Thomas Su
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Cell Press,
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Articles by Thomas Su
Stem cell therapies for retinal diseases: Recent trials
Take-home points Currently, there's no way to restore tissue lost to retinal degenerative diseases, so treatment primarily aims to slow progression; stem cell therapy is being explored as a way to replace damaged cells and slow progression.
Mediterranean diet may be effective for managing IBS
1. In this randomized clinical trial, a higher percentage of adults following a Mediterranean diet achieved clinical response to irritable bowel syndrome (IBS) compared with adults following traditional dietary advice. 2. A Mediterranean Diet was also associated with better diet adherence. Evidence Rating Level: 1 (Excellent) Study Rundown: Up to one-tenth of the population is affected by irritable bowel syndrome (IBS), which is usually initially managed through diet.
Staffing and clinical impacts of private equity acquisition of hospitals
1. In this matched difference-in-differences analysis, hospitals acquired by private equity firms had lower hospital-wide salary expenditures compared with hospitals not acquired by private equity. 2. Compared with non-private equity hospitals, private equity hospitals also experienced increased emergency department mortality and transfers to other acute care hospitals post-acquisition.
“Weekend warrior” and regular physical activity patterns may both reduce cardiovascular and all-cause mortality
1. In this prospective cohort study of adults with diabetes, “weekend warrior” and regular physical activity patterns were associated with similarly reduced risk of all-cause and cardiovascular mortality. 2. Regular activity, but not “weekend warrior” activity, was also associated with significantly reduced risk of cancer mortality.
Safety of investigational vaccines against human immunodeficiency virus
1. In this phase 1 randomized controlled trial, urticaria was reported in several participants who received a messenger RNA vaccine against human immunodeficiency virus. 2. Participants with urticaria were more likely to have received the Moderna COVID-19 vaccine compared with participants without urticaria.
Temporal patterns of emergency department visits for firearm injury
1. In this cross-sectional study, emergency department visits for firearm injury were found to be highest between 2:30 and 3:00 am and on Fridays, Saturdays, and Sundays. 2. During the year, visit rates were disproportionally high on Independence Day, New Year’s Eve, and Christmas.
Poor communication closely associated with patient safety incidents
1. In this systematic review and meta-analysis, poor communication was found to contribute to nearly a quarter of patient safety incidents. 2. Poor communication amongst clinical staff members and between clinical staff and patients were both implicated in a large fraction of patient safety incidents. Evidence Rating Level: 1 (Excellent) Study Rundown: Preventable harm affects 1 in 20 patients and makes up over 50% of overall patient harm worldwide.
Increased tirzepatide use for glycemic and weight control since United States market entry
1. In this retrospective cohort study, tirzepatide dispensations were found to have increased significantly following approval in the United States among people both with and without type 2 diabetes. 2. Among persons without type 2 diabetes, semaglutide remained the most frequently dispensed weight-lowering medication.
4:3 intermittent fasting effective for weight loss among adults with obesity
1. In this randomized controlled trial, 4:3 intermittent fasting was associated with significantly greater weight loss compared with daily caloric restriction. 2. Overall caloric intake was lower in the 4:3 IMF group, although both groups remained below the target weekly energy deficit. Evidence Rating Level: 1 (Excellent) Study Rundown: Although daily caloric restriction (DCR) remains a mainstay for weight loss, many patients struggle with diet adherence and weight regain.
Patient navigation may improve colonoscopy completion following abnormal stool test
1. In this randomized controlled trial, participants with an abnormal fecal immunochemical test who received patient navigation had higher rates of subsequent colonoscopy than those who received usual care. 2. The mean time to colonoscopy was also shorter in the patient navigation group than in the usual care group. Evidence Rating Level: 1 (Excellent) Study Rundown: Fecal immunochemical testing (FIT) is a recommended form of colorectal cancer (CRC) screening.
