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https://www.readbyqxmd.com/read/28319804/are-diabetes-guidelines-truly-evidence-based
#1
REVIEW
Matthew F Bouchonville, Sara Matani, Jason J DuBroff, Robert J DuBroff
The global epidemic of obesity and diabetes underscores the urgency to develop strategies to prevent cardiovascular (CV) disease in this vulnerable population. Clinical guidelines are intended to help the clinician manage these patients, but guidelines are often discordant among professional organizations and not always evidence based. Clinicians must rely upon the best available evidence, and therefore we critically reviewed the evidence behind the American Diabetes Association (ADA) 2016 guidelines on the prevention of CV disease in diabetes...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319564/improvement-in-the-outcomes-of-meld-%C3%A2-40-liver-transplantation-an-analysis-of-207-consecutive-transplants-in-a-highly-competitive-dsa
#2
Victor Nekrasov, Lea Matsuoka, Navpreet Kaur, Alejandro Pita, Gilbert Whang, Shu Cao, Susan Groshen, Sophoclis Alexopoulos
BACKGROUND: Organ donor shortages continue to persist, especially in regions of the United States where competition is highest and recipients frequently attain a MELD score ≥ 40 prior to transplantation. The benefits of Share 35 in highly competitive regions may be underestimated when examining the collective national experience. The purpose of this study is to examine the outcomes of liver transplantation in recipients with a MELD ≥ 40 after implementation of Share 35 in a single center located in region 5...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28319436/estimating-the-risks-of-breast-cancer-radiotherapy-evidence-from-modern-radiation-doses-to-the-lungs-and-heart-and-from-previous-randomized-trials
#3
Carolyn Taylor, Candace Correa, Frances K Duane, Marianne C Aznar, Stewart J Anderson, Jonas Bergh, David Dodwell, Marianne Ewertz, Richard Gray, Reshma Jagsi, Lori Pierce, Kathleen I Pritchard, Sandra Swain, Zhe Wang, Yaochen Wang, Tim Whelan, Richard Peto, Paul McGale
Purpose Radiotherapy reduces the absolute risk of breast cancer mortality by a few percentage points in suitable women but can cause a second cancer or heart disease decades later. We estimated the absolute long-term risks of modern breast cancer radiotherapy. Methods First, a systematic literature review was performed of lung and heart doses in breast cancer regimens published during 2010 to 2015. Second, individual patient data meta-analyses of 40,781 women randomly assigned to breast cancer radiotherapy versus no radiotherapy in 75 trials yielded rate ratios (RRs) for second primary cancers and cause-specific mortality and excess RRs (ERRs) per Gy for incident lung cancer and cardiac mortality...
March 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28318984/safety-and-efficacy-of-thrombectomy-in-acute-ischaemic-stroke-revascat-1-year-follow-up-of-a-randomised-open-label-trial
#4
Antoni Dávalos, Erik Cobo, Carlos A Molina, Angel Chamorro, M Angeles de Miquel, Luis San Román, Joaquín Serena, Elena López-Cancio, Marc Ribó, Mónica Millán, Xabier Urra, Pere Cardona, Alejandro Tomasello, Carlos Castaño, Jordi Blasco, Lucía Aja, Marta Rubiera, Meritxell Gomis, Arturo Renú, Blanca Lara, Joan Martí-Fàbregas, Brian Jankowitz, Neus Cerdà, Tudor G Jovin
BACKGROUND: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. METHODS: Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone...
