2018 ESC Guidelines for the diagnosis and management of syncope – European Heart Journal (free for a limited period)
Related guideline: 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society (free)
Commentaries: Barbershop-Based Intervention Leads to Blood Pressure Reductions in African-American Men – American College of Cardiology (free) AND Mixing Haircuts and Hypertension Rx a ‘Home Run’ for Blood Pressure Control – TCTMD (free)
“Among black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction when coupled with medication management in barbershops by specialty-trained pharmacists”.
Do Antidepressants Work? – The New York Times (10 articles per month are free)
“The most comprehensive study on them has recently been published, showing mostly modest effects”.
See related meta-analysis and commentaries in our February 23rd issue (see #3)
#ACC18 – The ODYSSEY Trial Ends Well— But Will It Be Enough? – Cardiobrief (free) AND Ten Quick Thoughts on ODYSSEY – John Mandrola, via Medscape (free registration required)
“An absolute risk reduction of 1.6% in the primary endpoint translates to a number needed to treat of 64. Using the current price of $14,500 per year, Kaul calculated that preventing one event over the trial period of almost 3 years would cost about $2.6 million” (via John Mandrola). This study was presented at #ACC18 and has not been published yet. Among the many commentaries, these two were selected for a balanced point of view.
Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial – Annals of Emergency Medicine (link to abstract – $ for full-text)
Commentaries: Practice Changing: Inhaled Isopropyl Alcohol Superior to Oral Ondansetron as an Antiemetic – NEJM Journal Watch (free) AND Wake Up And Smell the Isopropyl – Emergency Medicine Literature of Note (free)
Richard Lehman reviews the latest research in the top medical journals.
Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort – The BMJ (free)
“Wake me up when there is a positive randomized trial of vitamin D pills for anything” (from Richard Lehman’s review).
#ACC18 – Getting flu shot halves death risk for heart failure patients – Cardiovascular Business (free) AND Flu Vaccine Reduces Mortality, Hospitalization in HF Patients: Meta-analysis – TCTMD (free) AND Flu Shot Cuts Risk for Death by Half in Heart Failure – Medscape (free registration required) AND Getting Flu Vaccine Cuts Risk of Death by Half in People with Heart Failure – American College of Cardiology (free)
This meta-analysis of observational studies suggests a possible benefit.
#ACC18 – Aspirin Lowers Risk of Death for Patients with Diabetes, Heart Failure – American College of Cardiology (free) AND Aspirin Linked to Lower Mortality in Diabetes With Heart Failure – Medscape (free registration required) AND ACC 2018: Aspirin Lowers Risk of Death in Patients With Diabetes and Heart Failure – PracticeUpdate (free registration required)
The 2017 ESC Guidelines on PADs: what’s new? – European Heart Journal (free) AND The ‘Ten Commandments’ of 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases – European Heart Journal (free)
Related commentary: PD or HD: Which Road Do We Take? – AJKD Blog (free)
Original article: Comparison of Patient Survival Between Hemodialysis and Peritoneal Dialysis Among Patients Eligible for Both Modalities – American Journal of Kidney Diseases (link to abstract – $ for full-text)
Key Points: Evaluation and Treatment of Hirsutism in Premenopausal Women – JAMA Clinical Guidelines Synopsis (free for a limited period)
Commentaries: New analysis recommends against using digital rectal exam in primary care – American Academy of Family Physicians, vie EurekAlert (free) AND Little Evidence Supports Use of Digital Rectal Exam – Medscape (free registration required) AND Digital Rectal Exams for Routine Prostate Screening Discouraged – NEJM Physician’s First Watch (free)
Colonoscopy and Colorectal Cancer Mortality in the Veterans Affairs Health Care System: A Case–Control Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Colonoscopy significantly reduces mortality from colorectal cancer in Veterans Affairs study – 2 Minute Medicine (free) AND Colonoscopy Significantly Reduces CRC Deaths – Medscape (free registration required)
Commentaries: Gout Drug Febuxostat Linked to More CV Deaths Without Uptick in CV Events: CARES Trial – TCTMD (free) AND CARES: Increased Risk of Death With Febuxostat in Patients With Gout and CV Disease – American College of Cardiology (free) AND
