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https://www.readbyqxmd.com/read/28426519/toward-a-universal-antiretroviral-regimen-special-considerations-of-pregnancy-and-breast-feeding
#1
Amy L Slogrove, Polly Clayden, Elaine J Abrams
PURPOSE OF REVIEW: As optimized antiretroviral therapy (ART) regimens are prepared for introduction in low-income and middle-income countries (LMIC), we consider the current evidence related to dosing, efficacy and safety during pregnancy and breastfeeding of next-generation first-line and second-line ART regimens proposed for imminent introduction in the global marketplace. RECENT FINDINGS: Pregnancy pharmacokinetic considerations include potentially insufficient efavirenz exposure if dosed at 400 mg/day, the need for twice daily darunavir dosing and the paucity of data related to tenofovir alafenamide and dolutegravir dosing, safety and efficacy...
April 19, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28426239/performance-of-an-artificial-pancreas-system-for-young-children-with-type-1-diabetes
#2
Mark D DeBoer, Marc D Breton, Christian Wakeman, Elaine M Schertz, Emma G Emory, Jessica L Robic, Laura L Kollar, Boris P Kovatchev, Daniel R Cherñavvsky
BACKGROUND: Young children 5-8 years old with type 1 diabetes (T1D) exhibit clear needs for improved glycemic control but may be limited in their ability to safely interact with an artificial pancreas system. Our goal was to evaluate the safety and performance of an artificial pancreas (AP) system among young children with T1D. RESEARCH DESIGN AND METHODS: In a randomized, crossover trial, children with T1D age 5-8 years were enrolled to receive on separate study periods (in random order) either the UVa AP using the DiAs Control Platform software with child-resistant lock-out screens (followed as an out-patient admission) or their usual insulin pump+continuous glucose monitor (CGM) care at home...
April 20, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28419200/switching-to-efavirenz-versus-remaining-on-ritonavir-boosted-lopinavir-in-hiv-infected-children-exposed-to-nevirapine-long-term-outcomes-of-a-randomized-trial
#3
Pamela M Murnane, Renate Strehlau, Stephanie Shiau, Faeezah Patel, Ndileke Mbete, Gillian Hunt, Elaine J Abrams, Ashraf Coovadia, Louise Kuhn
Background: We previously demonstrated the non-inferiority of switching to efavirenz (EFV) versus remaining on ritonavir-boosted lopinavir (LPV/r) for virologic control in HIV-infected children exposed to nevirapine (NVP) for prevention of mother-to-child transmission. Here we assess outcomes up to four years post-randomization. Methods: From 2010-2013, 298 NVP-exposed HIV-infected children ≥3 years of age were randomized to switch to EFV or remain on LPV/r in Johannesburg, South Africa (Clinicaltrials...
April 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28419124/a-randomised-controlled-trial-of-losartan-as-an-anti-fibrotic-agent-in-non-alcoholic-steatohepatitis
#4
Stuart McPherson, Nina Wilkinson, Dina Tiniakos, Jennifer Wilkinson, Alastair D Burt, Elaine McColl, Deborah D Stocken, Nick Steen, Jane Barnes, Nicola Goudie, Stephen Stewart, Yvonne Bury, Derek Mann, Quentin M Anstee, Christopher P Day
INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease worldwide. Experimental and small clinical trials have demonstrated that angiotensin II blockers (ARB) may be anti-fibrotic in the liver. The aim of this randomised controlled trial was to assess whether treatment with Losartan for 96 weeks slowed, halted or reversed the progression of fibrosis in patients with non-alcoholic steatohepatitis (NASH). METHODS: Double-blind randomised-controlled trial of Losartan 50 mg once a day versus placebo for 96 weeks in patients with histological evidence of NASH...
2017: PloS One
https://www.readbyqxmd.com/read/28415776/targeting-protein-homeostasis-with-nelfinavir-salinomycin-dual-therapy-effectively-induces-death-of-mtorc1-hyperactive-cells
#5
Elaine A Dunlop, Charlotte E Johnson, Marie Wiltshire, Rachel J Errington, Andrew R Tee
Uncontrolled cell growth in Tuberous Sclerosis Complex occurs due to inappropriate activation of mechanistic (mammalian) target of rapamycin complex 1 (mTORC1). The current therapy, rapamycin, produced promising clinical trial results, but patient tumours regrow if treatment is discontinued, revealing rapamycin has cytostatic properties rather than a cytotoxic effect. Taking advantage of the enhanced levels of endoplasmic reticulum (ER) stress present in TSC2-null cells, we investigated drug combinations producing a cytotoxic response...