March 16, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28318654/safety-and-efficacy-of-drug-eluting-stents-in-patients-with-spontaneous-coronary-artery-dissection
#5
Federico Conrotto, Fabrizio D'Ascenzo, Enrico Cerrato, Antonio Fernandez Ortiz, Nieves Gonzalo, Carlos Macaya, Corrado Tamburino, Marco Barbanti, Martijn van Lavieren, Jan J Piek, Robert J Applegate, Azeem Latib, Maria Teresa Spinnler, Raffaella Marzullo, Mario Iannaccone, Marco Pavani, Gabriele Crimi, Rossella Fattori, Alessandra Chinaglia, Patrizia Presbitero, Ferdinando Varbella, Fiorenzo Gaita, Javier Escaned
AIMS: Given the different pathogenesis, use of drug eluting stent (DES) in patients with Spontaneous Coronary Artery Dissection SCAD may delay the healing of the dissected vessel. Aim of our study was to compare the safety and the efficacy of DES vs. bare metal stent (BMS) in a cohort of patients who underwent stenting for SCAD. METHODS AND RESULTS: Consecutive patients with SCAD between January 1995 and August 2014 were retrospectively identified in 12 centers and included...
March 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318621/early-peritoneal-dialysis-reduces-lung-inflammation-in-mice-with-ischemic-acute-kidney-injury
#6
Chris Altmann, Nilesh Ahuja, Carol M Kiekhaefer, Ana Andres Hernando, Kayo Okamura, Rhea Bhargava, Jane Duplantis, Lara A Kirkbride-Romeo, Jill Huckles, Benjamin M Fox, Kashfi Kahn, Danielle Soranno, Hyo-Wook Gil, Isaac Teitelbaum, Sarah Faubel
Although dialysis has been used in the care of patients with acute kidney injury (AKI) for over 50 years, very little is known about the potential benefits of uremic control on systemic complications of AKI. Since the mortality of AKI requiring renal replacement therapy (RRT) is greater than half in the intensive care unit, a better understanding of the potential of RRT to improve outcomes is urgently needed. Therefore, we sought to develop a technically feasible and reproducible model of RRT in a mouse model of AKI...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28318052/systematic-review-benefits-and-harms-of-transarterial-embolisation-for-treating-hepatocellular-adenoma
#7
REVIEW
C Zhao, S-L Pei, A Cucchetti, T-J Tong, Y-L Ma, J-H Zhong, L-Q Li
BACKGROUND: Transarterial embolisation (TAE) is a standard treatment for bleeding hepatocellular adenoma (HCA) and, occasionally, symptomatic HCA involving large tumours. Whether TAE is similarly safe and effective as an elective treatment for bleeding and nonbleeding HCA remains unclear. AIM: To investigate the benefits and harms of TAE for bleeding and nonbleeding HCA. METHODS: PubMed, Scopus, Embase and Cochrane Library databases were systematically searched for studies that examined post-TAE tumour reduction in patients with bleeding or nonbleeding HCA and that were published between January 2000 and January 2017...
March 20, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28318008/meta-analysis-of-prophylactic-abdominal-drainage-in-pancreatic-surgery
#8
REVIEW
F J Hüttner, P Probst, P Knebel, O Strobel, T Hackert, A Ulrich, M W Büchler, M K Diener
BACKGROUND: Intra-abdominal drains are frequently used after pancreatic surgery whereas their benefit in other gastrointestinal operations has been questioned. The objective of this meta-analysis was to compare abdominal drainage with no drainage after pancreatic surgery. METHODS: PubMed, the Cochrane Library and Web of Science electronic databases were searched systematically to identify RCTs comparing abdominal drainage with no drainage after pancreatic surgery...
March 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28317585/meta-analysis-and-cost-effective-analysis-of-portal-superior-mesenteric-vein-resection-during-pancreatoduodenectomy-impact-on-margin-status-and-survival
#9
REVIEW
Richard Bell, Braden Te Ao, Natasha Ironside, Adam Bartlett, John A Windsor, Sanjay Pandanaboyana
INTRODUCTION: The benefit of portal-superior mesenteric vein resection (PSMVR) with pancreatoduodenectomy (PD) remains controversial. This study assesses the impact of PSMVR on resection margin status and survival. METHOD: An electronic search was performed to identify relevant articles. Pooled odds ratios were calculated for outcomes using the fixed or random-effects models for meta-analysis. A decision analytical model was developed for estimating cost effectiveness...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28317421/a-prospective-cohort-study-evaluating-the-cost-effectiveness-of-carbetocin-for-prevention-of-postpartum-haemorrhage-in-caesarean-sections
#10
Yasmin Luni, Aditya Borakati, Arti Matah, Katie Skeats, Padma Eedarapalli
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylaxis with oxytocic medication is recommended by the WHO to prevent its occurrence. Carbetocin is a newer oxytocic, with potential to lower PPH rates, reduce the total use of oxytocic drugs and lead to financial savings. Meta-analyses have confirmed a reduction in the use of additional oxytocic medication with the use of carbetocin compared to oxytocin. However, there are few studies evaluating the costs of carbetocin prophylaxis...