Calcium and vitamin D supplementation and increased risk of serrated polyps: results from a randomised clinical trial – Gut (link to abstract – $ for full-text)
Commentaries: Calcium and vitamin D supplements may raise risk of polyps – MedicalNewsToday (free) AND Calcium Supplements Up Risk for Precancerous Serrated Polyps – Medscape (free registration required)
See original guideline and commentary: ACP Guideline: Hemoglobin A1c Targets for Glycemic Control in Type 2 Diabetes
Related: Get Ready For A Tsunami Of ECGs – Cardiobrief (free) AND: Thoughts on the Apple Watch and Mobile ECG, by Dr John Mandrola (free) AND Overdiagnosis Only a Matter of Time With ECG Watches – Medscape (free registration required)
Commentaries: High Cardiovascular Fitness in Midlife Tied to Lower Dementia Risk Later – NEJM Physician’s First Watch (free) AND Physically fit women nearly 90 percent less likely to develop dementia – American Academy of Neurology, via ScienceDaily (free)
Elder Abuse: Sometimes It’s Self-Inflicted – The New York Times (10 articles per month are free)
Related guidelines: Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults – United European Gastroenterology (free) Management Guidelines of Eosinophilic Esophagitis in Childhood – Journal of Pediatric Gastroenterology and Nutrition (free) AND ACG Clinical Guideline: Evidenced Based Approach to the Diagnosis and Management of Esophageal Eosinophilia and Eosinophilic Esophagitis (EoE) (free)
Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet) – Circulation (free PDF for a limited period)
Commentaries: Low-Calorie Vegetarian vs. Mediterranean Diets – American College of Cardiology, Latest in Cardiology (free) AND Vegetarian and Mediterranean diet may be equally effective in preventing heart disease – American Heart Association, via ScienceDaily (free)
Related: Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) (free)
Effect of dietary carbohydrate restriction on glycemic control in adults with diabetes: a systematic review and meta-analysis – Diabetes Research and Clinical Practice (link to abstract – $ for full-text)
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”
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.
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)
Maintenance proton pump inhibition therapy and risk of oesophageal cancer – Cancer Epidemiology (link to abstract – $ for full-text)
Commentary: Long-term PPI Use and Increased Esophageal CA Risk – Medscape (free registration required)
Related studies suggesting a link with gastric cancer: 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) AND Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden – BMJ Open (free)
This observational study suggests a possible link.
Metformin use in PCOS pregnancies increases the risk of offspring overweight at 4 years of age; follow-up of two RCTs – The Journal of Clinical Endocrinology & Metabolism (link to abstract – $ for full-text)
Commentaries: Diabetes drug use during pregnancy linked to child’s weight – The Endocrine Society, via ScienceDaily (free) AND Diabetes drug use during pregnancy affects child’s weight – OnMedica (free) AND Metformin in Pregnancy May Increase Childhood Obesity Risk – Medscape (free registration required)
Another interesting list of commonly used low-value practices that should be questioned.
Commentary: Probiotics and fish oil in pregnancy may reduce allergies in children – NHS Choices (free) AND Diet During Pregnancy May Cut Offspring Allergy Risk – MedPage Today (free registration required) AND Probiotics and Fish Oil During Pregnancy May Curb Allergies in Kids – The New York Times (10 articles per month are free)
In general practice or emergency care settings, brief alcohol interventions can reduce alcohol consumption and related harm.
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)
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)
When available, Factor Xa inhibitors seems to be a better choice for treating these patients.
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)
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)
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.
““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)
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.
