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https://www.readbyqxmd.com/read/28325520/percutaneous-revascularization-of-coronary-chronic-total-occlusion-toward-a-reappraisal-of-the-available-evidence
#1
REVIEW
Pasi P Karjalainen, Wail Nammas
Chronic total occlusion (CTO) is a challenging subset of coronary artery disease that is commonly encountered in real-world practice; it is associated with worse long-term prognosis. Observational studies suggest that percutaneous coronary intervention (PCI) for CTO is associated with reduction in myocardial ischemia and improvement in quality of life and left ventricular function. Some observational studies suggested that CTO-PCI is associated with improvement of the 'hard' clinical endpoints; others did not...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28319804/are-diabetes-guidelines-truly-evidence-based
#2
REVIEW
Matthew F Bouchonville, Sara Matani, Jason J DuBroff, Robert J DuBroff
The global epidemic of obesity and diabetes underscores the urgency to develop strategies to prevent cardiovascular (CV) disease in this vulnerable population. Clinical guidelines are intended to help the clinician manage these patients, but guidelines are often discordant among professional organizations and not always evidence based. Clinicians must rely upon the best available evidence, and therefore we critically reviewed the evidence behind the American Diabetes Association (ADA) 2016 guidelines on the prevention of CV disease in diabetes...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28281183/a-phase-1b-dose-expansion-study-of-the-pan-class-i-pi3k-inhibitor-buparlisib-bkm120-plus-carboplatin-and-paclitaxel-in-pten-deficient-tumors-and-with-dose-intensified-carboplatin-and-paclitaxel
#3
Lillian M Smyth, Kelsey R Monson, Komal Jhaveri, Alexander Drilon, Bob T Li, Wassim Abida, Gopa Iyer, John F Gerecitano, Mrinal Gounder, James J Harding, Martin H Voss, Vicky Makker, Alan L Ho, Pedram Razavi, Alexia Iasonos, Philip Bialer, Mario E Lacouture, Jerrold B Teitcher, Joseph P Erinjeri, Nora Katabi, Matthew G Fury, David M Hyman
Purpose We previously reported the phase I dose escalation study of buparlisib, a pan-class 1A PI3K inhibitor, combined with platinum/taxane-based chemotherapy in patients with advanced solid tumors. The combination was well tolerated and promising preliminary efficacy was observed in PTEN deficient tumors. This phase I dose expansion study now evaluates buparlisib plus high dose carboplatin and paclitaxel in unselected patients with advanced solid tumors and buparlisib plus standard dose carboplatin and paclitaxel in patients with PTEN deficient tumors (ClinicalTrials...
March 9, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28230637/mtor-inhibition-and-cardiovascular-diseases-cardiac-hypertrophy
#4
Ernesto Paoletti
Left ventricular hypertrophy (LVH) is highly prevalent in kidney transplant recipients, and is associated with poor clinical outcome. Immunosuppressive agents might affect LVH behavior after kidney transplantation. This review is an appraisal of available data regarding LVH in renal transplantation and especially of studies that evaluated LVH response to treatment. In particular, the role of mammalian target of rapamycin inhibitors adopted as immunosuppressive agents in kidney transplantation is reviewed in the light of recent studies that have shown LVH regression induced by this class of medications in kidney transplant recipients with posttransplant cardiomyopathy...
February 23, 2017: Transplantation
https://www.readbyqxmd.com/read/28214841/drug-dosing-and-estimated-renal-function-any-step-forward-from-effersoe
#5
Mads Hornum, Bo Feldt-Rasmussen
Drug dosing in accordance with the renal function is a long-standing challenge to clinicians. For many years it has been evident that in many clinical situations there is no easy way to correctly dose any drug that is mainly cleared by the kidneys. Despite the development of many formulas for estimating the glomerular filtration rate, they all have serious shortcomings. Much effort has been put in to develop estimation formulas to evaluate the renal function as an alternative to direct methods with the aim of safely dosing drugs that are mainly cleared by the kidneys...
