Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates

26Jun
2017

Viewpoint: Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates – JAMA (free)

“Contact precautions are easy to use w a single patient, but burdensome when applied to an entire hospital” (RT @JAMA_current see Tweet)

This viewpoint suggests a more selective use of contact precautions for the control of endemic pathogens.

 

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection

26Jun
2017

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis – Gastroenterology (free)

Source: EvidenceAlerts (free resource to find articles of interest)

In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by >50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. “There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses”.

 

A Meta-analysis of the Impact of Aspirin, Clopidogrel, and Dual Antiplatelet Therapy on Bleeding Complications in Noncardiac Surgery

26Jun
2017

A Meta-analysis of the Impact of Aspirin, Clopidogrel, and Dual Antiplatelet Therapy on Bleeding Complications in Noncardiac Surgery – Annals of Surgery (link to abstract – $ for full-text)

Source: EvidenceAlerts (free resource to find articles of interest)

“Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use”

 

Point of view: Generalists key to improved hospital outcomes

26Jun
2017

Adult weight management: guidance for commissioners and providers

26Jun
2017

Respiratory medicine: Six things physicians and patients should question

26Jun
2017

Richard Lehman’s journal review, 26 June 2017

26Jun
2017

Richard Lehman’s journal review, 26 June 2017 – The BMJ Blogs (free)

Richard Lehman reviews the latest research in the top medical journals

 

Obesity now kills more people worldwide than car crashes, terror attacks, and Alzheimer’s combined

25Jun
2017

Prevalence of Axial Spondyloarthritis Among Patients With Fibromyalgia

25Jun
2017

Prevalence of Axial Spondyloarthritis Among Patients With Fibromyalgia: A Magnetic Resonance Imaging Study With Application of the Assessment of SpondyloArthritis International Society Classification Criteria – Arthritis Care & Research (link to abstract – $ for full-text)

Commentary: Does Fibromyalgia Mask Spondyloarthritis? – MedPage Today (free registration required)

Small study (99 patients) showed some patients diagnosed with fibromyalgia have imaging changes suggestive of axial Spondyloarthritis, suggesting that Fibromyalgia may mask an underlying Spondyloarthropathy.

 

Heart Rate and Rhythm and the Benefit of Beta-Blockers in Patients With Heart Failure

25Jun
2017

Interesting initiative for improving quality and reducing readmissions from skilled nursing facilities

25Jun
2017

Necessity is the mother of invention: an innovative hospitalist-resident initiative for improving quality and reducing readmissions from skilled nursing facilities – Journal of Community Hospital Internal Medicine Perspectives (free) (RT @HMVJC see Tweet)

In this model of care, a hospitalist-led team, including the resident on the geriatrics rotation, followed patients discharged from the hospital to the skilled nursing facility, leading to significant decrease in readmission rates.

 

Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder

25Jun
2017

Topical antimicrobial agents for treating foot ulcers in people with diabetes

25Jun
2017

Topical antimicrobial agents for treating foot ulcers in people with diabetes – Cochrane Library (link to summary – & for full-text)

“Topical antimicrobial dressing may increase foot ulcer healing in people with diabetes” (RT @CochraneUK see Tweet)

 

Trans-catheter aortic valve implantation

23Jun
2017

Targeted temperature management in the ICU

23Jun
2017

ACG and CAG Clinical Guideline: Management of Dyspepsia

23Jun
2017

Guided graded exercise self-help as a treatment of fatigue in chronic fatigue syndrome

23Jun
2017

Spasticity Drug Cuts Alcohol Consumption in High-Risk Drinkers

23Jun
2017

Spasticity Drug Cuts Alcohol Consumption in High-Risk Drinkers – Medscape (free registration required)

Unpublished results, presented at the 13th World Congress of Biological Psychiatry, suggesting baclofen is an effective alternative for high-risk alcohol consumption.

