ADARRC

About ADARRC

This author has not yet filled in any details.
So far ADARRC has created 53 blog entries.

Severe hypocalcemia with denosumab therapy in dialysis-treated patients

2024-02-19T17:07:38+04:00

Denosumab use is not restricted to individuals with osteoporosis who have advanced kidney disease. However, concerns remain regarding the risk of severe hypocalcemia in such patients. In a cohort study of 2804 female patients (aged ≥65 years) with osteoporosis and undergoing dialysis, severe hypocalcemia (serum calcium <7.5 mg/dL [1.9 mmol/L] or hypocalcemia requiring emergency care) occurred in a higher proportion of patients who initiated denosumab compared with those who initiated an oral bisphosphonate (12-week weighted cumulative incidence 41.1 versus 2 percent, respectively) [1]. Denosumab also was associated with a higher incidence of very severe hypocalcemia (serum calcium <6.5 mg/dL [...]

Severe hypocalcemia with denosumab therapy in dialysis-treated patients2024-02-19T17:07:38+04:00

Sarilumab increases remission, decreases steroid dose in polymyalgia rheumatica taper, but at a high cost (SAPHYR)

2024-02-08T12:49:28+04:00

Does the monoclonal antibody sarilumab facilitate the tapering of glucocorticoid therapy in patients with polymyalgia rheumatica? Giving patients with PMR sarilumab twice monthly for 1 year allows an accelerated tapering regimen that greatly reduces the cumulative steroid dose and increases the likelihood of remission (which was low in both groups). Neutropenia, diarrhea, and arthralgia were common adverse effects. The annual drug cost is estimated to be $18,400. The cost per additional sustained response is more than $90,000, and it is unclear what the value is of the lower cumulative dose of prednisone. Spiera RF, Unizony S, Warrington KJ, et [...]

Sarilumab increases remission, decreases steroid dose in polymyalgia rheumatica taper, but at a high cost (SAPHYR)2024-02-08T12:49:28+04:00

No increased risk of esophageal cancer with nonerosive gastroesophageal reflux

2024-01-29T10:40:35+04:00

Are patients with nonerosive gastroesophageal disease at an increased risk of esophageal cancer as compared with the average population? We can reassure our patients (and ourselves) that nonerosive GERD does not increase the likelihood of esophageal cancer. Erosive GERD, however, is associated with a doubled — but still low — risk of developing cancer, with the likelihood increasing over time. Holmberg D, Santoni G, von Euler-Chelpin M, et al Non-erosive gastro-oesophageal reflux disease and incidence of oesophageal adenocarcinoma in three Nordic countries: Population based cohort study. BMJ 2023 Sep 13;382:e076017.

No increased risk of esophageal cancer with nonerosive gastroesophageal reflux2024-01-29T10:40:35+04:00

Signs and symptoms of successfully treated lower limb cellulitis can last

2024-01-22T16:34:33+04:00

How long do symptoms last after successful treatment of lower limb cellulitis? Despite successful treatment of lower limb cellulitis, signs and symptoms of inflammation can still be present 10 days after treatment begins. These remnants do not indicate that treatment was ineffective. Williams OM, Hamilton F, Brindle R. The natural history of antibiotic-treated lower limb cellulitis: analysis of data extracted from a multicenter clinical trial. Open Forum Infect Dis 2023;10(10):ofad488.

Signs and symptoms of successfully treated lower limb cellulitis can last2024-01-22T16:34:33+04:00

Twice-daily low-dose aspirin is similar to enoxaparin for thromboprophylaxis after inpatient treatment for fracture (PREVENT CLOT)

2024-01-22T16:31:40+04:00

Is twice-daily low-dose aspirin noninferior to a low-molecular-weight heparin for thromboprophylaxis after an extremity, acetabular, or pelvic fracture? Aspirin is noninferior to enoxaparin for thromboprophylaxis following inpatient treatment of a fracture. It is, of course, much cheaper, more convenient, and preferred by patients. The challenge will be convincing orthopedic surgeons that, in this case, "less is more." Major Extremity Trauma Research Consortium (METRC); O'Toole RV, Stein DM, et al. Aspirin or low-molecular-weight heparin for thromboprophylaxis after a fracture. N Engl J Med 2023;388(3):203-213.

Twice-daily low-dose aspirin is similar to enoxaparin for thromboprophylaxis after inpatient treatment for fracture (PREVENT CLOT)2024-01-22T16:31:40+04:00

Vitamin D supplementation slightly reduces diabetes diagnoses in at-risk adults

2023-09-25T10:26:13+04:00

In adults with prediabetes, can vitamin D supplementation decrease their likelihood of developing type 2 diabetes over several years? Vitamin D supplementation, over a median of 3 years, slightly reduces the diagnoses of diabetes in older people at risk of developing type 2 diabetes (NNT = 18 - 115). The benefit is greater in patients who achieve higher serum levels of vitamin D. Myhrvold SB, Brouwer EF, Andresen TKM, et al. Nonoperative or surgical treatment of acute Achilles’ tendon rupture. N Engl Med J 2022;386(15):1409-1420.

Vitamin D supplementation slightly reduces diabetes diagnoses in at-risk adults2023-09-25T10:26:13+04:00

Surgery is no better than nonoperative treatment for Achilles tendon rupture in adults

2023-09-18T09:03:33+04:00

Is open repair or minimally invasive surgery better than nonoperative management for adults with acute Achilles tendon rupture? There is no clear benefit to surgery over nonoperative management for adults with acute Achilles tendon rupture. Symptomatic improvement is the same, and surgery trades more nerve injuries for a lower risk of re-rupture. Myhrvold SB, Brouwer EF, Andresen TKM, et al. Nonoperative or surgical treatment of acute Achilles’ tendon rupture. N Engl Med J 2022;386(15):1409-1420.

Surgery is no better than nonoperative treatment for Achilles tendon rupture in adults2023-09-18T09:03:33+04:00

Another study fails to find PRP injections effective for adults with degenerative joint disease of the knee

2023-09-11T10:01:22+04:00

Are platelet-rich plasma injections, either single or multiple, more effective than saline injections in adults with early symptomatic degenerative joint disease of the knee? This is yet another study — this one of higher quality than the others — that finds PRP injections, singly or serially, to be no better than saline injections in improving outcomes in adults with mild radiographically confirmed degenerative joint disease of the knee. Lewis E, Merghani K, Robertson I, et al. The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial. Bone Joint [...]

Another study fails to find PRP injections effective for adults with degenerative joint disease of the knee2023-09-11T10:01:22+04:00

Short-term benefit from ultrasonography-guided steroid injection for Achilles tendinopathy

2023-09-07T10:24:31+04:00

Is the combination of physical therapy and an ultrasonography-guided corticosteroid injection safe and beneficial for the treatment of Achilles tendinopathy? This study found that the addition of an ultrasonography-guided corticosteroid injection to standard physical therapy for the treatment of Achilles tendinopathy resulted in a significant improvement in the composite outcome of pain relief, increased function, and activity at 6 months compared with a placebo injection. However, pain during physical activity was not significantly improved with the steroid injection compared with the placebo at any time. Johannsen F, Olesen JL, Ohlenschlager TF, et al. Effect of ultrasonography-guided corticosteroid [...]

Short-term benefit from ultrasonography-guided steroid injection for Achilles tendinopathy2023-09-07T10:24:31+04:00
Go to Top