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https://www.readbyqxmd.com/read/28743130/sglt-2-inhibition-a-potential-new-treatment-for-diabetic-kidney-disease
#1
Robert D Toto
Diabetic nephropathy is the leading cause of kidney failure. Treatments with drugs that block the renin-angiotensin system have proven beneficial in slowing kidney disease progression among those with diabetes; their benefit is limited and they do not stop disease progression. Despite multiple clinical trials of various interventions including dual blockade of the renin-angiotensin system over the past 15 years, no new therapies have emerged to slow kidney disease progression in diabetes. SGLT-2 inhibitors are a new class of antiglycemic drugs that have been shown to lower blood glucose by inhibition of the sodium-glucose transporter 2 in the proximal tubule of the kidney...
July 26, 2017: Nephron
https://www.readbyqxmd.com/read/28742984/single-versus-combined-immunoregulatory-approach-using-pd-1-and-ctla-4-modulators-in-controlling-sepsis
#2
Courtney P Rudick, David L Cornell, Devendra K Agrawal
Sepsis is a disease process characterized by an extreme inflammatory response followed by a period of severe immunosuppression. In recent years, there has been improved survival in the initial immune response during systemic inflammatory response syndrome, and compensatory anti-inflammatory response, yet is mostly unchanged with 18-30% mortality during the later stage of sepsis despite numerous Phase 3 clinical trials. Areas covered: This review article presents a critical evaluation of the most promising newer studies aimed at improving the immunosuppressive stage of sepsis...
July 25, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28742913/the-effect-of-nursing-quality-improvement-and-mobile-health-interventions-on-infant-sleep-practices-a-randomized-clinical-trial
#3
Rachel Y Moon, Fern R Hauck, Eve R Colson, Ann L Kellams, Nicole L Geller, Timothy Heeren, Stephen M Kerr, Emily E Drake, Kawai Tanabe, Mary McClain, Michael J Corwin
Importance: Inadequate adherence to recommendations known to reduce the risk of sudden unexpected infant death has contributed to a slowing in the decline of these deaths. Objective: To assess the effectiveness of 2 interventions separately and combined to promote infant safe sleep practices compared with control interventions. Design, Setting, and Participants: Four-group cluster randomized clinical trial of mothers of healthy term newborns who were recruited between March 2015 and May 2016 at 16 US hospitals with more than 100 births annually...
July 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28742880/same-day-hiv-testing-with-initiation-of-antiretroviral-therapy-versus-standard-care-for-persons-living-with-hiv-a-randomized-unblinded-trial
#4
Serena P Koenig, Nancy Dorvil, Jessy G Dévieux, Bethany L Hedt-Gauthier, Cynthia Riviere, Mikerlyne Faustin, Kerlyne Lavoile, Christian Perodin, Alexandra Apollon, Limathe Duverger, Margaret L McNairy, Kelly A Hennessey, Ariadne Souroutzidis, Pierre-Yves Cremieux, Patrice Severe, Jean W Pape
BACKGROUND: Attrition during the period from HIV testing to antiretroviral therapy (ART) initiation is high worldwide. We assessed whether same-day HIV testing and ART initiation improves retention and virologic suppression. METHODS AND FINDINGS: We conducted an unblinded, randomized trial of standard ART initiation versus same-day HIV testing and ART initiation among eligible adults ≥18 years old with World Health Organization Stage 1 or 2 disease and CD4 count ≤500 cells/mm3...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#5
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742771/perioperative-amino-acid-infusion-for-preventing-hypothermia-and-improving-clinical-outcomes-during-surgery-under-general-anesthesia-a-systematic-review-and-meta-analysis
#6
Yoshitaka Aoki, Yukie Aoshima, Kazuyuki Atsumi, Ryo Kaminaka, Rintaro Nakau, Kyoko Yanagita, Makiko Kora, Shunsuke Fujii, Junichiro Yokoyama