March 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28408714/association-between-peritoneal-glucose-exposure-and-peritonitis-in-peritoneal-dialysis-patients-the-balanz-trial
#6
Melissa Nataatmadja, Yeoungjee Cho, Elaine M Pascoe, Darsy Darssan, Carmel M Hawley, David W Johnson
♦Background: Glucose is the primary osmotic medium used in most peritoneal dialysis (PD) solutions, and exposure to glucose has been shown to exert detrimental effects both locally, at the peritoneal membrane, and systemically. Moreover, high dialysate glucose exposure may predispose patients to an increased risk of peritonitis, perhaps as a result of impaired host defences, vascular disease, and damage to the peritoneal membrane. ♦ Methods: In this post-hoc analysis of a multicenter, multi-national, open-label randomized controlled trial of neutral pH, low-glucose degradation product (GDP) versus conventional PD solutions (balANZ trial), the relationship between peritonitis rates of low (< 123...
April 13, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28406862/a-randomized-controlled-trial-of-corticosteroids-in-pediatric-septic-shock-a-pilot-feasibility-study
#7
Kusum Menon, Dayre McNally, Katharine O'Hearn, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVE: To determine the feasibility of conducting a randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: Randomized, double-blind, placebo controlled trial. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years old inclusive with suspected septic shock. INTERVENTION: Administration of IV hydrocortisone versus placebo until hemodynamic stability is achieved or for a maximum of 7 days...
April 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28402245/thyroid-hormone-therapy-for-older-adults-with-subclinical-hypothyroidism
#8
David J Stott, Nicolas Rodondi, Patricia M Kearney, Ian Ford, Rudi G J Westendorp, Simon P Mooijaart, Naveed Sattar, Carole E Aubert, Drahomir Aujesky, Douglas C Bauer, Christine Baumgartner, Manuel R Blum, John P Browne, Stephen Byrne, Tinh-Hai Collet, Olaf M Dekkers, Wendy P J den Elzen, Robert S Du Puy, Graham Ellis, Martin Feller, Carmen Floriani, Kirsty Hendry, Caroline Hurley, J Wouter Jukema, Sharon Kean, Maria Kelly, Danielle Krebs, Peter Langhorne, Gemma McCarthy, Vera McCarthy, Alex McConnachie, Mairi McDade, Martina Messow, Annemarie O'Flynn, David O'Riordan, Rosalinde K E Poortvliet, Terence J Quinn, Audrey Russell, Carol Sinnott, Jan W A Smit, H Anette Van Dorland, Kieran A Walsh, Elaine K Walsh, Torquil Watt, Robbie Wilson, Jacobijn Gussekloo
Background The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition. Methods We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 μg daily, or 25 μg if the body weight was <50 kg or the patient had coronary heart disease), with dose adjustment according to the thyrotropin level; 369 patients were assigned to receive placebo with mock dose adjustment...
April 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28399129/the-effects-of-implementing-a-point-of-care-electronic-template-to-prompt-routine-anxiety-and-depression-screening-in-patients-consulting-for-osteoarthritis-the-primary-care-osteoarthritis-trial-a-cluster-randomised-trial-in-primary-care
#9
Christian D Mallen, Barbara I Nicholl, Martyn Lewis, Bernadette Bartlam, Daniel Green, Sue Jowett, Jesse Kigozi, John Belcher, Kris Clarkson, Zoe Lingard, Christopher Pope, Carolyn A Chew-Graham, Peter Croft, Elaine M Hay, George Peat
BACKGROUND: This study aimed to evaluate whether prompting general practitioners (GPs) to routinely assess and manage anxiety and depression in patients consulting with osteoarthritis (OA) improves pain outcomes. METHODS AND FINDINGS: We conducted a cluster randomised controlled trial involving 45 English general practices. In intervention practices, patients aged ≥45 y consulting with OA received point-of-care anxiety and depression screening by the GP, prompted by an automated electronic template comprising five questions (a two-item Patient Health Questionnaire-2 for depression, a two-item Generalized Anxiety Disorder-2 questionnaire for anxiety, and a question about current pain intensity [0-10 numerical rating scale])...
April 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28389462/improved-outcomes-for-myeloid-leukemia-of-down-syndrome-a-report-from-the-children-s-oncology-group-aaml0431-trial
#10
Jeffrey W Taub, Jason N Berman, Johann K Hitzler, April D Sorrell, Norman J Lacayo, Kelley Mast, David Head, Susana Raimondi, Betsy Hirsch, Yubin Ge, Robert B Gerbing, Yi-Cheng Wang, Todd A Alonzo, Dario Campana, Elaine Coustan-Smith, Prasad Mathew, Alan S Gamis
Patients with myeloid leukemia of Down syndrome (ML-DS) have a favorable event-free survival (EFS), but experience significant treatment-related morbidity and mortality. ML-DS blast cells ex vivo have increased sensitivity to cytarabine (araC) and daunorubicin, suggesting that optimizing drug dosing may improve outcomes while reducing toxicity. The Children's Oncology Group (COG) AAML0431 trial consisted of 4 cycles of Induction and 2 cycles of Intensification therapy based on the treatment schema of the previous COG A2971 trial with several modifications...
