. But screening has potential harms. For a clearer picture of the benefits and harms of screening in this context have a look at The Conversation commentary above and the infographics from the Canadian Task Force.

 

2 – History of breast feeding and risk of incident endometriosis: prospective cohort study – The BMJ (free)

Commentaries: Breast-Feeding Associated with Reduced Endometriosis Risk – Physician’s First Watch (free) AND Breast-Feeding May Lower Risk of Endometriosis – The New York Times (10 articles per month are free)

 

3 – Sleep architecture and the risk of incident dementia in the community – Neurology (link to abstract – $ for full-text)

Commentaries: Lack of REM sleep may lead to higher risk for dementia – Boston University School of Medicine, via EurekAlert (free) AND Less REM Sleep May Significantly Boost Dementia Risk – Medscape (free registration required) AND Dreaming may keep dementia at bay – Medical News Today (free) AND Lack of REM sleep tied to increased risk of dementia – Reuters (free)

 

4 – Association of Sleep-Disordered Breathing With Cognitive Function and Risk of Cognitive Impairment: A Systematic Review Meta-analysis – JAMA Neurology (link to abstract – $ for full-text)

Commentaries: Breathing Disorders During Sleep Tied to Cognitive Issues – MedPage Today (free registration required) AND Sleep-Disordered Breathing Raises Risk for Cognitive Decline – Medscape (free registration required)

This meta-analysis of observational studies suggests a possible association. Further studies are needed to examine whether the treatment of this condition can help in the prevention of dementia and in improvement of cognition.

 

5 – Chest CT Signs in Pulmonary Disease: A Pictorial Review – Chest (free)

Source: Critical Care Review Newsletter (free)

 

6 – Viewpoint: Management of Parkinson Disease in 2017: Personalized Approaches for Patient-Specific Needs – JAMA (free)

 

7 – Chronic cough postacute respiratory illness in children: a cohort study – Archives of Disease in Childhood (link to abstract – $ for full-text)

Commentary: Kids often have a chronic cough after respiratory illness – Reuters (free)

 

8 – Medical News & Perspectives: Medical Students Fall Short on Blood Pressure Check Challenge – JAMA (free)

Original Article: Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge – The Journal of Clinical Hypertension (free)

“Only 1 out of 159 medical students correctly performed all 11 elements in a BP check challenge w simulated patients” (RT @JAMA_current see Tweet)

 

9 – #ESCCongress – Clopidogrel or ticagrelor in acute coronary syndrome patients treated with newer-generation drug-eluting stents: CHANGE DAPT – EuroIntervention (link to abstract – $ for full-text)

Commentaries: Rethinking dual antiplatelet guidelines in acute coronary syndrome? (CHANGE-DAPT) – ESC Press Releases (free) AND Ticagrelor for DAPT Again Questioned in Current Era of PCI for ACS: CHANGE DAPT – Medscape (free registration required) AND CHANGE DAPT: Study Contests Benefit of Ticagrelor Over Clopidogrel After PCI in ACS – TCTMD (free)

 

10 – Resistance training may prevent obese older people becoming frail when losing weight – NIHR Signal (free)

Original article: Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults – New England Journal of Medicine (link to abstract – $ for full-text) AND Video Summary: Exercise and Dieting in Obese Older Adults (free)

 

Wed, August 30 – 10 Stories of The Day!

30Aug
2017

 

#ESCCongress – Highlights from the European Society of Cardiology Congress 2017 – Part III

 

1 – #ESCCongress – Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet (link to abstract – $ for full-text)

Commentaries: Revisiting dietary fat guidelines? (PURE) – ESC Press Release (free) AND PURE Investigators: Rethink Diet Guidance to Plug More Fats, Fewer Carbs – TCTMD (free) AND International study shows moderate consumption of fats and carbohydrates best for health – McMaster University, via EurekAlert (free) AND PURE: Findings Could Have Implications For Global Dietary Guidelines – ACC News Story (free) AND Huge Diet Study Questions Conventional Wisdom About Carbs And Fats – Cardiobrief (free)

 

2 – #ESCCongress – Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study – The Lancet (link to abstract – $ for full-text)

