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NEWS - Chest Medicine

Prednisone for the Prevention of Paradoxical Tuberculosis-Associated IRIS – New England Journal of Medicine (free)

“Prednisone treatment during the first 4 weeks after the initiation of ART for HIV infection resulted in a lower incidence of tuberculosis-associated immune reconstitution inflammatory syndrome than placebo, without evidence of an increased risk of severe infections or cancers.”

 


Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD) – Cochrane Library (free)

Summary: Preventative antibiotic therapy for people with COPD – Cochrane Library (free)

“Use of continuous and intermittent prophylactic antibiotics results in a clinically significant benefit in reducing exacerbations in COPD patients.”

 


Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in Intensive Care Unit Patients Without ARDS: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Lessons From ARDS for Non-ARDS Research: Remembrance of Trials Past (free)

“Among patients in the ICU receiving invasive ventilation, a strategy with low tidal volume was not more effective than a strategy using intermediate tidal volume.”

 


Effect of Protocolized Weaning with Early Extubation to Noninvasive Ventilation vs Invasive Weaning on Time to Liberation From Mechanical Ventilation Among Patients With Respiratory Failure: The Breathe Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Weaning From Mechanical Ventilation: What Should Be Done When a Patient’s Spontaneous Breathing Trial Fails? (free for a limited period)

“Among patients requiring mechanical ventilation in whom a spontaneous breathing trial had failed, early extubation to noninvasive ventilation did not shorten time to liberation from any ventilation.”

 


Did Juul Lure Teenagers and Get ‘Customers for Life’? – The New York Times (10 articles per month are free)

“…will it be possible to get people who are addicted to cigarettes to switch to e-cigarettes, which are less harmful, without enticing a new generation or non-smokers to try them?” (via @CaulfieldTim see Tweet)

 


Antibiotics for prolonged wet cough in children – Cochrane Library (link to abstract and plain language summary – $ for full-text)

Commentary: Antibiotics for pediatric chronic wet cough: Cochrane review – Univadis (free registration required)

 


Association Between Electronic Cigarette Use and Myocardial Infarction – American Journal of Preventive Medicine (free for a limited period)

Commentary: Risk of heart attacks is double for daily e-cigarette users – University of California – San Francisco, via ScienceDaily (free)

“New analysis shows five-fold risk for people who use both cigarettes and e-cigarettes daily” (from ScienceDaily)

 


Antibiotics should be restricted for COPD – National Institute for Health and Care Excellence (free)

Commentaries: Antibiotics should be restricted for COPD, says NICE – OnMedica (free) AND UK officials recommend limits on antibiotics for COPD – CIDRAP (free)

“The draft antimicrobial guidance recommends that antibiotics should be offered to people who have a severe flare up of symptoms, also known as a severe acute exacerbation”

 


IOTA – Liberal vs Conservative Oxygen Therapy in the Critically Ill – The Bottom Line (free)

Original Meta-Analysis: Liberal vs Conservative Oxygen Therapy in Acutely ill Adults (link to abstract and commentary)

“Hyperoxia is BAD –> Aim for lowest safest inspired O2 in critically ill pts & titrate FiO2 down if SpO2 >95%” (via @srrezaie see Tweet)

 


E-cigarettes, Juuls and Heat-Not-Burn Devices: The Science and Regulation of Vaping – Hopkins Bloomberg Public Health Magazine (free)

E-cigarettes can help some people quit smoking but may entice others to start. So how should they be regulated?

 


Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome – New England Journal of Medicine (link to abstract – $ for full-text)

See also: NEJM Tweet with visual abstract

Commentary: Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome – The Bottom Line (free)

“There is something very disturbing about a trial with HR=0.76, 95% CI 0.55-1.04 for the primary endpoint being stopped early for futility”. This TWEETORIAL by @ADAlthousePhD is a huge help in interpreting the results of this important trial (see more on the rise of “Tweetorial” here).

 


E-cigarettes: A win or loss for public health? – Knowable Magazine (free)

Related Perspective: The Promise of Vaping and the Rise of Juul – The New Yorker (free)

See also: related guidelines, reports and commentaries on e-cigarettes (all free)

“Arguments over whether e-cigarettes are harmful or helpful seem gridlocked as emerging research underscores both the toxicity of vaping and its possible benefits”. (via @ghn_news see Tweet)

 


Clinical Practice Guideline: Chronic Asthma – Toward Optimized Practice (free PDF)

See also: Summary (free PDF)

Related: see all TOP Clinical Practice Guidelines, a practical resource for Family Physicians at the point of care.

 


Should we recommend e-cigarettes to help smokers quit? – The BMJ (free)

See also: related guidelines, reports and commentaries on e-cigarettes

“Experts debate: Should doctors recommend e-cigarettes to help smokers quit? Revelation in harm reduction or a way to keep people addicted and gateway to youth smoking?” (via @rich_hurley see Tweet)

 


Honey for acute cough in children – Cochrane Library (link to abstract – $ for full-text)

Summary: Honey for acute cough in children – Cochrane Library (free)

“Honey probably relieves cough symptoms to a greater extent than no treatment, diphenhydramine, and placebo, but may make little or no difference compared to dextromethorphan.”

 


Quantifying population-level health benefits and harms of e-cigarette use in the United States – PLOS One (free)

Commentaries: Study Suggests E-cigarettes Cause More Harm Than Good – AAFP News (free)

“Some Adults May Quit Smoking Traditional Cigarettes, But More Teens and Young Adults Will Start” (from AAFP)

 


Macrolide antibiotics for bronchiectasis – Cochrane Library (link to abstract – $ for full-text)

Summary: Macrolide antibiotics for bronchiectasis – Cochrane Library (free)

“Long-term macrolide therapy may reduce the frequency of exacerbations and improve quality of life, although supporting evidence is derived mainly from studies of azithromycin, rather than other macrolides, and predominantly among adults rather than children. However, macrolides should be used with caution, as limited data indicate an associated increase in microbial resistance”.

 


Are shorter courses of systemic steroids as effective as conventional longer courses in the treatment of patients with flare-ups of COPD? – Cochrane Library (free)

“Information from a new large study has increased our confidence that five days of oral corticosteroids is likely to be sufficient for treatment of adults with acute exacerbations of COPD”.

 


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