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NEWS - Internal Medicine / Hospital Medicine

Association of Antidepressant Use With Drug-Related Extrapyramidal Symptoms: A Pharmacoepidemiological Study – Journal of Clinical Psychopharmacology (link to abstract – $ for full-text)

Commentaries: Incidence of Extrapyramidal Symptoms Higher With Certain Antidepressants – MPR (free) AND Antidepressants tied to Parkinson’s-like symptoms – Univadis (free registration required)

“Observational study: Incidence of EPSs with antidepressants. RRs: duloxetine, 5.68; mirtazapine, 3.78; citalopram, 3.47; escitalopram, 3.23; paroxetine, 3.07; sertraline, 2.57; venlafaxine, 2.37; bupropion, 2.31; and fluoxetine, 2.03 (all significant)” (via @psychopharmacol see Tweet)

 


Cardiovascular disease risk factors in chronic kidney disease: A systematic review and meta-analysis – PLOS One (free)

“In addition to established traditional general population cardiovascular risk factors, left ventricular hypertrophy, serum albumin, phosphate, urate and hemoglobin were all found to be statistically significant in their association with future cardiovascular events”.

 


Prevalence and outcomes of incidental imaging findings: umbrella review – The BMJ (free)

Related: Giles Maskell: Incidental anarchy – The BMJ Opinion (free)

“Incidentalomas. If you order imaging studies, you know they are a problem. This meta-analysis quantifies incidentaloma prevalence for specific types of imaging. For MRI of the brain, the prevalence was 22% (95%CI 14 to 31) (via @RasoiniR and @eloder, see Tweet)

 


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)

 


Prognostic Implications of Single-Sample Confirmatory Testing for Undiagnosed Diabetes: A Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Diagnosing Diabetes From a Single Blood Sample – Johns Hopkins Bloomberg School of Public Health, via NewsWise (free) AND One Blood Test Might Be Enough to Diagnosis – HealthDay (free) AND Diabetes Dx Predicted Accurately with Single Blood Sample – MedPage Today (free registration required)

“The standard practice of repeat blood tests may not always be necessary, a new study suggests” (from Johns Hopkins Bloomberg School of Public Health)

 


Helping patients choose wisely – The BMJ (free)

Related: The Choosing Wisely initiative was launched 5 years ago, and now has over 490 recommendations from 18 countries (free)

See complete lists from: Choosing Wisely U.S., Choosing Wisely UKChoosing Wisely Australia AND Choosing Wisely Canada

“One of the main barriers to tackling the problem of overuse is that doctors are concerned patients will find it difficult to accept fewer interventions. However, informed patients often opt for less intervention, not more.” (via @bmj_latest see Tweet)

 


Richard Lehman’s journal review, 18 June 2018 – The BMJ Opinion (free)

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

 


Clinical Presentation and Outcome in a Contemporary Cohort of Patients with Acute Myocarditis: The Multicenter Lombardy Registry – Circulation (link to abstract – $ for full-text)

Commentary: Outcome of Acute Myocarditis Patients – American College of Cardiology (free)

“Retrospective study of 443 patients w/ acute myocarditis from 19 Italian hospitals reports relatively benign overall outcomes” (via @ACCinTouch see Tweet)

 


Effect of Negative Pressure Wound Therapy vs Standard Wound Management on 12-Month Disability Among Adults With Severe Open Fracture of the Lower Limb: The WOLLF Randomized Clinical Trial – JAMA (free for a limited period)

Commentaries: High-tech treatment of open leg wounds no better than using regular dressings – University of Warwick (free) AND Negative-Pressure Therapy No Better for Open Fractures – Medscape (free registration required)

“Negative pressure wound therapy did not improve 12-month disability for patients with severe open fracture of the lower limb compared with standard wound dressing”

 


