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https://www.readbyqxmd.com/read/28105738/glucagon-like-peptide-1-agonists-and-risk-of-acute-pancreatitis-in-patients-with-type-2-diabetes
#1
Heidi Storgaard, Frederik Cold, Lise L Gluud, Tina Vilsbøll, Filip K Knop
Glucagon-like peptide-1 receptor agonist (GLP-1RAs) labels warn about acute pancreatitis (AP) and impose doctors to inform patients about symptoms of AP. Here we systematically reviewed the risk of AP in randomized placebo-controlled trials (RCTs) investigating the effect of GLP-1RAs in type 2 diabetes. We performed a systematic review with meta-analysis of long-term (minimum 24 months), placebo-controlled GLP-1RA RCTs in which AP was a predefined adverse event and adjudicated by blinded and independent adjudicating committees...
January 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28095172/characterizing-the-nature-of-scan-results-discussions-insights-into-why-patients-misunderstand-their-prognosis
#2
Sarguni Singh, Dagoberto Cortez, Douglas Maynard, James F Cleary, Lori DuBenske, Toby C Campbell
INTRODUCTION: Patients with incurable cancer have poor prognostic awareness. We present a detailed analysis of the dialogue between oncologists and patients in conversations with prognostic implications. METHODS: A total of 128 audio-recorded encounters from a large multisite trial were obtained, and 64 involved scan results. We used conversation analysis, a qualitative method for studying human interaction, to analyze typical patterns and conversational devices...
January 17, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28093723/meta-analysis-and-trial-sequential-analysis-of-triclosan-coated-sutures-for-the-prevention-of-surgical-site-infection
#3
REVIEW
S W de Jonge, J J Atema, J S Solomkin, M A Boermeester
BACKGROUND: Triclosan-coated sutures (TCS) were developed to reduce the risk of surgical-site infection (SSI). Level 1A evidence of effectiveness has been presented in various recent meta-analyses, yet well designed RCTs have not been able to reproduce these favourable results. The aim of this study was to evaluate all available evidence critically with comprehensive analysis to seek a more reliable answer regarding the effectiveness of TCS in the prevention of SSI. METHODS: PubMed, MEDLINE, Embase and Cochrane Library databases were searched from 1990 to November 2015 for RCTs that compared TCS with sutures that were exactly the same, but uncoated, in the prevention of SSI...
January 17, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28089709/objective-assessment-of-dietary-patterns-by-use-of-metabolic-phenotyping-a-randomised-controlled-crossover-trial
#4
Isabel Garcia-Perez, Joram M Posma, Rachel Gibson, Edward S Chambers, Tue H Hansen, Henrik Vestergaard, Torben Hansen, Manfred Beckmann, Oluf Pedersen, Paul Elliott, Jeremiah Stamler, Jeremy K Nicholson, John Draper, John C Mathers, Elaine Holmes, Gary Frost
BACKGROUND: Accurate monitoring of changes in dietary patterns in response to food policy implementation is challenging. Metabolic profiling allows simultaneous measurement of hundreds of metabolites in urine, the concentrations of which can be affected by food intake. We hypothesised that metabolic profiles of urine samples developed under controlled feeding conditions reflect dietary intake and can be used to model and classify dietary patterns of free-living populations. METHODS: In this randomised, controlled, crossover trial, we recruited healthy volunteers (aged 21-65 years, BMI 20-35 kg/m(2)) from a database of a clinical research unit in the UK...
January 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28079737/dexmedetomidine-reduces-perioperative-opioid-consumption-and-postoperative-pain-intensity-in-neurosurgery-a-meta-analysis
#5
Yi Liu, Feng Liang, Xiaochen Liu, Xinxin Shao, Nan Jiang, Xiaoliang Gan
BACKGROUND: Dexmedetomidine (DEX) has been administered to patients during neurosurgery. Some studies have found that DEX could reduce perioperative opioid consumption and postoperative pain intensity. However, no firm conclusions have been reached. The purpose of this meta-analysis was to assess the efficacy of DEX for managing pain in neurosurgical patients. MATERIALS AND METHODS: A comprehensive literature review was conducted to identify randomized controlled trials (RCTs) focusing on the effects of DEX on perioperative opioid consumption and postoperative pain intensity in patients undergoing neurosurgery...
