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https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#1
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319004/updated-risk-factors-should-be-used-to-predict-development-of-diabetes
#2
Mary Angelyn Bethel, Kristen A Hyland, Antonio R Chacra, Prakash Deedwania, Gregory R Fulcher, Rury R Holman, Trond Jenssen, Naomi S Levitt, John J V McMurray, Eleni Boutati, Laine Thomas, Jie-Lena Sun, Steven M Haffner
AIMS: Predicting incident diabetes could inform treatment strategies for diabetes prevention, but the incremental benefit of recalculating risk using updated risk factors is unknown. We used baseline and 1-year data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) Trial to compare diabetes risk prediction using historical or updated clinical information. METHODS: Among non-diabetic participants reaching 1year of follow-up in NAVIGATOR, we compared the performance of the published baseline diabetes risk model with a "landmark" model incorporating risk factors updated at the 1-year time point...
March 2, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28318138/safety-and-efficacy-of-6-month-versus-12-month-dual-antiplatelet-therapy-in-patients-after-implantation-of-multiple-biodegradable-polymer-coated-sirolimus-eluting-coronary-stents-insight-from-the-i-love-it-2-trial
#3
Jing Qi, Yi Li, Jing Li, Quanmin Jing, Kai Xu, Chuanyu Gao, Likun Ma, Zhi Zhang, Bo Xu, Yaling Han
OBJECTIVE: This study sought to compare the clinical outcomes of 6-month versus 12-month dual antiplatelet therapy (DAPT) in patients receiving multiple biodegradable polymer-coated sirolimus-eluting stents (BP-SES) implants. BACKGROUND: The clinical outcomes for patients who undergo multiple BP-SES implantation with different DAPT durations are uncertain. METHODS: In the I-LOVE-IT 2 trial, 907 patients treated with multiple BP-SES (total stent number ≥2) were assigned to receive 6-month (n = 440) or 12-month (n = 467) DAPT...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28314397/effectiveness-of-botulinum-toxin-type-a-for-the-treatment-of-chronic-masticatory-myofascial-pain-a-case-series
#4
Jason S Baker, Patrick J Nolan
BACKGROUND: The aim of this study is to evaluate the effectiveness of botulinum toxin type A (BTX-A) for the treatment of chronic masticatory myofascial pain (MMP) over 12 months and to test a standardized protocol. METHODS: This is a prospective case series of consecutive adult patients with chronic MMP treated with injection of BTX-A into the bilateral temporalis and masseter muscles. The authors used the same anatomic landmarks and dosage and followed each patient for 12 months...
January 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28291476/ultrasound-versus-landmarks-for-great-toe-arthrocentesis
#5
Jason F Naylor, Kenneth B Dekay, Benjamin P Donham, Brian T Hall
BACKGROUND: Several studies have demonstrated ultrasound (US) is superior to traditional landmark (LM)-based techniques for large and medium joint aspiration; however, no studies of sufficient size have evaluated these interventions in the smaller toe joints. The purpose of this study was to determine if US provides an advantage over LM for successful first-pass aspiration of first metatarsophalangeal joint (1st MTPJ) effusions. METHODS: A cross-over, cadaveric trial evaluating the interventions of US and LM...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286578/validity-of-the-microsoft-kinect-system-in-assessment-of-compensatory-stepping-behavior-during-standing-and-treadmill-walking
#6
Guy Shani, Amir Shapiro, Goldstein Oded, Kagan Dima, Itshak Melzer
BACKGROUND: Rapid compensatory stepping plays an important role in preventing falls when balance is lost; however, these responses cannot be accurately quantified in the clinic. The Microsoft Kinect™ system provides real-time anatomical landmark position data in three dimensions (3D), which may bridge this gap. METHODS: Compensatory stepping reactions were evoked in 8 young adults by a sudden platform horizontal motion on which the subject stood or walked on a treadmill...
2017: European Review of Aging and Physical Activity
https://www.readbyqxmd.com/read/28281122/three-dimensional-versus-two-dimensional-endoscopic-assisted-thyroidectomy-via-the-anterior-chest-approach-a-preliminary-report
#7
Shi-Tong Yu, Ping Han, Faya Liang, Qian Cai, Peiliang Lin, Renhui Chen, Xiaoming Huang
OBJECTIVE: The objective of the study was to evaluate the safety and effectiveness of three-dimensional (3D) endoscopy for thyroidectomy and compare it to two-dimensional (2D) endoscopy. The major limitations of conventional endoscopy include its lack of depth perception and tactile feedback. The 3D endoscopy technique, which involves 3D imaging, is widely used. However, few reports have described the use of 3D endoscopic systems in thyroid surgery. METHOD: In this single-institutional study, 103 consecutive patients who underwent endoscopic thyroidectomy between July 2013 and April 2014 were enrolled...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28279314/meta-analysis-of-randomized-clinical-trials-comparing-biodegradable-polymer-drug-eluting-stent-to-second-generation-durable-polymer-drug-eluting-stents
#8
Georges El-Hayek, Sripal Bangalore, Abel Casso Dominguez, Chandan Devireddy, Wissam Jaber, Gautam Kumar, Kreton Mavromatis, Jacqueline Tamis-Holland, Habib Samady
OBJECTIVES: The authors sought to perform a meta-analysis of randomized clinical trials (RCTs) comparing the safety and efficacy of biodegradable polymer drug-eluting stents (BP-DES) to second-generation durable polymer drug-eluting stents (DP-DES). BACKGROUND: Prior meta-analyses have established the superiority of BP-DES over bare-metal stents and first-generation DP-DES; however, their advantage compared with second-generation DP-DES remains controversial. METHODS: The authors searched PubMed and Scopus databases for RCTs comparing BP-DES to the second-generation DP-DES...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28277835/selective-targeting-of-epigenetic-reader-domains
#9
Holger Greschik, Roland Schüle, Thomas Günther
Epigenetic regulators including writers, erasers, and readers of chromatin marks have been implicated in numerous diseases and are therefore subject of intense academic and pharmaceutical research. While several small-molecule inhibitors targeting writers or erasers are approved drugs or which are being evaluated in clinical trials, the targeting of epigenetic readers has lagged. Proof-of-principle that epigenetic readers are also relevant drug targets was provided by landmark discoveries of selective inhibitors targeting the BET family of acetyl-lysine readers...