Commentaries: Reassessing the benefits of plant-based eating (PURE) – ESC Press Release (free) Fruit, Vegetable, Legume Intake and CVD Events – American College of Cardiology, Latest in Cardiology (free) AND Life-saving fruit and vegetable diet need only be three portions – study – The Guardian (free) AND Less Is More? Health Benefits of Fruits, Vegetables, and Legumes Seen at Lower Intake Levels – TCTMD (free)

 

3 – #ESCCongress – Study confirms safety of rapid algorithm to rule-out and rule-in myocardial infarction – ESC Press Release (free) (the results have not been published yet)

Commentary: ESC Rapid Rule-In, Rule-Out Algorithm for NSTEMI Safe, Accurate – Medscape (free registration required)

Related guideline: 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation (free) AND Other Resources (free)

 

4 – #ESCCongress – Underweight associated with highest mortality and costs after cardiac catheterization (free) (the results have not been published yet)

Commentaries: Underweight and Overlooked: Low BMI Patients May Be Highest-Risk Post-PCI – TCTMD (free) AND Underweight Patients Fare Worse After Heart Catheterization – Medscape (free registration required) AND ESC 2017: Underweight Is Associated With Highest Mortality and Costs After Cardiac Catheterization – PracticeUpdate (free registration required)

 

5 – #ESCCongress – Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease – New England Journal of Medicine (free)

Commentaries: Anacetrapib REVEALs ‘Modest’ Effect on Cardiovascular Outcomes – Medscape (free registration required) AND Anacetrapib Finds (Modest) Success Where All Other CETP Inhibitors Failed – TCTMD (free) AND REVEAL Revealed: A Slightly Positive CETP Inhibitor Trial – Cardiobrief (free)

Interesting new drug, but with modest benefits. During the median follow-up period of 4.1 years, the primary outcome occurred in fewer patients in the anacetrapib group than in the placebo group (10.8% vs. 11.8% / absolute risk difference = 1%, meaning 100 patients would have to be treated for 4.1 years to benefit 1 patient)

 

6 – #ESCCongress – Automatic external defibrillators save lives in amateur sports and fitness centres (free) (the results have not been published yet)

“Neurologically intact survival was 93% for patients treated with an onsite Automatic external defibrillator (AED) compared to 9% without an AED”

 

7 – Richard Lehman’s journal review, 29 August 2017 – The BMJ Blogs (free)

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

 

8 – The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review – Critical Care (free)

 

9 – Management of Patients with Advanced Prostate Cancer: The Report of the Advanced Prostate Cancer Consensus Conference APCCC 2017 – European Urology (free)

Commentary: International Consensus (or Not) on Management of Advanced Prostate Cancer – ASCO Post (free)

 

10 – Clinical Report: Pediatric Integrative Medicine – American Academy of Pediatrics (free)

AAP News: From acupuncture to yoga, report updates integrative medicine therapies (free)

Commentaries: AAP Recommendations Address Complementary Therapies – Medscape (free registration required) AND AAP: Counsel on Complementary Medicine: Natural doesn’t always mean safe – MedPage Today (free registration required)

 

Tue, August 29 – 10 Stories of The Day!

29Aug
2017

 

#ESCCongress – Highlights from the European Society of Cardiology Congress 2017 – Part II

 

1 – #ESCCongress – Oxygen Therapy in Suspected Acute Myocardial Infarction – New England Journal of Medicine (free)

Editorial: Is Oxygen Therapy Beneficial in Acute Myocardial Infarction? Simple Question, Complicated Mechanism, Simple Answer (free)

Commentaries: Oxygen therapy does not improve survival in patients with heart attack symptoms (DETO2X-AMI) – ESC Press Releases (free) AND Supplemental Oxygen Provides No Benefit to Patients With Suspected MI: DETO2X-AMI – TCTMD (free) AND Suspected MI and Normal Oxygen Saturation? Don’t Bother with Supplemental Oxygen – Physician’s First Watch (free)

 

2 – #ESCCongress – Population screening and intervention for vascular disease in Danish men (VIVA): a randomised controlled trial – The Lancet (link to abstract – $ for full-text)

Commentaries: Screening for vascular disease saves one life for every 169 patients assessed (VIVA) – ESC Press Releases (free) AND VIVA: Could Population-Wide Screening Trial for AAA, PAD, and Hypertension Save Lives at Low Cost? – TCTMD (free) AND VIVA: Overall Mortality Significantly Reduced Among Older Men Receiving Triple Vascular Screening – American College of Cardiology, Latest in Cardiology (free)