Editorial: Escalating Inhaled Glucocorticoids to Prevent Asthma Exacerbations (free for a limited period)
Trial 1: Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations – The New England Journal of Medicine (free for a limited period)
Trial 2: Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations – The New England Journal of Medicine (free for a limited period)
Comparative cardiovascular safety of non-steroidal anti-inflammatory drugs in patients with hypertension: a population-based cohort study – British Journal of Clinical Pharmacology (link to abstract – $ for full-text)
Commentary and summary: New Guideline for Management of Alcoholic Liver Disease – NEJM Journal Watch (free for a limited period)
Public Health: Tackling multiple unhealthy risk factors: Emerging lessons from practice – The King’s Fund (free PDF)
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)
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)
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)
“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)
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)
Commentarires: Aerobic exercise may mildly delay, slightly improve Alzheimer’s symptoms – American Geriatrics Society, via EurekAlert (free) AND Aerobic exercise slows cognitive decline in Alzheimer’s disease – Reuters (free)
Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) – Journal of Pediatric Gastroenterology and Nutrition (free)
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)
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)
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)
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)
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)
Commentaries: Analysis finds lower IQ in children with chronic kidney disease – American Society of Nephrology, via ScienceDaily (free) AND CKD Linked to Cognitive Impairment in Kids – MedPage Today (free registration required)
Randomized double-blind controlled study of bedtime low dose amitriptyline in chronic neck pain – European Journal of Pain (link to abstract – $ for full-text)
Commentary: Low-dose amitriptyline reduces idiopathic chronic neck pain – Univadis (free registration required)
Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial – JAMA (free)
Commentaries: Low-Carb And Low-Fat Diets Battle To A Draw – Cardiobrief (free) AND Matching DNA to a diet doesn’t work: ‘We didn’t even come close,’ researcher says – STAT (free) AND Counting Calories Is Not the Key to Weight Loss, New Study Finds – The New York Times (10 articles per month are free) AND Debating low-fat vs low-carb diets? New study found a draw – Scope (free)
Commentaries: Alcohol and dementia: a complex relationship with potential for dementia prevention – The Lancet Public Health (free) AND Expert reaction to study looking at alcohol use disorders and dementia risk – Science Media Centre (free) AND Heavy Drinking Tied to Early-Onset Dementia in French Study – MedPage Today (free registration required)
“Of 57,000 people diagnosed before age 65 with early-onset dementia, 39% had alcohol-related dementia by definition, and 18% had an additional diagnosis of alcohol use disorders” (via @medpagetoday see Tweet)
Related AHA Scientific Statement: Preventing and Experiencing Ischemic Heart Disease as a Woman: State of the Science (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)
Perspective: Our Other Prescription Drug Problem – New England Journal of Medicine (free)
Related opinion: Benzodiazepines: our other prescription drug epidemic – STAT (free)
Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for atrial fibrillation: a population based study from UK primary care – The BMJ (free)
Commentaries: Anticoagulants Tied With Stroke, Hemorrhage in CKD – Renal & Urology News (free) AND Could a Blood Thinner Actually Raise Stroke Risk for Some? – HealthDay (free) AND Anticoagulants for Patients with Afib and Kidney Disease? Study Yields Mixed Findings – Physician’s First Watch (free) AND Blood-thinning drugs designed to cut stroke risk may actually increase it – The Guardian (free)
“Given the lack of guidelines, the decision to start anticoagulant treatment in patients with chronic kidney disease and new onset atrial fibrillation should be made on an individual basis, concludes research” (via @bmj_latest see Tweet)
Association of Cigarette, Cigar, and Pipe Use With Mortality Risk in the US Population – JAMA Internal Medicine (free for a limited period)
Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
The mean number of hypoglycemic events per 28 days was reduced from 10.8 to 3.5 among patients in the continuous glucose monitoring group and from 14.4 to 13.7 among control group participants.
Hydroxychloroquine Effectiveness in Reducing Symptoms of Hand Osteoarthritis: A Randomized Trial – Annals of Internal Medicine (link to abstract – $ for full-text)
“The review confirms small benefits on symptom relief, namely shortening duration of symptoms by half a day on average. However, there is little evidence to support any belief that use of NIs reduces hospital admission or the risk of developing confirmed pneumonia”. (from Cochrane)
Risk of Recurrent Disease and Surgery Following an Admission for Acute Diverticulitis – Diseases of the Colon and Rectum (link to abstract – $ for full-text)
In this large cohort of 65,162 patients identified with a first episode of acute diverticulitis, younger patients, women, smokers, obese individuals, and those who had diverticulitis with perforation and/or abscess were more likely to develop recurrent diverticulitis.
Richard Lehman reviews the latest research in the top medical journals.
Systolic Blood Pressure and Outcomes in Patients With Heart Failure With Preserved Ejection Fraction – JAMA Cardiology (link to abstract – $ for full-text)
Commentaries: Aggressive Systolic Blood Pressure Control In Older Patients With HFpEF Should Be Avoided – MedicalResearch.com (free) AND Low blood pressure linked to worse outcomes in HFpEF patients – Cardiovascular Business (free)
“A systolic blood pressure level of less than 120 mm Hg identifies patients with heart failure with preserved ejection fraction at higher risk for short- and long-term mortality and emphasizes the need for future prospective studies to evaluate optimal systolic blood pressure treatment goals in this patient population”.