 

Women and Heart Disease: New Data Reaffirm Lack of Awareness By Women and Physicians

23Jun
2017

Update on anti-TNF agents and other new drugs for IBD

23Jun
2017

Time-to-Furosemide Treatment and Mortality in Acute Heart Failure

23Jun
2017

Time-to-Furosemide Treatment and Mortality in Patients Hospitalized With Acute Heart Failure – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentary: Door-to-Furosemide Time in Acute Heart Failure – American College of Cardiology, Latest in Cardiology (free)

“God help us if this sort of observational data leads to “door to furosemide time” being adopted as a quality measure” (RT @adamcifu see Tweet)

 

Breast Cancer Risk Assessment and Screening in Average-Risk Women

23Jun
2017

Improving Awareness of and Screening for Health Risks Among Sex Workers

23Jun
2017

Guideline summary: Consensus on Surgical Treatment of Infective Endocarditis

23Jun
2017

What is people-centered care? And why does it matter?

23Jun
2017

WHO Framework on integrated people-centered health services (free resources)

Video: WHO – What is people-centered care? And why does it matter? Our new video explains! (free) (RT @WHO see Tweet)

“Integrated people-centered health services means putting the comprehensive needs of people and communities, not only diseases, at the center of health systems, and empowering people to have a more active role in their own health”.

 

Head Positioning in Acute Stroke

23Jun
2017

Radiation Associated Cardiac Disease

23Jun
2017

Why We Overrate the Lifesaving Power of Cancer Tests

23Jun
2017

Preventing Cognitive Decline and Dementia

23Jun
2017

Co-morbid OSA and insomnia increases depression prevalence and severity in men

23Jun
2017

Cardiopulmonary resuscitation – 30:2 or just keep going?

22Jun
2017

Cardiopulmonary resuscitation – 30:2 or just keep going? – by Scott Munro, in Evidently Cochrane (free) (RT @NIHR_DC see Tweet)

“Untrained bystander CPR had better outcomes when given telephone advice from EMS services to perform continuous CPR, rather than interrupted CPR with rescue breaths”. For trained EMS professionals, “it is possible that there is little or no difference between the two approaches”.

 

An update on Zika virus infection

22Jun
2017

An update on Zika virus infection – The Lancet (free registration required)

“Update on Zika virus infection (2017): review focuses on important updates & gaps in the knowledge” (RT @TheLancet see Tweet)

 

Performance Improvement: Phenytoin Toxicity

22Jun
2017

Performance Improvement: Phenytoin Toxicity – JAMA (free)

Interesting case of medication error and prevention of subsequent adverse events (RT @JAMA_current see Tweet)

 

Acupuncture for analgesia in the emergency department

21Jun
2017

Hormone therapy position statement of The North American Menopause Society

21Jun
2017

Nucleated RBCs may be a predictor of post-discharge mortality and unplanned hospital readmission

21Jun
2017

Nucleated red blood cells, critical illness survivors and postdischarge outcomes: a cohort study – Critical Care (free)

“Presence of nucleated RBCs is a robust predictor of post-discharge mortality and unplanned hospital readmission” (RT @Crit_Care see Tweet)

 

The Challenge of Polypharmacy

21Jun
2017

Screening for Obesity in Children and Adolescents

21Jun
2017

Yoga, Physical Therapy, or Education for Chronic Low Back Pain

21Jun
2017

Corticosteroids not helpful for acute urticaria

21Jun
2017

Your vitamin D tests and supplements are probably a waste of money

21Jun
2017

Your vitamin D tests and supplements are probably a waste of money – VOX (free)

Related: Why Are So Many People Popping Vitamin D? – The New York Times (10 articles per month are free)

“Screening for vitamin D has exploded — with no good evidence that it helps people.”

