Effectiveness of a digital vs face-to-face preoperative assessment: A randomized, noninferiority clinical trial
van Hoorn B et al. Journal of Clinical Anesthesia (November 2023)
Bottom line: This was a single center, randomized (1:1), parallel, open-label, noninferiority trial with 400 participants over a period of 6 months. All adult, Dutch-speaking, ASA I-IV patients with access to an online computer who required surgery were included. The primary outcome was quality of recovery, measured 48 hours after surgery. The mean quality of recovery score of patients undergoing digital screening (158) was non-inferior to that of patients undergoing face-to-face screening (155), with a mean difference of 3.2 points and a 97.5% lower confidence limit of -2.1 points. There were no adverse events. The results suggest that a digital preoperative screening is not inferior to face-to-face consultations in patients undergoing low- to moderate- risk surgery.
Renal function and decongestion with acetazolamide in acute decompensated heart failure (ADVOR)
Meekers E et al. European Heart Journal. (October 2023)
Bottom Line: This randomized, open-label study of 519 patients with acute decompensated heart failure compared the effects of intravenous acetazolamide to matching placebo on top of intravenous loop diuretics. The primary outcome was decongestion, with secondary outcomes of diuresis, natriuresis, and clinical outcomes. Acetazolamide was associated with a higher rate of successful decongestion across the entire range of renal function with more pronounced effects regarding natriuresis and diuresis in patients with a lower eGFR. Although worsening renal function occurred more frequently with acetazolamide, this was not associated with adverse clinical outcomes. Decongestion at discharge was associated with a lower incidence of adverse clinical outcomes irrespective of the onset of worsening renal function.
A Randomized Controlled Study Assessing Convalescent Immunoglobulins vs Convalescent Plasma for Hospitalized Patients With Coronavirus 2019
Maor Y H et al. Clinical Infectious Diseases (October 2023)
Bottom Line: This randomized controlled trial included 319 high risk COVID-19 patients with ≤10 days of symptoms, assigned to receive convalescent immunoglobulins (cIgGs) or convalescent plasma (CP). The primary endpoint was improvement on day 14 according to the World Health Organization scale. Results showed 81.9% in the cIgG group and 70.6% in the CP group improved by day 28 (95% confidence interval, 1.9-20.7; P < .001; for superiority P = .018). Survival and improvement by day 28 were better in unvaccinated patients treated with cIgGs , suggesting cIgGs are a viable option for treating COVID-19.
Trial Files Issue #2023-13
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