Cerebral Vein Thrombosis

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If you’re looking for vaccine-induced thrombotic thrombocytopenia (CVT/CVST with thrombocytopenia following AstraZeneca or J&J COVID-19 vaccine), check out this podcast.

Multicenter Cohort Study: Ferro JM et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004 Mar;35(3):664-70. Epub 2004 Feb 19. PMID: 14976332.

Utility of D-dimer:

Dentali F et al. D-dimer testing in the diagnosis of cerebral vein thrombosis: a systematic review and a meta-analysis of the literature. J Thromb Haemost. 2012 Apr;10(4):582-9.PMID: 22257124.
Meng R et al. Evaluation of plasma D-dimer plus fibrinogen in predicting acute CVST. Int J Stroke. 2014 Feb;9(2):166-73. Epub 2013 Mar 19. PMID: 23506130

COVID-19: Ivermectin

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Ivermectin is among the potential therapies proposed for COVID-19. In this episode, we review the available randomized trials of ivermectin as well as treatment guidelines.

COVID-19 Vaccines in Pregnancy Update

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The Advisory Committee on Immunization Practices (ACIP) released preliminary data from the CDC v-safe registry on mRNA COVID-19 vaccines and pregnancy. In this podcast episode, we discuss the mechanisms of the vaccines, what we know, and this new data. If you’re looking for the pregnancy decision aids, they’re available here.

Janssen (J&J) COVID-19 Vaccine

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This viral vector is currently going before the FDA, and more data was released in this briefing document here (a summary of all vaccines in the US can be found here).

Tranexamic acid in epistaxis

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In this episode we cover the literature on tranexamic acid (TXA) in epistaxis, including a new trial in Annals of Emergency Medicine by Reuben et al, the NoPac trial.

Other references include:

Tibbelin et al. Effect of local tranexamic acid gel in the treatment of epistaxis. ORL J Otorhinolaryngol Relat Spec. 1995 Jul-Aug;57(4):207-9. PMID: 7478455.
Zahed et al.A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. Am J Emerg Med. 2013 Sep;31(9):1389-92. doi: 10.1016/j.ajem.2013.06.043. Epub 2013 Jul 30. PMID: 23911102.
Atabaki et al. A Comparative Study on the Effect of Topical Phenylephrine with Topical Tranexamic Acid in Management of Epistaxis. Nurs Midwifery J. 2017; 15 (7) :488-496
Zahed R, et al. Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial. Acad Emerg Med. 2018 Mar;25(3):261-266. doi: 10.1111/acem.13345. Epub 2017 Dec 9. PMID: 29125679.
Akkan S et al. Evaluating Effectiveness of Nasal Compression With Tranexamic Acid Compared With Simple Nasal Compression and Merocel Packing: A Randomized Controlled Trial. Ann Emerg Med. 2019 Jul;74(1):72-78. doi: 10.1016/j.annemergmed.2019.03.030. Epub 2019 May 9. PMID: 31080025.
Amini et al. Topical Tranexamic Acid versus Phenylephrine-lidocaine for the Treatment of Anterior Epistaxis in Patients Taking Aspirin or Clopidogrel; a Randomized Clinical Trial. Arch Acad Emerg Med. 2020 Nov 19;9(1):e6. PMID: 33313573; PMCID: PMC7720853.
Whitworth et al. Comparative Effectiveness of Topically Administered Tranexamic Acid Versus Topical Oxymetazoline Spray for Achieving Hemostasis in Epistaxis. J Emerg Med. 2020 Feb;58(2):211-216.

COVID and Colchicine

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There’s been a lot of excitement over various drugs for COVID-19, including anti-inflammatory drugs. Colchicine, a medication long used for gout, fits that bill. In this podcast, we review 3 trials of colchicine including COLCORONA, GRECCO-19, and a study by Lopes et al.

Tocilizumab in COVID-19 – The RECOVERY trial

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In this episode, we cover the latest trial on tocilizumab, the preliminary analysis of the RECOVERY trial. While early trials were disappointing, REMAP-CAP and the RECOVERY trial have signaled mortality benefits when combined with steroids. Other tocilizumab trials include EMPACTA, TOCIBRAS, COR-IMUNO-TOCI, BACC Bay, RCT-TCZ-COVID

COVID Vaccine & Variants

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Wang et al [pre-print]

Convalescent Plasma in Older Outpatients with Mild, Early COVID-19

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In this podcast, we cover a new article on convalescent plasma – this time, one that is promising! We cover Libster et al in NEJM, an RCT that administered placebo or plasma to older outpatients with mild COVID-19.

We have covered convalescent plasma multiple times before, including this introduction in May 2020, an RCT in June 2020, and another update in August 2020.