Patient values and preferences when treating acute episodic migraine
1. In this rapid review, patients valued effectiveness for treating pain more highly than other attributes such as avoiding harm and reducing other migraine symptoms. 2. However, avoiding harm was also an important consideration, particularly minimizing the risk of nausea. Evidence Rating Level: 1 (Excellent) Study Rundown: Several pharmacologic treatments exist for acute migraine, each with different effectiveness for reducing pain and other symptoms, harm profiles, and cost-effectiveness.
Triptans may be the most effective treatments available for acute episodic migraine
1. In this systematic review and meta-analysis, the combination of triptans and non-steroidal anti-inflammatory drugs (NSAIDs) was the most effective treatment for achieving pain freedom or pain relief in adults with acute episodic migraine. 2. Triptan monotherapy was also more effective than acetaminophen and NSAID monotherapy, although there was a higher risk of adverse effects.
Evidence gap for acute pain outcomes in opioid use disorder
1. In this systematic review, evidence for the efficacy of acute pain interventions on individuals with opioid use disorder was generally limited. 2. Studies involving individuals already on buprenorphine showed that continuing the agent during episodes of acute pain may reduce pain severity.
Molecular imaging non-inferior to adrenal vein sampling in detecting aldosterone-producing adrenal adenomas
1. In this prospective within-patient trial, [11C]metomidate ([11C]MTO) positron emission tomography-computed tomography was non-inferior to adrenal vein sampling in identifying aldosterone-producing adrenal adenomas. 2. [11C]MTO showed high agreement with its analogue, para-chloro-2-[18F]fluoroethyletomidate ([18F]CETO).
Prevalence of common chronic conditions in Medicare Advantage and traditional Medicare beneficiaries
1. In this cross-sectional study, Medicare Advantage (MA) beneficiaries had a similar prevalence of obesity, hypertension, hyperlipidemia, and chronic kidney disease compared with traditional fee-for-service Medicare beneficiaries 2. The prevalence of diabetes was higher in the MA population versus the fee-for-service Medicare population.
Glucagon-like peptide-1 receptor agonists associated with lower depression risk in older adults with diabetes
1. In this target trial emulation, glucagon-like peptide-1 receptor agonists (GLP-1RAs) were associated with a lower risk of depression compared with dipeptidyl peptidase-4 inhibitors among older patients with type 2 diabetes. 2. GLP-1RAs were associated with a similar reduction in risk of depression compared with sodium-glucose cotransporter-2 inhibitors.
De-escalating dual antiplatelet therapy may lower major bleeding risk following drug-eluting stent implantation
1. In this systematic review and meta-analysis, de-escalating dual antiplatelet therapy to ticagrelor monotherapy following implantation of a drug-eluting stent was associated with a lower major bleeding risk without increasing the rate of ischemic events. 2. Ticagrelor monotherapy was associated with an overall reduction in adverse clinical effects, but not with a significant change in all-cause mortality or death from cardiac causes.
SEP-1 sepsis management bundle not associated with improved mortality
1. In this systematic review, there was minimal evidence of improved sepsis mortality with implementation of the Severe Sepsis and Septic Shock Management Bundle. 2. Studies that found an association between sepsis bundle compliance and reduced mortality tended to have limited generalizability.
Direct oral anticoagulants have similar bleeding risk compared with aspirin
1. In this systematic review and meta-analysis, the non-vitamin K oral anticoagulants apixaban and dabigatran both had similar rates of major bleeding and intracranial hemorrhage compared with aspirin monotherapy. 2. Rivaroxaban was found to have numerically greater rates of major bleeding and intracranial hemorrhage compared with aspirin, though this difference was not statistically significant.
Patient values and preferences when considering migraine prevention options
1. In this systematic review, patients with episodic migraine preferred oral pharmacologic treatments that reduced the severity, frequency, and duration of migraines. 2. Patients also valued a lower risk of developing migraines on day 1 post-dosing as well as a shorter duration of restriction on daily activities.
