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https://www.readbyqxmd.com/read/29161684/higher-versus-lower-continuous-renal-replacement-therapy-intensity-in-critically-ill-patients-with-liver-dysfunction
#1
Zachary O'Brien, Alan Cass, Louise Cole, Simon Finfer, Martin Gallagher, Colin McArthur, Shay McGuiness, John Myburgh, Rinaldo Bellomo, Johan Mårtensson
AIMS: To study the association between higher versus lower continuous renal replacement therapy (CRRT) intensity and mortality in critically ill patients with combined acute kidney injury and liver dysfunction. METHODS: Post-hoc analysis of patients with liver dysfunction (Sequential Organ Failure Assessment liver score ≥2 or diagnosis of liver failure/transplant) included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29159568/a-cross-sectional-and-longitudinal-study-between-association-of-n-3-polyunsaturated-fatty-acids-derived-from-fish-consumption-and-high-density-lipoprotein-heterogeneity
#2
Shigemasa Tani, Rei Matsuo, Kenji Kawauchi, Tsukasa Yagi, Wataru Atsumi, Atsushi Hirayama
Decreased high-density lipoprotein (HDL) particle size, cholesterol poor, apolipoprotein A-I-rich HDL particles leading to smaller HDL particle size, may be associated with an anti-atherosclerotic effect. The data are sparse regarding the relationship between n-3 polyunsaturated fatty acids [n-3 PUFAs: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)] and HDL particle size. This study was designed as a hospital-based cross-sectional study to investigate the relationship between the serum levels of n-3 PUFAs and the HDL-cholesterol/apolipoprotein A-1 ratio, as estimated by the HDL particle size, in patients with the presence of one or more risk factors for atherosclerotic cardiovascular disease (ASCVD)...
November 20, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29158831/identification-and-validation-of-a-salivary-protein-panel-to-detect-heart-failure-early
#3
Xi Zhang, Terry Walsh, John J Atherton, Karam Kostner, Benjamin Schulz, Chamindie Punyadeera
BACKGROUND: Over 26 million people suffer from heart failure (HF) globally. Current diagnosis of HF relies on clinical evaluation, blood assays and imaging techniques. Our aim is to develop a diagnostic assay to detect HF in at risk individuals within the community using human saliva as a medium, potentially leading to a simple, safe early warning system. METHODS: Saliva samples were collected from healthy controls (n=36) and HF patients (n=75). Salivary proteome profiles were analysed by Sequential Window Acquisition of All Theoretical fragment ion spectra - Mass Spectrometry (SWATH-MS)...
2017: Theranostics
https://www.readbyqxmd.com/read/29155768/slice-patch-clamp-technique-for-analyzing-learning-induced-plasticity
#4
Hiroyuki Kida, Yuya Sakimoto, Dai Mitsushima
The slice patch clamp technique is a powerful tool for investigating learning-induced neural plasticity in specific brain regions. To analyze motor-learning induced plasticity, we trained rats using an accelerated rotor rod task. Rats performed the task 10 times at 30-s intervals for 1 or 2 days. Performance was significantly improved on the training days compared to the first trial. We then prepared acute brain slices of the primary motor cortex (M1) in untrained and trained rats. Current-clamp analysis showed dynamic changes in resting membrane potential, spike threshold, afterhyperpolarization, and membrane resistance in layer II/III pyramidal neurons...
November 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29150209/exploring-the-relationship-between-polio-type-2-serum-neutralizing-antibodies-and-intestinal-immunity-using-data-from-two-randomized-controlled-trials-of-new-bopv-ipv-immunization-schedules
#5
Ananda S Bandyopadhyay, Edwin J Asturias, Miguel O'Ryan, M Steven Oberste, William Weldon, Ralf Clemens, Ricardo Rüttimann, John F Modlin, Chris Gast
BACKGROUND: Inactivated polio vaccine (IPV) is now the only source of routine type 2 protection. The relationship, if any, between vaccine-induced type 2 humoral and intestinal immunity is poorly understood. METHODS: Two clinical trials in five Latin American countries of mixed or sequential bOPV-IPV schedules in 1640 infants provided data on serum neutralizing antibodies (NAb) and intestinal immunity, assessed as viral shedding following oral mOPV2 challenge. Analyses with generalized additive and quantile regression models examined the relationships between prechallenge NAb titers and proportion, duration and titers (magnitude) of viral shedding...
