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https://www.readbyqxmd.com/read/28216356/fixed-and-variable-cost-of-carotid-endarterectomy-and-stenting-in-the-united-states-a-comparative-study
#1
Tammam Obeid, Husain Alshaikh, Besma Nejim, Isibor Arhuidese, Satinderjit Locham, Mahmoud Malas
OBJECTIVE: Despite multiple landmark clinical trials, little data exists on real-world cost of carotid artery stenting (CAS) and carotid endarterectomy (CEA) to the United States healthcare system. We aim to study differences in actual hospitalization cost between patients who underwent CAS vs CEA in a nationally representative database. METHODS: We studied hospital discharge and billing records of all patients, in the Premier Perspective Database, who underwent CEA or CAS between the third quarter of 2009 and the first quarter of 2015...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28215665/11-years-follow-up-of-trastuzumab-after-adjuvant-chemotherapy-in-her2-positive-early-breast-cancer-final-analysis-of-the-herceptin-adjuvant-hera-trial
#2
David Cameron, Martine J Piccart-Gebhart, Richard D Gelber, Marion Procter, Aron Goldhirsch, Evandro de Azambuja, Gilberto Castro, Michael Untch, Ian Smith, Luca Gianni, Jose Baselga, Nedal Al-Sakaff, Sabine Lauer, Eleanor McFadden, Brian Leyland-Jones, Richard Bell, Mitch Dowsett, Christian Jackisch
BACKGROUND: Clinical trials have shown that trastuzumab, a recombinant monoclonal antibody against HER2 receptor, significantly improves overall survival and disease-free survival in women with HER2-positive early breast cancer, but long-term follow-up data are needed. We report the results of comparing observation with two durations of trastuzumab treatment at a median follow-up of 11 years, for patients enrolled in the HERA (HERceptin Adjuvant) trial. METHODS: HERA (BIG 1-01) is an international, multicentre, open-label, phase 3 randomised trial of 5102 women with HER2-positive early breast cancer, who were enrolled from hospitals in 39 countries between Dec 7, 2001, and June 20, 2005...
February 16, 2017: Lancet
https://www.readbyqxmd.com/read/28211603/impact-of-six-versus-12-months-of-dual-antiplatelet-therapy-in-patients-with-drug-eluting-stent-implantation-after-risk-stratification-with-the-residual-syntax-score-results-from-a-secondary-analysis-of-the-i-love-it-2-trial
#3
Miaohan Qiu, Yi Li, Jing Li, Kai Xu, Quanmin Jing, Shaohong Dong, Zhe Jin, Pitian Zhao, Bo Xu, Yaling Han
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation remains undetermined, especially for those at high risk of cardiac events postprocedure. OBJECTIVES: This study was aimed to investigate the impact of 6 versus 12 months of DAPT after DES implantation based on risk stratification with the residual SYNTAX score (rSS). METHODS: A total of 2737 patients in the I-LOVE-IT 2 trial were grouped according to rSS status (low rSS [rSS = 0, n = 1474] versus high rSS [rSS > 0, n = 1263]) and DAPT duration (6 months vs...
February 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28194188/primum-non-nocere-first-do-no-harm-and-then-feed-peanut
#4
Kyla Jade Hildebrand, Elissa Michele Abrams, Timothy K Vander Leek, Julia Elizabeth Mainwaring Upton, Douglas P Mack, Linda Kirste, Christine McCusker, Sandeep Kapur
The Addendum Guidelines for the Prevention of Peanut Allergy in the United States-Report of the NIAID-Sponsored Expert Panel were developed to build on previous food allergy guidelines after several key studies demonstrated the benefit of early introduction of allergenic foods. These landmark studies including the Learning Early about Peanut (LEAP), LEAP-On and Enquiring about Tolerance trials created a paradigm shift in food allergy prevention. The "take home" messages of this guideline include that peanut should be introduced early in the first year of life, and for the majority of infants, peanut can be introduced at home...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28188324/-regional-anesthesia-for-carotid-surgery-an-overview-of-anatomy-techniques-and-their-clinical-relevance
#5
A Koköfer, J Nawratil, M Opperer
BACKGROUND: Perioperative care for patients undergoing carotid endarterectomy (CEA) often presents a challenge to the anesthesia provider, as this patient group commonly suffers from a wide range of comorbidities. Although clinical trials could not demonstrate a significant benefit associated with regional anesthesia for outcomes such as insult, cardiac infarction or mortality, many authors concur that regional anesthetic techniques might be preferential in specific patient populations for this type of surgery...