January 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28077734/intake-of-up-to-3-eggs-per-day-is-associated-with-changes-in-hdl-function-and-increased-plasma-antioxidants-in-healthy-young-adults
#6
Diana M DiMarco, Gregory H Norris, Courtney L Millar, Christopher N Blesso, Maria Luz Fernandez
BACKGROUND: HDL function may be more important than HDL concentration in determining risk for cardiovascular disease. In addition, HDL is a carrier of carotenoids and antioxidant enzymes, which protect HDL and LDL particles against oxidation. OBJECTIVE: The goal of this study was to determine the impact of consuming 0-3 eggs/d on LDL and HDL particle size, HDL function, and plasma antioxidants in a young, healthy population. METHODS: Thirty-eight healthy men and women [age 18-30 y, body mass index (in kg/m(2)) 18...
January 11, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28077414/implementation-of-a-consumer-focused-ehealth-intervention-for-people-with-moderate-to-high-cardiovascular-disease-risk-protocol-for-a-mixed-methods-process-evaluation
#7
Genevieve M Coorey, Lis Neubeck, Timothy Usherwood, David Peiris, Sharon Parker, Annie Y S Lau, Clara Chow, Kathryn Panaretto, Mark Harris, Nicholas Zwar, Julie Redfern
INTRODUCTION: Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understanding how, why and among whom such strategies have an effect can help determine the requirements for implementing them at a scale. This paper aims to detail a process evaluation that will (1) assess implementation fidelity of a multicomponent eHealth intervention; (2) determine its effective features; (3) explore contextual factors influencing and maintaining user engagement; and (4) describe barriers, facilitators, preferences and acceptability of such interventions...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28067711/early-goal-directed-therapy-for-sepsis-a-novel-solution-for-discordant-survival-outcomes-in-clinical-trials
#8
Andre C Kalil, Daniel W Johnson, Steven J Lisco, Junfeng Sun
OBJECTIVES: Early goal-directed therapy has shown discordant survival outcomes in sepsis studies. We aim to find the reasons for this discordance. DESIGN: Random-effects and Bayesian hierarchical analyses. SETTING: Studies that evaluated early goal-directed therapy. SUBJECTS: Patients with severe sepsis and/or septic shock. INTERVENTIONS: Early goal-directed therapy. MEASUREMENTS AND MAIN RESULTS: A total of 19,998 patients were included in the main analysis: 31 observational (n = 15,656) and six randomized (n = 4,342) studies...
January 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28066808/effect-of-mr-imaging-contrast-thresholds-on-prediction-of-neoadjuvant-chemotherapy-response-in-breast-cancer-subtypes-a-subgroup-analysis-of-the-acrin-6657-i-spy-1-trial
#9
Wen Li, Vignesh Arasu, David C Newitt, Ella F Jones, Lisa Wilmes, Jessica Gibbs, John Kornak, Bonnie N Joe, Laura J Esserman, Nola M Hylton
Functional tumor volume (FTV) measurements by dynamic contrast-enhanced magnetic resonance imaging can predict treatment outcomes for women receiving neoadjuvant chemotherapy for breast cancer. Here, we explore whether the contrast thresholds used to define FTV could be adjusted by breast cancer subtype to improve predictive performance. Absolute FTV and percent change in FTV (ΔFTV) at sequential time-points during treatment were calculated and investigated as predictors of pathologic complete response at surgery...
December 2016: Tomography: a Journal for Imaging Research
https://www.readbyqxmd.com/read/28060767/cytotoxic-t-lymphocyte-associated-protein-4-49a-g-polymorphisms-contribute-to-the-risk-of-type-1-diabetes-in-children-an-updated-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#10
Bo Wang, Wei Du, Yutao Jia, Xiaobai Zhang, Guorui Ma
Type 1 diabetes (T1D) is a heritable disease associated with multiple genetic variants. This systematic review and meta-analysis assessed the correlation between cytotoxic T-lymphocyte-associated protein 4(CTLA-4) +49A/G polymorphisms and the risk of T1D in children. The random effects model was used to estimate the related odds ratios (ORs) and 95% confidence intervals (CIs). Trial sequential analysis (TSA) was used to determine whether the currently available evidence was sufficient and conclusive. Our results indicated that CTLA-4 gene polymorphisms significantly increased the risk of childhood T1D in an allelic model (G vs...
