acid suppression

Quick Take: Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans

Proton pump inhibitors (PPIs) are widely used in the management of gastroesophageal reflux. However, several studies have demonstrated serious adverse events associated with PPI use including cardiovascular disease, acute kidney injury, chronic kidney disease, dementia, pneumonia, gastric cancer, Clostridium difficile infection, and increased risk of fracture. Recent evidence has also Czytaj więcej…

anesthesia

Quick Take: Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients

Protective intraoperative mechanical ventilation has been associated with reduced postoperative pulmonary complication risk. Obesity is associated with an increased risk of atelectasis and impaired respiratory function. In this setting, high positive end-expiratory pressure with alveolar recruitment maneuvers have been proposed for routine intraoperative mechanical ventilation to prevent these physiologic alterations. Czytaj więcej…

chronic disease

Quick Take: Low rates of specialized cancer consultation and cancer-directed therapy for noncurable pancreatic adenocarcinoma

Eighty percent of patients with advanced or metastatic pancreatic adenocarcinoma are not candidates for surgical resection and require noncurative therapy, including multi-agent chemotherapy regimens, radiation therapy, nerve blocks and other symptomatic relief modalities. Despite having established benefits for patients, a large proportion of pancreatic adenocarcinoma patients are unable to access Czytaj więcej…

blood glucose

The VADT-F trial: major cardiovascular events or death are not reduced in diabetics with intensive glucose control therapy

1. In a 15-year observational cohort study of type 2 diabetics treated with intensive compared to standard glucose control therapy the risk of major cardiovascular event or death was similar between both treatment groups. 2. There was no reported difference in health-related quality of life scores between the intensive and Czytaj więcej…

BCL2

The CLL14 trial: longer progression-free survival for CLL patients with coexisting conditions treated with venetoclax

1. In untreated chronic lymphocytic leukemia (CLL) patients with coexisting conditions, patients treated with venetoclax–obinutuzumab experienced greater progression-free survival compared to patients treated with chlorambucil–obinutuzumab. 2. Rates of adverse events in the two treatment groups were similar. Evidence Rating Level: 1 (Excellent)   Study Rundown: Many patients with CLL are Czytaj więcej…

Cardiology

Neladenoson does not increase exercise capacity for heart failure with preserved ejection fraction

1. In this randomized controlled trial, heart failure with preserved ejection fraction (HFpEF) patients did not have improved exercise capacity with neladenoson versus placebo. 2. There were no changes in activity intensity, NT-proBNP level, high-sensitivity troponin T level, or quality of life with neladenoson. Evidence Rating Level: 1 (Excellent) Study Czytaj więcej…

Cancer

Quick Take: Treatment and Long-Term Clinical Outcomes of Incidental Pulmonary Embolism in Patients With Cancer

Venous thromboembolism (VTE) is a common complication in patients with cancer. Often, VTEs are incidentally detected on imaging studies undertaken for cancer staging or evaluation of treatment response. Current guidelines recommend that the same anticoagulant treatment be used for both incidental pulmonary embolism (PE) and symptomatic PE in patients with Czytaj więcej…