Internal Medicine

Association between vitamin D supplementation and mortality: systematic review and meta-analysis – The BMJ (free)

Related: Meta-Analysis: Vitamin D Not Effective for Cardiovascular Disease Prevention (link to abstract and commentary) AND NICE Guideline: Vitamin D Supplementation (free)

Vitamin D supplementation was not associated with all-cause mortality, cardiovascular mortality, or non-cancer, non-cardiovascular mortality. However, Vitamin D supplementation statistically significantly reduced the risk of cancer death by 16%.

 

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Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial – Annals of Emergency Medicine (link to abstract – $ for full-text)

Commentary: Don’t Use More Than 400 mg of Ibuprofen for Pain Control – NEJM Journal Watch (free for a limited period)

 

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#165 Things We Do For No Reason™ Part 2 – The Curbsiders Internal Medicine Podcast (free audio and summary)

See also: Part 1: #109: Things We Do For No Reason: A High Value Episode – The Curbsiders internal Medicine Podcast (free audio and summary)

Related Series: Choosing Wisely: Things We Do For No Reason – Journal of Hospital Medicine (free articles)

“Discover common practices that persist in the hospital wards despite no proven benefit!”

 


Long-term adverse events after sleeve gastrectomy or gastric bypass: a 7-year nationwide, observational, population-based, cohort study – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)

Commentary: Death Risk Drops After Bariatric Surgery in Obese Patients – MedPage Today (free registration required)

Related Research: Association of Bariatric Surgery vs Usual Care Obesity Management With All-Cause Mortality (free study and commentaries)

 

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Medications Affecting the Biochemical Conversion to Type 2 Diabetes: A Systematic Review and Meta-Analysis – The Journal of Clinical Endocrinology & Metabolism (free)

α-Glucosidase inhibitors, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, metformin, orlistat, phentermine/topiramate, and pioglitazone significantly reduced the risk of biochemical conversion to T2DM, whereas statins and nateglinide increased the risk”

 


Too Much Medicine: Not Enough trust?

11 Aug, 2019 | 22:18h | UTC

Too Much Medicine: Not Enough trust? – Journal of Medical Ethics (free)

 

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NCCN Guideline: Adult Cancer Pain

9 Aug, 2019 | 08:12h | UTC

Three versus five days of pivmecillinam for community-acquired uncomplicated lower urinary tract infection: A randomised, double-blind, placebo-controlled superiority trial – EClinicalMedicine (free)

 

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Perioperative Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant – JAMA Internal Medicine (free for a limited period)

Commentary: Study Sheds Light on Stopping and Resuming DOACs in Afib Patients Undergoing Surgery – NEJM Journal Watch (free)

“The DOAC regimens were omitted for 1 day before a low–bleeding-risk procedure and 2 days before a high–bleeding-risk procedure. The DOAC regimens were resumed 1 day after a low–bleeding-risk procedure and 2 to 3 days after a high–bleeding-risk procedure.”

 

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Potential Medicare Savings From Generic Substitution and Therapeutic Interchange of ACE Inhibitors and Angiotensin-II-Receptor Blockers – JAMA Internal Medicine (free for a limited period)

“By maximizing generic substitution and therapeutic interchange, Medicare could have saved approximately $676 million (89.6%) in 2016 and 2017 of the total $754 million spent on these brand-name ACEIs and ARBs during those 2 years”.

 


Alex Nowbar’s journal review, 5 August 2019 – The BMJ Opinion (free)

Alex Nowbar reviews the latest research from the top medical journals.

 


Consensus on Non-cardiac Chest Pain

1 Aug, 2019 | 08:52h | UTC

Digoxin Discontinuation and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentaries: Stopping digoxin after a heart failure exacerbation associated with risk of readmission – ACP Hospitalist (free) AND Digoxin Swings Toward Benefit in HFrEF, But Lack of Clarity Remains – Medscape (free registration required)

 

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New Protocol For HIV Prevention Drug Reduces The Number Of Pills Required – Kaiser Health News (free)

Related: British Guidelines on the Use of HIV Pre–exposure Prophylaxis (PrEP) (several guidelines on the subject) AND USPSTF Statement: Preexposure Prophylaxis for the Prevention of HIV Infection (free guideline and commentaries)

“both organizations now endorse a strategy that requires taking just four pills timed to a specific sexual encounter — two within two to 24 hours before sex and one on each of the two following days… The new strategy, called “2-1-1” or “on-demand” PrEP, is becoming popular overseas but has gotten little traction in the United States thus far.”