February 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28179574/association-between-tumor-progression-endpoints-and-overall-survival-in-patients-with-advanced-neuroendocrine-tumors
#6
Monica Ter-Minassian, Sui Zhang, Nichole V Brooks, Lauren K Brais, Jennifer A Chan, David C Christiani, Xihong Lin, Sylvie Gabriel, Jérôme Dinet, Matthew H Kulke
Endpoints related to tumor progression are commonly used in clinical trials of novel therapeutic agents for neuroendocrine tumors (NETs). Whether improved tumor control translates into improved overall survival (OS), however, is uncertain. We assessed associations between tumor progression endpoints and OS in observational cohorts of patients with advanced neuroendocrine tumors treated with somatostatin analogs or with everolimus. We identified 440 patients with advanced NET who had received treatment with single-agent somatostatin analogs and 109 patients treated with everolimus, all of whom were treated at our institution and were evaluable for both tumor progression and survival...
February 8, 2017: Oncologist
https://www.readbyqxmd.com/read/28161360/wild-hummingbirds-can-use-the-geometry-of-a-flower-array
#7
Mark A W Hornsby, Susan D Healy, T Andrew Hurly
Animals use cues from their environment to orient in space and to navigate their surroundings. Geometry is a cue whose informational content may originate from the metric properties of a given environment, and its use has been demonstrated in the laboratory in nearly every species of animal tested. However, it is not clear whether geometric information, used by animals typically tested in small, rectangular boxes, is directly relevant to animals in their natural environment. Here we present the first data that confirm the use of geometric cues by a free-living animal in the wild...
February 1, 2017: Behavioural Processes
https://www.readbyqxmd.com/read/28137368/addendum-guidelines-for-the-prevention-of-peanut-allergy-in-the-united-states-report-of-the-national-institute-of-allergy-and-infectious-diseases-sponsored-expert-panel
#8
Alkis Togias, Susan F Cooper, Maria L Acebal, Amal Assa'ad, James R Baker, Lisa A Beck, Julie Block, Carol Byrd-Bredbenner, Edmond S Chan, Lawrence F Eichenfield, David M Fleischer, George J Fuchs, Glenn T Furuta, Matthew J Greenhawt, Ruchi S Gupta, Michele Habich, Stacie M Jones, Kari Keaton, Antonella Muraro, Marshall Plaut, Lanny J Rosenwasser, Daniel Rotrosen, Hugh A Sampson, Lynda C Schneider, Scott H Sicherer, Robert Sidbury, Jonathan Spergel, David R Stukus, Carina Venter, Joshua A Boyce
BACKGROUND: Food allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy...
January 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28134823/correction-of-monogenic-and-common-retinal-disorders-with-gene-therapy
#9
REVIEW
Jesse D Sengillo, Sally Justus, Thiago Cabral, Stephen H Tsang
The past decade has seen major advances in gene-based therapies, many of which show promise for translation to human disease. At the forefront of research in this field is ocular disease, as the eye lends itself to gene-based interventions due to its accessibility, relatively immune-privileged status, and ability to be non-invasively monitored. A landmark study in 2001 demonstrating successful gene therapy in a large-animal model for Leber congenital amaurosis set the stage for translation of these strategies from the bench to the bedside...
January 27, 2017: Genes
https://www.readbyqxmd.com/read/28129994/impact-of-tissue-plasminogen-activator-dosing-on-patients-weighing-more-than-100%C3%A2-kg-on-3-month-outcomes-in-acute-ischemic-stroke
#10
Jeffrey Garavaglia, Jay Sherman, Hannah Yetzer, Michael Regier, Matthew Smith
BACKGROUND AND PURPOSE: The landmark National Institute of Neurological Disorders and Stroke (NINDS) tissue plasminogen activator (tPA) trial established the effectiveness and dosing of intravenous tPA for acute ischemic stroke (AIS) at .9 mg/kg with a maximum dose of 90 mg. Since the publication of the NINDS trial in 1995, there has been a drastic increase in the amount of obesity and the average weight of adults in the United States, which has caused an increase in the number of patients receiving 90 mg of alteplase for AIS...