 

3 – #ESCCongress – PATHWAY-2 uncovers main cause of drug-resistant hypertension, finds old drugs work best – ESC Press Releases (free) (the results have not been published yet)

Commentary: Prevention And Treatment of Hypertension With Algorithm based therapY-2 – PATHWAY-2 – American College of Cardiology, Latest in Cardiology (free)

 

4 – #ESCCongress – Bag-mask ventilation fails to improve on endotracheal intubation in cardiac arrest (CAAM) – ESC Press Releases (free) (the results have not been published yet)

Commentary: CAAM: Is Bag-Mask Ventilation Superior to ETI During CPR? – American College of Cardiology, Latest in Cardiology (free)

 

5 – #ESCCongress – Closure of left atrial appendage during heart surgery protects the brain (LAACS) – ESC Press Releases (free) (the results have not been published yet)

Commentary: LAACS: LAA Closure May Protect Against Long-Term Cerebral Ischemic Events – American College of Cardiology, Latest in Cardiology (free)

 

6 – #ESCCongress – Risk factor driven upstream atrial fibrillation therapy improves sinus rhythm maintenance (RACE 3) – ESC Press Releases (free) (the results have not been published yet)

Commentaries: Broad, Early AF Risk-Factor Intervention Preserves Sinus Rhythm: RACE-3 – Medscape (free registration required) AND Routine vs. Aggressive upstream rhythm Control for prevention of Early persistent atrial fibrillation in heart failure study – RACE 3 – American College of Cardiology, Latest in Cardiology (free)

 

7 – #ESCCongress – The Prognostic Value of Coronary Artery Calcium in the PROMISE Study – Circulation (free PDF)

Editorial: Computed Tomography or Functional Stress Testing for the Prediction of Risk: Can I Have My Cake and Eat It? (free PDF)

Commentary: Prospective Multicenter Imaging Study for Evaluation of Chest Pain – PROMISE – American College of Cardiology, Latest in Cardiology (free)

 

8 – Why developing countries must improve primary care – The Economist (free) (RT @AnjaNitzscheB see Tweet)

“The changing burden of disease requires a better approach to keeping people healthy”

 

9 – Necrotizing pancreatitis: Diagnose, treat, consult – Cleveland Clinic Journal of Medicine (free)

Source: Hospital Medicine Virtual Journal Club (free resource to find articles of interest)

 

10 – Using mesh does not improve results in vaginal prolapse surgery – NIHR Signal (free)

Original article: Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT) – The Lancet (free) AND Commentary: Mesh, graft, or standard repair for prolapse surgery? – The Lancet (free)

“About 12% of vaginal prolapse patients had complications from surgery using mesh” (RT @NIHR_DC see Tweet)

 

Mon, August 28 – 10 Stories of The Day!

28Aug
2017

 

#ESCCongress – Highlights from the European Society of Cardiology Congress 2017

 

1 – 2017 ESC/EACTS Guidelines for the management of valvular heart disease (free) (RT @rafavidalperez see Tweet)

Commentary: European Societies Issue New Valvular Heart Disease Guidelines, With Important Shifts – TCTMD (free)

See also: #ESCCongress Slides (free PPT file)

 

2 – 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) (free) (RT @rafavidalperez see Tweet)

Commentary: ESC Updates Guidelines for Treating STEMI Patients – TCTMD (free)

See also: #ESCCongress Slides (free PPT file)

 

3 – 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries (free) (RT @rafavidalperez see Tweet)

See also: #ESCCongress Slides (free PPT file)

 

4 – 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS (free) (RT @rafavidalperez see Tweet)

See also: #ESCCongress Slides (free PPT file)

 

5 – Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease – New England Journal of Medicine (free)

Editorial by Dr. Eugene Braunwald: An Important Step for Thrombocardiology (free)

Commentaries: Cardiovascular Outcomes for People Using Anticoagulation Strategies – COMPASS – American College of Cardiology, Latest in Cardiology (free) AND COMPASS: Does Rivaroxaban Plus Aspirin Improve CV Outcomes in Patients With Stable Atherosclerotic Vascular Disease or PAD? – ACC News Story (free) AND Rivaroxaban, Aspirin, or Both in Stable Coronary Disease – Physician’s First Watch (free)

The primary outcome (composite of cardiovascular death, stroke, or myocardial infarction) occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (4.1% vs. 5.4% / Absolute risk difference = 1.3% / NNT = 76), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (3.1% vs. 1.9% / Absolute risk difference = 1.2 / NNH = 83).