Amino acid (AA) infusion is sometimes selected to avoid hypothermia during general anesthesia. However, the widespread clinical use of AA infusion therapy has not been established. This study aimed to clarify the evidence that AA infusion can increase patient body temperature and improve clinical outcomes using the Grading of Recommendations Assessment, Development, and Evaluation system. We searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Japana Centra Revuo Medicina) in November 2015...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742713/does-prolonged-enteral-feeding-with-supplemental-omega-3-fatty-acids-impact-on-recovery-post-esophagectomy-results-of-a-randomized-double-blind-trial
#7
Laura A Healy, Aoife Ryan, Suzanne L Doyle, Éadaoin Bríd Ní Bhuachalla, Samantha Cushen, Ricardo Segurado, Thomas Murphy, Narayanasamy Ravi, Claire L Donohoe, John V Reynolds
OBJECTIVE: This randomized controlled trial (RCT) hypothesized that prolonged enteral nutrition (EN) with supplemental eicosapentanoic acid (EPA), an omega-3 fatty acid with immune and anabolic properties, may impact on clinical and nutritional outcomes. BACKGROUND: Esophagectomy is associated with significant weight loss and catabolism, and negatively impacts quality of life (QL). Strategies to counter sustained catabolism have therapeutic rationale. METHODS: This multicenter, double-blind, placebo-controlled RCT was powered on a 5% difference in lean body mass (LBM) at 1 month...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742687/the-allosteric-hemoglobin-effector-itpp-inhibits-metastatic-colon-cancer-in-mice
#8
Perparim Limani, Michael Linecker, Marcel A Schneider, Philipp Kron, Christoph Tschuor, Ekaterina Kachaylo, Udo Ungethuem, Claude Nicolau, Jean-Marie Lehn, Rolf Graf, Bostjan Humar, Pierre-Alain Clavien
OBJECTIVE: To test the effects of enhanced intracellular oxygen contents on the metastatic potential of colon cancer. BACKGROUND: Colorectal cancer is the commonest gastrointestinal carcinoma. Distant metastases occur in half of patients and are responsible for most cancer-related deaths. Tumor hypoxia is central to the pathogenesis of metastases. Myo-Inositoltrispyrophosphate (ITPP), a nontoxic, antihypoxic compound, has recently shown significant benefits in experimental cancer, particularly when combined with standard chemotherapy...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742684/endovascular-repair-of-abdominal-aortic-aneurysm-in-patients-physically-ineligible-for-open-repair-very-long-term-follow-up-in-the-evar-2-randomized-controlled-trial
#9
Michael J Sweeting, Rajesh Patel, Janet T Powell, Roger M Greenhalgh
OBJECTIVE: The aim of the study was to compare long-term total and aneurysm-related mortality in physically frail patients with abdominal aortic aneurysm (AAA) randomized to either early endovascular aneurysm repair (EVAR) or no-intervention. SUMMARY BACKGROUND DATA: EVAR-2 remains the sole randomized trial to identify whether EVAR reduces mortality in patients physically ineligible for open repair. METHODS: Between September 1999 and August 2004, 404 patients from 33 centers in the United Kingdom aged ≥60 years with AAA >5...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742644/update-on-sglt2-inhibitors-new-data-released-at-the-american-diabetes-association
#10
Sara Lee
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are one of the newer classes of antiglycemic agents approved for the management of patients with type 2 diabetes mellitus. Due to their unique mechanism of action, SGLT2 inhibitors have shown to be beneficial beyond glucose control. The improvement in cardiovascular (CV) outcomes was first observed in the landmark EMPA-REG OUTCOMES study. Following these results, numerous CV outcome trials were designed to identify whether the beneficial CV and renal effects observed with empagliflozin are unique or a drug class effect...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742609/the-efficacy-of-dynamic-contract-relax-stretching-on-delayed-onset-muscle-soreness-among-healthy-individuals-a-randomized-clinical-trial
#11
Yanfei Xie, Beibei Feng, Kedi Chen, Lars L Andersen, Phil Page, Yuling Wang
OBJECTIVE: To evaluate the efficacy of dynamic contract-relax stretching on delayed-onset muscle soreness (DOMS) in the calf muscle of healthy individuals. DESIGN: Randomized clinical trial. SETTING: Research laboratory. PARTICIPANTS: Three groups of 16 healthy participants (n = 48) were recruited by convenience sampling. INTERVENTIONS: Three sets of resisted bilateral heel-raising exercises until exhaustion were conducted to initiate DOMS...