November 14, 2017: Vaccine
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#6
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29146401/neratinib-after-trastuzumab-based-adjuvant-therapy-in-her2-positive-breast-cancer-extenet-5-year-analysis-of-a-randomised-double-blind-placebo-controlled-phase-3-trial
#7
Miguel Martin, Frankie A Holmes, Bent Ejlertsen, Suzette Delaloge, Beverly Moy, Hiroji Iwata, Gunter von Minckwitz, Stephen K L Chia, Janine Mansi, Carlos H Barrios, Michael Gnant, Zorica Tomašević, Neelima Denduluri, Robert Šeparović, Erhan Gokmen, Anna Bashford, Manuel Ruiz Borrego, Sung-Bae Kim, Erik Hugger Jakobsen, Audrone Ciceniene, Kenichi Inoue, Friedrich Overkamp, Joan B Heijns, Anne C Armstrong, John S Link, Anil Abraham Joy, Richard Bryce, Alvin Wong, Susan Moran, Bin Yao, Feng Xu, Alan Auerbach, Marc Buyse, Arlene Chan
BACKGROUND: ExteNET showed that 1 year of neratinib, an irreversible pan-HER tyrosine kinase inhibitor, significantly improves 2-year invasive disease-free survival after trastuzumab-based adjuvant therapy in women with HER2-positive breast cancer. We report updated efficacy outcomes from a protocol-defined 5-year follow-up sensitivity analysis and long-term toxicity findings. METHODS: In this ongoing randomised, double-blind, placebo-controlled, phase 3 trial, eligible women aged 18 years or older (≥20 years in Japan) with stage 1-3c (modified to stage 2-3c in February, 2010) operable breast cancer, who had completed neoadjuvant and adjuvant chemotherapy plus trastuzumab with no evidence of disease recurrence or metastatic disease at study entry...
November 13, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29137605/effects-of-aspirin-and-non-aspirin-nonsteroidal-anti-inflammatory-drugs-on-the-incidence-of-recurrent-colorectal-adenomas-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-randomized-clinical-trials
#8
Sajesh K Veettil, Kean Ghee Lim, Siew Mooi Ching, Surasak Saokaew, Pochamana Phisalprapa, Nathorn Chaiyakunapruk
BACKGROUND: Beneficial effects of aspirin and non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) against recurrent colorectal adenomas have been documented in systematic reviews; however, the results have not been conclusive. Uncertainty remains about the appropriate dose of aspirin for adenoma prevention. The persistence of the protective effect of NSAIDs against recurrent adenomas after treatment cessation is yet to be established. METHODS: Our objective was to update and systematically evaluate the evidence for aspirin and other NSAIDs on the incidence of recurrent colorectal adenomas taking into consideration the risks of random error and to appraise the quality of evidence using GRADE (The Grading of Recommendations, Assessment, Development and Evaluation) approach...
November 14, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29135366/radiofrequency-ablation-versus-hepatic-resection-for-small-hepatocellular-carcinoma-systematic-review-of-randomized-controlled-trials-with-meta-analysis-and-trial-sequential-analysis
#9
Xiao-Lin Xu, Xiao-Di Liu, Ming Liang, Bao-Ming Luo
Purpose To compare the benefits and harms of radiofrequency ablation (RFA) and hepatic resection (HR) and to test the consistency of currently available evidence. Materials and Methods PubMed, Embase, and the Cochrane Library were systematically searched for randomized controlled trials (RCTs) that compared the effects of HR and RFA for Barcelona Clinic Liver Cancer very early or early stage hepatocellular carcinoma (HCC). The primary outcome was overall survival, and secondary outcomes were recurrence rate, complication rate, and hospitalization duration...