No significant differences between medications for episodic migraine prophylaxis
1. In this systematic review and meta-analysis, there were no significant differences between various pharmacologic treatments for preventing episodic migraine in adults. 2. While calcitonin gene-related peptide antagonist monoclonal antibodies appeared to be more efficacious and tolerable than other drug classes, the evidence was of lower certainty. Evidence Rating Level: 1 (Excellent) Study Rundown: Many pharmacologic options exist for treating episodic migraine.
Blood pressure readings remain consistent in noisy and public settings
1. In this randomized crossover trial, differences in mean blood pressure readings between private and public settings were minimal. 2. Blood pressure measurements also did not differ significantly between loud and quiet public spaces. Evidence Rating Level: 1 (Excellent) Study Rundown: Despite clinical guidelines for hypertension highlighting the importance of proper patient orientation for blood pressure (BP) measurement, BP screening is often done in loud spaces.
Roux-en-Y gastric bypass and sleeve gastrectomy may be equally cost-effective among patients with type 2 diabetes
1. In this retrospective cohort study of patients with diabetes who received Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy, health expenditures decreased by around 30% every 6 months. 2. Health expenditures were overall similar between patients who received either of the two surgeries except in the 6 months immediately after surgery, when inpatient expenditures were higher for the RYGB group.
High incidence of post-transplant lymphoproliferative disorder in Epstein-Barr virus-seronegative kidney recipients
1. In this retrospective cohort study, individuals who were Epstein-Barr virus-seronegative had higher rates of post-transplant lymphoproliferative disorder than their seropositive counterparts following transplant with seropositive donor kidneys. 2. The incidence of post-transplant lymphoproliferative disorder in seronegative recipients was found to be five to ten times higher than previously reported.
Semaglutide may aid tobacco cessation in patients with comorbid diabetes
1. In this retrospective study of patients with comorbid type 2 diabetes mellitus and tobacco use disorder (TUD), semaglutide use was associated with lower health care utilization relating to TUD compared with other antidiabetes medications. 2. Patients who received semaglutide were also less likely to receive prescriptions for smoking cessation medications compared to their counterparts.
Genome classifiers may aid prostate cancer risk stratification and treatment
1. In this systematic review, ten studies reported risk reclassification of prostate cancer with genome classifier testing, with wide variation across different genome classifier tests. 2. Treatment decisions tended to either remain unchanged or slightly favor conservative management following genome classifier testing. Evidence Rating Level: 1 (Excellent) Study Rundown: Prostate cancer is the most prevalent cancer among men.
Racial disparities may exist in access to lung cancer screening facilities
1. In this cross-sectional study, distance to the nearest lung cancer screening facility was greater in American Indian/Alaska Native-majority census tracts compared to non-Hispanic White-majority census tracts, even after adjustment for rurality. 2. Asian-, Black-, and Hispanic-majority census tracts exhibited shorter distances to lung cancer screening facilities than non-Hispanic White-majority census tracts.
Postdischarge contacts may not significantly affect unplanned healthcare utilization or patient satisfaction
1. In this systematic review and meta-analysis, postdischarge contacts did not significantly affect hospital readmission rates, emergency department use, or unplanned health care use in general within 30 days of discharge compared with usual care. 2. Most included studies did not report a significant effect on patient satisfaction associated with postdischarge contacts.
Electronic visit billing implementation led to decrease in patient-initiated portal messages
1. In this mixed-methods study, the number of patient-initiated online portal messages moderately decreased with the implementation of e-visit billing. 2. The majority of providers who completed the survey approved of the e-visit billing system, but there were some concerns regarding the operational process and the potential for increased administrative burden.
Denosumab may increase risk of major adverse cardiovascular events but reduce fracture risk in patients receiving dialysis
1. In this target trial emulation study, denosumab was associated with an increased risk of major adverse cardiovascular events compared with oral bisphosphonates among patients with osteoporosis who were also receiving dialysis. 2. However, denosumab was also found to be associated with a lower risk of composite fractures versus bisphosphonates.
