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BMC Medicine

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https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#1
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28514961/how-many-people-will-need-palliative-care-in-2040-past-trends-future-projections-and-implications-for-services
#2
S N Etkind, A E Bone, B Gomes, N Lovell, C J Evans, I J Higginson, F E M Murtagh
BACKGROUND: Current estimates suggest that approximately 75% of people approaching the end-of-life may benefit from palliative care. The growing numbers of older people and increasing prevalence of chronic illness in many countries mean that more people may benefit from palliative care in the future, but this has not been quantified. The present study aims to estimate future population palliative care need in two high-income countries. METHODS: We used mortality statistics for England and Wales from 2006 to 2014...
May 18, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28514962/revisiting-annual-screening-for-latent-tuberculosis-infection-in-healthcare-workers-a-cost-effectiveness-analysis
#3
Guillaume A Mullie, Kevin Schwartzman, Alice Zwerling, Dieynaba S N'Diaye
BACKGROUND: In North America, tuberculosis incidence is now very low and risk to healthcare workers has fallen. Indeed, recent cohort data question routine annual tuberculosis screening in this context. We compared the cost-effectiveness of three potential strategies for ongoing screening of North American healthcare workers at risk of exposure. The analysis did not evaluate the cost-effectiveness of screening at hiring, and considered only workers with negative baseline tests. METHODS: A decision analysis model simulated a hypothetical cohort of 1000 workers following negative baseline tests, considering duties, tuberculosis exposure, testing and treatment...
May 17, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28511652/ing3-promotes-prostate-cancer-growth-by-activating-the-androgen-receptor
#4
Arash Nabbi, Urszula L McClurg, Subhash Thalappilly, Amal Almami, Mahsa Mobahat, Tarek A Bismar, Olivier Binda, Karl T Riabowol
BACKGROUND: The androgen receptor (AR) is a major driver of prostate cancer, and increased AR levels and co-activators of the receptor promote the development of prostate cancer. INhibitor of Growth (ING) proteins target lysine acetyltransferase or lysine deacetylase complexes to the histone H3K4Me3 mark of active transcription, to affect chromatin structure and gene expression. ING3 is a stoichiometric member of the TIP60 lysine acetyltransferase complex implicated in prostate cancer development...
May 16, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28494808/observational-studies-goldmines-of-information-on-rare-diseases
#5
EDITORIAL
Robert S Benjamin
The article by Savina et al. from the large METASARC database of the French Sarcoma Group (BMC Med 15:78, 2017) provides a wealth of information about the natural history and therapy of patients with metastatic soft tissue sarcomas. The information complements - and in some cases surpasses - that obtained from randomized clinical trials, and should not be overlooked because of its retrospective nature. For rare diseases, retrospective data are often more important than data from randomized trials because of the inherent restrictions on sample size...
May 12, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28490333/micronutrient-powders-to-combat-anemia-in-young-children-does-it-work
#6
Frank T Wieringa
In developing countries, anemia and iron deficiency in early childhood are two highly prevalent public health problems. Providing caregivers with a powder containing multiple vitamins and minerals (also known as micronutrient powder or MNP) as a food supplement is a widely used strategy to combat these problems. However, concerns exist around MNP programs with regards to effectiveness and potential negative impact on diarrheal disease prevalence and gut flora. Teshome et al. (BMC Medicine 15:89, 2017) recently tested a MNP with a new iron formulation, iron-EDTA, which has a potentially higher bioavailability and thus requires a lower iron content...
