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2 Minute Medicine ® - Otolaryngology (E.N.T.)

https://read.qxmd.com/read/101001793/cefepime-taniborbactam-is-superior-to-meropenem-in-treating-complicated-urinary-tract-infections
#1
SUMMARY
Nhat Hung Benjamin Lam, Kiera Liblik
1. In this randomized controlled trial, among hospitalized adults with a complicated urinary tract infection (UTI), cefepime-taniborbactam was superior to meropenem in achieving microbiologic and clinical resolution. 2. Cefepime-taniborbactam had a similar safety profile to meropenem with comparable rates of serious adverse events. Evidence Rating Level: 1 (Excellent) Study Rundown: Complicated UTI, including acute pyelonephritis, accounts for a high number of hospitalizations. Emerging bacterial resistance to b-lactam antibiotics poses a challenge in treating these serious infections...
March 8, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001764/sodium-glucose-cotransporter-2-inhibitor-use-in-patients-with-type-2-diabetes-linked-to-decreased-risk-of-nephrolithiasis
#2
SUMMARY
Yasin Avci, Yuchen Dai
1. A reduced risk of nephrolithiasis was linked with patients with type 2 diabetes (T2D) initiating sodium-glucose cotransporter 2 inhibitor (SGLT2i) treatment compared to starting glucagon-like peptide 1 receptor agonists (GLP-1RA) or dipeptidyl peptidase 4 inhibitors (DPP4i). 2. The results of the study remained consistent across various predetermined sensitivity analyses and subgroup evaluations (some being race, sex, and lifestyle factors). Evidence Rating Level: 2 (Good) Study Rundown: Kidney stone prevalence is increasing globally, posing significant costs and health risks...
February 20, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001757/egfr-is-more-strongly-associated-with-adverse-outcomes-when-cystatin-c-is-included
#3
SUMMARY
Thomas Su, Kiera Liblik
1. In this cohort study, estimated glomerular filtration rate based on both creatinine and cystatin C (eGFRcr-cys   ) was more strongly associated with cardiovascular events than estimates based on creatinine alone (eGFRcr). 2. Nearly one-third of individuals were reclassified into a different severity category after recalculation. Evidence Rating Level: 2 (Good) Study Rundown: GFR is used to define chronic kidney disease (CKD) and is typically estimated using serum creatinine. However, loss of muscle mass in old age can depress circulating creatinine levels, creating the illusion of better renal function...
February 16, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001724/lower-risk-of-adverse-outcomes-secondary-to-hypertension-observed-at-higher-ages-in-elderly
#4
SUMMARY
Jayden Berdugo, Alex Chan
1. When comparing cohorts of patients above and below 75 years of age, hypertension had a greater association with mortality, cardio-kidney composite events, and overt dementia in patients aged 45-74 years. Evidence Rating Level: 2 (Good) Blood pressure (BP) gets increasingly higher as people begin aging. Not only does hypertension increase, but other risk factors for high BP such as diabetes also have higher prevalence in older individuals. High BP is typically treated with antihypertensives; however, it is important to establish the point where this intervention is needed...
February 5, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001705/cemiplimab-for-kidney-transplant-recipients-with-cutaneous-squamous-cell-carcinoma
#5
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. There was no kidney rejection noted in the cemiplimab for kidney transplant recipients. 2. Cemiplimab was found to have a median progression-free survival and overall survival of 22.5 months. Evidence Rating Level: 2 (Good) Study Rundown: Solid organ transplant recipients receiving chronic immunosuppression have an increased risk of cutaneous squamous cell carcinoma (CSCC). Cemiplimab, a PD-1 inhibitor, has shown promising results in treating advanced CSCC but hasn’t been studied in transplant recipients due to concerns about organ rejection...
January 29, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001670/increased-salt-intake-may-be-associated-with-greater-chronic-kidney-disease-risk
#6
SUMMARY
Soroush Nedaie, Alex Chan
1. This large cohort study found that in the general population, a higher self-reported frequency of adding salt to foods was significantly associated with increased chronic kidney disease (CKD) risk. Evidence Rating Level : 2 (Good) Sodium intake is essential for various physiological functions, but high consumption has been associated with hypertension and CKD. Self-reported frequency of adding salt to foods is associated with an increased risk of cardiovascular diseases, premature mortality, and type 2 diabetes, but there are no studies investigating its relation with CKD...
