255. CSIM- Top Papers of the Year 2024 Live Episode
Oct 23, 2024
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Rajender Hanmiah, an academic internist with 27 years of experience, shares insights from the Canadian Conference of Internal Medicine. He discusses innovative blood biomarkers for Alzheimer's diagnosis and critical findings on atrial fibrillation risks. The conversation dives into promising new treatments for NASH, alongside challenges in drug trials, including significant side effects. Key highlights also cover the intersection of liver disease, long COVID, and the importance of continued vaccination efforts in tackling public health issues.
Blood biomarkers, particularly phosphorylated tau ratios and amyloid protein scores, significantly enhance Alzheimer's disease diagnostics over traditional clinical assessments.
The monitoring of transient atrial fibrillation in post-surgical patients revealed a concerning 33% recurrence rate, underscoring the need for proactive surveillance.
COVID vaccination showed a protective effect against long COVID symptoms, reducing incidence rates by 30 to 50% across diverse populations.
Deep dives
Blood Biomarkers for Alzheimer's Diagnosis
A study evaluated the effectiveness of blood biomarkers for diagnosing Alzheimer's disease in both primary and secondary care settings. Conducted in Sweden, this research involved patients already suspected of cognitive impairment and assessed them using blood biomarkers alongside lumbar punctures and PET scans for confirmation. The findings showed that blood tests, particularly the phosphorylated tau ratio and an amyloid protein score, provided a significant diagnostic accuracy, outperforming clinical assessments from specialists and primary care. Although promising, the study acknowledged limitations, including its small size and lack of generalizability beyond the Swedish population.
A research piece focused on the recurrence of atrial fibrillation (AF) in patients who experienced transient AF during non-cardiac surgery or medical illness. Conducted in Hamilton, this study tracked 139 patients and found that 33% developed AF within a year, a stark contrast to just 5% in a matched control group. The monitoring method utilized two 14-day patches over the year, which highlighted the importance of proactive surveillance in identifying post-hospitalization AF. While the results were significant, the limited sample size and lack of information on clinical outcomes were noted as critical limitations that warrant further research.
Efficacy of Resmetron in NASH Treatment
A randomized trial examined the use of resmetron, a thyroid hormone receptor agonist, for treating patients with biopsy-confirmed nonalcoholic steatohepatitis (NASH) and liver fibrosis. Participants received different doses of resmetron or a placebo, with the study aiming to assess improvements in steatohepatitis and fibrosis based on biopsy results. Results indicated a notable 20% resolution in steatohepatitis and a 12% improvement in fibrosis, highlighting the drug as a pioneering pharmacotherapy in a previously untreated condition. However, the study's limitations included its reliance on biopsy outcomes and lack of longer-term clinical effectiveness data.
COVID Vaccines and Long COVID Prevention
A cohort study investigated the efficacy of COVID vaccines in preventing long COVID symptoms across populations in the UK, Spain, and Estonia. By utilizing health databases, the study demonstrated that vaccinated individuals had a substantial decrease in the incidence of long COVID symptoms, achieving a protective effect of about 30 to 50%. This highlights the importance of vaccination, particularly as vaccine hesitancy grows in younger demographics who are at risk for long COVID. However, the study's retrospective nature raised concerns about the accuracy of coding and long-term vaccine effectiveness amidst an evolving pandemic landscape.
Steroid Therapy in Community-Acquired Pneumonia
A meta-analysis assessed the effects of steroid therapy on all-cause mortality in patients with community-acquired pneumonia (CAP). Results indicated a 3% improvement in mortality rates among those receiving corticosteroids, primarily benefiting patients with severe pneumonia. The study collated data from multiple sources, analyzing variations in corticosteroid regimens while emphasizing the need for a tailored approach based on severity. Despite its findings, the analysis acknowledged heterogeneity among studies and called for future work to establish standardized treatment protocols and further explore the long-term impacts of steroid use in pneumonia.
Take a listen to our live recording of The Canadian Conference of Internal Medicine Top papers of the year 2024 session! We talk about recent studies involving alzheimer's dementia, community acquired pneumonia, atrial fibrillation, MASLD and long covid.
Host: Dr. Zahra Merali, Expert: Dr. Rajender Hanmiah.
Check out www.medicinepods.com for a live video recording. You can also see a link to each paper there.