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The new DOAC score had stronger predictive performance for major bleeding in patients on anticoagulation for atrial fibrillation (A-fib) compared to the HAS BLED score.

Source
Development and Validation of the DOAC Score: A Novel Bleeding Risk Prediction Tool for Patients With Atrial Fibrillation on Direct-Acting Oral Anticoagulants. Circulation. 2023 Sep 19;148(12):936-946. doi: 10.1161/CIRCULATIONAHA.123.064556. Epub 2023 Aug 25.

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This prospective observational cohort study found implementing a protocol for peripheral norepinephrine (NE) decreased median number of central venous catheter (CVC) days per patient by one, and 51.6% avoided a CVC entirely. 

Source
Peripheral administration of norepinephrine: a prospective observational study. Chest, S0012-3692(23)05350-3. 21 Aug. 2023, doi:10.1016/j.chest.2023.08.019

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For pediatric patients with acute sinusitis, amoxicillin-clavulanate does not offer treatment benefit over amoxicillin alone and is more likely to be associated with gastrointestinal (GI) side effects and yeast infections than amoxicillin.

Source
Treatment Failure and Adverse Events After Amoxicillin-Clavulanate vs Amoxicillin for Pediatric Acute Sinusitis. JAMA. 2023 Sep 19;330(11):1064-1073. doi: 10.1001/jama.2023.15503.

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There was a strong association with lower mortality and hospitalization in high-risk patients with COVID-19 who were treated with either nirmatrelvir/ritonavir or molnupiravir.

Source
Nirmatrelvir or Molnupiravir Use and Severe Outcomes From Omicron Infections. JAMA Netw Open. 2023 Sep 5;6(9):e2335077. doi: 10.1001/jamanetworkopen.2023.35077.

We're trying something new! Watch quick videos, with my personal take on the articles we cover each week and more! Here's the JournalFeed YouTube channel link. ~Clay

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Modified dose nirmaltrevir-ritonavir is well-tolerated in patients with CKD as therapy for mild COVID-19 and effectively suppresses viral load.

Source
Safety Profile and Clinical and Virological Outcomes of Nirmatrelvir-Ritonavir Treatment in Patients With Advanced Chronic Kidney Disease and Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2023 Aug 2:ciad371. doi: 10.1093/cid/ciad371. Epub ahead of print.

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Neurosyphilis is on the rise – brush up on the facts now before you miss it.

Source
State-of-the-Art Review: Neurosyphilis. Clin Infect Dis. 2023 Aug 18;ciad437. doi: 10.1093/cid/ciad437. Online ahead of print.

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Syphilis is on the rise in certain subgroups. This article provides a well-organized infographic that can be used to summarize treatment and management of patients in all stages of infection.

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Children with persistent or worsening rhinosinusitis experienced a modest improvement in symptoms when given amoxicillin-clavulanate vs. placebo.

Source
Identifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial. JAMA. 2023;330(4):349-358. doi:10.1001/jama.2023.10854

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Treatment with direct oral anticoagulants (DOACs) in pediatric patients appears to reduce venous thromboembolism (VTE) recurrence compared to standard of care, with no difference in major bleeding or serious adverse events. Prophylaxis with DOACs was comparable to standard of care and was associated with a nonsignificant reduction in VTE.

Source
Efficacy and safety of direct oral anticoagulants in the pediatric population: a systematic review and a meta-analysis. J Thromb Haemost. 2023 Jul 20:S1538-7836(23)00573-1. doi: 10.1016/j.jtha.2023.07.011. Epub ahead of print.

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Proton pump inhibitor (PPI) use in young children is associated with risk of serious infection. It's best to avoid PPI use in the absence of a very clear indication.

Source
Proton Pump Inhibitor Use and Risk of Serious Infections in Young Children. JAMA Pediatr. 2023 Aug 14;e232900. doi: 10.1001/jamapediatrics.2023.2900. Online ahead of print.