#367 Weekend Warriors, Fluids for Acute Pancreatitis, Colonoscopy Screening & Mortality, and SPRINT trial Revisited (Hotcakes)
Nov 21, 2022
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Join Dr. Era Kryzhanovskaya and guests as they discuss mortality benefits for weekend warriors, fluid strategies for acute pancreatitis, colonoscopy screening impact on mortality, and the legacy of the SPRINT trial. Delve into intense blood pressure control, colon cancer risks, and patient population considerations in this engaging episode.
Weekend warriors show similar mortality outcomes to regularly active participants in a concentrated physical activity study.
Aggressive fluid resuscitation in acute pancreatitis may lead to harm and volume overload compared to a moderate approach.
Intensive blood pressure control in the SPRINT trial yielded reduced cardiovascular mortality over time but benefits diminished, emphasizing sustained management.
Deep dives
The Importance of Weekend Warrior Physical Activity in All-Cause Mortality
A study published in JAMA examined the impact of concentrated physical activity on mortality. Participants who engaged in recommended levels of weekly physical activity in one to two sessions, referred to as 'weekend warriors,' had similar mortality outcomes compared to regularly active participants.
Effectiveness of Aggressive vs. Moderate Fluid Resuscitation in Acute Pancreatitis
The Waterfall Trial, comparing aggressive and moderate fluid resuscitation in acute pancreatitis, was halted due to evidence of harm with aggressive fluid resuscitation. While both groups showed reduced mortality outcomes, the aggressive group had a higher risk of volume overload.
Long-Term Effects of Intensive Blood Pressure Control on Mortality
A secondary analysis of the SPRINT trial in JAMA Cardiology revealed that intensive blood pressure control resulted in reduced cardiovascular mortality over three to five and a half years. However, the mortality benefits seemed to diminish over time, highlighting the importance of sustained blood pressure management.
Evaluation of Colonoscopy Screening for Colorectal Cancer Risk
The Nordic study group scrutinized the impact of colonoscopy screening in reducing colorectal cancer incidence. While the invitation to screen group exhibited a lower risk of colorectal cancer diagnosis, it did not translate into reduced mortality rates, emphasizing the complexities of population-based screening strategies.
Conclusion
The episodes covered distinct areas from physical activity benefits to fluid resuscitation in acute pancreatitis and colorectal cancer screening effectiveness. While some interventions showed promising outcomes initially, the long-term sustainability and applicability in diverse populations require further scrutiny and evaluation.
Join us as we review recent practice-changing articles addressing the questions: Do weekend warriors experience a mortality benefit from exercise? Is an aggressive fluid strategy superior to a moderate strategy in acute pancreatitis? Does an invite for colonoscopy decrease colon cancer-related mortality? Did the benefits of intensive blood pressure control continue after the SPRINT trial ended? Fill your plate with a stack of hot tofurkey cakes! Featuring Drs. Era Kryzhanovskaya (@erakryzhmd), Nora Taranto (@norataranto), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).