April 7, 2017: Blood
https://www.readbyqxmd.com/read/28382755/innovative-approaches-to-weight-loss-in-a-high-risk-population-the-small-changes-and-lasting-effects-scale-trial
#11
Erica G Phillips, Martin T Wells, Ginger Winston, Rosio Ramos, Carol M Devine, Elaine Wethington, Janey C Peterson, Brian Wansink, Mary Charlson
OBJECTIVE: To evaluate the efficacy of a small change behavioral weight loss intervention with or without a positive affect/self-affirmation (PA/SA) component on weight loss at 12 months. METHODS: Black and Hispanic adults (N = 405) with body mass index 25-50 kg/m(2) selected one of ten small change eating strategies and a physical activity goal, randomly with/without PA/SA. Participants were followed by community health workers at set intervals (weekly in months 1-3; biweekly in months 4-9; once monthly in months 10-12)...
April 5, 2017: Obesity
https://www.readbyqxmd.com/read/28366440/progressive-learning-in-endoscopy-simulation-training-improves-clinical-performance-a-blinded-randomized-trial
#12
Samir C Grover, Michael A Scaffidi, Rishad Khan, Ankit Garg, Ahmed Al-Mazroui, Tareq Alomani, Jeffrey J Yu, Ian S Plener, Mohamed Al-Awamy, Elaine L Yong, Maria Cino, Nikila C Ravindran, Mark Zasowski, Teodor P Grantcharov, Catharine M Walsh
BACKGROUND AND AIMS: A structured comprehensive curriculum (SCC) using simulation-based training (SBT) can improve clinical colonoscopy performance. This curriculum may be enhanced through the application of progressive learning, a training strategy centered on incrementally challenging learners. We aimed to determine whether a progressive learning-based curriculum (PLC) would lead to superior clinical performance compared with an SCC. METHODS: This was a single-blinded randomized controlled trial conducted at a single academic center...
March 30, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28357131/aquatic-therapy-for-boys-with-duchenne-muscular-dystrophy-dmd-an-external-pilot-randomised-controlled-trial
#13
Daniel Hind, James Parkin, Victoria Whitworth, Saleema Rex, Tracey Young, Lisa Hampson, Jennie Sheehan, Chin Maguire, Hannah Cantrill, Elaine Scott, Heather Epps, Marion Main, Michelle Geary, Heather McMurchie, Lindsey Pallant, Daniel Woods, Jennifer Freeman, Ellen Lee, Michelle Eagle, Tracey Willis, Francesco Muntoni, Peter Baxter
BACKGROUND: Standard treatment of Duchenne muscular dystrophy (DMD) includes regular physiotherapy. There are no data to show whether adding aquatic therapy (AT) to land-based exercises helps maintain motor function. We assessed the feasibility of recruiting and collecting data from boys with DMD in a parallel-group pilot randomised trial (primary objective), also assessing how intervention and trial procedures work. METHODS: Ambulant boys with DMD aged 7-16 years established on steroids, with North Star Ambulatory Assessment (NSAA) score ≥8, who were able to complete a 10-m walk test without aids or assistance, were randomly allocated (1:1) to 6 months of either optimised land-based exercises 4 to 6 days/week, defined by local community physiotherapists, or the same 4 days/week plus AT 2 days/week...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28347533/influence-of-drugs-carried-in-lipid-nanoparticles-in-coronary-disease-of-rabbit-transplanted-heart
#14
Lucas R Barbieri, Domingos D Lourenço-Filho, Elaine R Tavares, Priscila O Carvalho, Paulo S Gutierrez, Raul C Maranhão, Noedir A G Stolf
BACKGROUND: Coronary allograft vasculopathy is an inflammatory-proliferative process that compromises the long-term success of heart transplantation and currently has no effective prevention and treatment. Lipid nanoparticles, termed LDE can carry chemotherapeutic agents in the circulation and concentrates them in the heart. METHODS: Twenty-eight rabbits fed a cholesterol-rich diet and submitted to heterotopic heart transplantation were treated with cyclosporine A (10 mg/kg daily) and allocated to four groups of 7 animals treated with intravenous LDE-methotrexate (MTX; 4 mg/kg weekly), with LDE-paclitaxel (PACLI; 4 mg/kg weekly), or with LDE-PACLI (4 mg/kg weekly) and LDE-MTX (4 mg/kg weekly)...