New Choosing Wisely Lists in Pediatrics: Four Things Physicians and Patients Should Question in Pediatric Infectious Diseases and Medical Microbiology – Choosing Wisely Canada (free) AND Five Things Physicians and Patients Should Question in Pediatric Orthopedics – Choosing Wisely U.S. (free)
Commentaries: Breast MRIs may lead to more biopsies that catch fewer cancers – Reuters (free) AND MRI-Based Breast Screening Leads to More Biopsies, Lower Cancer Yields – Physician’s First Watch (free)
Draft Recommendation Statement: Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions – U.S. Preventive Services Task Force (free)
Commentaries: USPSTF Again Recommends Offering Behavioral Interventions to Obese Adults – Physician’s First Watch (free) AND USPSTF Posts Draft Recs for Treatment of Adults With Obesity – Medscape (free registration required) AND USPSTF: ‘Yes’ To Behavioral Obesity Therapy – MedPage Today (free)
Commentaries: Takeaways linked to increased cardiovascular risk factors and obesity in children – NIHR Signal (free) AND Takeout Food May Increase Adverse Health Consequences in Children – Endocrinology Advisor (free)
Related position statement: Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association – Circulation (free PDF)
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)
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)
Commentary: Beta-blockers may not change COPD lung function – Univadis (free registration required)
Regular Yogurt Intake and Risk of Cardiovascular Disease Among Hypertensive Adults – American Journal of Hypertension (link to abstract – $ for full-text)
Effect of Oral Administration of a Mixture of Probiotic Strains on SCORAD Index and Use of Topical Steroids in Young Patients With Moderate Atopic Dermatitis: A Randomized Clinical Trial – JAMA Dermatology (link to abstract – $ for full-text)
Commentaries: Probiotics may improve pediatric AD symptoms – DermatologyTimes (free) AND Probiotics May Improve Pediatric AD Symptoms – MedPage Today (free registration required)
Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) (free)
Related: The Fake Hypertension War: Medical politics and mud fights – MedPage Today (free registration required)
Commentaries: Risk of Psychotic Experiences Up With Teen Cannabis Use – Physician’s Briefing (free) AND Teen Pot Use Linked to Increased Risk for Psychotic Episodes – MedPage Today (free registration required)
Editorials: Screening for Ovarian Cancer in Asymptomatic Women (free) AND The Yet Unrealized Promise of Ovarian Cancer Screening (free) AND Is There a Future for Ovarian Cancer Screening? (free)
Author interview: USPSTF Recommendation: Screening for Ovarian Cancer (free audio)
“The USPSTF recommends against screening for ovarian cancer in asymptomatic women. (D recommendation) This recommendation applies to asymptomatic women who are not known to have a high-risk hereditary cancer syndrome”.
Review: Physical Activity in the Prevention and Treatment of Coronary Artery Disease – Journal of the American Heart Association (free for a limited period)
Medical News & Perspectives: Do All Patients Need β-Blockers After a Heart Attack? – JAMA (free for a limited period)
Opioid Analgesic Use and Risk for Invasive Pneumococcal Diseases: A Nested Case–Control Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Opioids may be associated with increased risk for serious invasive pneumococcal infections – ACP Internist (free) AND Opioids For Pain Can Exacerbate Pneumococcal Infections – MedicalResearch.com (free) AND Prescription Opioid Use Tied to Higher Pneumonia Risk – MedPage Today (free registration required)
Randomized Trial of Dexamethasone Versus Prednisone for Children with Acute Asthma Exacerbations – The Journal of Pediatrics (link to abstract – $ for full-text)
Commentary: Asthma Exacerbation in Kids: A Trial of Two Steroids – Medscape (free registration required)
Related meta-analysis: Dexamethasone for Acute Asthma Exacerbations in Children: A Meta-analysis – Pediatrics (free PDF)
Related study in adults: A Randomized Controlled Noninferiority Trial of Single Dose of Oral Dexamethasone Versus 5 Days of Oral Prednisone in Acute Adult Asthma – Annals of Emergency Medicine (link to abstract – $ for full-text) AND Commentary: Single Dose Dexamethasone or 5 Days of Prednisone in Adult Asthmatics? – R.E.B.E.L.EM commentary (free full-text)
Opinion: Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used – The New York Times (10 articles per month are free)
Richard Lehman reviews the latest research in the top medical journals.