July 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28742550/can-concurrent-abnormalities-in-free-light-chains-and-immunoglobulin-concentrations-identify-a-target-population-for-immunoglobulin-trials-in-sepsis
#12
Manu Shankar-Hari, Mervyn Singer, Jo Spencer
OBJECTIVES: Light chains κ and λ are immunoglobulin constituents but also circulate independently in blood as free light chains. We investigated whether a concomitant abnormality in free light chain and immunoglobulin levels could identify a high risk of death sepsis subpopulation to inform future IV immunoglobulin trials. We tested whether light chain allelic inclusion occurs in circulating B cells. DESIGN: Prospective cohort study. SETTING: Adult general ICUs...
July 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28742502/temozolomide-therapy-for-resistant-prolactin-secreting-pituitary-adenomas-and-carcinomas-a-systematic-review
#13
REVIEW
Mussa H Almalki, Nora Nasser Aljoaib, Maha Jurais Alotaibi, Bayan Saloum Aldabas, Tayba Saleh Wahedi, Maswood H Ahmad, Fahad Alshahrani
Pituitary tumors represent 10-15% of all intracranial tumors; of these, prolactinomas account for 40-50% of cases. Prolactinomas usually respond well to dopamine agonists (DA) as first-line therapy. However, treatment resistance remains a concern. Temozolomide (TMZ) is an oral alkylating agent that has shown promise in treating aggressive pituitary adenomas and carcinomas that are resistant to other therapies. To date, no control trials have been undertaken and only single case reports of pituitary tumors treated with TMZ have been published...
April 2017: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28742498/subthalamic-nucleus-gamma-activity-increases-not-only-during-movement-but-also-during-movement-inhibition
#14
Petra Fischer, Alek Pogosyan, Damian M Herz, Binith Cheeran, Alexander L Green, James Fitzgerald, Tipu Z Aziz, Jonathan Hyam, Simon Little, Thomas Foltynie, Patricia Limousin, Ludvic Zrinzo, Peter Brown, Huiling Tan
Gamma activity in the subthalamic nucleus (STN) is widely viewed as a pro-kinetic rhythm. Here we test the hypothesis that rather than being specifically linked to movement execution, gamma activity reflects dynamic processing in this nucleus. We investigated the role of gamma during fast stopping and recorded scalp electroencephalogram and local field potentials from deep brain stimulation electrodes in 9 Parkinson's disease patients. Patients interrupted finger tapping (paced by a metronome) in response to a stop-signal sound, which was timed such that successful stopping would occur only in ~50% of all trials...
July 25, 2017: ELife
https://www.readbyqxmd.com/read/28742454/lenalidomide-maintenance-after-autologous-stem-cell-transplantation-in-newly-diagnosed-multiple-myeloma-a-meta-analysis
#15
Philip L McCarthy, Sarah A Holstein, Maria Teresa Petrucci, Paul G Richardson, Cyrille Hulin, Patrizia Tosi, Sara Bringhen, Pellegrino Musto, Kenneth C Anderson, Denis Caillot, Francesca Gay, Philippe Moreau, Gerald Marit, Sin-Ho Jung, Zhinuan Yu, Benjamin Winograd, Robert D Knight, Antonio Palumbo, Michel Attal
Purpose Lenalidomide maintenance therapy after autologous stem-cell transplantation (ASCT) demonstrated prolonged progression-free survival (PFS) versus placebo or observation in several randomized controlled trials (RCTs) of patients with newly diagnosed multiple myeloma (NDMM). All studies had PFS as the primary end point, and none were powered for overall survival (OS) as a primary end point. Thus, a meta-analysis was conducted to better understand the impact of lenalidomide maintenance in this setting. Patients and Methods The meta-analysis was conducted using primary-source patient-level data and documentation from three RCTs (Cancer and Leukemia Group B 100104, Gruppo Italiano Malattie Ematologiche dell'Adulto RV-MM-PI-209, and Intergroupe Francophone du Myélome 2005-02) that met the following prespecified inclusion criteria: an RCT in patients with NDMM receiving ASCT followed by lenalidomide maintenance versus placebo or observation with patient-level data available and achieved database lock for primary efficacy analysis...