January 2, 2017: Oncotarget
https://www.readbyqxmd.com/read/28057037/role-of-vasopressin-and-terlipressin-in-refractory-shock-compared-to-conventional-therapy-in-the-neonatal-and-pediatric-population-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#11
Reem Masarwa, Gideon Paret, Amichai Perlman, Shimon Reif, Bruria Hirsh Raccah, Ilan Matok
BACKGROUND: Vasopressin (AVP) and terlipressin (TP) have been used as last-line therapy in refractory shock in children. However, the efficacy and safety profiles of AVP and TP have not been determined in pediatric refractory shock of different origins. We aimed to assess the efficacy and safety of the addition of AVP/TP therapy in pediatric refractory shock of all causes compared to conventional therapy with fluid resuscitation and vasopressor and inotropic therapy. METHODS: We conducted a systematic review, meta-analysis, and trial sequential analysis (TSA) comparing AVP and TP to conventional therapy...
January 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28052313/thromboelastography-teg-or-rotational-thromboelastometry-rotem-to-monitor-haemostatic-treatment-in-bleeding-patients-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#12
REVIEW
A Wikkelsø, J Wetterslev, A M Møller, A Afshari
Coagulopathy and severe bleeding are associated with high mortality. We evaluated haemostatic treatment guided by the functional viscoelastic haemostatic assays, thromboelastography or rotational thromboelastometry in bleeding patients. We searched for randomised, controlled trials irrespective of publication status, publication date, blinding status, outcomes published or language from date of inception to 5 January 2016 in six bibliographic databases. We included 17 trials (1493 participants), most involving cardiac surgery...
January 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28044017/cat-and-mouse-search-the-influence-of-scene-and-object-analysis-on-eye-movements-when-targets-change-locations-during-search
#13
Anne P Hillstrom, Joice D Segabinazi, Hayward J Godwin, Simon P Liversedge, Valerie Benson
We explored the influence of early scene analysis and visible object characteristics on eye movements when searching for objects in photographs of scenes. On each trial, participants were shown sequentially either a scene preview or a uniform grey screen (250 ms), a visual mask, the name of the target and the scene, now including the target at a likely location. During the participant's first saccade during search, the target location was changed to: (i) a different likely location, (ii) an unlikely but possible location or (iii) a very implausible location...
February 19, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28029718/a-smart-data-analysis-method-for-constructing-adaptive-treatment-strategies-for-substance-use-disorders
#14
Inbal Nahum-Shani, Ashkan Ertefaie, Xi Lu, Kevin G Lynch, James R McKay, David Oslin, Daniel Almirall
AIMS: To demonstrate how Q-learning, a novel data analysis method, can be used with data from a sequential, multiple assignment, randomized trial (SMART) to construct empirically an adaptive treatment strategy (ATS) that is more tailored than the ATSs already embedded in a SMART. METHOD: We use Q-learning with data from the Extending Treatment Effectiveness of Naltrexone (ExTENd) SMART (N = 250) to construct empirically an ATS employing naltrexone, behavioral intervention, and telephone disease management to reduce alcohol consumption over 24 weeks in alcohol dependent individuals...
December 28, 2016: Addiction
https://www.readbyqxmd.com/read/28018971/integrated-multicohort-analysis-of-systemic-sclerosis-identifies-robust-transcriptional-signature-of-disease-severity
#15
Shane Lofgren, Monique Hinchcliff, Mary Carns, Tammara Wood, Kathleen Aren, Esperanza Arroyo, Peggie Cheung, Alex Kuo, Antonia Valenzuela, Anna Haemel, Paul J Wolters, Jessica Gordon, Robert Spiera, Shervin Assassi, Francesco Boin, Lorinda Chung, David Fiorentino, Paul J Utz, Michael L Whitfield, Purvesh Khatri
Systemic sclerosis (SSc) is a rare autoimmune disease with the highest case-fatality rate of all connective tissue diseases. Current efforts to determine patient response to a given treatment using the modified Rodnan skin score (mRSS) are complicated by interclinician variability, confounding, and the time required between sequential mRSS measurements to observe meaningful change. There is an unmet critical need for an objective metric of SSc disease severity. Here, we performed an integrated, multicohort analysis of SSc transcriptome data across 7 datasets from 6 centers composed of 515 samples...