May 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28486979/mediation-of-the-effect-of-malaria-in-pregnancy-on-stillbirth-and-neonatal-death-in-an-area-of-low-transmission-observational-data-analysis
#7
Kerryn A Moore, Freya J I Fowkes, Jacher Wiladphaingern, Nan San Wai, Moo Kho Paw, Mupawjay Pimanpanarak, Verena I Carrara, Jathee Raksuansak, Julie A Simpson, Nicholas J White, François Nosten, Rose McGready
BACKGROUND: Malaria in pregnancy is preventable and contributes significantly to the estimated 5.5 million stillbirths and neonatal deaths that occur annually. The contribution of malaria in pregnancy in areas of low transmission has not been quantified, and the roles of maternal anaemia, small-for-gestational-age status, and preterm birth in mediating the effect of malaria in pregnancy on stillbirth and neonatal death are poorly elucidated. METHODS: We analysed observational data routinely collected at antenatal clinics on the Thai-Myanmar border (1986-2015)...
May 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28486942/habitual-coffee-consumption-and-genetic-predisposition-to-obesity-gene-diet-interaction-analyses-in-three-us-prospective-studies
#8
Tiange Wang, Tao Huang, Jae H Kang, Yan Zheng, Majken K Jensen, Janey L Wiggs, Louis R Pasquale, Charles S Fuchs, Hannia Campos, Eric B Rimm, Walter C Willett, Frank B Hu, Lu Qi
BACKGROUND: Whether habitual coffee consumption interacts with the genetic predisposition to obesity in relation to body mass index (BMI) and obesity is unknown. METHODS: We analyzed the interactions between genetic predisposition and habitual coffee consumption in relation to BMI and obesity risk in 5116 men from the Health Professionals Follow-up Study (HPFS), in 9841 women from the Nurses' Health Study (NHS), and in 5648 women from the Women's Health Initiative (WHI)...
May 9, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28472982/comparative-safety-of-anti-epileptic-drugs-during-pregnancy-a-systematic-review-and-network-meta-analysis-of-congenital-malformations-and-prenatal-outcomes
#9
Areti Angeliki Veroniki, Elise Cogo, Patricia Rios, Sharon E Straus, Yaron Finkelstein, Ryan Kealey, Emily Reynen, Charlene Soobiah, Kednapa Thavorn, Brian Hutton, Brenda R Hemmelgarn, Fatemeh Yazdi, Jennifer D'Souza, Heather MacDonald, Andrea C Tricco
BACKGROUND: Pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed anti-epileptic drugs (AEDs) to manage their symptoms. However, less is known about the comparative safety of AED exposure in utero. We aimed to compare the risk of congenital malformations (CMs) and prenatal outcomes of AEDs in infants/children who were exposed to AEDs in utero through a systematic review and Bayesian random-effects network meta-analysis...
May 5, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28468648/expedited-partner-therapy-ept-increases-the-frequency-of-partner-notification-among-msm-in-lima-peru-a-pilot-randomized-controlled-trial
#10
Jesse L Clark, Eddy R Segura, Catherine E Oldenburg, Jessica Rios, Silvia M Montano, Amaya Perez-Brumer, Manuel Villaran, Jorge Sanchez, Thomas J Coates, Javier R Lama
BACKGROUND: Expedited Partner Therapy (EPT) has been shown to improve treatment outcomes among heterosexual partners of individuals with curable sexually transmitted infections (STIs). Although the use of EPT with men who have sex with men (MSM) has been debated, due to the potential for missed opportunities to diagnose unidentified cases of HIV and syphilis infection in symptomatic partners, increases in partner notification (PN) resulting from use of EPT may promote testing and treatment of otherwise unidentified partners...
May 4, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28464883/late-presentation-of-chronic-viral-hepatitis-for-medical-care-a-consensus-definition
#11
Stefan Mauss, Stanislas Pol, Maria Buti, Erika Duffell, Charles Gore, Jeffrey V Lazarus, Hilje Logtenberg-van der Grient, Jens Lundgren, Antons Mozalevskis, Dorthe Raben, Eberhard Schatz, Stefan Wiktor, Jürgen K Rockstroh
INTRODUCTION: We present two consensus definitions of advanced and late stage liver disease being used as epidemiological tools. These definitions can be applied to assess the morbidity caused by liver diseases in different health care systems. We focus is on hepatitis B and C virus infections, because effective and well tolerated treatments for both of these infections have greatly improved our ability to successfully treat and prevent advanced and late stage disease, especially if diagnosed early...
