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Benefit analysis

Helena Sandoval-Insausti, Raúl F Pérez-Tasigchana, Esther López-García, José R Banegas, Fernando Rodríguez-Artalejo, Pilar Guallar-Castillón
BACKGROUND: The prospective association between protein intake and falls has been little studied. We assessed this association in a Spanish community-dwelling cohort. METHODS: We performed a prospective cohort study of 2464 men and women 60 years or older who were recruited in 2008-2010 and followed up through 2012. At baseline, the habitual protein intake was determined with a validated dietary history. At the end of follow-up, participants reported the number of falls experienced in the preceding year...
December 5, 2018: Journal of the American Geriatrics Society
Shaikh M Ahmad, Md J Alam, Afsana Khanam, Mamunur Rashid, Sharmin Islam, Yearul Kabir, Rubhana Raqib, Mark C Steinhoff
Background: In the growing embryo, the vitamin A requirement is tightly regulated. Maternal vitamin A deficiency during pregnancy may alter maternal immune function to accommodate the fetus. Objective: Our primary objective was to determine the effect of oral vitamin A supplementation (VAS) during pregnancy and until 6 mo postpartum on pandemic H1N1-vaccine responses in mothers and their infants at 6 mo of age. Methods: In this randomized controlled clinical trial, pregnant women (n = 112) during the second trimester (mean ± SD: 14 ± 1 wk) were assigned to receive either an oral dose of 10,000 IU vitamin A or placebo weekly until 6 mo postpartum...
December 1, 2018: Journal of Nutrition
Michel Pompeu Barros Oliveira Sá, Erik Everton Silva Vieira, Luiz Rafael Pereira Cavalcanti, Roberto Gouveia Silva Diniz, Sérgio da Costa Rayol, Alexandre Motta de Menezes, Ricardo Felipe de Albuquerque Lins, Ricardo Carvalho Lima
OBJECTIVE: We aimed to analyze whether patent foramen ovale (PFO) closure reduces the risk of stroke, assessing also some safety outcomes after the publication of a new trial. INTRODUCTION: The clinical benefit of closing a PFO has been an open question, so it is necessary to review the current state of published medical data in regards to this subject. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were used to search for randomized controlled trials (RCTs) that reported any of the following outcomes: stroke, death, major bleeding or atrial fibrillation...
September 2018: Brazilian Journal of Cardiovascular Surgery
Maria Teresa Fialho de Sousa Campos, Francisco Miguel Quintão Valente, Raquel Maria Amaral Araújo, Josefina Bressan
This article aims to make reference to some recent mourning aspects considered risk factors for cardiovascular disease, specifically the Takotsubo cardiomyopathy. The objective was to describe the stress from the death of a loved one combining it to the possibility of occurrence of Takotsubo cardiomyopathy through the perception of a traumatic event by the cortex, which triggers the subcortical brain circuit affecting the endocrine response. Given the growing acknowledgement of this cardiomyopathy, it is possible to contextualize the nutritional behaviours and decisions surrounding it, whose benefits must exceed the condition of temporary cardiac dysfunction and extend to food choices that have some influence in the limbic system...
October 2018: Revista da Associação Médica Brasileira
Ding Zhu, Mindan Wu, Yuan Cao, Shihua Lin, Nanxia Xuan, Chen Zhu, Wen Li, Huahao Shen
INTRODUCTION: We performed a meta-analysis on whether heated humidification during positive airway pressure (PAP) could improve compliance and subjective daytime sleepiness in obstructive sleep apnea syndrome (OSAS) patients. MATERIALS AND METHODS: We searched PubMed, EMBASE, Medline, Cochrane Library, Clinical Trials, Web of Science and Scopus from inception to Oct 29, 2017. We made meta-analysis on the all available randomized controlled trials (RCTs) which assessed effects of heated humidification intervention on PAP compliance and subjective daytime sleepiness, by subgroups of automatic adjusting positive airway pressure/ continuous positive airway pressure (APAP/CPAP) usage and patients with/without upper airway symptoms prior to PAP therapy...
2018: PloS One
Christina H Buckton, Chris Patterson, Lirije Hyseni, S Vittal Katikireddi, Ffion Lloyd-Williams, Alex Elliott-Green, Simon Capewell, Shona Hilton
BACKGROUND: Excess sugar consumption, including sugar-sweetened beverages (SSBs), contributes to a variety of negative health outcomes, particularly for young people. The mass media play a powerful role in influencing public and policy-makers' perceptions of public health issues and their solutions. We analysed how sugar and SSB policy debates were presented in UK newspapers at a time of heightened awareness and following the announcement of the UK Government's soft drinks industry levy (SDIL), to inform future public health advocacy...
