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This study is primarily an evaluation of a specific RAT, the Coris coronavirus disease 2019 Ag Respi-Strip test – which while showing poor sensitivity, it again demonstrates that RAT-positivity correlates with viral load. This study used PCR-detection as the gold standard for evaluation, which because of the extreme sensitivity of PCR testing, does not easily translate to assessment of contagiousness (although Ct > 25-30 seems to correlate with inability to grow in viral culture).
Ciotti M, Maurici M, Pieri M et al. Performance of a rapid antigen test in the diagnosis of SARS-CoV-2 infection. J. Med. Virol. 2021 May 1; 93 (5): 2988-2991.
  Daniel Jolley
pearl
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SARS-CoV-2 rapid antigen test positivity correlates well with viral loads typically seen in the infectious period. RATs may be useful tools to discriminate between infectious and non-infectious individuals.
Corman VM, Haage VC, Bleicker T et al. Comparison of seven commercial SARS-CoV-2 rapid point-of-care antigen tests: a single-centre laboratory evaluation study. Lancet Microbe. 2021 Apr 7.
  Daniel Jolley
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Early 2021 update of the 2020 Cochrane Review: Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection.
Better data is now available on correlation between PCR cycle threshold and likely infectivity.
Dinnes J, Deeks JJ, Berhane S et al. Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection. Cochrane Db Syst Rev. 2021 Mar 24; 3 (3): CD013705CD013705.
  Daniel Jolley
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Early 2020 studies of COVID rapid antigen tests were of low quality and of variable applicability to COVID diagnostic decisions. This situation improved dramatically in 2021 and 2022, and many RATs are now continually validated in existing and emerging variants.
This Cochrane Review was updated in 2021.
Dinnes J, Deeks JJ, Adriano A et al. Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection. Cochrane Db Syst Rev. 2020 Aug 26; 8 (8): CD013705CD013705.
  Daniel Jolley
pearl
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Lateral Flow Devices / RATs show good correlation with low cycle threshold PCR results, and subsequent viral culture, indicating excellent sensitivity for identifying contagious individuals.
Pickering S, Batra R, Merrick B et al. Comparative performance of SARS-CoV-2 lateral flow antigen tests and association with detection of infectious virus in clinical specimens: a single-centre laboratory evaluation study. Lancet Microbe. 2021 Sep 1; 2 (9): e461-e471.
  Daniel Jolley
pearl
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A negative SARS-CoV-2 RAT result with a Roche Cobas RAT indicates a non-contagious individual, even if PCR positive.
Kessler HH, Prüller F, Hardt M et al. Identification of contagious SARS-CoV-2 infected individuals by Roche's Rapid Antigen Test. Clin Chem Lab Med. 2022 Apr 26; 60 (5): 778-785.
  Daniel Jolley
pearl
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The nuance of differences, strengths & indications between direct Macintosh laryngoscopy and various videolaryngoscopes is not easily definable and continues to be open to debate.
de CC, da DM, Lemos VM et al. Videolaryngoscopy vs. direct Macintosh laryngoscopy in tracheal intubation in adults: a ranking systematic review and network meta-analysis. Anaesthesia. 2022 Mar 1; 77 (3): 326-338.
  Daniel Jolley
pearl
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Paravertebral block for breast surgery reduces acute postoperative pain, but not the incidence of chronic pain.
Albi-Feldzer A, Dureau S, Ghimouz A et al. Preoperative Paravertebral Block and Chronic Pain after Breast Cancer Surgery: A Double-blind Randomized Trial. Anesthesiology. 2021 Dec 1; 135 (6): 1091-1103.
  Daniel Jolley
pearl
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Perioperative vitamin C in patients undergoing non-cardiac surgery likely does not offer significant outcome benefit.
Suter M, Bollen PintoBernardoBDivision of Anaesthesiology, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland., Belletti A et al. Efficacy and safety of perioperative vitamin C in patients undergoing noncardiac surgery: a systematic review and meta-analysis of randomised trials. Br J Anaesth. 2022 Apr 1; 128 (4): 664-678.
  Daniel Jolley
pearl
1
Goal-directed haemodynamic therapy might decrease mortality, hospital stay & postoperative complications, yet only infectious complications & anastomotic leak show moderate evidence certainty.
Jessen MK, Vallentin MF, Holmberg MJ et al. Goal-directed haemodynamic therapy during general anaesthesia for noncardiac surgery: a systematic review and meta-analysis. Br J Anaesth. 2022 Mar 1; 128 (3): 416433416-433.
  Daniel Jolley