February 18, 2017: Nephron
https://www.readbyqxmd.com/read/28205339/doing-it-hard-in-the-bush-aligning-what-gets-measured-with-what-matters
#6
Malcolm I McDonald, Kenny D Lawson
What gets measured gets managed. Funding of health services is substantially determined by operational activity and specific outcome indicators. In day-to-day clinical decision-making, surrogate markers, such as glycosylated haemoglobin and blood pressure, are commonly used to modify risks of 'hard' outcomes that include kidney failure, ischaemic cardiac events, stroke and all-cause mortality. In many settings, surrogates are all we have to go on. As a consequence, current health funding models heavily rely on surrogate-based key performance indicators [KPIs]...
February 16, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28191271/the-unchartered-frontier-preventive-cardiology-between-the-ages-of-15-and-35-years
#7
Holly Gooding, Heather M Johnson
It is well established that atherosclerosis, the pathological basis of cardiovascular disease (CVD), begins in childhood and progresses steadily between the ages of 15 to 35 years. These adolescent and young adult years are also marked by significant physiological, psychological, and sociodemographic changes that impact both CVD risk factor development and CVD prevention and treatment strategies. In this review, we highlight the importance of the primordial prevention of CVD risk factors before they ever occur and the primary prevention of CVD by treating CVD risk factors in this age group...
September 2016: Current Cardiovascular Risk Reports
https://www.readbyqxmd.com/read/28152385/propofol-fentanyl-interaction-in-beagles-apnea-response-to-mechanical-ventilation-endotracheal-tube-and-tetanic-stimulation
#8
T Iizuka, K Masui, T Miyabe-Nishiwaki, H Kanazawa, R Nishimura
The objective of this study was to characterize the propofol-fentanyl interaction in Beagles for four pharmacodynamic endpoints: apnea, response to mechanical ventilation, endotracheal tube, and tetanic stimulation. After anesthesia was induced with varying combinations of propofol and fentanyl, the pharmacodynamic endpoints were assessed in intubated dogs (n=6) using the cross-over design. Effective concentrations of propofol plasma concentration (Cp) and fentanyl Cp were assessed using additive, reduced Greco, Minto, and hierarchical interaction models...
January 23, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28134125/hierarchical-testing-of-composite-endpoints-applying-the-win-ratio-to-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-the-syntax-trial
#9
Milan Milojevic, Stuart J Head, Eleni-Rosalina Andrinopoulou, Patrick W Serruys, Friedrich W Mohr, Jan G Tijssen, A Pieter Kappetein
AIMS: Compare long-term outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG), accounting for the clinical impact of individual components in the composite endpoints and prioritizing these using the win ratio (Rw). METHODS AND RESULTS: The win ratio was compared with conventional methods of analyses [hazard ratio (HR) and relative risk] in the SYNTAX trial (n=1800). For the composite of death/stroke/myocardial infarction (MI), the win ratio favoured CABG and was 1...
January 31, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28112940/adaptive-landscape-flattening-accelerates-sampling-of-alchemical-space-in-multisite-%C3%AE-dynamics
#10
Ryan L Hayes, Kira A Armacost, Jonah Z Vilseck, Charles L Brooks
Multisite λ dynamics (MSλD) is a powerful emerging method in free energy calculation that allows prediction of relative free energies for a large set of compounds from very few simulations. Calculating free energy differences between substituents that constitute large volume or flexibility jumps in chemical space is difficult for free energy methods in general, and for MSλD in particular, due to large free energy barriers in alchemical space. This study demonstrates that a simple biasing potential can flatten these barriers and introduces an algorithm that determines system specific biasing potential coefficients...