March 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28317290/the-effect-of-engagement-in-an-hiv-aids-integrated-health-programme-on-plasma-hiv-1-rna-suppression-among-hiv-positive-people-who-use-illicit-drugs-a-marginal-structural-modelling-analysis
#11
L Ti, H Dong, T Kerr, R B Turje, S Parashar, J E Min, J Montaner, E Wood, M-J Milloy
OBJECTIVES: HIV treatment-as-prevention campaigns emphasize early diagnosis and immediate access to care and antiretroviral therapy for HIV-positive individuals in order to increase levels of plasma HIV RNA viral load (VL) suppression. However, the possible role of harm reduction-based programmes in this objective has not yet been well evaluated. The objective of the study was to examine the relationship between being a client of the Dr. Peter Centre (DPC; an HIV/AIDS-focused adult integrated health programme) and VL suppression among highly active antiretroviral therapy (HAART)-exposed HIV-positive people who use illicit drugs (PWUD) in Vancouver, Canada...
March 19, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28316104/implantable-cardioverter-defibrillators-for-primary-prevention-of-mortality-in-patients-with-non-ischemic-cardiomyopathy-a-meta-analysis-of-randomized-controlled-trials
#12
Stavros Stavrakis, Zain Asad, Dwight Reynolds
BACKGROUND: Implantable cardioverter defibrillators (ICDs) improve survival in patients with heart failure due to ischemic cardiomyopathy, but their benefit in non-ischemic cardiomyopathy (NICM) has been recently questioned. We performed a meta-analysis of randomized clinical trials to examine the effect of ICDs on total mortality and arrhythmic death in patients with NICM. We also examined the impact of age and cardiac resynchronization therapy (CRT) on the relative effect of ICD compared to control...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28316006/management-of-heart-failure-with-preserved-ejection-fraction-current-challenges-and-future-directions
#13
REVIEW
Bharathi Upadhya, Dalane W Kitzman
Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF in patients older than 65 years. Among elderly women living in the community, HFpEF comprises nearly 90% of incident HF cases. The health and economic impact of HFpEF is at least as great as that of HF with reduced ejection fraction (HFrEF), with similar severity of acute hospitalization rates and substantial mortality. Despite the importance of HFpEF, our understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined...
March 18, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28315902/postoperative-radioactive-iodine-131-ablation-is-not-necessary-among-patients-with-intermediate-risk-differentiated-thyroid-carcinoma-a-population-based-study
#14
Hong Zhang, Yuechang Cai, Li Zheng, Zhanlei Zhang, Ningyi Jiang
OBJECTIVE: To assess the effectiveness of radioactive iodine (RAI) ablation among patients with intermediate-risk differentiated thyroid cancer (DTC) following surgery. SUBJECTS AND METHODS: This population based study obtained information from the Surveillance, Epidemiology, and End Results (SEER) Program Research Data (1973-2013). National Cancer Institute, DCCPS, Surveillance Research Programme, Surveillance Systems Branch, released April 2016, based on the November 2015 submission...
March 20, 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28315856/an-update-on-hla-alleles-associated-with-adverse-drug-reactions
#15
Ingrid Fricke-Galindo, Adrián LLerena, Marisol López-López
Adverse drug reactions (ADRs) are considered as an important cause of morbidity and mortality. The hypersensitivity reactions are immune-mediated ADRs, which are dose-independent, unpredictable and have been associated with several HLA alleles. The present review aimed to describe HLA alleles that have been associated with different ADRs in populations worldwide, the recommendations of regulatory agencies and pharmacoeconomic information and databases for the study of HLA alleles in pharmacogenetics. A systematic search was performed in June 2016 of articles relevant to this issue in indexed journals and in scientific databases (PubMed and PharmGKB)...