A Placebo-Controlled Trial of Bezafibrate in Primary Biliary Cholangitis – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: A Trial of Bezafibrate in Primary Biliary Cholangitis – NEJM Resident 360 (free) AND Bezafibrate Normalizes Liver Enzymes in PBC – MedPage Today (free registration required)

“In a randomized trial of patients with primary biliary cholangitis, bezafibrate and ursodeoxycholic acid resulted in a higher rate of complete biochemical response than ursodeoxycholic acid alone” (via @NEJM see Tweet with visual abstract)

 


Richard Lehman’s journal review, 11 June 2018 – The BMJ Opinion (free)

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

 


Continuous low-dose antibiotic prophylaxis to prevent urinary tract infection in adults who perform clean intermittent self-catheterisation: the AnTIC RCT – Health Technology Assessment (free)

“The results of this large randomised trial, conducted in accordance with best practice, demonstrate clear benefit for antibiotic prophylaxis in terms of reducing the frequency of UTI for people carrying out CISC”.

 


Richard Lehman’s journal review, 4 June 2018 – The BMJ Opinion (free)

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

 


Richard Lehman’s journal review, 29 May 2018 – The BMJ Opinion (free)

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

 


Incidental anarchy – The BMJ Opinion (free)

“Giles Maskell writes on over diagnosis and underdiagnosis, the complexities of incidental findings and urges clinicians to “Think before you scan because you can” (via @bmj_latest see Tweet)


A1C Targets Should Be Personalized to Maximize Benefits While Limiting Risks – Diabetes Care (free) (via @Abraham_RMI)

Related guideline: 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)

“Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes” (from ACP Guideline, prompting the Editorial)

 


Richard Lehman’s weekly journal review, 21 May 2018 – The BMJ Opinion (free)

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

 


Rapid Recommendations: Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline – The BMJ (free)

We issue a strong recommendation for use of atraumatic needles in all patients (adults and children) undergoing lumbar puncture because they decrease complications and are no less likely to work than conventional needles”

 


Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis – Critical Care Medicine (free for a limited period)

Source: Critical Care Reviews Newsletter

“In adults with septic shock treated with low dose corticosteroids, short- and longer-term mortality are unaffected, adverse events increase, but duration of shock, mechanical ventilation and ICU stay are reduced”.

 


Aldosterone Antagonist Therapy and Mortality in Patients With ST-Segment Elevation Myocardial Infarction Without Heart Failure: A Systematic Review and Meta-analysis – JAMA Internal Medicine (free for a limited period)

Invited Commentary: Mineralocorticoid Receptor Antagonists in ST-Segment Elevation Myocardial Infarction – JAMA Internal Medicine (free for a limited period)

Aldosterone antagonists are beneficial for patients with STEMI and reduced ejection fraction. This meta-analysis suggests that patients with STEMI and LVEF greater than 40% or without heart failure also have improved outcomes with aldosterone antagonists.

 


Dose Increase Versus Unchanged Continuation of Antidepressants After Initial Antidepressant Treatment Failure in Patients With Major Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized, Double-Blind Trials – The Journal of Clinical Psychiatry (link to abstract – $ for full-text)

Commentary: Depression: boosting SSRIs doesn’t work – Univadis (free registration required)

“Meta-analysis: there is evidence from RCTs against increasing the dose of SSRIs (with the possible exception of citalopram) in adult patients with major depression and antidepressant treatment failure” (via @psychopharmacol see Tweet)

 


Richard Lehman’s journal review, 14 May 2018 – The BMJ Opinion (free)

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

 


Clinical Pearl: Essential Tremor – NEJM Resident 360 (free)

 


High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial – Circulation (free)

With a median follow-up of 3.9 years, high-dose as compared with low-dose pitavastatin significantly reduced the risk of the primary end point (4.3% vs 5.4%; NNT = 90), a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergency hospitalization.

 


Richard Lehman’s journal review, 8 May 2018 – The BMJ Opinion (free)

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

 


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.

 


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