Family Medicine
Top studies of 2022 relevant to primary care
25 May, 2023 | 11:34h | UTCTop studies of 2022 relevant to primary care – Canadian Family Physician
Phase 2a RCT | Emodepside demonstrates superior efficacy to albendazole in treating Trichuris trichiura and Hookworm Infection
25 May, 2023 | 11:33h | UTCEmodepside for Trichuris trichiura and Hookworm Infection – New England Journal of Medicine (link to abstract – $ for full-text)
A pragmatic approach to the management of menopause
25 May, 2023 | 11:30h | UTCA pragmatic approach to the management of menopause – Canadian Medical Association Journal
News Release: Managing menopause: Hormone therapy is back – Canadian Medical Association Journal
Review | Exercise training and revascularization in the management of symptomatic peripheral artery disease
25 May, 2023 | 11:23h | UTC
Commentary on Twitter
Exercise Therapy and Revascularization in the Management of Symptomatic Peripheral Artery Diseasehttps://t.co/Nywh4YxIs3 pic.twitter.com/K8z7E5eK9v
— Physio Meets Science (@PhysioMeScience) May 7, 2023
Graves’ disease in children: an update
25 May, 2023 | 11:18h | UTCGraves’ Disease in Children: An Update – Clinical Medicine Insights: Endocrinology and Diabetes
Consensus Statement | Pre-discharge and early post-discharge management of patients hospitalized for acute heart failure
24 May, 2023 | 13:39h | UTC
Consensus Statement | Worsening of chronic heart failure: definition, epidemiology, management and prevention
24 May, 2023 | 13:38h | UTC
SR | Balanced crystalloid solutions versus 0.9% saline for treating acute diarrhea and severe dehydration in children
25 May, 2023 | 11:15h | UTC
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes
24 May, 2023 | 13:30h | UTC
RCT | Spironolactone enhances acne outcomes and offers a viable alternative to oral antibiotics
24 May, 2023 | 13:27h | UTCSummary: The SAFA (Spironolactone for Adult Female Acne) trial was a multicenter, phase 3, double-blind, randomized controlled trial in England and Wales and evaluated the efficacy of spironolactone for treating adult women with acne vulgaris. A total of 410 women, aged ≥18 years and suffering from facial acne for a minimum of six months, were randomly assigned to receive either 50 mg/day of spironolactone or a placebo, increasing to 100 mg/day until week 24.
The primary outcome was measured by the Acne-Specific Quality of Life (Acne-QoL) symptom subscale score at week 12 and 24. The trial demonstrated that spironolactone improved Acne-QoL scores more effectively than the placebo, particularly at week 24. Additionally, more participants in the spironolactone group reported acne improvement, and treatment success was significantly higher in this group at week 12. Mild side effects, notably headaches, were more common in the spironolactone group.
The findings from the SAFA trial highlight spironolactone’s effectiveness, safety, and tolerability in treating adult women with acne vulgaris, suggesting it is a viable alternative to long-term antibiotic treatments. Future research is proposed on higher initial dosages of spironolactone, and its effects on different subgroups like patients with different ages, body mass index, and ethnicity.
Editorial: What do we know about prescribing spironolactone for acne? – The BMJ
News Release: Non-antibiotic treatment for women with persistent acne shown to be effective – University of Southhampton
Cohort Study | Ambulatory blood pressure more predictive of mortality than clinic blood pressure
24 May, 2023 | 13:19h | UTCSummary: This cohort study analyzed the relationship between clinic and ambulatory blood pressure with mortality. The study utilized data from March 2004 to December 2014, sourced from the Spanish Ambulatory Blood Pressure Registry, which included 59,124 patients from 223 primary care centers across all regions of Spain. Patients were monitored until their date of death or until December 31, 2019.
During a median follow-up of 9.7 years, 7174 (12.1%) patients died, including 2361 (4.0%) due to cardiovascular causes. Findings revealed J-shaped associations for several blood pressure measures. Notably, 24-hour systolic blood pressure had a stronger association with all-cause death (HR 1.41 per 1 SD increment [95% CI 1.36–1.47]) than clinic systolic blood pressure. When adjusted for clinic blood pressure, the association between 24-hour blood pressure and all-cause death remained strong (HR 1.43 [95% CI 1.37–1.49]). Night-time systolic blood pressure was found to be the most predictive of all-cause and cardiovascular death.
The findings imply that ambulatory blood pressure, particularly night-time blood pressure, is more informative about the risk of all-cause death and cardiovascular death than clinic blood pressure. Masked hypertension and sustained hypertension were associated with increased mortality risks, but not white-coat hypertension. These results emphasize the importance of ambulatory blood pressure monitoring in hypertension management and risk prediction. Future research should focus on potential causes and strategies to control night-time blood pressure effectively, considering its substantial association with death risk.