 

6 – Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation – New England Journal of Medicine (free)

Commentaries: Randomized Evaluation of Dual Antithrombotic Therapy With Dabigatran vs. Triple Therapy With Warfarin in Patients With Nonvalvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention – RE-DUAL PCI – American College of Cardiology, Latest in Cardiology (free) Dual Antithrombotic Therapy Is Safe for Patients with AF and a New Stent – Physician’s First Watch (free) AND When two is better than three: Dual antithrombotic therapy cuts bleeding risk – Brigham and Women’s Hospital, via ScienceDaily (free)

“In summary, several lines of evidence now suggest that it is safe to treat atrial fibrillation patients who undergo coronary revascularization with anticoagulation (warfarin studied in WOEST, rivaroxaban studied in PIONEER AF-PCI, dabigatran studied in RE-DUAL PCI) and clopidogrel monotherapy” (from American College of Cardiology, Latest in Cardiology).

 

7 – Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease – New England Journal of Medicine (free)

Editorial: Targeting Inflammation in Coronary Artery Disease (free)

Commentaries: Anti-Inflammatory Therapy for Atherosclerotic Disease: A Step Closer? – Physician’s First Watch (free) AND CANTOS: Anti-inflammatory Agent Canakinumab Modestly Reduces Major CVD Events – TCTMD (free) AND CANTOS Validates Role Of Inflammation In Heart Disease – Cardiobrief (free)

“This widely anticipated study delivered some modestly positive results (fewer nonfatal MIs), some worrisome results (increased fatal infections), and some unexpected results (fewer cancer deaths)” (from Physician’s First Watch). 

 

8 – Catheter ablation improves outcomes in patients with heart failure and atrial fibrillation (CASTLE-AF) (free)

Commentary: CASTLE-AF: Catheter Ablation vs. Conventional Therapy For Patients With AFib and LV Dysfunction – American College of Cardiology, Latest in Cardiology (free)

The study has not been published yet, but the results suggest that patients with symptomatic paroxysmal or persistent AF and heart failure with ejection fraction less than 35% may have a better outcome with catheter ablation.

 

9 – Incidence of Previously Undiagnosed Atrial Fibrillation Using Insertable Cardiac Monitors in a High-Risk Population: The REVEAL AF Study (free)

Commentaries: What Do Implanted Cardiac Monitors Reveal About Atrial Fibrillation? – JAMA Cardiology (free) AND REVEAL AF: Incidence of AFib Could Be Substantial in Older Patients With Stroke Risk Factors – American College of Cardiology, Latest in Cardiology (free) AND Detection of Undiagnosed AF Using Insertable Cardiac Monitors – American College of Cardiology, Latest in Cardiology (free)

Implanted Cardiac Monitors showed the incidence of intermittent atrial fibrillation is extremely common among older individuals with stroke risk factors, but the clinical significance of these findings (do they need to be anticoagulated??) remains to be determined by further trials.

“Previous long-term monitoring studies have suggested that patients with short episodes of subclinical AF have a lower risk of stroke compared with traditional clinical AF, which raises important questions about the risk-benefit ratio of anticoagulation in this setting” (from Latest in Cardiology).

 

10 – CI Versus CABG in Patients With Type 1 Diabetes and Multivessel Disease – Journal of The American College of Cardiology (link to abstract – $ for full-text)

Commentaries: Patients With Type 1 Diabetes and Multivessel Disease Have Greater Benefit From CABG Than PCI – American College of Cardiology, Latest in Cardiology (free) AND Revascularization in Patients With Type 1 Diabetes – American College of Cardiology, Latest in Cardiology (free) AND CABG Appears Superior to PCI for Patients With Type 1 Diabetes, Multivessel Disease – TCTMD (free)

“The observational findings support existing recommendations favoring surgical revascularization in patients with diabetes” (from TCTMD).

 

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