Current medical research and opinion
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Influenza is associated with significant disease burden in the US and is currently best controlled by vaccination programs. Influenza vaccine effectiveness (VE) is low and may be reduced by several factors, including egg adaptations. Although non-egg-based influenza vaccines reportedly have greater VE in egg-adapted seasons, evidence for egg adaptations' reduction of VE is indirect and dissociated, apart from two previous European consensuses. ⋯ After review of extensive evidence for reduction of VE due to egg-based influenza vaccine manufacture, influenza experts in the US joined those in Europe in unanimous agreement for a mechanistic basis for the effect. Vaccine providers and administrators should consider use of non-egg-based influenza vaccine manufacture to reduce the risk of egg adaptations and likely impact on VE.
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Multicenter Study
Effect of preoperative moderate-dose statin and duration on acute kidney injury after cardiac surgery: a retrospective cohort study.
The impact of preoperative statin use on postoperative acute kidney injury (AKI) is uncertain. We aimed to examine the association of statin therapy before cardiac surgery with postoperative AKI. ⋯ Preoperative moderate-dose statin was significantly related to a decreased risk of postoperative AKI, especially in patients who received statins for a longer duration. Further large-scale multicenter randomized controlled trials are needed to ascertain the impact of statin dose, duration, and timing on postoperative AKI in cardiac surgery patients.
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Studies demonstrate that people who have been infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, have experienced cognitive dysfunction, including working memory impairment, executive dysfunction, and decreased concentration. This review aimed to explore the incidence of working memory impairment and possible concomitant symptoms in the acute phase (< 3 months) and chronic phase (> 6 months) of COVID-19. ⋯ COVID-19 can cause a decline in working memory ability, accompanied by neurological symptoms. However, there is a lack of studies to identify the structural and functional changes in specific brain regions that relate to the impaired working memory.
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Large language models, like ChatGPT and Bard, have potential clinical applications due to their ability to generate conversational responses and encode medical knowledge. However, their clinical adoption faces challenges including hallucinations, lack of transparency, and lack of consistency. Ethicolegal concerns surrounding patient consent, legal liability, and data privacy further complicate matters. Despite their promise, an optimistic but cautious approach is essential for the safe integration of large language models into clinical settings.
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To describe bDMARD initiators by biologic experience among ankylosing spondylitis (AS) patients and change in disease activity and patient-reported outcomes (PROs) in real-world US patients. ⋯ Although AS patients initiate bDMARDs, many do not achieve optimal treatment responses. Future research is needed to investigate the aspects associated with inadequate improvement and treatment response to bDMARDs.