Commentary: Tight Link Between Ambulatory BP and Mortality Affirmed in Revamped Analysis – TCTMD
Review | Update in musculoskeletal pain in older adults with a focus on osteoarthritis-related pain
24 May, 2023 | 13:09h | UTC
WHO Report | 152 million babies born preterm in the last decade
23 May, 2023 | 13:15h | UTCNews Release: 152 million babies born preterm in the last decade – World Health Organization
Report: Born too soon: decade of action on preterm birth – World Health Organization
The Lancet Series | Small vulnerable newborns
23 May, 2023 | 13:13h | UTCNews Release: An estimated 1 million stillbirths and newborn baby deaths could be prevented each year with low-cost solutions – Lancet
Homepage: Small vulnerable newborns – The Lancet (free registration required for all articles)
Small vulnerable newborns—big potential for impact
Biological and pathological mechanisms leading to the birth of a small vulnerable newborn
Opinion Video | Questioning the reliability of nutrition science
23 May, 2023 | 13:02h | UTC
RCT | Tonsillectomy shown to be clinically and cost-effective in adults with recurrent acute tonsillitis
23 May, 2023 | 13:06h | UTCSummary: The NATTINA trial, a pragmatic multicentre, open-label, randomized controlled study, sought to compare the clinical and cost-effectiveness of conservative management versus tonsillectomy in adults with recurrent acute tonsillitis. Conducted across 27 UK hospitals, 453 participants aged 16 or older were randomly assigned to either undergo immediate tonsillectomy or receive standard non-surgical care.
The main finding was that participants in the immediate tonsillectomy group had fewer days of sore throat over a 24-month period than those in the conservative management group (median 23 vs. 30 days). After adjusting for site and baseline severity, the incident rate ratio of total sore throat days in the immediate tonsillectomy group was significantly lower than in the conservative management group (0.53, 95% CI 0.43 to 0.65, p < 0.0001). The most common adverse event related to tonsillectomy was bleeding, which occurred in 19% of participants.
The NATTINA trial is the largest to date assessing the clinical and cost-effectiveness of tonsillectomy in adults. The results indicate that immediate tonsillectomy is clinically effective and cost-effective for recurrent acute tonsillitis. However, patients should weigh the benefits of fewer sore throat days against the risks of surgery.
News Release: Tonsillectomy both clinically and cost effective for adults – Newcastle University
Commentary on Twitter
Compared with conservative management, immediate tonsillectomy is clinically effective and cost-effective in adults with recurrent acute #tonsillitis, suggests trial. https://t.co/LvSjn6XUx0 pic.twitter.com/yKzH9RqY5J
— The Lancet (@TheLancet) May 18, 2023
RCT | No significant differences among three exercise strategies for knee osteoarthritis
23 May, 2023 | 12:38h | UTC
USPSTF Draft Statement recommends biennial screening mammography for women ages 40 to 74 years
22 May, 2023 | 13:56h | UTCBreast Cancer: Screening – U.S. Preventive Services Task Force
Critical perspectives on the statement:
Earlier screening for breast cancer: Benefits and harms – Lown Institute
Why more mammograms aren’t the solution to breast cancer – Vox
AGA/ACG Guideline | Pharmacological management of chronic idiopathic constipation
22 May, 2023 | 13:53h | UTC
Underdiagnosis of primary aldosteronism: a review of screening and detection
22 May, 2023 | 13:40h | UTC
Commentary on Twitter
Underdiagnosis of Primary Aldosteronism: A Review of Screening and Detection https://t.co/PYzSCZD2L7 (FREE)@MarioFunesMD @BhallaResearch @StanfordNeph pic.twitter.com/k7intLqpK3
— AJKD (@AJKDonline) May 19, 2023
Drug-induced abnormal involuntary movements: prevalence and treatment
22 May, 2023 | 13:30h | UTC
M-A | Limited evidence for safety and effectiveness of most antidepressants in chronic pain management
18 May, 2023 | 13:50h | UTC
RCT | Once-weekly insulin icodec shows non-inferiority to daily insulin glargine in type 2 diabetes patients
18 May, 2023 | 13:48h | UTCSwitching to once-weekly insulin icodec versus once-daily insulin glargine U100 in individuals with basal-bolus insulin-treated type 2 diabetes (ONWARDS 4): a phase 3a, randomised, open-label, multicentre, treat-to-target, non-inferiority trial – The Lancet (link to abstract – $ for full-text)
Podcast | Dysphagia pearls
18 May, 2023 | 13:42h | UTC#395 Dysphagia with Dr. Diana Snyder – The Curbsiders
WHO advises not to use non-sugar sweeteners for weight control in newly released guideline
16 May, 2023 | 15:04h | UTCNews Release: WHO advises not to use non-sugar sweeteners for weight control in newly released guideline – World Health Organization
WHO Guideline: Use of non-sugar sweeteners – World Health Organization
Meta-Analysis: Health effects of the use of non-sugar sweeteners – World Health Organization