May 3, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28464900/application-of-real-time-global-media-monitoring-and-derived-questions-for-enhancing-communication-by-regulatory-bodies-the-case-of-human-papillomavirus-vaccines
#12
Priya Bahri, Julianna Fogd, Daniel Morales, Xavier Kurz
BACKGROUND: The benefit-risk balance of vaccines is regularly debated by the public, but the utility of media monitoring for regulatory bodies is unclear. A media monitoring study was conducted at the European Medicines Agency (EMA) concerning human papillomavirus (HPV) vaccines during a European Union (EU) referral procedure assessing the potential causality of complex regional pain syndrome (CRPS) and postural orthostatic tachycardia syndrome (POTS) reported to the authorities as suspected adverse reactions...
May 2, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28464885/erratum-to-should-all-acutely-ill-children-in-primary-care-be-tested-with-point-of-care-crp-a-cluster-randomised-trial
#13
Jan Y Verbakel, Marieke B Lemiengre, Tine De Burghgraeve, An De Sutter, Bert Aertgeerts, Bethany Shinkins, Rafael Perera, David Mant, Ann Van den Bruel, Frank Buntinx
No abstract text is available yet for this article.
May 2, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28457231/disease-management-in-the-treatment-of-patients-with-chronic-heart-failure-who-have-universal-access-to-health-care-a-randomized-controlled-trial
#14
Ofra Kalter-Leibovici, Dov Freimark, Laurence S Freedman, Galit Kaufman, Arnona Ziv, Havi Murad, Michal Benderly, Barbara G Silverman, Nurit Friedman, Tali Cukierman-Yaffe, Elad Asher, Avishay Grupper, Dorit Goldman, Miriam Amitai, Shlomi Matetzky, Mordechai Shani, Haim Silber
BACKGROUND: The efficacy of disease management programs in improving the outcome of heart failure patients remains uncertain and may vary across health systems. This study explores whether a countrywide disease management program is superior to usual care in reducing adverse health outcomes and improving well-being among community-dwelling adult patients with moderate-to-severe chronic heart failure who have universal access to advanced health-care services and technologies. METHODS: In this multicenter open-label trial, 1,360 patients recruited after hospitalization for heart failure exacerbation (38%) or from the community (62%) were randomly assigned to either disease management or usual care...
May 1, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28449690/daily-home-fortification-with-iron-as-ferrous-fumarate-versus-nafeedta-a-randomised-placebo-controlled-non-inferiority-trial-in-kenyan-children
#15
Emily M Teshome, Pauline E A Andang'o, Victor Osoti, Sofie R Terwel, Walter Otieno, Ayşe Y Demir, Andrew M Prentice, Hans Verhoef
BACKGROUND: We aimed to show the non-inferiority of home fortification with a daily dose of 3 mg iron in the form of iron as ferric sodium ethylenediaminetetraacetate (NaFeEDTA) compared with 12.5 mg iron as encapsulated ferrous fumarate in Kenyan children aged 12-36 months. In addition, we updated a recent meta-analysis to assess the efficacy of home fortification with iron-containing powders, with a view to examining diversity in trial results. METHODS: We gave chemoprevention by dihydroartemisinin-piperaquine, albendazole and praziquantel to 338 afebrile children with haemoglobin concentration ≥70 g/L...