 

Review: Differentiating lower motor neuron syndromes

20Jun
2017

Antiplatelet Therapy in Patients With Coronary Stents Undergoing Elective Noncardiac Surgery

20Jun
2017

Glucose targets for preventing diabetic kidney disease and its progression

20Jun
2017

Glucose targets for preventing diabetic kidney disease and its progression – Cochrane Library (link to summary – $ for full review)

Sources: EvidenceAlerts and @anupam1623

Intensive glycemic control had no effect on risks of kidney failure, death and major cardiovascular events. “The clinical impact of targeting an HbA1c < 7% or blood glucose < 6.6 mmol/L (120 mg/dL) is unclear and the potential harms of this treatment approach are largely unmeasured.

 

Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management

20Jun
2017

Antibiotic stewardship reduces the incidence of antibiotic-resistant bacteria

20Jun
2017

Patients with opioid disorders frequently have other comorbidities

20Jun
2017

Richard Lehman’s weekly review of medical journals

20Jun
2017

Who Should Assess the Needs of and Care for a Dementia Patient’s Caregiver?

20Jun
2017

Who Should Assess the Needs of and Care for a Dementia Patient’s Caregiver? – AMA Journal of Ethics (free)

“Physicians have an obligation to check in on dementia patients’ caregivers, and provide support if necessary” (RT @JournalofEthics see Tweet)

 

Why overtreatment and overdiagnosis can be bad for your health

20Jun
2017

Why overtreatment and overdiagnosis can be bad for your health – CBC Radio (free text and audio)

See more on the Choosing Wisely initiative in our April 5 issue, see #6.

“Choosing Wisely on CBC Sunday about overdiagnosis & importance of speaking with your doc about tests/treatments” (RT @ChooseWiselyCA see Tweet)

 

ACR Thyroid Imaging and Reporting

20Jun
2017

Incretin based treatments and mortality in patients with type 2 diabetes

20Jun
2017

Incretin based treatments and mortality in patients with type 2 diabetes: systematic review and meta-analysis – The BMJ (free)

“The current evidence provides no support for the hypothesis that incretin based treatment increases all-cause mortality in patients with type 2 diabetes”

 

Comparison of sputum collection methods for tuberculosis diagnosis

19Jun
2017

Comparison of sputum collection methods for tuberculosis diagnosis: a systematic review and pairwise and network meta-analysis – The Lancet Global Health (free)

Invited commentary: Remembering the basics: interventions to improve sputum collection for tuberculosis diagnosis (free)

Pooled sputum collection (sputum that was pooled from each spontaneous expectoration into the same sputum container over a period of several hours) increased the diagnostic performance of smear microscopy 1.6 times and the delivery of standardized instruction emphasizing the difference between sputum and saliva (verbally or visually) increased the odds of a positive microscopy result 1.4 times. “The effect of these simple, inexpensive strategies on diagnostic performance was similar to that of the relatively expensive GeneXpert MTB/RIF test, which, in the largest published studies, increased the odds of diagnosing tuberculosis by 1.3–1.5 times”

 

Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association

19Jun
2017

Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association (free PDF)

Invited Commentary: Trimming the Fat on Diet Recommendations for a Healthy Heart: Emphasis on Eating Patterns over Dietary Restrictions (free)

Top Ten Things to Know: Dietary Fats and Cardiovascular Disease: A Presidential Advisory from the American Heart Association (free PDF)

AHA News: Advisory: Replacing saturated fat with healthier fat could lower cardiovascular risks (free)

News release: Replacing saturated fat with healthier fat may lower cholesterol as well as drugs in context of a healthy diet (free)

AHA no longer recommends decreasing total fat, but to replace saturated fats with polyunsaturated or monounsaturated fats. “Replacing saturated fat with healthier fat in the diet lowers cardiovascular disease risk as much as cholesterol-lowering statin drugs”

 

Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels

19Jun
2017

Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Glycation of Hemoglobin Differs by Race – Physician’s Briefing (free) AND Hemoglobin A1c Overestimates Average Glucose in Blacks – Medscape (free registration required) AND Why a key diabetes test may work differently depending on your race – CNN (free)

In this study with 104 black patients and 104 white patients with type 1 diabetes, HbA1c values in black persons were 0.4 percentage points higher than those in white persons for a given mean glucose concentration.