January 6, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001607/inflammatory-tongue-conditions-associated-with-increased-risk-of-oral-tongue-cancer
#7
SUMMARY
Donika Yakoub, Alex Chan
1. In this case-control study, those with tongue cancer were found to have ten-fold increases in rates of inflammatory tongue conditions (e.g., glossodynia, glossitis, precancer) preceding cancer diagnosis, and this remained significant even in conditions diagnosed ≥ 5 years prior to cancer occurrence. 2. Rates of oropharyngeal and oral cavity cancers were not found to be associated with tongue cancers. Evidence Rating Level: 3 (Average) Over the past decade alone, the rate at which people are being diagnosed with oral cancers, and specifically tongue cancer, is on the rise...
December 5, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001492/prophylactic-antibiotics-prevent-urinary-tract-infections-in-infants-with-vesicoureteral-reflux
#8
SUMMARY
Grace Yin, Kiera Liblik
1. In this randomized controlled trial, prophylactic antibiotics resulted in significantly lower rates of first-occurrence urinary tract infections (UTIs) in infants with vesicoureteral reflux.  2. The groups did not differ in kidney scarring, kidney filtration function, or hospitalization rates due to UTI. Evidence Rating Level: 1 (Excellent) Study Rundown: Infants with vesicoureteral reflux are at an elevated risk of developing UTIs. This increases their cumulative risk of adverse events such as kidney scarring and reduced filtration function...
October 6, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001477/budesonide-may-be-effective-for-slowing-renal-function-decline-in-patients-with-iga-nephropathy
#9
SUMMARY
Neel Mistry, Teddy Guo
1. Reduction in time-weighted glomerular filtration rate (GFR) decline was significantly greater in Nefecon versus placebo. 2. Majority of adverse events were mild-to-moderate in nature with no treatment-related deaths. Evidence Rating Level: 1 (Excellent) Study Rundown : IgA nephropathy is a chronic immune-mediated kidney disease with marked proteinuria. Nefecon, a novel, targeted-release form of budesonide, is designed to inhibit galactose-deficient IgA1 (gd-IgA1) within the gastrointestinal tract, although little is currently known...
September 29, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001374/acute-kidney-injury-more-prevalent-amongst-extremely-premature-neonates
#10
SUMMARY
Donika Yakoub, Alex Chan
1. A secondary  analysis of a randomized clinical trial found that when correcting for fluid balance, AKI was more commonly diagnosed in extremely premature neonates.  2. A diagnosis of fluid-corrected AKI resulted in a significantly higher risk of requiring mechanical ventilation, longer hospital stay, and bronchopulmonary dysplasia (BPD). Evidence Rating Level: 1 (Excellent) Acute kidney injury (AKI) is a common condition in premature neonates, particularly those of extremely low gestational age. The potential complications of AKI do not exist solely in the short term; AKI in neonates also increases the risk of future chronic kidney disease...
August 14, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001348/risk-of-adverse-kidney-related-events-for-patients-on-lithium-is-low-but-increases-with-greater-exposure
#11
SUMMARY
Davy Lau, Alex Chan
1. For patients newly initiated on lithium or valproate, the absolute risks of chronic kidney disease (CKD) progression or acute kidney injury (AKI) were low and similar. 2. Higher cumulative exposure to lithium was associated with greater risk of CKD progression compared to valproate. 3. Higher median lithium levels were associated with increased risk of AKI in a dose-response relationship. EvidEnce Rating Level: 2 (Good) Study Rundown:  Lithium is used in the treatment of bipolar disorder, but has always been associated with concerns of nephrotoxicity, although the pathophysiology is not well understood...
August 1, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001347/atezolizumab-added-to-cabozantinib-does-not-improve-clinical-outcomes-in-patients-with-metastatic-renal-cell-carcinoma
#12
SUMMARY
Neel Mistry, Teddy Guo
1. Progression-free and overall survival was comparable in both the intervention and control groups. 2. Serious adverse events were more common among patients taking a combination of atezolizumab-cabozantinib than cabozantinib-only. Evidence Rating Level: 1 (Excellent) Study Rundown: Immune checkpoint inhibitors are first-line therapy for patients with metastatic renal cell carcinoma (MRCC); however, optimal management for patients with disease progression following therapy remains unknown. This randomized controlled trial aimed to assess whether the addition of atezolizumab to cabozantinib could delay disease progression and improve survival in patients with MRCC refractory to immune checkpoint inhibitor treatment...
August 1, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001337/there-is-a-low-risk-of-chronic-kidney-disease-progression-following-acute-kidney-injury
#13
SUMMARY
David Xiang, Kiera Liblik
1. In this prospective cohort study, there was a limited association between acute kidney injury (AKI) and worsening kidney function in patients with chronic kidney disease (CKD). 2. There was no significant decrease in estimated glomerular filtration rate (eGFR) after a mild to moderate AKI in patients with CKD.  Evidence Rating Level: 1 (Excellent) Study Rundown: AKI is typically considered a significant risk factor for the progression of loss of kidney function. However, in prior studies that examined this association, there were many methodological limitations...
