geoffrey modest medical blogs

  A new trial of remdesivir for treatment of patients with moderate Covid-19 pneumonia found a statistically significant difference in clinical status with the medication, though the difference was of uncertain clinical importance ( see  covid remdesivir review jama2020  in dropbox, or doi:10.1001/jama.2020.16349 )    Details: -- 580 for patients with confirmed SARS-CoV-2 infection by PCR and moderate Covid-19 pneumonia (pulmonary infiltrates and room air oxygen saturation >94%) were randomized to receive a 10-day course of remdesivir, a 5-day course of remdesivir, or standard care. Remdesivir was dosed at 200 mg on day one followed by 100 mg per day IV, in an open label trial in 105 hospitals in the US, Europe, and Asia between March 15 and April 18 -- median age 57, 39% women, 58% white/18% black/18% Asian/18% Hispanic, BMI 27, 84% were at clinical status 5 (see below) -- 56% had cardiovascular disease at baseline, 42% hypertension, 40% diabetes, and 1...

There was a small but (I think) important study showing that blood pressure measurement technique by medical students was strikingly inaccurate (see   doi:10.1001/jama.2017.11255 ). This was a quite brief report without a lot of details about their methodology.   Details: --159 medical students were asked to check the blood pressure on a simulated patient --they were assessed for the 11 elements identified as necessary to get an accurate blood pressure measurement, which included:     --using the correct cuff size, correctly placing the cuff over a bare arm, asking patient not to talk during the measurement, having patients uncross their legs, making sure that the patient's feet were flat on the floor, asking patient not to use their cellphones or read during the measurement, supporting the arm, checking the BP in both arms, noting which arm had the higher BP, correctly answering which arm should be used for future measurements, an...