 

Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty

19Jun
2017

Evolocumab for Treatment of High Cholesterol: Clinical Effectiveness

19Jun
2017

Why are doctors killing themselves

19Jun
2017

EULAR/EFORT recommendations for the management of fragility fractures

19Jun
2017

PSA Test for Prostate Cancer

19Jun
2017

Guidelines for the Chronic Use of Opioid Analgesics

19Jun
2017

Hundreds died while taking an arthritis drug, but nobody alerted patients

19Jun
2017

Managing epilepsy in women of childbearing age

19Jun
2017

Chronic Myeloid Leukemia: What Every Practitioner Needs to Know in 2017

16Jun
2017

Pain and Opioids in Cancer Care: Benefits, Risks, and Alternatives

16Jun
2017

American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question

16Jun
2017

New Choosing Wisely List: American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question (free)

See more on the Choosing Wisely initiative in our April 5 issue, see #6.

“Great choosing wisely list from @ASHPOfficial. Great doctoring tips for physicians & trainees” (RT @AnilMakam see Tweet)

 

Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction

15Jun
2017

Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction – Journal of The American College of Cardiology (link to abstract – $ for full-text)

Commentary: NOAC Doses: Just Stick to the Label – MedPage Today (free registration required)

“Among the 1,473 patients with a renal indication for dose reduction, 43.0% were potentially overdosed, which was associated with a higher risk of major bleeding”

 

Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex for Iron-Deficiency Anemia

15Jun
2017

Effect of Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex on Hemoglobin Concentration in Young Children With Nutritional Iron-Deficiency Anemia: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

The JAMA Network – For the Media: Treating Nutritional Iron-Deficiency Anemia in Children (free)

Commentaries: Ferrous Sulfate Drops Tied to Higher Hemoglobin Increases in Kids with Anemia – Physician’s First Watch (free) AND Traditional treatment is better for iron-deficiency anaemia in children – OnMedica (free) AND Ferrous Sulfate Effective for Iron-Deficiency Anemia in Kids – Medscape (free registration required)

Researchers expected that Iron Polysaccharide Complex would restore hemoglobin more effectively, because it is designed to be tolerated better, but the proportion of infants and children with a complete resolution of iron-deficiency anemia was higher in the ferrous sulfate group (29 percent vs 6 percent).

 

Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events

15Jun
2017

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes

14Jun
2017

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes – New England Journal of Medicine (free)

Commentary: CANVAS: Canagliflozin Reduces CV Events, but at Cost of Amputations – Medscape (free registration required)

Patients treated with canagliflozin had a lower risk of cardiovascular events than those who received placebo but a greater risk of amputation and fractures. The benefits and harms were likely small. See interesting commentaries on the trade-offs by @AnilMakam, see Tweet 1Tweet 2Tweet 3Tweet 4Tweet 5Tweet 6Tweet 7Tweet 8; and Tweet 9.

 

Association of Adverse Events With Antibiotic Use in Hospitalized Patients

14Jun
2017

Association of Adverse Events With Antibiotic Use in Hospitalized Patients – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentary: Antibiotic-Associated Adverse Events Common – Medscape (free registration required)

“20% of hospitalized patients receiving antibiotics had adverse drug event. Of those, 20% of regimens inappropriate” (RT @PeterPronovost see Tweet)

 

A Test in Context: Fractional Flow Reserve: Accuracy, Prognostic Implications, and Limitations

14Jun
2017

Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks

14Jun
2017

Guidelines for the Management of Hypertension

13Jun
2017

Drugs may help people pass larger kidney stones

13Jun
2017

Is the finger-stick blood test necessary for type 2 diabetes treatment?