July 25, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001242/comparison-between-hydroxychloroquine-and-systemic-corticosteroids-in-iga-nephropathy
#14
SUMMARY
Soroush Nedaie, Alex Chan
1. For patients with IgA nephropathy (IgAN), long-term use of hydroxychloroquine demonstrated antiproteinuric effects compared to corticosteroids at 24 months.  Evidence Rating Level : 3 (Average) IgAN is the most common form of primary glomerulonephritis, occurring in 1 in 100 people worldwide, and can lead to end-stage renal disease. No specific treatment currently exists for IgAN, but corticosteroids (CS) are widely used as supportive treatment to maintain renal function in patients, despite their significant side effects...
June 22, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001184/zolbetuximab-improves-survival-in-patients-with-advanced-or-metastatic-gastric-adenocarcinoma
#15
SUMMARY
Neel Mistry, Teddy Guo
1. Median progression-free survival in zolbetuximab group was greater than in the placebo group (10.6 months vs. 8.7 months). 2. There were significantly more serious adverse events in the Zolbetuximab group with nausea, vomiting, and decreased appetite being the most common symptoms. Evidence Rating Level: 1 (Excellent) Study Rundown: First-line treatment for gastric and gastro-esophageal adenocarcinoma includes chemotherapy including folinic acid, fluorouracil, and oxaliplatin regimen (FOLFOX). Zolbetuximab is a monoclonal antibody targeting claudin-18 isoform 2 (CLDN18...
May 31, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001168/sparsentan-superior-to-irbesartan-for-reduction-of-proteinuria-in-patients-with-iga-nephropathy
#16
SUMMARY
Neel Mistry, Teddy Guo
1. Patients in sparsentan group reported a 50% reduction in proteinuria compared to 15% in the irbesartan group at week 36. 2. Complete remission of proteinuria was significantly higher in the sparsentan group. Evidence Rating Level: 1 (Excellent) Study Rundown: IgA nephropathy is the most common cause of primary glomerulonephritis worldwide. Although renin-angiotensin blockers (ARBs), such as irbesartan, have been primarily used for treatment, some patients continue to have persistent proteinuria. Sparsentan, a novel single-molecule, angiotensin II receptor antagonist, may have improved efficacy in patients with refractory proteinuria although existing trials suggest mixed results...
May 23, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001133/shorter-antibiotic-therapy-courses-likely-noninferior-in-the-treatment-of-complicated-urinary-tract-infections-and-bacteremia
#17
SUMMARY
Alex Chan
1. In bacteremic patients with complicated UTI, a 10-day course of typical antibiotics or a 7-day course of IV beta-lactams or highly available antibiotics were statistically similar to 14-day courses when comparing 30-day reinfection and antibiotic-resistant infection rates. Evidence Rating Level: 2 (Good) Urinary tract infections (UTIs) are the most common bacterial infections worldwide. Complicated UTIs (cUTIs) occur in the setting of pre-existing structural or functional abnormalities of the urinary tract (or any male patient with UTI), and generally have poorer outcomes...
May 8, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001102/intradialytic-exercise-may-improve-patient-survival-rates-in-patients-receiving-hemodialysis
#18
SUMMARY
Soroush Nedaie, Alex Chan
1. Intradialytic exercise for a minimum of 60 minutes during thrice weekly dialysis sessions improved survival rates in adult patients who are receiving hemodialysis (HD). Evidence Rating Level :1 (Excellent) Chronic kidney disease is becoming increasingly prevalent worldwide, leading to an exponential increase in the number of individuals experiencing kidney failure requiring kidney-replacement therapy (KRT), which is primarily achieved through hemodialysis. Patients undergoing HD experience high rates of morbidity, and a mortality rate 10-30 times higher than those with normal kidney function...
April 26, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001085/parathyroidectomy-does-not-impact-renal-function-in-adults-with-primary-hyperparathyroidism
#19
SUMMARY
David Xiang, Kiera Liblik
1. In this target emulation trial, parathyroidectomy did not affect long-term renal function in adults with primary hyperparathyroidism (PHPT). 2. Patients with parathyroidectomy had no difference in the estimated glomerular filtration rate (eGFR) decline compared to those without parathyroidectomy. Evidence Rating Level: 1 (Excellent) Study Rundown: The definitive treatment for PHPT is parathyroidectomy to remove one or more abnormal parathyroid glands. However, observation for disease progression is an alternative that can be considered in patients without apparent end-organ damage related to PHPT...
April 19, 2023: 2 Minute Medicine
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