February 10, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28094130/acute-systolic-heart-failure-with-normal-admission-bnp-clinical-features-and-outcomes
#11
Hesham R Omar, Maya Guglin
INTRODUCTION: The characteristics and outcomes of patients hospitalized with acute systolic heart failure (HF) and normal admission B-type natriuretic peptide (BNP) has not been previously explored. METHODS: Using the ESCAPE trial data, we compared patients with acute HF and left ventricular ejection fraction (LVEF) ≤30% who have either normal or elevated BNP on the day of hospitalization. The study endpoints were 30-day and 6-month mortality, all-cause rehospitalization and rehospitalization for HF...
December 20, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28091709/use-of-in-silico-models-for-prioritization-of-heat-induced-food-contaminants-in-mutagenicity-and-carcinogenicity-testing
#12
Falko Frenzel, Thorsten Buhrke, Irina Wenzel, Jennifer Andrack, Jan Hielscher, Alfonso Lampen
Numerous Maillard reaction and lipid oxidation products are present in processed foods such as heated cereals, roasted meat, refined oils, coffee, and juices. Due to the lack of experimental toxicological data, risk assessment is hardly possible for most of these compounds. In the present study, an in silico approach was employed for the prediction of the toxicological endpoints mutagenicity and carcinogenicity on the basis of the structure of the respective compound, to examine (quantitative) structure-activity relationships for more than 800 compounds...
January 16, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28090762/use-of-ace-inhibition-and-blood-pressure-management-in-deferring-dialysis-initiation
#13
Lucia Del Vecchio, Ugo Teatini, Francesco Locatelli
Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for <140/90 mmHg is suggested for non-proteinuric CKD patients...
June 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28063051/optimized-mouse-models-for-liver-fibrosis
#14
Yong Ook Kim, Yury Popov, Detlef Schuppan
Fibrosis is the excessive accumulation of extracellular matrix components due to chronic injury, with collagens as predominant structural components. Liver fibrosis can progress to cirrhosis, which is characterized by a severe distortion of the delicate hepatic vascular architecture, the shunting of the blood supply away from hepatocytes and the resultant functional liver failure. Cirrhosis is associated with a highly increased morbidity and mortality and represents the major hard endpoint in clinical studies of chronic liver diseases...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28040285/diagnostic-performance-of-a-high-sensitive-troponin-t-assay-and-a-troponin-t-point-of-care-assay-in-the-clinical-routine-of-an-emergency-department-a-clinical-cohort-study
#15
Anna Slagman, Johannes von Recum, Martin Möckel, Fabian Holert, Dirk Meyer Zum Büschenfelde, Christian Müller, Julia Searle
BACKGROUND: A point of care test (POCT) for troponin T (TnT) in the Emergency Department (ED) was compared to a high-sensitivity TnT (hsTnT) central laboratory test (CLT) to determine the influence of test system and different cut-off values on the diagnostic performance in patients with suspected acute coronary syndrome (ACS) under routine conditions. METHODS: All patients with routine TnT testing in the ED were enrolled. Only internal medicine patients without STEMI and with both troponin values were analyzed...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28011313/prognostic-value-of-high-sensitivity-cardiac-troponin-t-compared-with-risk-scores-in-stable-cardiovascular-disease
#16
Moritz Biener, Evangelos Giannitsis, Manuel Kuhner, Thomas Zelniker, Matthias Mueller-Hennessen, Mehrshad Vafaie, Dietmar Trenk, Franz-Josef Neumann, Willibald Hochholzer, Hugo A Katus
BACKGROUND: Risk stratification of patients with cardiovascular disease remains challenging despite consideration of risk scores. METHODS: We aimed to evaluate the prognostic performance of high-sensitivity cardiac troponin T in a low-risk outpatient population presenting for nonsecondary and secondary prevention. All-cause mortality, a composite of all-cause mortality, acute myocardial infarction, and stroke (end point 2), and a composite of all-cause mortality, acute myocardial infarction, stroke and rehospitalization for acute coronary syndrome, and decompensated heart failure (end point 3) were defined...