“Trimethoprim is associated with a greater risk of acute kidney injury and hyperkalaemia compared with other antibiotics used to treat UTIs, but not a greater risk of death”
Draft Recommendation Statement: Screening Syphilis Infection in Pregnant Women – U.S. Preventive Services Task Force (free)
Commentaries: USPSTF Recommends Screening Pregnant Women for Syphilis – American Academy of Family Physicians (free) AND USPSTF: Screening for Syphilis in Pregnant Women Beneficial – MPR (free) AND Syphilis Rising In Newborns, Pregnant Moms: USPSTF Reaffirms Mandatory Testing – American Council on Science and Health (free)
Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
“Steroid-containing fine-mist triple inhaler comp with dry powder double inhaler resulting in 0.09 fewer exacerbations per year. Yup.” (via @RichardLehman1 see Tweet) See Richard Lehman’s point of view
Original article: Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment – The Lancet Diabetes & Endocrinology (free) AND Commentary: Diabetes and adiposity: a heavy load for cancer (free)
Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies – Progress in Neuro-Psychopharmacology and Biological Psychiatry (link to abstract – $ for full-text) (via @psychopharmacol see Tweet)
“These findings provide preliminary evidence that atypical antipsychotics cause insulin resistance and weight gain directly, independent of psychiatric disease and may be associated with length of treatment”.
Original article: Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective – Public Health Research (free)
“There’s moderate quality evidence that behavioural support to motivate & sustain smoking cessation delivered by nurses can lead to a modest increase in the number of people who achieve prolonged abstinence” (via @CochraneUK see Tweet)
Blood Pressure Profile 1 Year After Severe Preeclampsia – Hypertension (link to abstract – $ for full-text)
Commentaries: High blood pressure in pregnancy may not disappear afterward – Reuters (free) AND Ambulatory Monitoring Shows Persistent HTN Common After Severe Preeclampsia – MedPage Today (free registration required)
Commentaries: Postnatal Depression Has Greater Impact on Child Development When it is Persistent and Severe – Neuroscience News (free) AND Severe Postnatal Depression Doubles Child Behavioral Problems – Medscape (free registration required)
Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes: A Systematic Review and Meta-analysis – JAMA Cardiology (link to abstract – $ for full-text)
Commentaries: Could NOACs Have a Role for Secondary Prevention After STEMI? – TCTMD (free) AND Meta-Analysis: ACS Type Matters for DOAC Use in Secondary Prevention – MedPage Today (free registration required) AND Adding DOACs Beneficial for STEMI — Not Non-STEMI — But with Bleeding Risk – Physician’s First Watch (free)
“63 STEMI patients would need to receive a DOAC to prevent one cardiovascular event, while 96 would need to be treated to cause one major bleeding event”. (from Physician’s First Watch)
Rapid Recommendations: Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline – The BMJ (free text and infographics)
The Immunization Schedules for 2018 are available in the Red Book Online (free) and in the Centers for Disease Control and Prevention Website (free)
Related study: Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza season – American Journal of Infection Control (link to abstract – $ for full-text) AND Commentaries: Working while sick – ACP Internist (free) AND Health worker survey reveals many work during flu illness – CIDRAP (free)
Editorial: The failure of anti-obesity programmes in schools (free)
““In the words of Winston Churchill, “However beautiful the strategy, you should occasionally look at the results.”” (from editorial)
Preoperative exercise halves the postoperative complication rate in patients with lung cancer: a systematic review of the effect of exercise on complications, length of stay and quality of life in patients with cancer – British Journal of Sports Medicine (link to abstract – $ for full-text)
Commentaries: Regular exercise halves complication rate after lung cancer surgery – eCancer News (free) AND Lung Cancer Postoperative Complications Reduced With Preoperative Exercise – Pulmonology Advisor (free)
Richard Lehman reviews the latest research in the top medical journals.
