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BMC Medicine

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https://www.readbyqxmd.com/read/27908294/outcomes-of-notifications-to-health-practitioner-boards-a-retrospective-cohort-study
#1
Matthew J Spittal, David M Studdert, Ron Paterson, Marie M Bismark
BACKGROUND: Medical boards and other practitioner boards aim to protect the public from unsafe practice. Previous research has examined disciplinary actions against doctors, but other professions (e.g., nurses and midwives, dentists, psychologists, pharmacists) remain understudied. We sought to describe the outcomes of notifications of concern regarding the health, performance, and conduct of health practitioners from ten professions in Australia and to identify factors associated with the imposition of restrictive actions...
December 2, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27903264/adult-onset-still-s-disease-evaluation-of-prognostic-tools-and-validation-of-the-systemic-score-by-analysis-of-100-cases-from-three-centers
#2
Piero Ruscitti, Paola Cipriani, Francesco Masedu, Daniela Iacono, Francesco Ciccia, Vasiliki Liakouli, Giuliana Guggino, Francesco Carubbi, Onorina Berardicurti, Paola Di Benedetto, Marco Valenti, Giovanni Triolo, Gabriele Valentini, Roberto Giacomelli
BACKGROUND: Adult-onset Still's disease (AOSD) is rare inflammatory disease of unknown etiology that usually affects young adults. The more common clinical manifestations are spiking fevers, arthritis, evanescent rash, elevated liver enzymes, lymphadenopathy, hepatosplenomegaly, and serositis. The multi-visceral involvement of the disease and the different complications, such as macrophage activation syndrome, may strongly decrease the life expectancy of AOSD patients. METHODS: This study aimed to identify the positive and negative features correlated with the outcome of patients...
December 1, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27899150/reporting-of-statistically-significant-results-at-clinicaltrials-gov-for-completed-superiority-randomized-controlled-trials
#3
Agnes Dechartres, Elizabeth G Bond, Jordan Scheer, Carolina Riveros, Ignacio Atal, Philippe Ravaud
BACKGROUND: Publication bias and other reporting bias have been well documented for journal articles, but no study has evaluated the nature of results posted at ClinicalTrials.gov. We aimed to assess how many randomized controlled trials (RCTs) with results posted at ClinicalTrials.gov report statistically significant results and whether the proportion of trials with significant results differs when no treatment effect estimate or p-value is posted. METHODS: We searched ClinicalTrials...
November 30, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27894343/post-marketing-withdrawal-of-anti-obesity-medicinal-products-because-of-adverse-drug-reactions-a-systematic-review
#4
Igho J Onakpoya, Carl J Heneghan, Jeffrey K Aronson
BACKGROUND: We identified anti-obesity medications withdrawn since 1950 because of adverse drug reactions after regulatory approval, and examined the evidence used to support such withdrawals, investigated the mechanisms of the adverse reactions, and explored the trends over time. METHODS: We conducted searches in PubMed, the World Health Organization database of drugs, the websites of drug regulatory authorities, and selected full texts, and we hand searched references in retrieved documents...
November 29, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27894295/impact-of-a-web-based-tool-webconsort-to-improve-the-reporting-of-randomised-trials-results-of-a-randomised-controlled-trial
#5
Sally Hopewell, Isabelle Boutron, Douglas G Altman, Ginny Barbour, David Moher, Victor Montori, David Schriger, Jonathan Cook, Stephen Gerry, Omar Omar, Peter Dutton, Corran Roberts, Eleni Frangou, Lei Clifton, Virginia Chiocchia, Ines Rombach, Karolina Wartolowska, Philippe Ravaud
BACKGROUND: The CONSORT Statement is an evidence-informed guideline for reporting randomised controlled trials. A number of extensions have been developed that specify additional information to report for more complex trials. The aim of this study was to evaluate the impact of using a simple web-based tool (WebCONSORT, which incorporates a number of different CONSORT extensions) on the completeness of reporting of randomised trials published in biomedical publications. METHODS: We conducted a parallel group randomised trial...