Glucagon-like peptide-1 receptor agonists and co-agonists safe and effective for weight loss
1. In this systematic review, glucagon-like peptide-1 receptor agonists and co-agonists were effective in inducing weight loss in overweight adults who were otherwise healthy and did not have diabetes. 2. Glucagon-like peptide-1 receptor agonists and co-agonists were associated with mild-to-moderate, transient gastrointestinal side effects.
Gabapentin may be associated with improved fall-related outcomes in older adults being treated for neuropathic pain
1. In this retrospective cohort study, gabapentin use was associated with a reduced incidence of fall-related healthcare visits in older adults when compared with the use of duloxetine. 2. There was no observable difference in the hazard of having a fall involving a hip fracture or hospitalization, but gabapentin users did have a reduced incidence of fall-related emergency department visits.
Poor control over clinical work associated with burnout among physicians
1. In this cross-sectional survey, poor control over patient load, team composition, and clinical schedule were each associated with burnout among physicians. 2. Poor control over patient load and workload were associated with intent to reduce clinical hours, while poor control over hiring of staff and accountability were each associated with intent to leave current practice.
Expanding human papillomavirus vaccination to high-risk mid-adults may be cost-effective
1. In this modeling study, the cost-effectiveness and number needed to vaccinate of mid-adult human papillomavirus (HPV) vaccination improved when limited to those at higher risk for acquiring HPV infection. 2. HPV vaccination of mid-adults was found to be significantly less cost-effective and required a higher number needed to vaccinate compared to the vaccination of persons 26 years of age and younger.
Denosumab increases risk of severe hypocalcemia in women with osteoporosis and chronic kidney disease
1. In this target trial emulation study, denosumab was found to increase the risk of hypocalcemia requiring emergency treatment as compared with bisphosphonates among women with osteoporosis in the setting of chronic kidney disease (CKD). 2. The risk of developing emergently treated hypocalcemia with denosumab increased with worsening CKD stage, particularly in patients with CKD-mineral and bone disorder.
Performance assessment of preoperative risk assessment tools for elective noncardiac surgery
1. In this scoping review of preoperative risk assessment tools for elective noncardiac surgery, cardiopulmonary exercise testing (CPET) was the most assessed tool, particularly with regard to predictive validity. 2. Most tools did not have strong evidence for reliability, pragmatic qualities, or validity compared with CPET.
Weight loss interventions may improve metabolic and reproductive outcomes in polycystic ovarian syndrome
1. In this systematic review and meta-analysis, weight loss interventions for overweight people with polycystic ovary syndrome were associated with greater reductions in insulin resistance and free androgen index as well as greater increases in menstruation frequency. 2. Weight loss interventions were also linked to greater reductions in fasting insulin with no effect on fasting glucose.
Novel colorectal cancer screening tests’ utility depends on patient context
1. Based on a validated model of colorectal cancer screening, cell-free DNA blood tests may deliver net benefit when screening persons who decline alternatives, but net harm when substituting for more effective alternatives. 2. Next-generation multitarget stool DNA and RNA fecal immunochemical tests may achieve similar efficacy as standard fecal immunochemical tests in reducing colorectal cancer incidence and mortality.
Fecal immunochemical testing may be efficient for colorectal cancer screening in younger patients
1. In this retrospective cohort study, fecal immunochemical test completion rates in individuals aged 45 to 49 years were slightly higher than those aged 50 years, and positivity rates were slightly lower in the younger cohort. 2. Receipt of colonoscopy after a positive fecal immunochemical test was similar in both age groups, but the false-positive rate was higher among the younger group.
Risk of financial precarity from hospitalization among Medicare beneficiaries ineligible for Medicaid
1. In this cross-sectional study examining four scenarios, many participants earning between 100% and 400% of the federal poverty level did not have enough balance or liquid assets to pay for the Part A Medicare deductible. 2. Financially precarious individuals tended to be Black, Hispanic, or of other, non-White race and ethnicity; lack high school education; and have at least 3 chronic conditions and 3 limitations in activities of daily living.