March 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28339460/evaluating-implementation-of-a-fire-prevention-injury-prevention-briefing-in-children-s-centres-cluster-randomised-controlled-trial
#15
Toity Deave, Adrian Hawkins, Arun Kumar, Mike Hayes, Nicola Cooper, Michael Watson, Joanne Ablewhite, Carol Coupland, Alex Sutton, Gosia Majsak-Newman, Lisa McDaid, Trudy Goodenough, Kate Beckett, Elaine McColl, Richard Reading, Denise Kendrick
BACKGROUND: Many developed countries have high mortality rates for fire-related deaths in children aged 0-14 years with steep social gradients. Evidence-based interventions to promote fire safety practices exist, but the impact of implementing a range of these interventions in children's services has not been assessed. We developed an Injury Prevention Briefing (IPB), which brought together evidence about effective fire safety interventions and good practice in delivering interventions; plus training and facilitation to support its use and evaluated its implementation...
2017: PloS One
https://www.readbyqxmd.com/read/28335798/treatment-of-mucocutaneous-manifestations-in-beh%C3%A3-et-s-disease-with-anakinra-a-pilot-open-label-study
#16
Peter C Grayson, Yusuf Yazici, Melissa Merideth, H Nida Sen, Michael Davis, Elaine Novakovich, Elizabeth Joyal, Raphaela Goldbach-Mansky, Cailin H Sibley
BACKGROUND: The effect of IL-1 blocking therapy on mucocutaneous manifestations of Behçet's disease is incompletely understood. METHODS: Six patients with Behçet's disease and ongoing oral/genital ulcers for ≥1 month were enrolled into an adaptive, two-phase clinical trial and included in the analysis. Study duration was 6 months with extension up to 16 months. All were treated non-blinded with anakinra 100 mg subcutaneous daily with the option to escalate the dose to 200 mg in partial responders after 1 month and 300 mg after 6 months...
March 24, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28333512/randomized-controlled-trial-of-a-positive-affect-intervention-for-people-newly-diagnosed-with-hiv
#17
Judith T Moskowitz, Adam W Carrico, Larissa G Duncan, Michael A Cohn, Elaine O Cheung, Abigail Batchelder, Lizet Martinez, Eisuke Segawa, Michael Acree, Susan Folkman
OBJECTIVE: We conducted a randomized controlled trial to determine whether IRISS (Intervention for those Recently Informed of their Seropositive Status), a positive affect skills intervention, improved positive emotion, psychological health, physical health, and health behaviors in people newly diagnosed with HIV. METHOD: One-hundred and fifty-nine participants who had received an HIV diagnosis in the past 3 months were randomized to a 5-session, in-person, individually delivered positive affect skills intervention or an attention-matched control condition...
May 2017: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/28319263/a-review-of-family-caregiving-intervention-trials-in-oncology
#18
REVIEW
Betty Ferrell, Elaine Wittenberg
This article contains a review of literature published from 2010 to 2016 on family caregiving in oncology. An analysis of 810 citations resulted in 50 randomized trials. These trials describe the need to prepare family caregivers for the complex role they play in cancer care. Several studies have demonstrated improved quality of life for family caregivers and improved emotional support from interventions. Several studies addressed communication and relational intimacy, which are key concerns. An additional focus of these trials was in the area of caregiving tasks and ways to diminish the burden of caregiving and preparedness for this role...
March 20, 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/28316636/the-siesta-trial-a-randomized-study-investigating-the-efficacy-safety-and-tolerability-of-acupressure-versus-sham-therapy-for-improving-sleep-quality-in-patients-with-end-stage-kidney-disease-on-hemodialysis
#19
Kunyu Shen, Yeoungjee Cho, Elaine M Pascoe, Carmel M Hawley, Veronica Oliver, Kathryn M Hughes, Richard Baer, Jeremy Frazier, Elizabeth Jarvis, Ken-Soon Tan, Xusheng Liu, Glenda Gobe, David W Johnson
Objectives. To compare the effectiveness of real acupressure versus sham acupressure therapy in improving sleep quality in patients receiving hemodialysis (HD) or hemodiafiltration (HDF). Methods. A multicenter, single-blind, randomized controlled trial was conducted in two Australian dialysis units located in Princess Alexandra Hospital and Logan Hospital, respectively. Forty-two subjects with self-reported poor sleep quality were randomly assigned to real (n = 21) or sham (n = 21) acupressure therapy delivered thrice weekly for four consecutive weeks during routine dialysis sessions...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28301775/the-microbiome-and-host-behavior
#20
Helen E Vuong, Jessica M Yano, Thomas C Fung, Elaine Y Hsiao
The microbiota is increasingly recognized for its ability to influence the development and function of the nervous system and several complex host behaviors. In this review, we discuss emerging roles for the gut microbiota in modulating host social and communicative behavior, stressor-induced behavior, and performance in learning and memory tasks. We summarize effects of the microbiota on host neurophysiology, including brain microstructure, gene expression, and neurochemical metabolism across regions of the amygdala, hippocampus, frontal cortex, and hypothalamus...
March 8, 2017: Annual Review of Neuroscience
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