November 28, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27884190/how-do-you-design-randomised-trials-for-smaller-populations-a-framework
#6
Mahesh K B Parmar, Matthew R Sydes, Tim P Morris
How should we approach trial design when we can get some, but not all, of the way to the numbers required for a randomised phase III trial?We present an ordered framework for designing randomised trials to address the problem when the ideal sample size is considered larger than the number of participants that can be recruited in a reasonable time frame. Staying with the frequentist approach that is well accepted and understood in large trials, we propose a framework that includes small alterations to the design parameters...
November 25, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27884150/identifying-and-prioritizing-lower-value-services-from-dutch-specialist-guidelines-and-a-comparison-with-the-uk-do-not-do-list
#7
Joost Johan Godert Wammes, M Elske van den Akker-van Marle, Eva W Verkerk, Simone A van Dulmen, Gert P Westert, Antoinette D I van Asselt, R B Kool
BACKGROUND: The term 'lower value services' concerns healthcare that is of little or no value to the patient and consequently should not be provided routinely, or not be provided at all. De-adoption of lower value care may occur through explicit recommendations in clinical guidelines. The present study aimed to generate a comprehensive list of lower value services for the Netherlands that assesses the type of care and associated medical conditions. The list was compared with the NICE do-not-do list (United Kingdom)...
November 25, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27884148/a-framework-make-it-useful-to-guide-and-improve-practice-of-clinical-trial-design-in-smaller-populations
#8
EDITORIAL
Kit C B Roes
The increased attention to design and analysis of randomised clinical trials in small populations has triggered thinking regarding the most appropriate design methods for a particular clinical research question. Decision schemes and algorithms have been proposed, with varying starting points and foci. Parmar et al. (BMC Medicine 14:183, 2016) proposed a framework designed to assist the clinical trial team in design choices during protocol preparation. Herein, further stimulus is given regarding the extent to which a framework may help change practice for the better, the careful considerations for changing the usual error levels applied and the room for innovation in clinical trial design...
November 25, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27881167/differing-association-of-alcohol-consumption-with-different-stroke-types-a-systematic-review-and-meta-analysis
#9
Susanna C Larsson, Alice Wallin, Alicja Wolk, Hugh S Markus
BACKGROUND: Whether light-to-moderate alcohol consumption is protective against stroke, and whether any association differs by stroke type, is controversial. We conducted a meta-analysis to summarize the evidence from prospective studies on alcohol drinking and stroke types. METHODS: Studies were identified by searching PubMed to September 1, 2016, and reference lists of retrieved articles. Additional data from 73,587 Swedish adults in two prospective studies were included...
November 24, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27881133/alcohol-and-stroke-the-splitters-win-again
#10
EDITORIAL
Arthur L Klatsky, H Nicole Tran
Study of the relationships of alcohol drinking and risk of stroke can readily become mired in the labyrinthine interactions of drinking categorizations, non-linear associations, disparate cardiovascular conditions, and the heterogeneous types of stroke. This Commentary discusses the recent article by Larsson et al. (BMC Medicine 14:178, 2016). The authors split their material into separate meta-analyses of subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke, finding disparate alcohol-stroke relationships...
November 24, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27876024/evaluation-of-computer-based-computer-tomography-stratification-against-outcome-models-in-connective-tissue-disease-related-interstitial-lung-disease-a-patient-outcome-study
#11
Joseph Jacob, Brian J Bartholmai, Srinivasan Rajagopalan, Anne Laure Brun, Ryoko Egashira, Ronald Karwoski, Maria Kokosi, Athol U Wells, David M Hansell
BACKGROUND: To evaluate computer-based computer tomography (CT) analysis (CALIPER) against visual CT scoring and pulmonary function tests (PFTs) when predicting mortality in patients with connective tissue disease-related interstitial lung disease (CTD-ILD). To identify outcome differences between distinct CTD-ILD groups derived following automated stratification of CALIPER variables. METHODS: A total of 203 consecutive patients with assorted CTD-ILDs had CT parenchymal patterns evaluated by CALIPER and visual CT scoring: honeycombing, reticular pattern, ground glass opacities, pulmonary vessel volume, emphysema, and traction bronchiectasis...