April 28, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28446169/the-relative-importance-of-large-problems-far-away-versus-small-problems-closer-to-home-insights-into-limiting-the-spread-of-antimicrobial-resistance-in-england
#16
Tjibbe Donker, Katherine L Henderson, Katie L Hopkins, Andrew R Dodgson, Stephanie Thomas, Derrick W Crook, Tim E A Peto, Alan P Johnson, Neil Woodford, A Sarah Walker, Julie V Robotham
BACKGROUND: To combat the spread of antimicrobial resistance (AMR), hospitals are advised to screen high-risk patients for carriage of antibiotic-resistant bacteria on admission. This often includes patients previously admitted to hospitals with a high AMR prevalence. However, the ability of such a strategy to identify introductions (and hence prevent onward transmission) is unclear, as it depends on AMR prevalence in each hospital, the number of patients moving between hospitals, and the number of hospitals considered 'high risk'...
April 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28441944/effects-of-unconditional-cash-transfers-on-the-outcome-of-treatment-for-severe-acute-malnutrition-sam-a-cluster-randomised-trial-in-the-democratic-republic-of-the-congo
#17
Emmanuel Grellety, Pélagie Babakazo, Amina Bangana, Gustave Mwamba, Ines Lezama, Noël Marie Zagre, Eric-Alain Ategbo
BACKGROUND: Cash transfer programs (CTPs) aim to strengthen financial security for vulnerable households. This potentially enables improvements in diet, hygiene, health service access and investment in food production or income generation. The effect of CTPs on the outcome of children already severely malnourished is not well delineated. The objective of this study was to test whether CTPs will improve the outcome of children treated for severe acute malnutrition (SAM) in the Democratic Republic of the Congo over 6 months...
April 26, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28438156/relative-contribution-of-type-1-and-type-2-diabetes-loci-to-the-genetic-etiology-of-adult-onset-non-insulin-requiring-autoimmune-diabetes
#18
Rajashree Mishra, Alessandra Chesi, Diana L Cousminer, Mohammad I Hawa, Jonathan P Bradfield, Kenyaita M Hodge, Vanessa C Guy, Hakon Hakonarson, Didac Mauricio, Nanette C Schloot, Knud B Yderstræde, Benjamin F Voight, Stanley Schwartz, Bernhard O Boehm, Richard David Leslie, Struan F A Grant
BACKGROUND: In adulthood, autoimmune diabetes can present as non-insulin-requiring diabetes, termed as 'latent autoimmune diabetes in adults' (LADA). In this study, we investigated established type 1 diabetes (T1D) and type 2 diabetes (T2D) genetic loci in a large cohort of LADA cases to assess where LADA is situated relative to these two well-characterized, classic forms of diabetes. METHODS: We tested the association of T1D and T2D GWAS-implicated loci in 978 LADA cases and 1057 non-diabetic controls of European ancestry using a linear mixed model...
April 25, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28434406/efavirenz-based-simplification-after-successful-early-lopinavir-boosted-ritonavir-based-therapy-in-hiv-infected-children-in-burkina-faso-and-c%C3%A3-te-d-ivoire-the-monod-anrs-12206-non-inferiority-randomised-trial
#19
Désiré Lucien Dahourou, Madeleine Amorissani-Folquet, Karen Malateste, Clarisse Amani-Bosse, Malik Coulibaly, Carole Seguin-Devaux, Thomas Toni, Rasmata Ouédraogo, Stéphane Blanche, Caroline Yonaba, François Eboua, Philippe Lepage, Divine Avit, Sylvie Ouédraogo, Philippe Van de Perre, Sylvie N'Gbeche, Angèle Kalmogho, Roger Salamon, Nicolas Meda, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: The 2016 World Health Organization guidelines recommend all children <3 years start antiretroviral therapy (ART) on protease inhibitor-based regimens. But lopinavir/ritonavir (LPV/r) syrup has many challenges in low-income countries, including limited availability, requires refrigeration, interactions with anti-tuberculous drugs, twice-daily dosing, poor palatability in young children, and higher cost than non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Successfully initiating LPV/r-based ART in HIV-infected children aged <2 years raises operational challenges that could be simplified by switching to a protease inhibitor-sparing therapy based on efavirenz (EFV), although, to date, EFV is not recommended in children <3 years...
April 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#20
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
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