 


Comparison of the Harms, Advantages, and Costs Associated With Alternative Guidelines for the Evaluation of Hematuria – JAMA Internal Medicine (free for a limited period)

Commentaries: Hematuria Practice Guidelines That Explicitly Consider Harms and Costs – JAMA Internal Medicine (free for a limited period) AND Evaluating Hematuria: Uniform Use of CT Seen as Risky and Expensive – NEJM Journal Watch (free)

 

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Early TIPS with covered stents versus standard treatment for acute variceal bleeding in patients with advanced cirrhosis: a randomised controlled trial – The Lancet Gastroenterology & Hepatology (link to abstract – $ for full-text)

 

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Alex Nowbar’s journal reviews, 25 July 2019 – The BMJ Opinion (free)

Alex Nowbar reviews the latest research from the top medical journals.

 


Clinical Guide and Update on Porphyrias

26 Jul, 2019 | 01:11h | UTC

Long term risk of symptomatic recurrent venous thromboembolism after discontinuation of anticoagulant treatment for first unprovoked venous thromboembolism event: systematic review and meta-analysis – The BMJ (free)

Commentary: Long-Term Risk for Recurrent VTE Significant After Stopping Anticoagulation – NEJM Journal Watch (free)

“the risk of recurrent VTE was 10% in the first year after treatment, 16% at two years, 25% at five years, and 36% at 10 years, with 4% of recurrent VTE events resulting in death.”

 

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Diagnosing the Onset of Menopause

23 Jul, 2019 | 01:47h | UTC

Diagnosing the Onset of Menopause – JAMA (free for a limited period)

Clinical Review Audio: Diagnosing Menopause (free)

 


Alex Nowbar’s journal reviews, 18 July 2019 – The BMJ Opinion (free)

Alex Nowbar reviews the latest research from the top medical journals.

 


Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis – The BMJ (free)

Editorial: Preventable harm: getting the measure right (free)

Commentaries: One in 20 patients exposed to preventable harm in medical care – OnMedica (free) AND Half of All Patient Harms ‘Preventable’ – Medscape (free registration required)

 

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Antiplatelet Therapy After Noncardioembolic Stroke: An Individual Patient Data Network Meta-Analysis – Stroke (free)

Source: EvidenceAlerts

“Results favor clopidogrel and aspirin/dipyridamole combination for long-term secondary prevention after noncardioembolic stroke or transient ischemic attack”.

 


Clinical Practice: Measles

14 Jul, 2019 | 20:05h | UTC

Urinary Tract Infections Affect Millions. The Cures Are Faltering. – The New York Times (10 articles per month are free)

“As the infections become increasingly resistant to antibiotics, some standard treatments no longer work for an ailment that was once easily cured.”

 


Preclinical Alzheimer Disease—Early Diagnosis or Overdiagnosis? – JAMA Internal Medicine (free for a limited period)

 

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Quality Improvement Goals for Acute Kidney Injury – Clinical Journal of the American Society of Nephrology (free)

 

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Ann Robinson’s journal review, 10 July 2019 – The BMJ Opinion (free)

Ann Robinson reviews the latest research from the top medical journals.

 


Review: Subclinical Hypothyroidism

10 Jul, 2019 | 02:36h | UTC

Subclinical Hypothyroidism – A Review – JAMA (free link for a limited period)

Related: BMJ Guideline: Treatment of Subclinical Hypothyroidism (free guideline and commentaries)

 


Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentary: Pneumonia patients get too many antibiotics – especially as they leave the hospital – University of Michigan (free)

 

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Use of Directly Observed Therapy to Assess Treatment Adherence in Patients With Apparent Treatment-Resistant Hypertension – JAMA Internal Medicine (free link for a limited period)

Commentaries: Directly Observed Therapy Effective for Treatment-Resistant Hypertension – Clinical Advisor (free) AND Think it’s treatment-resistant hypertension? Your eyes need to DOT (directly observe therapy) – Univadis (free registration required)

 

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GINA 2019: a fundamental change in asthma management – European Respiratory Journal (free)

Original Guideline: 2019 GINA Report, Global Strategy for Asthma Management and Prevention (free PDF)

Related Studies: #ATS2019 – Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma (link to abstract and commentaries) AND Randomized Controlled Trials: Treatments for Mild Asthma Compared (link to abstract and commentaries)

“GINA no longer recommends treating adults/adolescents with asthma with short-acting bronchodilators alone. Instead, they should receive symptom-driven (in mild asthma) or a daily corticosteroid-containing inhaler, to reduce risk of severe exacerbations.”

 


Ann Robinson’s journal review, 3 July 2019 – The BMJ Opinion (free)

Ann Robinson reviews the latest research from the top medical journals.

 


Review: Ulcerative Colitis

3 Jul, 2019 | 06:10h | UTC

Clinical Update: Syphilis

30 Jun, 2019 | 17:53h | UTC

IDSA Draft Lyme Disease Guidelines

30 Jun, 2019 | 17:48h | UTC