November 23, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27871281/physical-multimorbidity-and-psychosis-comprehensive-cross-sectional-analysis-including-242-952-people-across-48-low-and-middle-income-countries
#12
Brendon Stubbs, Ai Koyanagi, Nicola Veronese, Davy Vancampfort, Marco Solmi, Fiona Gaughran, André F Carvalho, John Lally, Alex J Mitchell, James Mugisha, Christoph U Correll
BACKGROUND: In people with psychosis, physical comorbidities, including cardiovascular and metabolic diseases, are highly prevalent and leading contributors to the premature mortality encountered. However, little is known about physical health multimorbidity in this population or in people with subclinical psychosis and in low- and middle-income countries (LMICs). This study explores physical health multimorbidity patterns among people with psychosis or subclinical psychosis. METHODS: Overall, data from 242,952 individuals from 48 LMICs, recruited via the World Health Survey, were included in this cross-sectional study...
November 22, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27866470/the-inevitable-colonisation-of-singapore-by-zika-virus
#13
EDITORIAL
Dale Fisher, Jeffery Cutter
Singapore is endemic for Dengue virus, with approximately 10,000 to 20,000 annual cases reported in recent years. In 2012, Chikungunya was introduced, although the numbers of cases reported is much fewer. The current Zika virus pandemic originating in Brazil represents a threat to all regions with Aedes mosquitoes, particularly those well connected by travellers. In this respect, it was felt inevitable that Singapore would eventually realise its third endemic flavivirus. In late August 2016, a primary care practitioner observed a cluster of geographically linked patients attending with fever and rash...
November 21, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27855693/modelling-the-effect-of-short-course-multidrug-resistant-tuberculosis-treatment-in-karakalpakstan-uzbekistan
#14
James M Trauer, Jay Achar, Nargiza Parpieva, Atadjan Khamraev, Justin T Denholm, Dennis Falzon, Ernesto Jaramillo, Anita Mesic, Philipp du Cros, Emma S McBryde
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a major threat to global TB control. MDR-TB treatment regimens typically have a high pill burden, last 20 months or more and often lead to unsatisfactory outcomes. A 9-11 month regimen with seven antibiotics has shown high success rates among selected MDR-TB patients in different settings and is conditionally recommended by the World Health Organization. METHODS: We construct a transmission-dynamic model of TB to estimate the likely impact of a shorter MDR-TB regimen when applied in a low HIV prevalence region of Uzbekistan (Karakalpakstan) with high rates of drug resistance, good access to diagnostics and a well-established community-based MDR-TB treatment programme providing treatment to around 400 patients...
November 18, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27852253/genomic-profiling-for-copy-number-changes-in-plasma-of-ovarian-cancer-patients-a-new-era-for-cancer-diagnostics
#15
EDITORIAL
Vathany Kulasingam, Eleftherios P Diamandis
A blood test that can detect human malignancy with high clinical sensitivity and specificity is highly desirable. To achieve this, a tumor marker is needed that correlates with tumor burden and that can be measured with high analytical sensitivity and specificity. Over the past decades, a number of different types of tumor markers have emerged, including proteins such as enzymes, glycoproteins, and oncofetal antigens. Besides proteins, genetic abnormalities such as mutations, amplifications, and circulating tumor DNA have served as tumor markers...
November 17, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27846837/prevalence-aetiology-treatment-and-outcomes-of-shock-in-children-admitted-to-kenyan-hospitals
#16
George Mbevi, Philip Ayieko, Grace Irimu, Samuel Akech, Mike English
BACKGROUND: Shock may complicate several acute childhood illnesses in hospitals within low-income countries and has a high case fatality. Hypovolemic shock secondary to diarrhoea/dehydration and septic shock are thought to be common, but there are few reliable data on prevalence or treatment that differ for the two major forms of shock. Examining prevalence and treatment practices has become important since reports suggest high risks from liberal use of fluid boluses in African children...