November 13, 2017: Radiology
https://www.readbyqxmd.com/read/29133706/a-randomized-placebo-controlled-trial-of-progesterone-with-or-without-hypothermia-in-patients-with-acute-severe-traumatic-brain-injury
#10
Sumit Sinha, Amol Raheja, Neha Samson, Keshav Goyal, Sanjeev Bhoi, Arul Selvi, Pushpa Sharma, Bhawani Shankar Sharma
OBJECTIVE: Among newer neuroprotectant modalities, hypothermia and progesterone have shown a beneficial role in preliminary studies enrolling patients with severe traumatic brain injury (sTBI). The primary objective of this study was to evaluate the efficacy of progesterone with or without prophylactic hypothermia in acute sTBI patients. MATERIALS AND METHODS: This is a prospective, outcome assessor, statistician blinded, randomized, and placebo-controlled phase II trial of progesterone with or without hypothermia (factorial design)...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29128659/on-line-confidence-monitoring-during-decision-making
#11
Dror Dotan, Florent Meyniel, Stanislas Dehaene
Humans can readily assess their degree of confidence in their decisions. Two models of confidence computation have been proposed: post hoc computation using post-decision variables and heuristics, versus online computation using continuous assessment of evidence throughout the decision-making process. Here, we arbitrate between these theories by continuously monitoring finger movements during a manual sequential decision-making task. Analysis of finger kinematics indicated that subjects kept separate online records of evidence and confidence: finger deviation continuously reflected the ongoing accumulation of evidence, whereas finger speed continuously reflected the momentary degree of confidence...
November 9, 2017: Cognition
https://www.readbyqxmd.com/read/29127294/preventing-shivering-with-adjuvant-low-dose-intrathecal-meperidine-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analysis
#12
Yu-Cih Lin, Chien-Yu Chen, Yuan-Mei Liao, Alan Hsi-Wen Liao, Pi-Chu Lin, Chuen-Chau Chang
The aim of this systematic review and meta-analysis is to evaluate the pros and cons of adjuvant low dose intrathecal meperidine for spinal anaesthesia. We searched electronic databases for randomized controlled trials using trial sequential analysis (TSA) to evaluate the incidence of reduced rescue analgesics, shivering, pruritus, nausea and vomiting when applying adjuvant intrathecal meperidine. Twenty-eight trials with 2216 patients were included. Adjuvant intrathecal meperidine, 0.05-0.5 mg kg(-1), significantly reduced incidence of shivering (relative risk, RR, 0...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29126653/perioperative-levosimendan-in-cardiac-surgery-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#13
Alessandro Putzu, Sara Clivio, Alessandro Belletti, Tiziano Cassina
BACKGROUND: Several studies suggested beneficial effects of perioperative levosimendan on postoperative outcome after cardiac surgery. However, three large randomized controlled trials (RCTs) have been recently published and presented neutral results. We performed a systematic review with meta-analysis and trial sequential analysis (TSA) to assess benefits and harms of perioperative levosimendan therapy in cardiac surgery. METHODS: Electronic databases were searched up to September 2017 for RCTs on preoperative levosimendan versus any type of control...
October 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29126437/framing-the-conversation-use-of-precis-2-ratings-to-advance-understanding-of-pragmatic-trial-design-domains
#14
Paula Darby Lipman, Kirsty Loudon, Leanora Dluzak, Rachael Moloney, Donna Messner, Catherine M Stoney
BACKGROUND: There continues to be debate about what constitutes a pragmatic trial and how it is distinguished from more traditional explanatory trials. The NIH Pragmatic Trials Collaborative Project, which includes five trials and a coordinating unit, has adopted the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS-2) instrument. The purpose of the study was to collect PRECIS-2 ratings at two points in time to assess whether the tool was sensitive to change in trial design, and to explore with investigators the rationale for rating shifts...
November 10, 2017: Trials
https://www.readbyqxmd.com/read/29124826/comparing-the-behavioral-impact-of-a-nudge-based-handwashing-intervention-to-high-intensity-hygiene-education-a-cluster-randomized-trial-in-rural-bangladesh
#15
Elise Grover, Mohammed Kamal Hossain, Saker Uddin, Mohini Venkatesh, Pavani K Ram, Robert Dreibelbis
OBJECTIVE: To determine the impact of environmental nudges on handwashing behaviors among primary school children as compared to a high-intensity hygiene education intervention. METHODS: In a cluster-randomized trial (CRT), we compared the rates of handwashing with soap (HWWS) after a toileting event among primary school students in rural Bangladesh. Eligible schools (government run, on-site sanitation and water, no hygiene interventions in last year, fewer than 450 students) were identified and 20 schools were randomly selected and allocated without blinding to one of four interventions, five schools per group: simultaneous handwashing infrastructure and nudge construction, sequential infrastructure then nudge construction, simultaneous infrastructure and high-intensity hygiene education (HE) and sequential handwashing infrastructure and HE...