July 25, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28742420/orthodontics-with-customized-versus-noncustomized-appliances-a-randomized-controlled-clinical-trial
#16
E W Penning, R H J Peerlings, J D M Govers, R J Rischen, K Zinad, E M Bronkhorst, K H Breuning, A M Kuijpers-Jagtman
This randomized controlled trial aimed to evaluate the duration and outcome quality of orthodontic treatment with a customized fixed appliance system versus a noncustomized system. Patients ( n = 180) were randomized and received orthodontic treatment with the Insignia customized orthodontic system or the Damon Q noncustomized orthodontic system. The allocation sequence was concealed using identical, sequentially numbered, opaque, sealed envelopes. Patients with nonextraction treatment plans were treated by 2 equally experienced orthodontists...
July 1, 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/28742409/the-effects-of-vitamin-d-and-evening-primrose-oil-co-supplementation-on-lipid-profiles-and-biomarkers-of-oxidative-stress-in-vitamin-d-deficient-women-with-polycystic-ovary-syndrome-a-randomized-double-blind-placebo-controlled-trial
#17
Khadijeh Nasri, Sedighe Akrami, Maryam Rahimi, Mohsen Taghizadeh, Masoud Behfar, Mohammad Reza Mazandaranian, Abbas Kheiry, Mohammad Reza Memarzadeh, Zatollah Asemi
PURPOSE OF THE STUDY: There was inconsistent evidence about the benefit of vitamin D plus evening primrose oil (EPO) supplement intake on lipid profiles and reduced oxidative stress among women with polycystic ovary syndrome (PCOS). The current study was performed to evaluate the effects of vitamin D plus EPO supplementation on lipid profiles and biomarkers of oxidative stress in vitamin D-deficient women with PCOS. MATERIALS AND METHODS: This randomized, double-blind, placebo-controlled trial was performed among 60 vitamin D-deficient women with PCOS...
July 25, 2017: Endocrine Research
https://www.readbyqxmd.com/read/28742289/tai-chi-exercise-for-the-quality-of-life-in-a-perimenopausal-women-organization-a-systematic-review
#18
Ying Wang, Weichao Shan, Qing Li, Na Yang, Weiying Shan
BACKGROUND: Improvement of the quality of life in perimenopausal women has recently become an important global health issue. Extensive research reports provide evidence of Tai Chi for the quality of life, but no systematic review has individually investigated Tai Chi as a main intervention on the quality of life in perimenopausal women. OBJECTIVE: To assess clinical evidence of Tai Chi for the quality of life in perimenopausal women. METHODS: Studies related to the effect of Tai Chi on the quality of life in perimenopausal women in the databases of China and abroad were searched...
August 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28742263/progesterone-receptor-modulators-for-endometriosis
#19
REVIEW
Jing Fu, Hao Song, Min Zhou, Huili Zhu, Yuhe Wang, Hengxi Chen, Wei Huang
BACKGROUND: Endometriosis is defined as the presence of endometrial tissue (glands and stroma) outside the uterine cavity. This condition is oestrogen-dependent and thus is seen primarily during the reproductive years. Owing to their antiproliferative effects in the endometrium, progesterone receptor modulators (PRMs) have been advocated for treatment of endometriosis. OBJECTIVES: To assess the effectiveness and safety of PRMs primarily in terms of pain relief as compared with other treatments or placebo or no treatment in women of reproductive age with endometriosis...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28742262/bladder-neck-needle-suspension-for-urinary-incontinence-in-women
#20
REVIEW
Cathryn Ma Glazener, Kevin Cooper, Atefeh Mashayekhi
BACKGROUND: Bladder neck needle suspension is an operation traditionally used for moderate or severe stress urinary incontinence in women. About a third of adult women experience some urinary incontinence, and about a third of these have moderate or severe symptoms. Stress urinary incontinence (SUI) imposes significant health and economic burdens on society and the women affected. OBJECTIVES: To determine the effects of needle suspension on stress or mixed urinary incontinence in comparison with other management options...
July 25, 2017: Cochrane Database of Systematic Reviews
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