2018: PloS One
Sheila A M Rauch, H Myra Kim, Corey Powell, Peter W Tuerk, Naomi M Simon, Ron Acierno, Carolyn B Allard, Sonya B Norman, Margaret R Venners, Barbara O Rothbaum, Murray B Stein, Katherine Porter, Brian Martis, Anthony P King, Israel Liberzon, K Luan Phan, Charles W Hoge
Importance: Meta-analyses of treatments for posttraumatic stress disorder (PTSD) suggest that trauma-focused psychotherapies produce greater benefits than antidepressant medications alone. Objective: To determine the relative efficacy of prolonged exposure therapy plus placebo, prolonged exposure therapy plus sertraline hydrochloride, and sertraline plus enhanced medication management in the treatment of PTSD. Design, Setting, and Participants: The Prolonged Exposure and Sertraline Trial was a randomized, multisite, 24-week clinical trial conducted at the Veterans Affairs Ann Arbor Healthcare System, Veterans Affairs San Diego Healthcare System, Ralph H...
December 5, 2018: JAMA Psychiatry
Saptharishi Lalgudi Ganesan
PURPOSE OF REVIEW: In patients with acute respiratory distress syndrome (ARDS), the airway pressure release ventilation (APRV) has been purported to have several physiological benefits. This review synthesizes recent research evaluating APRV mode and provides perspectives on the utility of this mode in children with ARDS. RECENT FINDINGS: Two single-center clinical trials on APRV, one adult and one pediatric, have been published this year. These two trials have not only elicited editorials and letters that highlight some of their strengths and weaknesses but also rekindled debate on several aspects of APRV...
December 3, 2018: Current Opinion in Critical Care
Michelle Barakat-Johnson, Michelle Lai, Timothy Wand, Fiona Coyer, Kathryn White
Incontinence-associated dermatitis (IAD) is a common, painful, difficult-to-treat skin condition. PURPOSE: A 2-part, quasi-experimental, post-test study was conducted to evaluate the impact of prevention initiatives on IAD prevalence and incontinence practices. METHOD: In part 1, from May 2017 to November 2017, a quasi-experimental post-test study design was conducted in a health district in Australia. Following an audit of IAD prevalence and identification of evidence practice gaps in 4 hospitals in a local health district (12 wards, 250 patients), an implementation science approach was used to implement evidence-based initiatives...
December 2018: Ostomy/wound Management
Marco Roffi, Dragana Radovanovic, Juan F Iglesias, Franz R Eberli, Philip Urban, Giovanni B Pedrazzini, Paul Erne, Hans Rickli
INTRODUCTION: Limited data are available on the impact of multisite artery disease in patients with acute coronary syndromes. In particular, it is unknown whether the outcomes of those high-risk patients have improved over time. Therefore, we addressed the multisite artery disease patient population enrolled in the Swiss nationwide prospective acute coronary syndromes cohort study AMIS Plus over two decades. METHODS: All patients enrolled from January 1999 to October 2016 were stratified according to the presence of isolated coronary artery disease or multisite artery disease, defined as coronary artery disease with known concomitant vascular disease (i...
December 5, 2018: European Heart Journal. Acute Cardiovascular Care
Xiaowei Qiu, Hang Yuan, Bin Sima
BACKGROUND: The aim of this study was to investigate the relationship between EGFR mutation and computed tomography (CT) features in patients with adenocarcinoma of the lung. METHODS: One hundred and ninety two lung adenocarcinoma patients who underwent surgery were retrospectively included in this study. Examination of EGFR gene mutation was performed on all resected tumor samples. The 192 recruited lung adenocarcinoma patients were divided into groups according to EGFR mutation status: patients with mutations in exons 18-21 (effective mutated, n = 61) and non-mutated (n = 131)...
December 5, 2018: Thoracic Cancer
Lucas Moreno, Sucheta J Vaidya, Dominik Schrey, C Ross Pinkerton, Ian J Lewis, Pamela R Kearns, David Machin, Andrew D J Pearson
BACKGROUND: The European Neuroblastoma Study Group 5 (ENSG5) trial showed that time-intensive "rapid" induction chemotherapy (COJEC) was superior to "standard" 3-weekly chemotherapy for children with high-risk metastatic neuroblastoma. Long-term outcomes of the ENSG5 trial were analysed. PROCEDURE: Patients with metastatic neuroblastoma aged ≥12 months were randomly assigned to "standard" or "rapid" induction, receiving the same chemotherapy drugs and doses...
December 5, 2018: Pediatric Blood & Cancer
Masaki Takenaka, Yasuya Inden, Satoshi Yanagisawa, Aya Fujii, Monami Ando, Junya Funabiki, Yosuke Murase, Noriaki Otake, Yusuke Sakamoto, Rei Shibata, Toyoaki Murohara
INTRODUCTION: Patients with advanced heart failure and dyssynchrony can benefit from cardiac resynchronization therapy (CRT). To predict the response to CRT, myocardial viability and improved dyssynchrony are suggested to be important. METHODS: We retrospectively investigated 93 patients who underwent CRT implantation in Nagoya University Hospital. We assessed QRS narrowing the day after implantation to measure the improvement in dyssynchrony and measured the left ventricular pacing threshold (LVPT) to determine the local myocardial viability in all patients...
