Therapeutic Anticoagulation with Heparin in Critically Ill ... were then randomized to either Rtx (375 mg/m2 on days 1 and 8) and NIAT versus NIAT alone. Journal Club: Association between aspirin dose and ... Roberts I, Shakur-Still H, Afolabi A, et al.. "Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial". The new england journal medicine The current standard dose of the drug is 0.9 mg/kg given over 1 hour. COLCOT - Wiki Journal Club DOSE - Wiki Journal Club POSEIDON — NephJC FDA expands Pfizer COVID booster, 3rd dose available for ... The following are key points to remember from this state-of-the-art review on diuretic therapy for patients with heart failure (HF): Chronic kidney disease (CKD) is a strong predictor of adverse outcome in HF, and CKD impairs the "reserve" available for the kidneys to respond to the insult posed by congestion. Acad Emerg Med. Importantly, colchicine was not only effective, but had a favorable side-effect profile. 1. Registered attendees receive complimentary access to the webcast for one year. Pfizer and BioNTech said that a third dose of their Covid-19 vaccine neutralized the Omicron variant in lab tests but that the two-dose regimen was significantly less effective at blocking the virus. JOURNAL CLUB: Molecular Breast Imaging at Reduced Radiation Dose for Supplemental Screening in Mammographically Dense Breasts Deborah J. Rhodes 1 , Carrie B. Hruska 2 , Amy Lynn Conners 2 , Cindy L. Tortorelli 2 ,3 , Robert W. Maxwell 2 , Katie N. Jones 2 , Alicia Y. Toledano 4 and Michael K. O'Connor 2 "Controlled trial of budesonide+formoterol as needed for mild asthma". The analysis was done by a statistician employed by Mallinckrodt (S.E. The 10 mg/d dose used in EMPEROR-Reduced was based on the lack of difference between 10 mg/d and 25 mg/d in the EMPA-REG trial. This randomized trial compares the effect of intermediate-dose vs standard prophylactic enoxaparin on a composite outcome of acute venous thromboembolism (VTE), arterial thrombosis, need for extracorporeal membrane oxygenation (ECMO), and all-cause mortality within 30 days among patients with. No significant differences were observed in either patient symptoms or the change in creatine from baseline to . Detailed Description: This study will be an open-label parallel randomized pilot study comparing an individualized weight-based torsemide dosing regimen vs. standard outpatient management in patients with a diagnosis of heart failure.The study will include consenting subjects who are admitted to Jacobi Medical Center with heart failure and were . Patients with NYHA class III-IV ischemic or nonischemic HF and EF <35% were randomized to spironolactone or placebo, with a majority of patients receiving a background of loop diuretics, ACE inhibitors, and digoxin. Effectiveness and tolerability of high-dose (23 mg/d) versus standard-dose (10 mg/d) donepezil in moderate to severe Alzheimer's disease: A 24-week . 1 ubrogepant 25 milligram (mg) tablet, orally for treatment of a qualifying migraine attack. Eplerenone treatment led to a mean furosemide equivalent dose reduction of -2.2 mg/day (-2.9 to -1.6) throughout the follow-up. Mean patient age: 61 years. High dose methylprednisolone sodium succinate (MPSS) was associated with greater improvement in motor score than those in the non methylprednisone group. ACP Journal Club helps you stay current with the latest evidence-based clinical information relevant to internal medicine and its subspecialties. Monthly Journal Club: Dylan Zylla, MD. Farlow MR, Salloway S, Tariot PN, et al. (1999) Circulation 100, 2312. Does high-dose methylprednisolone treatment of acute cervical spinal cord injury within 8 hours of injury improve neurologic motor function outcomes?. We assigned adults with migraine, with or without aura, in a 1:1:1 ratio to receive an initial dose of placebo, ubrogepant at a dose of 50 mg, or . Also, check out our Journal Club review of the Cal-PAT Trial, which studied prehospital TXA use for trauma. Clinical Question. The secondary outcome of dose switching occurred in 7.1% in the aspirin 81 mg group compared with 41.6% of the aspirin 325 mg group. A retrospective study published in 2012 demonstrated a lower incidence of MI in patients with gout on colchicine, although a randomized prospective trial was lacking. The DOSE study was a prospective, randomized, double-blind, controlled trial. April Virtual Journal Club - Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT) Background ULTRA Trial Lesson Progress 0% Complete ULTRA Trial4 Published in the Lancet in Jan 2021, this study aimed to investigate whether ultra-early, short-term treatment with TXA after subarachnoid […] Journal Club: Association between aspirin dose and subarachnoid hemorrhage from saccular aneurysms: A case-control study. one of the authors). Apixaban is an oral, direct factor Xa inhibitor that inhibits both free