Questioning Medicine23 Des 2024

Episode 356: 255. Real-world use of glucocorticoids for adults hospitalized with community-acquired pneumonia

Real‐world use of glucocorticoids and clinical outcomes in adults hospitalized with community‐acquired pneumonia on medical wards - Malecki - 2024 - Journal of Hospital Medicine - Wiley Online Library

This was a retrospective cohort study of 11,500 patients with CAP who were admitted to general medicine units in 7 Canadian hospitals, researchers compared outcomes for patients who received systemic corticosteroids. Patients were excluded if they were admitted to the intensive care units or had COPD or COVID-19 infection.

Between those that got steroids and those that didn’t get steroids there was no differences in intensive care admissions, hospital length of stay, or 30-day readmissions. HOWEVER, In an adjusted analysis, patients who received systemic corticosteroids were significantly more likely to die in the hospital than were patients who didn't receive steroids (8.0% vs. 6.3%; P=0.03).

LET’S BE CLEAR THIS IS FOR NON-SEVERE PNA!! If you have severe pna and are going to the ICU then the evidence and guidelines clearly indicate steroids are appropriate. Critical Care Medicine (lww.com)

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Episoder(401)

Episode 439: 446. mRNA flu vaccine? Is it worth the outcome hype?

https://www.nejm.org/doi/full/10.1056/NEJMoa2516491https://www.ahajournals.org/doi/10.1161/CIR.0000000000001466

21 Okt 19min

Episode 438: 445. GLP1 CME

OMED GLP1 CME

14 Okt 39min

Episode 437: 444. Monday Morning Articles

Silvain J, et al. Discontinuation of β-blockers in stable patients with previous myocardial infarction, preserved left ventricular ejection fraction, and no heart failure: A pooled analysis of individ...

12 Okt 27min

Episode 436: 443. Fast 5 Medical Article Review

Kanwal F, et al. Clinical care pathway for the risk stratification and management of patients with metabolic dysfunction–associated steatotic liver disease. Gastroenterology 2026 Jul; 171:164. DOI: 10...

30 Sep 24min

Episode 435: 442. 7 article review

we unpack whether rivaroxaban followed by aspirin improves thromboprophylaxis after hip and knee arthroplasty, put oral GLP-1 therapy orforglipron head-to-head with dapagliflozin for type 2 diabetes, ...

10 Sep 33min

Episode 434: 441. Coronary Artery Calcium (CAC) -- Yacky Yack, the details on CAC

Does a Coronary Artery Calcium (CAC) scan still earn its place in modern cardiovascular prevention? This podcast cuts through the headlines to examine the recent research, challenge overconfident conc...

31 Aug 48min