November 16, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27842554/men1-redefined-a-clinical-comparison-of-mutation-positive-and-mutation-negative-patients
#17
Joanne M de Laat, Rob B van der Luijt, Carolina R C Pieterman, Maria P Oostveen, Ad R Hermus, Olaf M Dekkers, Wouter W de Herder, Anouk N van der Horst-Schrivers, Madeleine L Drent, Peter H Bisschop, Bas Havekes, Menno R Vriens, Gerlof D Valk
BACKGROUND: Multiple Endocrine Neoplasia type 1 (MEN1) is diagnosed when two out of the three primary MEN1-associated endocrine tumors occur in a patient. Up to 10-30 % of those patients have no mutation in the MEN1 gene. It is unclear if the phenotype and course of the disease of mutation-negative patients is comparable with mutation-positive patients and if these patients have true MEN1. The present study aims to describe and compare the clinical course of MEN1 mutation-negative patients with two out of the three main MEN1 manifestations and mutation-positive patients during long-term follow-up...
November 15, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27842541/heterogeneous-response-and-progression-patterns-reveal-phenotypic-heterogeneity-of-tyrosine-kinase-inhibitor-response-in-metastatic-renal-cell-carcinoma
#18
Shanthini M Crusz, Yen Zhi Tang, Shah-Jalal Sarker, Warner Prevoo, Irfan Kiyani, Luis Beltran, John Peters, Anju Sahdev, Axel Bex, Thomas Powles, Marco Gerlinger
BACKGROUND: Molecular intratumour heterogeneity (ITH) is common in clear cell renal carcinomas (ccRCCs). However, it remains unknown whether this is mirrored by heterogeneity of drug responses between metastases in the same patient. METHODS: We performed a retrospective central radiological analysis of patients with treatment-naïve metastatic ccRCC receiving anti-angiogenic tyrosine kinase inhibitors (TKIs) (sunitinib or pazopanib) within three similar phase II trials...
November 14, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27832792/gout-will-the-king-of-diseases-be-the-first-rheumatic-disease-to-be-cured
#19
EDITORIAL
Jasvinder A Singh
Gout is the most common inflammatory arthritis in adults in the Western world. Characterized by hyperuricemia and the effects of acute and chronic inflammation in joints and bursa, gout leads to an agonizing, chronically painful arthritis. Arthritis can also be accompanied by urate nephropathy and subcutaneous urate deposits (tophi). Exciting new developments in the last decade have brought back the focus on this interesting, crystal-induced chronic inflammatory condition. New insights include the role of NALP3 inflammasome-induced inflammation in acute gout, the characterization of diagnostic signs on ultrasound and dual-energy computed tomography imaging modalities, the recognition of target serum urate less than 6 mg/day as the goal for urate-lowering therapies, and evidence-based treatment guidelines...
November 11, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27829460/renal-function-estimation-and-cockroft-gault-formulas-for-predicting-cardiovascular-mortality-in-population-based-cardiovascular-risk-heart-failure-and-post-myocardial-infarction-cohorts-the-heart-omics-in-ageing-homage-and-the-high-risk-myocardial-infarction
#20
João Pedro Ferreira, Nicolas Girerd, Pierpaolo Pellicori, Kevin Duarte, Sophie Girerd, Marc A Pfeffer, John J V McMurray, Bertram Pitt, Kenneth Dickstein, Lotte Jacobs, Jan A Staessen, Javed Butler, Roberto Latini, Serge Masson, Alexandre Mebazaa, Hans Peter Brunner-La Rocca, Christian Delles, Stephane Heymans, Naveed Sattar, J Wouter Jukema, John G Cleland, Faiez Zannad, Patrick Rossignol
BACKGROUND: Renal impairment is a major risk factor for mortality in various populations. Three formulas are frequently used to assess both glomerular filtration rate (eGFR) or creatinine clearance (CrCl) and mortality prediction: body surface area adjusted-Cockcroft-Gault (CG-BSA), Modification of Diet in Renal Disease Study (MDRD4), and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The CKD-EPI is the most accurate eGFR estimator as compared to a "gold-standard"; however, which of the latter is the best formula to assess prognosis remains to be clarified...
November 10, 2016: BMC Medicine
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