December 21, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27977053/protease-modulating-matrix-treatments-for-healing-venous-leg-ulcers
#17
REVIEW
Maggie J Westby, Gill Norman, Jo C Dumville, Nikki Stubbs, Nicky Cullum
BACKGROUND: Venous leg ulcers (VLUs) are open skin wounds on the lower leg that occur because of poor blood flow in the veins of the leg; leg ulcers can last from weeks to years, and are both painful and costly. Prevalence in the UK is about 2.9 cases per 10,000 people. First-line treatment for VLUs is compression therapy, but around 60% of people have unhealed ulcers after 12 weeks' treatment and about 40% after 24 weeks; therefore, there is scope for further improvement. Limited evidence suggests non-healing leg ulcers may have persisting elevated levels of proteases, which is thought to deter the later stages of healing; thus, timely protease-modulating matrix (PMM) treatments may improve healing by physically removing proteases from the wound fluid...
December 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27960172/effect-of-ast-120-in-chronic-kidney-disease-treatment-still-a-controversy
#18
REVIEW
Junna Yamaguchi, Tetsuhiro Tanaka, Reiko Inagi
AST-120 (kremezin; Kureha Chemical, Tokyo, Japan) is an oral spherical carbonaceous adsorbent, which was approved for clinical use in Japanese chronic kidney disease (CKD) patients in 1991. It adsorbs indole, the precursor of indoxyl sulfate, in the intestines and prevents indoxyl sulfate production. Indoxyl sulfate, initially identified as a major uremic toxin that causes uremic symptoms, contributes to CKD progression. Since AST-120 decreases serum indoxyl sulfate in a dose-dependent manner, multicenter prospective trials have been conducted in Japan in the 1980s; these trials were mostly in favor of the efficacy of AST-120 in delaying the initiation of dialysis in patients with advanced stage CKD...
2017: Nephron
https://www.readbyqxmd.com/read/27958695/aldosterone-receptor-antagonists-decrease-mortality-and-cardiovascular-hospitalizations-in-chronic-heart-failure-chf-with-reduced-left-ventricular-ejection-fraction-lvef-but-not-in-chf-with-preserved-lvef-a-meta-analysis-of-randomized-controlled-trials
#19
Renato DE Vecchis, Carmelina Ariano
INTRODUCTION: Aldosterone receptor antagonists (ARAs) were introduced in the treatment of chronic heart failure (CHF), as a result of the demonstration of their protective effect on the failing heart. However, important questions remain unanswered regarding the clinical efficacy of the ARAs on the clinical and echocardiographic phenotype of heart failure, called heart failure with preserved left ventricular ejection fraction( HFpEF). EVIDENCE ACQUISITION: The aim of the present meta-analysis was to verify the impact of the ARAs on some hard endpoints, such as all - cause death and hospitalizations from cardiovascular cause, making a comparative evaluation of these outcomes in CHF patients with reduced left ventricular ejection fraction (HFREF) and in those with HFpEF, respectively...
December 13, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27931809/report-on-the-rat-pig-a-assay-using-an-anti-rat-erythroid-marker-his49-antibody-in-a-single-dose-study-of-1-2-dimethylhydrazine
#20
Satsuki Chikura, Yuki Okada, Takafumi Kimoto, Hideshi Kaneko, Daishiro Miura, Yoshinori Kasahara
As part of a collaborative study in the Mammalian Mutagenicity Study (MMS) Group of the Japanese Environmental Mutagen Society (JEMS), we investigated the in vivo genotoxicity profile of 1,2-dimethylhydrazine (DMH) using a Pig-a assay in total red blood cells (RBC Pig-a assay) or a reticulocyte Pig-a assay (PIGRET assay). We also assessed the genotoxic potential of DMH using both a bone marrow micronucleus test and a liver comet assay as follow-up studies. Single administration of 25, 50, 100mg/kg DMH to male rats did not show time- or dose-related increases in Pig-a mutant frequency (MF) in either the RBC Pig-a or PIGRET assays up to 4 weeks after treatment...
November 15, 2016: Mutation Research
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