Rosuvastatin may reduce risk of all-cause mortality and major adverse cardiovascular events compared with atorvastatin
1. In this multi-database retrospective cohort study, rosuvastatin was found to be associated with slightly decreased risk of all-cause mortality and major adverse cardiovascular events compared with atorvastatin. 2. Initiation of rosuvastatin and atorvastatin carried similar risks for the development of chronic kidney disease. Evidence Rating Level: 2 (Good) Study Rundown: Atorvastatin and rosuvastatin are both widely prescribed for reducing LDL-C levels.
Caregivers of people with dementia may benefit from online decision aid when managing firearm access
1. In this randomized controlled trial involving caregivers for people with Alzheimer’s disease and related dementias, the use of the Safety in Dementia program increased preparation for decision-making about firearm access. 2. No effect was observed on caregivers’ self-reported action to reduce firearm access during study follow-up.
Computer-aided detection may improve detection of polyps and adenomas compared with conventional colonoscopy
1. In this updated systematic review and meta-analysis, computer-aided detection found more polyps and adenomas per colonoscopy compared with standard detection methods. 2. While the average number of advanced colorectal neoplasms per colonoscopy was similar between the two groups, advanced lesions were detected at a slightly higher rate when using computer-aided detection.
High cardiovascular disease mortality among Native Hawaiian and Pacific Islander adults
1. In this cross-sectional study, researchers found that Native Hawaiian and Pacific Islander (NHPI) adults aged 35 years or older died of cardiovascular disease at a rate 50% higher than Asian adults, a group in which they had historically been classified. 2. The age-standardized mortality rate among NHPI adults was the third highest after Black adults and White adults.
Risk factors for diabetes in people with HIV
1. This follow-up analysis of the phase 3 REPRIEVE trial demonstrated that region of residence, prediabetes, high BMI, and metabolic syndrome were risk factors for new-onset diabetes in people with HIV. 2. While pitavastatin use was also associated with a higher risk of diabetes, there was negligible interaction with the other risk factors except among the few patients with a combination of obesity, prediabetes, and multiple metabolic syndrome components.
Suicide care implementation in primary care decreases suicide attempts
1. In this secondary analysis of a stepped-wedge randomized trial, implementing strategies for suicide prevention concurrently with substance care programs was associated with a decreased number of suicide attempts. 2. The rates of safety planning also significantly increased after the transition from usual care to suicide care.
Liberal transfusion may improve outcomes in myocardial infarction and anemia
1. In this secondary analysis of the MINT trial, 30-day risks for the composite outcome of death and recurrent myocardial infarction increased with lower hemoglobin thresholds for transfusion among patients with acute myocardial infarction. 2. Given the imprecision of the trial data, definitive conclusions regarding hemoglobin thresholds for transfusion remain uncertain.
Time-restricted eating may improve glycemic control in patients with metabolic syndrome
1. In this randomized controlled trial, patients with metabolic syndrome who underwent time-restricted eating in addition to standard-of-care counseling had a greater decrease in HbA1c levels compared to those who received standard-of-care counseling alone. 2. Patients on a time-restricted eating regimen also had greater decreases in body weight, body mass index, body fat percentage, total fat mass, and low-density lipoprotein cholesterol.
Risk factors for recurrent firearm injury among children
1. In this retrospective observational cohort study of children in St. Louis, those with the highest risk of firearm injury were older, Black, non-Hispanic males. 2. Children who were treated at an adult hospital had an increased risk of recurrent firearm injury compared to children treated at a children’s hospital.
New prognostic model for hepatocellular carcinoma in chronic hepatitis B
1. In this cohort study involving noncirrhotic patients with chronic hepatitis B, a new prognostic model based on viral load was found to have good overall performance in predicting risk for hepatocellular carcinoma. 2. Additional predictors of hepatocellular carcinoma risk in the model included platelet counts, ALT levels, and hepatitis B e antigen result.
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