January 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28123977/use-of-novel-oral-anticoagulant-agents-in-venous-thromboembolism
#11
REVIEW
Shivanshu Madan, Shenil Shah, Patrick Dale, Sasan Partovi, Sahil A Parikh
New oral anticoagulants (NOAC) serve as alternatives for patients currently using warfarin for the prevention and treatment of venous thromboembolic (VTE) disease. This article provides a brief summary of the clinical use of these drugs as well as a review of the landmark clinical trials which evaluated described their safety and efficacy. As more data becomes available, a fundamental understanding of these medications will be vital to cardiovascular practitioners managing patients with VTE.
December 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28116988/efficacy-of-home-based-visuomotor-feedback-training-in-stroke-patients-with-chronic-hemispatial-neglect
#12
Stéphanie Rossit, Christopher S Y Benwell, Larissa Szymanek, Gemma Learmonth, Laura McKernan-Ward, Elaine Corrigan, Keith Muir, Ian Reeves, George Duncan, Philip Birschel, Margaret Roberts, Katrina Livingstone, Hazel Jackson, Pauline Castle, Monika Harvey
Hemispatial neglect is a severe cognitive condition frequently observed after a stroke, associated with unawareness of one side of space, disability and poor long-term outcome. Visuomotor feedback training (VFT) is a neglect rehabilitation technique that involves a simple, inexpensive and feasible training of grasping-to-lift rods at the centre. We compared the immediate and long-term effects of VFT vs. a control training when delivered in a home-based setting. Twenty participants were randomly allocated to an intervention (who received VFT) or a control group (n = 10 each)...
January 24, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28104306/midterm-and-one-year-outcome-of-amphilimus-polymer-free-drug-eluting-stent-in-patients-needing-short-dual-antiplatelet-therapy-insight-from-the-astute-registry-amphilimus-italian-multicenter-registry
#13
Cosmo Godino, Mauro Chiarito, Michael Donahue, Luca Testa, Riccardo Colantonio, Alberto Cappelletti, Alberto Monello, Valeria Magni, Diego Milazzo, Rosario Parisi, Annamaria Nicolino, Shahram Moshiri, Rossella Fattori, Gianfranco Aprigliano, Altin Palloshi, Giuseppe Caramanno, Matteo Montorfano, Francesco Bedogni, Carlo Briguori, Alberto Margonato, Antonio Colombo
BACKGROUND: To assess clinical outcomes of patients needing short dual antiplatelet therapy (S-DAPT) after PCI with Cre8 polymer-free amphilimus eluting-stent (AES). The Cre8-AES with pure i-Carbofilm coating was supposed to induce faster stent endothelialization and reduce device thrombogenicity. METHODS: We performed a sub-analysis of unrestricted consecutive patients treated with Cre8-AES between August 2011 and January 2015. Two groups were formed: 1) patients discharged with S-DAPT (≤3-month), because of high bleeding risk or attending urgent non-cardiac surgery; and 2) patients discharged with Recommended DAPT duration (R-DAPT; ≥6-month)...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28102030/impact-of-sodium-glucose-cotransporter-2-inhibitors-on-nonglycemic-outcomes-in-patients-with-type-2-diabetes
#14
Jennifer M Trujillo, Wesley A Nuffer
The efficacy of the sodium-glucose cotransporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, and empagliflozin in reducing hyperglycemia in patients with type 2 diabetes is well documented. In addition, positive effects have been observed with these agents on nonglycemic variables, such as reductions in body weight and blood pressure, which may confer additional health benefits. SGLT2 inhibitors are also associated with evidence of renal-protecting benefits. Furthermore, during the landmark Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) trial, a substantial reduction in major adverse cardiovascular outcomes was demonstrated with empagliflozin therapy...
