HCN Year-in-Review: Clinical EssentialsDecember 20, 2021 | Trending in Healthcare Allergy & Immunology Awaited Ivermectin Review Is Out The results of the International Ivermectin Project Team were finally published this week in Open Forum Infectious Diseases, and although they’re positive, they haven’t escaped criticism, and most researchers still want results from a randomized controlled trial. In addition, many studies included in the analysis were not peer reviewed, which was a limitation, and studies varied widely in terms of dosage, treatment duration, and inclusion criteria. Read full article Endocrinology, Diabetes, Metabolism USPSTF Makes ‘Huge’ Change to Prediabetes, Diabetes Screening Recommendations for Adults Research shows that the “old” 2015 recommendation would only identify about half of Americans with prediabetes and undiagnosed type 2 diabetes. Based on this data, the US Preventive Services Task Force has lowered the recommended screening age from 40 to 35 years in asymptomatic, nonpregnant adults who are overweight or obese. Read full article Allergy & Immunology Putting ACP’s Guidance on Shorter Courses for Antibiotics to Practice In practice, “standard” duration of antibiotic therapy is often based on archaic studies. Newer evidence shows that shorter durations are often a better choice and that antibiotic resistance is more likely to develop with longer durations of therapy. Here are the recommendations applied to four commonly treated infections. Read full article Cardiology Profound Changes in Lipid-Lowering Therapy Coming with New Agents Targeting LP(a) and Triglycerides Our understanding of lipid pathology is shifting from what might be called the “LDL hypothesis” to the “atherogenic lipoprotein hypothesis.” LDL is just a surrogate of the actual process of lipoprotein interaction with the arterial wall. This shift in understanding is driving a host of budding therapies with novel approaches to targeting key atherogenesis players like lipoprotein(a) and triglycerides. Read full article Cardiology Hypertension Journal Study: Evaluating ARBs vs. ACE Inhibitors Safety Outcomes Findings: Primary outcomes included AMI, HF, stroke, and CVEs; 51 secondary and safety outcomes included angioedema, cough, syncope, and electrolyte abnormalities. ACE inhibitors were associated with a significantly increased risk of four secondary and safety outcomes compared with ARBs.Design: Multinational cohort study; Patients: ~2.3M ACE, ~674K ARB Read full article Cardiology Statins and Diabetes Progression Publication: JAMA Internal MedicineDesign: Retrospective cohort study of more than 83,000 propensity-scored matched pairs over a 12-year period.Results: Diabetes progression was significantly greater among diabetes patients using statins vs. those not using statins. Read full article Cardiology Certain Antihypertensive Drugs Yield Less Memory Decline in Older Adults According to Daniel A. Nation, PhD, associate professor of psychological science at University of California, Irvine: “Studies of angiotensin II receptor blockers and ACE inhibitors have suggested these medicines may confer the greatest benefit to long-term cognition, while other studies have shown the benefits of calcium channel blockers and diuretics on reducing dementia risk.” Read full article Dermatology Hereditary Angioedema is Often Misdiagnosed Often undiagnosed due to its unspecific symptoms, hereditary angioedema (HAE) is a tricky condition that causes many patients unnecessary suffering with unnecessary surgeries and invasive diagnostic/therapeutic interventions. Read on to educate yourself on some of the alarming numbers on the orphan disease. Read full article Cardiology Intervention Reduces “Death Rattle” in End-of-Life Care Publication: JAMADesign: Multicenter, randomized, double-blind, placebo-controlled trial performed in six hospices in the Netherlands of 162 patients with a life expectancy of three or more days. Administration of subcutaneous scopolamine butylbromide, 20 mg four times a day (n = 79) or placebo (n=78) in the 157 patients included in the primary analysis.Results: A death rattle occurred in 10 patients (13%) in the scopolamine group compared with 21 patients (27%) in the placebo group. Read full article
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