and clot-bound factor Xa, and has been approved for clinical use in several thromboembolic disorders, including reduction of stroke risk in non-valvular atrial fibrillation, thromboprophylaxis following hip or knee replacement surgery, the treatment of deep vein thrombosis or pulmonary embolism, and prevention of recurrent . The primary outcome was a composite of death, major cardiovascular events (stroke, transient ischemic attack . Complete Journal Club Article Mercedes Ortiz, Alfonso Martín, Fernando Arribas, Blanca Coll-Vinent, Carmen del Arco, Rafael Peinado, Jesús Almendral. (CESAR): a multicentre randomised controlled trial. , et al, on behalf of the ATLAS Study Group . Conclusion. This study is the largest aspirin dosing trial conducted in routine care and clinical settings, and the first randomized controlled trial conducted using . Initial treatment with a single pill containing quadruple combination of quarter doses of blood pressure medicines versus standard dose monotherapy in patients with hypertension (QUARTET): a phase 3, randomised, double-blind, active-controlled trial Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage Kapur J, Elm J, Chamberlain JM, et al. Total number of enrollees: 299. The trial was funded by Mallinckrodt - the company that bought the licensing rights from Ikaria in 2015 (who bought it from Orphan therapeutics before that). HF defined by at least one symptom and one sign. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus. The discussion includes all residents and is led by senior residents or our research director, Dr. Michael Plewa. Journal Club: Cal-PAT Trial Journal club at the Mercy St. Vincent EM Residency takes place once a month, and we discuss up to four potentially practice-changing papers. Follow the conversation at #SCCMJC. The incidence of serious adverse events during the treatment period ranged from 3 to 16% across trial groups. This industry-funded trial of tirzepatide, a unimolecular dual agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, heralds a new era of "twincretins" in diabetes management, an ACP Journal Club commentary said. The U.S. and many other nations already were urging adults to get . When more objective outcomes were used, high-dose diuretic therapy consistently bested low-dose therapy; this is seen in the study's secondary endpoints of proportion free of congestion (18% vs. 11%), 72-hour weight loss (3.9 vs. 2.8 kg), and 72-hour fluid loss (4.9 vs. 3.6 L), all of which favored high-dose therapy. CardioNerds Journal Club STRENGTH TRIAL Visual Abstract November 15, 2020 Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk The 2013 Low-Dose Colchicine (LoDoCo) trial randomized 532 patients with stable CAD to colchicine or observation. Prior clinical diagnosis of HF with daily home use of oral loop diuretic for at least 1 month. In the personalized cohort, those receiving 40 mg or less had an average failure rate of 44.4%, compared to 22.9% in those receiving higher than 40mg (p=0.027). incomplete Journal Club Article. Trial Status: Active Description The purpose of this study is to evaluate the efficacy and safety of pemigatinib versus gemcitabine plus cisplatin chemotherapy in first-line treatment of participants with unresectable or metastatic cholangiocarcinoma with FGFR2 rearrangement. Few patients had RV enlargement (21%) or RV dysfunction (6%), two . WASHINGTON - The U.S. is expanding COVID-19 boosters, ruling that 16- and 17-year-olds can get a third dose of Pfizer's vaccine. : . In this new NEJM Resident 360 discussion format, we have invited the residents and faculty from the Emory University Department of Medicine to engage in a journal club discussion about the NEJM article, "Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism," which can be found at. The CAPTAIN trial was a randomised, double-blind, 24-52 week, active controlled, parallel group, . Cefiderocol was non-inferior to high-dose, extended-infusion meropenem in terms of all-cause mortality on day 14 in patients with Gram-negative nosocomial pneumonia, with similar tolerability. Example Journal Club Template Background and Overview Study Citation Cite your article here using proper format. For this round of NephJC, we have somewhat of a rarity in the nephrology literature - a randomized clinical trial with a positive result! 