January 19, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28100525/transoesophageal-echocardiographic-evaluation-of-central-venous-catheter-positioning-using-peres-formula-or-a-radiological-landmark-based-approach-a-prospective-randomized-single-centre-study
#15
J H Ahn, I S Kim, J H Yang, I G Lee, D H Seo, S P Kim
BACKGROUND: The lower superior vena cava (SVC), near its junction with the right atrium (RA), is considered the ideal location for the central venous catheter tip to ensure proper function and prevent injuries. We determined catheter insertion depth with a new formula using the sternoclavicular joint and the carina as radiological landmarks, with a 1.5 cm safety margin. The accuracy of tip positioning with the radiological landmark-based technique (R) and Peres' formula (P) was compared using transoesophageal echocardiography...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28098771/breast-cancer-brain-metastases-clonal-evolution-in-clinical-context
#16
REVIEW
Jodi M Saunus, Amy E McCart Reed, Zhun Leong Lim, Sunil R Lakhani
Brain metastases are highly-evolved manifestations of breast cancer arising in a unique microenvironment, giving them exceptional adaptability in the face of new extrinsic pressures. The incidence is rising in line with population ageing, and use of newer therapies that stabilise metastatic disease burden with variable efficacy throughout the body. Historically, there has been a widely-held view that brain metastases do not respond to circulating therapeutics because the blood-brain-barrier (BBB) restricts their uptake...
January 13, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28094482/real-time-ultrasound-guided-spinal-anesthesia-in-patients-with-predicted-difficult-anatomy
#17
Hesham Elsharkawy, Ankit Maheshwari, Rovnat Babazade, Anahi Perlas, Sherif Zaky, Loran M Soliman
BACKGROUND: There are limited reports of lumbar neuraxial blocks using real-time ultrasound in patients with predicted difficulties. We compared the number of attempts to perform spinal anesthesia using real time ultrasound guidance versus landmark technique in patients meeting predefined criteria for difficult spinal anesthesia. We also compared procedure time, block success, patient satisfaction and difficulty scores between groups. METHODS: Following institutional review board approval patients scheduled for total hip or knee arthroplasty with expected difficulty to perform spinal anesthesia were included...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28092723/pertuzumab-and-breast-cancer-another-piece-in-the-anti-her2-puzzle
#18
Lorenzo Gerratana, Marta Bonotto, Claudia Bozza, Elena Ongaro, Valentina Fanotto, Giacomo Pelizzari, Fabio Puglisi
The mechanism of action of pertuzumab, a recombinant anti-HER2 humanized monoclonal antibody, is complementary to trastuzumab's. On 8 June 2012, the Food and Drug Administration approved the combination of pertuzumab with trastuzumab and docetaxel as first-line treatment of HER2-positive metastatic breast cancer. Furthermore, pertuzumab is the first drug to be approved in the neoadjuvant setting using a pathological complete response as an endpoint. Areas covered: The review provides insights into the main mechanisms of action of pertuzumab...
January 30, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28088553/the-influence-of-landmark-stability-on-control-by-occasion-setters
#19
REVIEW
Lauren M Cleland, Chad M Ruprecht, Ronnie V Lee, Kenneth J Leising
In an operant serial feature-positive procedure, an occasion setter (OSX) signals that a response will be reinforced in the presence of a second stimulus (e.g., a discriminative stimulus, A). During a transfer test, the OS is paired with a different discriminative stimulus. Experiment 1a tested transfer effects in a touchscreen-based spatial occasion setting task with pigeons. During training, four OSs (OSW, OSX, OSY, and OSZ) were paired on separate trials with landmark A (LMA) or B (LMB) and the opportunity for a reinforced response at one location to the immediate left (R1) or right (R2) of the LM (OSW→LMA:R1, OSX→LMA:R2, OSY→LMB:R1, OSZ→LMB:R2)...
January 11, 2017: Behavioural Processes
https://www.readbyqxmd.com/read/28087008/apol1-genotype-blood-pressure-and-survival-in-african-americans-with-nondiabetic-nephropathy
#20
Todd W Robinson, Barry I Freedman
Several landmark trials have assessed the effects of aggressive hypertension control on the progression of nondiabetic chronic kidney disease. Results generally have been disappointing. With the realization that lowering blood pressure, including with renin-angiotensin system blockade, failed to reliably prevent end-stage kidney disease, studies now are analyzing longer-term effects of hypertension control on survival in chronic kidney disease. This commentary reviews the current findings and extends the discussion to apolipoprotein L1 gene by blood pressure (or gene by environment) interactions...
February 2017: Kidney International
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