December 22, 2016: JCI Insight
https://www.readbyqxmd.com/read/28018015/bayesian-nonparametric-estimation-for-dynamic-treatment-regimes-with-sequential-transition-times
#16
Yanxun Xu, Peter Müller, Abdus S Wahed, Peter F Thall
We analyze a dataset arising from a clinical trial involving multi-stage chemotherapy regimes for acute leukemia. The trial design was a 2 × 2 factorial for frontline therapies only. Motivated by the idea that subsequent salvage treatments affect survival time, we model therapy as a dynamic treatment regime (DTR), that is, an alternating sequence of adaptive treatments or other actions and transition times between disease states. These sequences may vary substantially between patients, depending on how the regime plays out...
2016: Journal of the American Statistical Association
https://www.readbyqxmd.com/read/28012979/contribution-of-a-reflective-debriefing-to-nursing-students-clinical-judgment-in-patient-deterioration-simulations-a-mixed-methods-study
#17
Patrick Lavoie, Jacinthe Pepin, Sylvie Cossette
BACKGROUND: While reflection is a hallmark of debriefing, there is little understanding of how it contributes to nursing students' clinical judgment. OBJECTIVES: The aim of this study was to describe how nursing students perceived that the Reflective dEbriefing after a PatieNt Deterioration simulation (REsPoND) fostered learning and how it contributed to their clinical judgment in patient deterioration simulations. DESIGN: A sequential explanatory mixed-methods study...
December 16, 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27998961/do-all-patients-with-advanced-her2-positive-breast-cancer-need-upfront-chemo-when-receiving-trastuzumab-randomized-phase-iii-trial-sakk-22-99
#18
O Pagani, D Klingbiel, T Ruhstaller, F Nolè, S Eppenberger, C Oehlschlegel, J Bernhard, P Brauchli, D Hess, C Mamot, E Munzone, B Pestalozzi, M Rabaglio, S Aebi, K Ribi, C Rochlitz, K Rothgiesser, B Thürlimann, R von Moos, K Zaman, A Goldhirsch
BackgroundHER2-targeted therapy plus chemotherapy is standard treatment in advanced HER2+ breast cancer. Trastuzumab alone followed by addition of chemotherapy at disease progression versus upfront combination therapy has not been elucidated.Patients and methodsOne-hundred-seventy-five patients with measurable/evaluable HER2+ advanced disease without previous HER2-directed therapy were randomized to trastuzumab alone followed, at disease progression, by the combination with chemotherapy (Arm A) or upfront trastuzumab plus chemotherapy (Arm B)...
December 19, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27995425/prophylactic-mesh-to-prevent-parastomal-hernia-after-end-colostomy-a-meta-analysis-and-trial-sequential-analysis
#19
REVIEW
M López-Cano, H-T Brandsma, K Bury, B Hansson, I Kyle-Leinhase, J G Alamino, F Muysoms
PURPOSE: Prevention of parastomal hernia (PSH) formation is crucial, given the high prevalence and difficulties in the surgical repair of PSH. To investigate the effect of a preventive mesh in PSH formation after an end colostomy, we aimed to meta-analyze all relevant randomized controlled trials (RCTs). METHODS: We searched five databases. For each trial, we extracted risk ratios (RRs) of the effects of mesh or no mesh. The primary outcome was incidence of PSH with a minimum follow-up of 12 months with a clinical and/or computed tomography diagnosis...
December 19, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27990167/relative-bioavailability-of-three-formulations-of-galunisertib-administered-as-monotherapy-in-patients-with-advanced-or-metastatic-cancer
#20
Ivelina Gueorguieva, Ann Cleverly, Durisala Desaiah, Analia Azaro, Joan Seoane, Irene Braña, Elisabet Sicart, Colin Miles, Michael M Lahn, Malcolm I Mitchell, Jordi Rodon
OBJECTIVE: Galunisertib (LY2157299 monohydrate), an inhibitor of the transforming growth factor β (TGFβ) pathway, is currently under investigation in several clinical trials involving multiple tumor types. The primary objective of this study was to assess relative bioavailability of two new galunisertib formulations developed using the roller compaction (RC) dry-milled (RCD) and RC slurry-milled (RCS) processes, compared with the existing formulation developed using the high-sheer wet granulation (HSWG) process...
2016: Drugs in Context
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