November 10, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29124727/untargeted-antifungal-therapy-in-adult-patients-with-complicated-intra-abdominal-infection-a-systematic-review
#16
REVIEW
M W Petersen, A Perner, F Ravn, F Sjövall, M H Møller
BACKGROUND: Systematic reviews comparing untargeted antifungal treatment with placebo or no treatment in critically ill patients have provided conflicting results. We aimed to assess patient-important benefits and harms of untargeted antifungal therapy vs. placebo or no treatment in adult patients with complicated intra-abdominal infection. METHODS: We conducted a systematic review with meta-analysis and trial sequential analysis of randomised clinical trials assessing untargeted antifungal therapy compared to placebo or no treatment in adults with complicated intra-abdominal infection...
November 9, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29124236/implementation-recruitment-and-baseline-characteristics-a-randomized-trial-of-combined-treatments-for-smoking-cessation-and-weight-control
#17
Terry Bush, Jennifer Lovejoy, Harold Javitz, Stacey Mahuna, Alula Jimenez Torres, Ken Wassum, Brooke Magnusson, Cody Benedict, Bonnie Spring
Background: Two-thirds of treatment-seeking smokers are obese or overweight. Most smokers are concerned about gaining weight after quitting. The average smoker experiences modest post-quit weight gain which discourages many smokers from quitting. Although evidence suggests that combined interventions to help smokers quit smoking and prevent weight gain can be helpful, studies have not been replicated in real world settings. Methods: This paper describes recruitment and participant characteristics of the Best Quit Study, a 3-arm randomized controlled trial testing tobacco cessation treatment alone or combined with simultaneous or sequential weight management...
September 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29122784/impact-of-heterogeneity-and-effect-size-on-the-estimation-of-the-optimal-information-size-analysis-of-recently-published-meta-analyses
#18
Josep M Garcia-Alamino, Clare Bankhead, Carl Heneghan, Nicola Pidduck, Rafael Perera
OBJECTIVE: To estimate the proportion of systematic reviews that meet the optimal information size (OIS) and assess the impact heterogeneity and effect size have on the OIS estimate by type of outcome (eg, mortality, semiobjective or subjective). METHODS: We carried out searches of Medline and Cochrane to retrieve meta-analyses published in systematic reviews from 2010 to 2012. We estimated the OIS using Trial Sequential Analysis software (TSA V.0.9) and based on several heterogeneity and effect size scenarios, stratifying by type of outcome (mortality/semiobjective/subjective) and by Cochrane/non-Cochrane reviews...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29116954/impact-of-an-original-methodological-tool-on-the-identification-of-corrective-and-preventive-actions-after-root-cause-analysis-of-adverse-events-in-health-care-facilities-results-of-a-randomized-controlled-trial
#19
Anthony Vacher, Sana El Mhamdi, Alain dʼHollander, Marion Izotte, Yves Auroy, Philippe Michel, Jean-Luc Quenon
OBJECTIVE: The aim of the study was to assess the effectiveness of a new methodological tool for the identification of corrective and preventive actions (CAPAs) after root cause analysis of health care-related adverse events. METHODS: From January to June 2010, we conducted a randomized controlled trial involving risk managers from 111 health care facilities of the Aquitaine Regional Center for Quality and Safety in Health Care (France). Fifty-six risk managers, randomly assigned to two groups (intervention and control), identified CAPAs in response to two sequentially presented adverse event scenarios...
November 8, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29113968/symptomatic-treatment-of-uncomplicated-lower-urinary-tract-infections-in-the-ambulatory-setting-randomised-double-blind-trial
#20
RANDOMIZED CONTROLLED TRIAL
Andreas Kronenberg, Lukas Bütikofer, Ayodele Odutayo, Kathrin Mühlemann, Bruno R da Costa, Markus Battaglia, Damian N Meli, Peter Frey, Andreas Limacher, Stephan Reichenbach, Peter Jüni
Objective To investigate whether symptomatic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) is non-inferior to antibiotics in the treatment of uncomplicated lower urinary tract infection (UTI) in women, thus offering an opportunity to reduce antibiotic use in ambulatory care.Design Randomised, double blind, non-inferiority trial.Setting 17 general practices in Switzerland.Participants 253 women with uncomplicated lower UTI were randomly assigned 1:1 to symptomatic treatment with the NSAID diclofenac (n=133) or antibiotic treatment with norfloxacin (n=120)...
November 7, 2017: BMJ: British Medical Journal
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