News release: PHE publishes independent expert e-cigarettes evidence review (free)
Commentaries: UK experts urge smokers to switch to e-cigs for big health gains – Reuters (free) AND E-cigarettes ‘should be on prescription’ – BBC News (free) AND Doctors should encourage smokers to switch to vaping – OnMedica (free)
See related report recently released by the National Academies of Sciences, Engineering, and Medicine (free report and commentaries)
Viewpoint: Vitamin and Mineral Supplements: What Clinicians Need to Know – JAMA Internal Medicine (free for a period)
Effect of Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Hot tea tied to higher cancer risk for smokers and drinkers – Reuters (free) AND Very hot tea can raise risk of oesophageal cancer, suggests study – The Guardian (free) AND Hot Tea and Increased Risk for Esophageal Cancer – Medscape (free registration required)
Use of social media is associated with short sleep duration in a dose–response manner in students aged 11 to 20 years – Acta Paediatrica (link to abstract – $ for full-text)
Commentary: Social media use linked to lack of sleep in students – Wiley, via EurekAlert (free)
See also a recent Pediatrics supplement: Children, Adolescents and Screens: What We Know and What We Need To Learn (series of free articles) and related articles on Social Media and Mental Health
Source: ACP Journal Wise ($)
“Metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin”
Commentary: Breastfeeding May Halve Diabetes Risk in Women – Medscape (free registration required)
Catheter Ablation for Atrial Fibrillation with Heart Failure – New England Journal of Medicine (link to abstract – $ for full-text)
Editorial: Migraine and risk of cardiovascular disease (free)
Commentaries: Migraine Associated With Broad Range of CVD Diagnoses in Nationwide Study – TCTMD (free) AND Migraine Linked To Increased Risk of Stroke, AFib, PE and Cardiovascular Disease – MedicalResearch.com (free)
Author Interview: Prevalence of Pulmonary Embolism in Patients With Syncope (free)
Commentaries: Longer Early Childhood Intervention Linked To Greater Post-Secondary Attainment – MedicalResearch.com (free) AND Does Preschool Make a Long-Term Difference? – MedPage Today (free) AND Graduates of early childhood program show greater educational gains as adults – EurekAlert (free)
One Day Your Mind May Fade. At Least You’ll Have a Plan – The New York Times (10 articles per month are free)
Source: New document allows advance planning for dementia – Univadis (free registration required)
“A Simple Way to Document the Medical Care You Would Want If You Had Dementia”
Related reviews: Complications of Proton Pump Inhibitor Therapy – Gastroenterology (free) AND Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence – Therapeutic Advances in Drug Safety (free)
Commentary: D-dimer Predicts Long-Term Mortality, Vascular Events, Cancer – American College of Cardiology, Latest in Cardiology (free) AND D-Dimer Predicts CV, Cancer Mortality Over 16 Years in Patients With Stable CHD – Medscape (free registration required)
Commentary: Omega-3 Supplements Don’t Protect Against Heart Disease – The New York Times (10 articles per month are free)
Omega-3 fatty acids did not prevent fatal or nonfatal coronary heart disease or any major vascular events.
Commentaries: TBI is associated with increased dementia risk for decades after injury – PLOS, via ScienceDaily (free) AND More evidence traumatic brain injuries raise later dementia risk – Reuters (free)
“Using longitudinal, case-control, and sibling-matched analyses of nationwide data from Sweden, Peter Nordström & Anna Nordström describe the association between TBI and dementia, its time course, and the influence of familial factors”. (via @PLOSMedicine see Tweet)
Summary and commentary: New guideline released on lung cancer screening – ACP Internist (free)
Commentaries: The Startling Link Between Sugar and Alzheimer’s – The Atlantic (free) And Study Shows Long-Term Effects Of Diabetes And Prediabetes On The Brain – Forbes (free) AND New research shows diabetes and worse blood sugar control are associated with long-term cognitive decline – MedicalXpress (free) AND HbA1c Levels in Diabetes Linked to Cognitive Decline – Medscape (free registration required)
Metformin Treatment in Patients With Type 2 Diabetes and Chronic Kidney Disease Stages 3A, 3B, or 4 – Diabetes Care (link to abstract – $ for full-text)
Commentaries: How I learned to stop worrying and love metformin – NephJC (free) AND Adjusted-Dose Metformin Appears Safe in Patients With Type 2 Diabetes and Chronic Kidney Disease Stage 3 or 4 – PracticeUpdate (free registration required)
History of Childhood Kidney Disease and Risk of Adult End-Stage Renal Disease – New England Journal of Medicine (link to abstract – $ for full-text)
Quick Take Video Summary: Childhood Kidney Disease and Adult ESRD (free)
Commentaries: History of Childhood Kidney Disease Linked to Risk of ESRD – Physician’s Weekly (free) AND Childhood Kidney Disease Predicts Adult ESRD – MedPage Today (free registration required)
Related Guideline: SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment – Task Force on Sudden Infant Death Syndrome, American Academy of Pediatrics (free)
Commentaries: More evidence of link between severe gum disease and cancer risk – eCancer News (free) AND Evidence mounts of link between severe gum disease and various cancers – eCancer News (free) AND Severe Gum Disease Increases Both Cancer Risk and Mortality – Medscape (free registration required)
Commentary: Europe’s safety watchdog says laxatives may increase cancer risk – Reuters (free)
“This group of substances naturally occurs in plants such as aloe or senna species. Extracts containing them are used in food supplements for their laxative effect”. (from Press Release)