5 The study was designed and conducted by the Heart Failure Clinical Research Network (see the Supplementary Appendix . Andexanet Alfa, a Novel Antidote to the anticoagulation Effects of Factor Xa Inhibitors (ANNEXA-4) Patients with acute major bleeding within 18 hours after administration of a factor Xa inhibitor were given a bolus of andexanet alpha followed by a 2-hour infusion. The Diuretic Optimization Strategies Evaluation (DOSE) study, published in the New England Journal of Medicine, randomized 308 ADHF patients to a bolus every 12 hours or a continuous infusion of furosemide at either a high or low dose. An additional trial was the RI-CYCLO trial which was also y presented as a late breaking clinical trials . Apixaban drug concentrations were lower in patients receiving 2.5 mg twice daily compared with 5 mg twice daily. The trial was designed to provide at least 90% power to show noninferiority of tirzepatide at a dose of 10 mg or 15 mg as compared with semaglutide at a dose of 1 mg with respect to the change . Comparative Effectiveness Trials: When comparing commercially available products in a heterogenous population the results are typically very small in effect size (Smaller than you would expect with something compared to placebo). Background: Despite continued debate on the efficacy of alteplase (tPA), it currently remains one of the major interventions directed at patients presenting with acute ischemic stroke. Participants had the option to take a second dose, placebo-matching ubrogepant tablet or rescue medication, orally, 2 to 48 hours after initial dose. View Article Appraisal. RALES was the first of a series of trials to prospectively study aldosterone antagonists' mortality benefits in HFrEF. Anticoagulation in Critically Ill Patients with Covid-19 In a randomized trial, patients with severe Covid-19 were assigned to receive either therapeutic-dose anticoagulation or usual-care pharmaco. To directly compare the safety and effectiveness of levetiracetam, fosphenytoin, and valproate for the treatment of . The results suggest that cefiderocol is a potential option for the treatment of patients with nosocomial pneumonia, including those caused by multidrug-resistant Gram-negative bacteria. 2020. Trauma Journal Club Education Graduate Medical Education Fellowship Programs Surgical Critical Care Fellowship Trauma Journal Club . However, this trial was limited by its poor design. Background: Ubrogepant is an oral, small-molecule calcitonin gene-related peptide receptor antagonist for acute migraine treatment. A randomized trial of medical cannabis in patients with stage IV cancers to assess feasibility, dose requirements, impact on pain and opioid use, safety, and overall patient satisfaction. You can also provide a short background on the drug, disease state, or procedure that is being evaluated. Following treatment failure, a lower additional dose of corticosteroids and a shorter duration of treatment was needed in the personalised-dose group to achieve control of the exacerbation. 2019 May 7;92(19):920-922. doi: 10.1212/WNL.0000000000007460. Apixaban is an oral, direct factor Xa inhibitor that inhibits both free and clot-bound factor Xa, and has been approved for clinical use in several thromboembolic disorders, including reduction of stroke risk in non-valvular atrial fibrillation, thromboprophylaxis following hip or knee replacement surgery, the treatment of deep vein thrombosis or pulmonary embolism, and prevention of recurrent . Major Points. (UPDATED) Treating patients with atherosclerotic cardiovascular disease (ASCVD) with low-dose aspirin is just as effective as using the 325-mg dose for the prevention of major cardiovascular events, and both doses are associated with a very low rate of bleeding, according to findings from the open-label, pragmatic ADAPTABLE trial. In that trial, NASH resolution (without worsening of fibrosis) was reported in 39% of the patients who had received once-daily liraglutide at a dose of 1.8 mg as compared with 9% of the patients . Eplerenone was effective in reducing morbidity and mortality regardless of the baseline loop diuretic dose used: hazard ratio for the outcome of cardiovascular death or heart failure hospitalization was 0.83 ([95% CI . Patient with likely cardioembolic strokes were excluded. Daily oral dose of furosemide ≥80 mg and ≤240 mg (or equivalent) Identified within 24 hours of hospital admission. Given that status epilepticus is a life-threatening process, it makes sense to dose levetiracetam like you mean it. The results, presented as a late-breaking clinical trial during . COLCOT is the first trial to provide strong evidence for the role of antiinflammatory agents to reduce recurrent event risk in the acute post-MI period. Friday, October 1st, 2021 . Many of them are also animated. They are all artistically enhanced with visually stunning color, shadow and lighting effects. ACP Journal Club. The differences between the groups assigned to receive intravenous evinacumab at a dose of 15 mg per kilogram and 5 mg per kilogram and the placebo group were -50.5 percentage points (P<0.001) and -24.2 percentage points, respectively. -8. . Dexamethasone was given as 20 mg intravenously once daily for 5 days, followed by 10 mg intravenously once daily for an additional 5 days or until intensive care unit (ICU) discharge, whichever occurred first. 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