March 6, 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/28258642/benchmarking-recent-national-practice-in-rectal-cancer-treatment-with-landmark-randomised-controlled-trials
#10
Wernard Aat Antoine Borstlap, Pieter Tanis
AIM: A Snapshot study design eliminates changes in treatment and outcome over time. This population based Snapshot study aimed to determine current practice and outcome of rectal cancer treatment with published landmark randomised controlled trials (RCTs) as a benchmark. METHODS: In this collaborative research project, the dataset of the Dutch Surgical Colorectal Audit was extended with additional treatment and long-term outcome data. All registered patients who underwent resection for rectal cancer in 2011 were eligible...
March 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28256025/development-of-allocentric-spatial-recall-from-new-viewpoints-in-virtual-reality
#11
James Negen, Edward Heywood-Everett, Hannah E Roome, Marko Nardini
Using landmarks and other scene features to recall locations from new viewpoints is a critical skill in spatial cognition. In an immersive virtual reality task, we asked children 3.5-4.5 years old to remember the location of a target using various cues. On some trials they could use information from their own self-motion. On some trials they could use a view match. In the very hardest kind of trial, they were 'teleported' to a new viewpoint and could only use an allocentric spatial representation. This approach provides a strict test for allocentric coding (without either a matching viewpoint or self-motion information) while avoiding additional task demands in previous studies (it does not require them to deal with a small table-top environment or to manage stronger cue conflicts)...
March 2, 2017: Developmental Science
https://www.readbyqxmd.com/read/28252315/checkpoint-blockade-in-lung-cancer-and-mesothelioma
#12
Lysanne A Lievense, Daniel H Sterman, Robin Cornelissen, Joachim G Aerts
In the past decade, immunotherapy has emerged as a new treatment modality in cancer. The most success has been achieved with the class of checkpoint inhibitors; antibodies which unleash the anti-tumor immune response. Following the success in melanoma, numerous clinical trials are being conducted investigating checkpoint inhibitors in lung cancer and mesothelioma. The programmed death protein 1-protein death ligand 1/2 (PD-1 - PD-L1/2) pathway and cytotoxic T-lymphocyte associated protein 4 (CTLA4) are currently the most studied immunotherapeutic targets in these malignancies...
March 2, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28235536/the-use-of-ultrasound-in-planned-cesarean-delivery-under-spinal-anesthesia-for-patients-having-nonprominent-anatomic-landmarks
#13
Mursel Ekinci, Hacı Ahmet Alici, Ali Ahiskalioglu, Ilker Ince, Mehmet Aksoy, Erkan Cem Celik, Aysenur Dostbil, Mine Celik, Pinar Karaca Baysal, Birzat Emre Golboyu, Ayşe Nur Yeksan
STUDY OBJECTIVE: The aim of the study was to compare conventional landmark method with ultrasound-guided spinal anesthesia in cesarean delivery cases where spinous processes and interspinous spaces were not prominent on physical examination. DESIGN: Randomized controlled clinical trial. SETTING: Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: Sixty-four 18- to 45-year-old American Society of Anesthesiologists I-II patients scheduled for cesarean delivery under spinal anesthesia having hardly palpated anatomic landmarks on vertebral column...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235522/preprocedural-ultrasound-assessment-does-not-improve-trainee-performance-of-spinal-anesthesia-for-obstetrical-patients-a-randomized-controlled-trial
#14
Timothy P Turkstra, Kristine L Marmai, Kevin P Armstrong, Kamal Kumar, S Indu Singh
STUDY OBJECTIVE: This randomized controlled trial was designed to evaluate the efficacy of additional information from preprocedure ultrasound examination to aid anesthesiology trainees performing spinal anesthesia for obstetric patients. DESIGN: Trainee residents were randomly allocated to landmark technique and anatomy demonstration via ultrasound examination or landmark technique only for spinal anesthetic placement. SETTING: Obstetric delivery suite...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28216356/fixed-and-variable-cost-of-carotid-endarterectomy-and-stenting-in-the-united-states-a-comparative-study
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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