March 18, 2017: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/28315826/early-invasive-strategy-and-in-hospital-survival-among-diabetics-with-non-st-elevation-acute-coronary-syndromes-a-contemporary-national-insight
#16
Ahmed N Mahmoud, Islam Y Elgendy, Hend Mansoor, Xuerong Wen, Mohammad K Mojadidi, Anthony A Bavry, R David Anderson
BACKGROUND: There are limited data on the merits of an early invasive strategy in diabetics with non-ST-elevation acute coronary syndrome, with unclear influence of this strategy on survival. The aim of this study was to evaluate the in-hospital survival of diabetics with non-ST-elevation acute coronary syndrome treated with an early invasive strategy compared with an initial conservative strategy. METHODS AND RESULTS: The National Inpatient Sample database, years 2012-2013, was queried for diabetics with a primary diagnosis of non-ST-elevation acute coronary syndrome defined as either non-ST-elevation myocardial infarction or unstable angina (unstable angina)...
March 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28314731/long-term-outcomes-of-provisional-stenting-compared-with-a-two-stent-strategy-for-bifurcation-lesions-a-meta-analysis-of-randomised-trials
#17
Ramez Nairooz, Marwan Saad, Islam Y Elgendy, Ahmed N Mahmoud, Fuad Habash, Partha Sardar, David Anderson, David M Shavelle, J Dawn Abbott
BACKGROUND: The optimal interventional technique for addressing coronary bifurcation lesions is debatable. Long-term clinical outcomes with provisional stenting (PS) compared with a two-stent (TS) strategy for bifurcation lesions are scarce. We aim to perform the first meta-analysis of randomised controlled trials (RCTs) to explore long-term outcomes comparing both strategies. METHODS: An electronic search was performed for online databases until August 2016 for RCTs comparing PS with TS for bifurcation lesions reporting outcomes at 1 year of follow-up or more...
March 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28314588/risk-of-breast-cancer-after-a-diagnosis-of-ovarian-cancer-in-brca-mutation-carriers-is-preventive-mastectomy-warranted
#18
Jacob McGee, Vasily Giannakeas, Beth Karlan, Jan Lubinski, Jacek Gronwald, Barry Rosen, John McLaughlin, Harvey Risch, Ping Sun, William D Foulkes, Susan L Neuhausen, Joanne Kotsopoulos, Steven A Narod
OBJECTIVE: Preventive breast surgery and MRI screening are offered to unaffected BRCA mutation carriers. The clinical benefit of these two modalities has not been evaluated among mutation carriers with a history of ovarian cancer. Thus, we sought to determine whether or not BRCA mutation carriers with ovarian cancer would benefit from preventive mastectomy or from MRI screening. METHODS: First, the annual mortality rate for ovarian cancer patients was estimated for a cohort of 178 BRCA mutation carriers from Ontario, Canada...
March 14, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#19
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28304120/comparative-effectiveness-of-chemotherapy-versus-resection-of-the-primary-tumor-as-the-initial-treatment-in-older-patients-with-stage-iv-colorectal-cancer
#20
Hemalkumar B Mehta, Gabriela M Vargas, Deepak Adhikari, Francesca Dimou, Taylor S Riall
AIM: The objective was to determine trends in the use of chemotherapy as the initial treatment and evaluate the comparative effectiveness of initial chemotherapy versus resection of the primary tumour on survival (intention-to-treat analysis) in stage IV colorectal cancer (CRC). METHODS: This cohort study used Surveillance Epidemiology, and End Results (SEER)-Medicare (2000-2011) data, including patients ≥66 years presenting with stage IV CRC. Cox proportional hazards models and instrumental variable analysis were used to determine the association of chemotherapy versus resection of the primary tumour as the initial treatment with 2-year survival...
March 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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