geoffrey modest medical blogs

  A current  JAMA letter to the editor  ( cdiff recurrent microbiome transplant jama2022  in dropbox, or doi:10.1001/jama.2022.16476)   is a follow-up to the previous article in NEJM nine months earlier by the same research group (for the full earlier article, see   cdiff SER-109 microbiome treatment for recurrent CDI nejm2022   in dropbox, or DOI: 10.1056/NEJMoa2106516, the ECOSPOR III trial). The former article reported C. diff recurrences up until 8 weeks after microbiome transplant, finding a 68% risk reduction independent of patient age or antibiotics received, and that most of the adverse effects were mild to moderate gastrointestinal ones, similar to that found with placebo   Details : -- 182 patients who had at least three C difficile infection (CDI) episodes within 12 months  were enrolled in the trial and randomized  to four capsules daily of SER-109 for three days -- all patients had a positive C. difficile test for toxin...

  A recent article confirmed the superiority of prescribing budesonide/formoterol (eg symbicort, and its ilk) as both the maintenance and the rescue inhaler, in a Korean real-world study (see  asthma symbicort as maint and rescue best JAlerCLinImmunPractice2022  in dropbox, or  doi.org/10.1016/j.jaip.2022.06.009   Brief background: there were 2 pivotal studies (SYGMA1 and SYGMA2) that set in motion a profound change in treating adult asthmatic patients, codified in the quite impressive global GINA recommendations of 2019:  http://gmodestmedblogs.blogspot.com/2019/10/new-and-improved-asthma-guidelines.html  . see below for more   Details : -- retrospective data analysis from the medical records of the Ajou University Medical Center in Korea of adult asthmatics, from 2008 to 2021 -- patients were divided into and propensity score-matched for MART (Maintenance and Reliever Therapy, using inhaled corticosteroid with formoterol) versus non-MART (using ...