Prone Positioning Falls Flat for Weaning COVID Patients Off ECMO
Early application of prone positioning did not help patients with severe acute respiratory distress syndrome (ARDS) — mostly from COVID — get off venovenous extracorporeal membrane oxygenation (VV-ECMO) any faster compared to supine positioning, a randomized trial found. Among ARDS patients receiving ECMO, an identical 44% of patients were successfully weaned off ECMO after 60 […]
‘Alexa, Titrate My Insulin’: AI App Boosts Glycemic Control in Randomized Trial
A custom artificial intelligence (AI) app for insulin management advice helped patients with type 2 diabetes gain rapid glycemic control, a small randomized clinical trial found. In titrating basal insulin, those who used a voice-based conversational AI application — delivered over Amazon’s Alexa at home — more quickly achieved optimal insulin dosing (median 15 days […]
Noninvasive Therapy Shows Efficacy in Non-Muscle-Invasive Bladder Cancer
WASHINGTON — An investigational non-surgical treatment led to a “robust” complete response rate in patients with recurrent, low-grade non-muscle-invasive bladder cancer, the phase III ENVISION study showed. Patients treated with the UGN-102 (mitomycin) intravesical solution achieved a complete response rate of 79.2% (95% CI 73.5-84.1) at 3 months without having to undergo transurethral resection of […]
Progression Independent of Relapse Activity in Pediatric-Onset MS
Pediatric-onset multiple sclerosis (MS) patients showed progression independent of relapse activity (PIRA) even when they were relatively young, a prospective cohort study found. Confirmed PIRA events within 48 weeks of baseline occurred in 40.4% of pediatric-onset MS patients and were more frequent in older-onset groups, reported Maria Pia Amato, MD, of the University of Florence […]
Methotrexate Tied to Greater Risks for Older Patients With CKD
Older patients with chronic kidney disease (CKD) had greater risks for serious adverse events when starting on low-dose methotrexate rather than hydroxychloroquine, a propensity score-matched analysis found. About 60% of the cohort’s new prescription came from a rheumatologist. Within 90 days of starting either treatment, the risk for the composite outcome — a hospital visit […]
Clinical Challenges: Test Your Knowledge on New Breast Cancer Treatments
The number of available treatment options for patients newly diagnosed with breast cancer continues to grow. The following three-question quiz will test one aspect from each article in our “Clinical Challenges” series on advanced breast cancer, which covered managing adverse effects of novel therapies and sequencing of treatments in metastatic HER2-positive breast cancer and metastatic […]
Two Approaches for Infected Necrotizing Pancreatitis Go Head-to-Head
Upfront endoscopic necrosectomy may be suitable for certain patients with confirmed or suspected infected necrotizing pancreatitis, results of a small randomized trial suggested. In 70 patients undergoing drainage with endoscopic transluminal stenting, upfront necrosectomy immediately afterward led to fewer subsequent interventions to achieve treatment success compared with when this procedure was reserved for stubborn cases […]
High-Sensitivity Troponin Test May Overestimate Risk in PE
For patients with hemodynamically stable pulmonary embolism (PE), there was no prognostic value found for the mild elevations in cardiac troponin captured only on high-sensitivity assays at the emergency room, based on an exploratory analysis of the PROTECT cohort study. Whereas a finding of conventional cardiac troponin I (cTnI) elevation was associated with a complicated […]
High-Sensitivity Troponin Test May Overestimate Risk in PE
For patients with hemodynamically stable pulmonary embolism (PE), there was no prognostic value found for the mild elevations in cardiac troponin captured only on high-sensitivity assays at the emergency room, based on an exploratory analysis of the PROTECT cohort study. Whereas a finding of conventional cardiac troponin I (cTnI) elevation was associated with a complicated […]
Higher-Dose Fluvoxamine Fails for COVID Outpatients
The extensive quest to repurpose a cheap therapy for non-hospitalized COVID patients has once again fallen short, this time using a higher dose of fluvoxamine (Luvox), a selective serotonin reuptake inhibitor (SSRI). In the latest readout from the multi-platform ACTIV-6 trial, time to sustained recovery landed at an identical 10 days whether patients with mild […]