12Jun
2017

Prevention of acute kidney injury and protection of renal function in the intensive care unit

12Jun
2017

‘How long have I got?’: Why many cancer patients don’t have answers

12Jun
2017

Lower Risk of Heart Failure and Death in Patients Initiated on SGLT-2 Inhibitors?

12Jun
2017

Canagliflozin will receive new boxed warning about amputation risks

12Jun
2017

Working while sick

12Jun
2017

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)

Commentaries: Working while sick – ACP Internist (free) AND Health worker survey reveals many work during flu illness – CIDRAP (free)

Over 40% of surveyed health care personnel worked with self-reported influenza-like illness. “To reduce levels of health-worker–associated flu transmission, the researchers said that misconceptions about working while sick and sick leave policies both need to be addressed” (from CIDRAP)

 

Gastroesophageal Reflux Disease Guideline

12Jun
2017

Prevention and Treatment of Glucocorticoid-Induced Osteoporosis

9Jun
2017

Practice Guidelines for Preoperative Fasting

9Jun
2017

Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor

9Jun
2017

Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline

8Jun
2017

Serum uric acid levels and multiple health outcomes

8Jun
2017

Serum uric acid levels and multiple health outcomes: umbrella review of evidence from observational studies, randomised controlled trials, and Mendelian randomisation studies – The BMJ (free)

Observational studies suggest that high serum uric acid levels are associated with multiple health outcomes, including cardiovascular and metabolic diseases. This review findings suggest there is a clear association only for gout and nephrolithiasis.

 

Management of polypharmacy

8Jun
2017

Handshake-free zones to prevent infections?

8Jun
2017

Can Personalized Care Planning Improve Primary Care?

8Jun
2017

Short-term catheterisation: considerations for best practice

8Jun
2017

Pharmacologic Management of Newly Detected Atrial Fibrillation

7Jun
2017

Antibiotics Versus Surgical Therapy for Uncomplicated Appendicitis (again)

7Jun
2017

Antibiotics Versus Surgical Therapy for Uncomplicated Appendicitis: Systematic Review and Meta-analysis of Controlled Trials – Annals of Surgery (link to abstract – $ for full-text)

Commentary: Antibiotics Versus Surgery: Equally Effective in Treating Appendicitis? – Medscape (free registration required)

This meta-analysis and the author’s conclusions do not favor antibiotics alone for the treatment of uncomplicated appendicitis, contradiction the results of other recent meta-analysis, as well as a recent guideline on the subject, suggesting antibiotics might be an option in selected cases.

 

BSACI guideline for the diagnosis and management of peanut and tree nut allergy

7Jun
2017

Inflammatory bowel disease: Five things physicians and patients should question

7Jun
2017

Association Between Cirrhosis and Stroke

7Jun
2017

Association Between Cirrhosis and Stroke in a Nationally Representative Cohort – JAMA Neurology (free)

Commentary: Cirrhosis Tied to Stroke Risk- Physician’s First Watch (free)

Patients with cirrhosis seem to have a higher risk of stroke, particularly hemorrhagic stroke.

 

Simplified diagnostic management of suspected pulmonary embolism

7Jun
2017

Growth and Rupture Risk of Small Unruptured Intracranial Aneurysms

7Jun
2017

Growth and Rupture Risk of Small Unruptured Intracranial Aneurysms: A Systematic Review – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Growth, rupture risk appear low for small intracranial aneurysms, review indicates – ACP Internist Weekly (free) AND How Frequently Do Small Brain Aneurysms Rupture? – MedPage Today (free registration required)

“The annualized rupture rate was 0% for aneurysms 3 mm or smaller, below 0.5% for aneurysms 5 mm or smaller, and below 1% for aneurysms 7 mm or smaller”

 

What is the best antidote for a jellyfish sting?

7Jun
2017

Home blood pressure monitors inaccurate 70 percent of the time?

7Jun
2017
Page 1 of 41234

Share with you friends


Follow Us





Share Button