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Benefit analysis

XiaoMin Wan, YuCong Zhang, JinAn Ma, Chongqing Tan, XiaoHui Zeng, LiuBao Peng
BACKGROUND: The addition of ribociclib (RIB) to letrozole (LET) significantly increases progression free survival for patients with hormone-receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC). We identified the range of drug costs for which RIB could be considered cost effective from a Chinese perspective. METHODS: A discrete event simulation model was developed to model the treatment sequences among patients with ABC...
October 16, 2018: Breast: Official Journal of the European Society of Mastology
Matthew W R Stevens, Daniel L King, Diana Dorstyn, Paul H Delfabbro
OBJECTIVE: While there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases (ICD-11), relatively little is known about the effectiveness of first-line psychological treatment for gaming disorder or Internet gaming disorder (IGD) as it is listed in the DSM-5. This systematic review employed meta-analytic techniques to determine the effectiveness of cognitive-behavioral therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming...
October 20, 2018: Clinical Psychology & Psychotherapy
Praveen Sharma, Zehra Yonel, Michael Busby, Iain L Chapple, Thomas Dietrich
AIMS: To explore the associations between periodontal status and patient reported outcomes (PROs) in a large cohort of patients based in non-specialist general dental practice. MATERIALS AND METHODS: Analysis was conducted using data from 14,620 patients, in 233 non-specialist dental practices across the UK. As part of routine clinical care, data on periodontal probing depths (PPD), alveolar bone loss (ABL), bleeding on probing (BoP) as well as PROs (oral pain/discomfort, dietary restrictions and dental appearance) were recorded using an online database...
October 20, 2018: Journal of Clinical Periodontology
Laurentiu Craciunas, Nikolaos Tsampras, Nick Raine-Fenning, Arri Coomarasamy
BACKGROUND: Most women undergoing assisted reproduction treatment will reach the stage of embryo transfer (ET), but the proportion of embryos that can be successfully implanted after ET has remained small since the mid-1990s. Human chorionic gonadotropin (hCG) is a hormone that is synthesised and released by the syncytiotrophoblast and has a fundamental role in embryo implantation and the early stages of pregnancy. Intrauterine administration of hCG via ET catheter during a mock procedure around the time of ET is a novel approach that has been suggested to improve the outcomes of assisted reproduction...
October 20, 2018: Cochrane Database of Systematic Reviews
Chamukuttan Snehalatha, Susairaj Priscilla, Arun Nanditha, Raghavan Arun, Krishnamoorthy Satheesh, Ambady Ramachandran
Identification and treatment of individuals with prediabetes is crucial. Effective interventional strategies are key to reducing the diabetes risk at the population level. Lifestyle intervention is found to be more effective but more expensive. Evidence of potential benefits from pharmacotherapy is accumulating. The choice of a pharmacologic intervention to reduce the progression of type 2 diabetes (T2DM) in high risk individuals must consider the balance between the benefit to risk ratio. A meta-analysis of the results of the three important studies has shown that metformin used for up to three years decrease the likelihood of progression to diabetes...
March 2018: Journal of the Association of Physicians of India
Elaine Burke, Mary Teeling, Martina Hennessy
INTRODUCTION: A combined academic and clinical training programme for junior doctors in Ireland, the academic track for internship, has recently been launched. The academic track offers newly graduated doctors protected time within the working week to undertake a research project in addition to funding, an academic supervisor, and additional training in research skills. This study seeks to investigate the views of undergraduate medical students. METHODS: The study population was undergraduate medical students at Trinity College Dublin in their penultimate year of study...
October 20, 2018: Irish Journal of Medical Science
Michael D Quartermain, Kevin D Hill, David J Goldberg, Jeffrey P Jacobs, Marshall L Jacobs, Sara K Pasquali, George R Verghese, Amelia S Wallace, Ross M Ungerleider
The early postnatal course for a newborn with critical congenital heart disease (CHD) can be negatively impacted if diagnosis is delayed. Despite this, there continues to be inconsistent evidence regarding potential benefits associated with prenatal diagnosis (PND) in neonates who undergo cardiac surgery. The objective of this study was to better define the impact of a PND on pre-operative morbidity by utilizing a large clinical database. Neonates (< 30 days) undergoing heart surgery from 2010 to 2014 and entered in the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) were included...