December 5, 2018: Journal of Cardiovascular Electrophysiology
D J Hepple, J W Durrand, O Bouamra, P Godfrey
The deployment of physician-led pre-hospital enhanced care teams capable of critical care interventions at the scene of injury may confer a survival benefit to victims of major trauma. However, the evidence base for this widely adopted model is disputed. Failure to identify a clear survival benefit has been attributed to several factors, including an inherently more severely injured patient group who are attended by these teams. We undertook a novel retrospective analysis of the impact of a regional enhanced care team on observed vs...
December 5, 2018: Anaesthesia
Gunter von Minckwitz, Chiun-Sheng Huang, Max S Mano, Sibylle Loibl, Eleftherios P Mamounas, Michael Untch, Norman Wolmark, Priya Rastogi, Andreas Schneeweiss, Andres Redondo, Hans H Fischer, William Jacot, Alison K Conlin, Claudia Arce-Salinas, Irene L Wapnir, Christian Jackisch, Michael P DiGiovanna, Peter A Fasching, John P Crown, Pia Wülfing, Zhimin Shao, Elena Rota Caremoli, Haiyan Wu, Lisa H Lam, David Tesarowski, Melanie Smitt, Hannah Douthwaite, Stina M Singel, Charles E Geyer
BACKGROUND: Patients who have residual invasive breast cancer after receiving neoadjuvant chemotherapy plus human epidermal growth factor receptor 2 (HER2)-targeted therapy have a worse prognosis than those who have no residual cancer. Trastuzumab emtansine (T-DM1), an antibody-drug conjugate of trastuzumab and the cytotoxic agent emtansine (DM1), a maytansine derivative and microtubule inhibitor, provides benefit in patients with metastatic breast cancer that was previously treated with chemotherapy plus HER2-targeted therapy...
December 5, 2018: New England Journal of Medicine
Chong Huang, Kangkang Yu, Zheng Jianming, Ning Li
AIM: Steroid treatment in acute-on-chronic liver failure (ACLF) is controversial due to data scarcity. Our aim was to investigate the efficacy of steroid in ACLF patients precipitated by hepatitis B in a retrospective cohort. METHODS: Patients with Hepatitis B-precipitated ACLF were included and categorized according to treatment modalities (steroid vs. control). Survival and clinical characteristics including age, baseline ACLF grade, Model for End-stage Liver Disease (MELD) score, occurrence of infection were compared between the 2 groups...
December 4, 2018: Journal of Digestive Diseases
Annarita Marrano, Pedro J Martínez-García, Luca Bianco, Gina M Sideli, Erica A Di Pierro, Charles A Leslie, Kristian A Stevens, Marc W Crepeau, Michela Troggio, Charles H Langley, David B Neale
Over the last 20 years, global production of Persian walnut (Juglans regia L.) has grown enormously, likely reflecting increased consumption due to its numerous benefits to human health. However, advances in genome-wide association (GWA) studies and genomic selection (GS) for agronomically important traits in walnut remain limited due to the lack of powerful genomic tools. Here, we present the development and validation of a high-density 700K single nucleotide polymorphism (SNP) array in Persian walnut. Over 609K high-quality SNPs have been thoroughly selected from a set of 9...
November 22, 2018: Plant Biotechnology Journal
Jesse Elliott, Deirdre DeJean, Tammy Clifford, Doug Coyle, Beth K Potter, Becky Skidmore, Christine Alexander, Alexander E Repetski, Vijay Shukla, Bláthnaid McCoy, George A Wells
OBJECTIVE: To assess the benefits and harms of cannabis-based products for pediatric epilepsy. METHODS: We identified in this living systematic review randomized controlled trials (RCTs) and nonrandomized studies (NRSs) involving children with epilepsy treated with cannabis-based products. We searched MEDLINE, Embase, PsycINFO, Cochrane Library, and gray literature (April 25, 2018). The primary outcome was seizure freedom; secondary outcomes were seizure frequency (total, ≥50% reduction), quality of life, sleep, status epilepticus, death, gastrointestinal adverse events, and visits to the emergency room...
December 4, 2018: Epilepsia
J A Fox, D Langbecker, J Rosenberg, S Ekberg
BACKGROUND: Recent advances in advanced melanoma therapies are associated with improved survival for some patients. How patients with diagnoses of advanced disease and their carers experience this expanding treatment paradigm, however, is not well understood. OBJECTIVES: We explored bereaved carers' accounts of the trajectory of advanced melanoma involving treatment by immune or targeted therapies to build an understanding of their experiences of care relating to diagnosis and prognosis...
December 4, 2018: British Journal of Dermatology
Min Huang, M Catherine Pietanza, Ayman Samkari, James Pellissier, Thomas Burke, Sheenu Chandwani, Fansen Kong, A Simon Pickard
OBJECTIVES: Pembrolizumab monotherapy showed significantly longer overall survival and fewer treatment-related adverse events compared to chemotherapy in patients with advanced or metastatic non-small cell lung cancer (NSCLC) with programmed death ligand-1 (PD-L1)-positive tumors in the first-line setting in KEYNOTE (KN)-024 and in those previously treated in KN010. The objective of this analysis was to assess the benefit-risk of pembrolizumab in terms of quality-adjusted survival amongst patients in these trials...
December 4, 2018: PharmacoEconomics
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