October 19, 2018: Pediatric Cardiology
Wangmi Liu, Jiayan Wu
The present study used the Surveillance, Epidemiology and End Results (SEER) database to identify demographic and prognostic characteristics of lung cancer with bone metastases in the United States from 2010 to 2014. 30,364 patients with metastatic lung cancer to bones were identified in the SEER database. Their information on the basic characteristics and the histological signatures of the cancer was extracted and analyzed. Joinpoint analysis was used to test the trends in annual percentage change (APC) of the incidence...
October 19, 2018: Clinical & Experimental Metastasis
Jing-Yong Song, Shi-Ran Sun, Fang Dong, Tao Huang, Bin Wu, Jing Zhou
BRAFV600E mutation has been thought to be a valuable molecular marker that may predict a worse prognosis for papillary thyroid cancer (PTC). But whether BRAFV600E mutation is associated with lymph node metastasis (LNM) remains controversial. Different surgical strategies may bring a bias in demonsstrating the association between them. In order to delineate a risk stratification to guide a tailored initial approach to tumors that express BRAFV600E mutation, we performed this meta-analysis by using the articles in which total or near-total thyroidectomy plus bilateral central lymph node dissection was routinely performed to avoid the bias from the surgical strategy...
October 2018: Current medical science
Jean-Baptiste LeMeur, Brigitte Lefebvre, Jean-François Proulx, Philippe De Wals
OBJECTIVE: In 2002, a mass immunization campaign using the 23-valent pneumococcal polysaccharide vaccine (PPV23) was carried out in Nunavik to control an outbreak caused by a virulent clone of serotype 1 Streptococcus pneumoniae. At the same time, the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced for routine immunization of infants, replaced by the 10-valent vaccine (PCV10) in 2009, and the 13-valent vaccine (PCV13) in 2011. The objective of this study was to describe the epidemiology of invasive pneumococcal disease (IPD) in relation to pneumococcal vaccine use...
October 19, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Xuexin He, Jiali Ji, Rongrong Dong, Hong Liu, Xiaolan Dai, Chongjian Wang, Francisco J Esteva, Sai-Ching Jim Yeung
BACKGROUND: Metaplastic breast cancer (MpBC) is a rare histological subtype of breast cancer recognized as a unique pathologic entity in 2000. However, the pathogenesis, optimal therapy, and prognosis of MpBC and the potential effect of systemic treatments on different subtypes of MpBC are not well defined. METHODS: A retrospective population-based study was performed to identify breast cancer patients with MpBC and other triple-negative breast cancers (TNBC) between 2010 and 2014 using the surveillance, Epidemiology, and End Results (SEER) database...
October 19, 2018: Breast Cancer Research and Treatment
Kannan Sridharan, Gowri Sivaramakrishnan, Reginald Paul Sequeira, Abdelaziz Elamin
AIM: Several drugs have been used for treating non-alcoholic fatty liver disease (NAFLD). The present study is a network meta-analysis of such drugs. DESIGN, SETTING AND PATIENTS: Randomised clinical trials comparing drug interventions in patients with NAFLD were analysed. OR and weighted mean difference (95 % CI) were the effect estimates for categorical and numerical outcomes, respectively. Random-effects model was used to generate pooled estimates. Surface under the cumulative ranking curve was used to rank the treatments...
October 19, 2018: Postgraduate Medical Journal
Guo Tian, Shigui Yang, Jinqiu Yuan, Diane Threapleton, Qiyu Zhao, Fen Chen, Hongcui Cao, Tian'an Jiang, Lanjuan Li
OBJECTIVE: Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. We conducted network meta-regression within a Bayesian framework to compare and rank different treatment strategies for HCC through direct and indirect evidence from international studies. METHODS AND ANALYSES: We pooled the OR for 1-year, 3-year and 5-year overall survival, based on lesions of size ˂ 3 cm, 3-5 cm and ≤5 cm, using five therapeutic options including resection (RES), radiofrequency ablation (RFA), microwave ablation (MWA), transcatheter arterial chemoembolisation (TACE) plus RFA (TR) and percutaneous ethanol injection (PEI)...
October 18, 2018: BMJ Open
Jiao Liu, Yu Wang, Yujiao Lu, Xiaomeng Ni, Xuan Guo, Jing Zhao, Jiuzhou Chen, Taiwo Dele-Osibanjo, Ping Zheng, Jibin Sun, Yanhe Ma
Corynebacterium glutamicum is frequently engineered to serve as a versatile platform and model microorganism. However, due to its complex cell wall structure, transformation of C. glutamicum with exogenous DNA is inefficient. Although efforts have been devoted to improve the transformation efficiency by using cell wall weakening agents, direct genetic engineering of cell wall synthesis for enhancing cell competency has not been explored thus far. Herein, we reported that engineering of peptidoglycan synthesis could significantly increase the transformation efficiency of C...
October 19, 2018: Applied and Environmental Microbiology
Silvia G V Alvarez, Nee S Khoo, Timothy Colen, Angela McBrien, Luke Eckersley, Paul Brooks, Winnie Savard, Lisa K Hornberger
BACKGROUND: Accurate fetal arrhythmia (FA) diagnosis is key for effective management. Currently, FA assessment relies on standard echocardiography-based techniques (M mode and spectral Doppler), which require adequate fetal position and cursor alignment to define temporal relationships of mechanical events. Few data exist on the application of color Doppler tissue imaging (c-DTI) in FA assessment. The aim of this study was to examine the feasibility and clinical applicability of c-DTI in FA assessment in comparison with standard techniques...
October 16, 2018: Journal of the American Society of Echocardiography
Zuzana Špacírová, David Epstein, Leticia García-Mochón, Virginia A Aparicio, Milkana Borges-Cosic, M Puerto López Del Amo, José J Martín-Martín
OBJECTIVE: Adequate physical activity levels and a healthy lifestyle may prevent all kinds of non-communicable diseases, promote well-being and reduce health-care costs among perimenopausal women. This study assessed an exercise programme for perimenopausal women. METHOD: A total of 150 women (aged 45-64 years) not engaged in regular physical activity were randomly assigned to either a 16 week exercise intervention or to the control group. The study was conducted from the perspective of the National Health System...
October 16, 2018: Gaceta Sanitaria
Serge Korjian, Eugene Braunwald, Yazan Daaboul, Michael Mi, Deepak L Bhatt, Freek W A Verheugt, Marc Cohen, Christoph Bode, Paul Burton, Alexei N Plotnikov, C Michael Gibson
Patients with both acute coronary syndromes (ACS) and congestive heart failure are at an increased risk of recurrent cardiovascular (CV) events attributed in part to both excess thrombin generation and impaired fibrinolysis. We hypothesized that patients with the overlap of ACS and CHF would thus derive particular benefit from antithrombotic therapy with rivaroxaban. ATLAS-ACS-2 Thrombolysis in Myocardial Infarction-51 was a double-blind, multicenter, phase 3 clinical trial that randomized patients within 7 days of an ACS event to standard of care plus either rivaroxaban 2...
September 7, 2018: American Journal of Cardiology
Michelle M Porter, Andrew W Cull
OBJECTIVE: Cataract surgery can have many benefits for older adults, including enabling continued ability to drive. However, it is not known how objectively measured driving patterns change after cataract surgery. The purpose of this study was to examine how participants drove before and after cataract surgery. DESIGN: Longitudinal study. PARTICIPANTS: Individuals from the Winnipeg site of Candrive (a longitudinal study of older drivers in Canada)...
October 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Sisir Siddamsetti, Senthil Balasubramanian, Srikanth Yandrapalli, Aviral Vij, Udit Joshi, Gilbert Tang, Vamsi Kodumuri
The present American College of Cardiology/American Heart Association guidelines (Grade IIb, level of evidence C) recommend dual antiplatelet therapy (DAPT) with aspirin and clopidogrel for 6 months followed by lifelong aspirin after transcathter aortic valve implantation (TAVI). However, studies that have compared DAPT to single antiplatelet therapy (SAPT) after TAVI have questioned this recommendation as DAPT has been associated with more bleeding events compared with SAPT. We performed a meta-analysis of all the trials that compared DAPT to SAPT in patients who underwent TAVI...
October 15, 2018: American Journal of Cardiology
Siw Waffenschmidt, Elke Hausner, Wiebke Sieben, Thomas Jaschinski, Marco Knelangen, Inga Overesch
BACKGROUND: Systematic information retrieval generally requires a two-step selection process for studies, which is conducted by two persons independently of one another (double-screening approach). To increase efficiency, two methods seem promising, which will be tested in the planned study: the use of text mining to prioritize search results as well as the involvement of only one person in the study selection process (single-screening approach). The aim of the present study is to examine the following questions related to the process of study selection: Can the use of the Rayyan or EPPI Reviewer tools to prioritize the results of study selection increase efficiency? How accurately does a single-screening approach identify relevant studies? Which advantages or disadvantages (e...
October 20, 2018: Systematic Reviews
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