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https://www.readbyqxmd.com/read/28579834/hypoglycemia-a-review-of-definitions-used-in-clinical-trials-evaluating-antihyperglycemic-drugs-for-diabetes
#1
REVIEW
Chakrapani Balijepalli, Eric Druyts, Gaye Siliman, Michel Joffres, Kristian Thorlund, Edward J Mills
OBJECTIVE: To understand the severity and potential impact of heterogeneity in definitions of hypoglycemia used in diabetes research, we aimed to review the hypoglycemia definitions adopted in randomized controlled trials (RCTs). METHODS: We reviewed 109 RCTs included in the Canadian Agency for Drugs and Technologies in Health reports for the second- and third-line therapy for the patients with type 2 diabetes (T2D). RESULTS: Nearly 60% (n=66) of the studies reviewed presented the definitions for overall hypoglycemia, and another 20% (n=22) of the studies reported the results for hypoglycemia but did not report a definition...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28549563/no-346-advanced-reproductive-age-and-fertility
#2
Kimberly E Liu, Allison Case
OBJECTIVE: To improve awareness of the natural age-related decline in female and male fertility with respect to natural fertility and assisted reproductive technologies (ART), provide recommendations for their management, and to review investigations in the assessment of ovarian aging. OPTIONS: This guideline reviews options for the assessment of ovarian reserve and fertility treatments using ART with women of advanced reproductive age presenting with infertility...
May 23, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28528449/the-canadian-national-breast-screening-studies-are-compromised-and-their-results-are-unreliable-they-should-not-factor-into-decisions-about-breast-cancer-screening
#3
REVIEW
Daniel B Kopans
The Canadian National Breast Screening Studies were compromised by an unblinded allocation process and poor quality mammography. Contrary to the requirement that allocation in a randomized controlled trial (RCT) be blinded to avoid any possible intentional or unintentional subversion of a random allocation, all women in the CNBSS trials underwent a clinical breast examination prior to assignment to the study arm or the usual care arm. Women with abnormal clinical breast examinations were identified, and this information was available to the coordinators who then assigned the women on open lists...
May 20, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28526669/development-of-an-evidence-informed-blog-to-promote-healthy-eating-among-mothers-use-of-the-intervention-mapping-protocol
#4
Audrée-Anne Dumas, Simone Lemieux, Annie Lapointe, Véronique Provencher, Julie Robitaille, Sophie Desroches
BACKGROUND: Low adherence to dietary guidelines and a concurrent rise of obesity-related chronic diseases emphasize the need for effective interventions to promote healthy eating. There is growing recognition that behavior change interventions should draw on theories of behavior change. Online interventions grounded in theory lead to increased effectiveness for health behavior change; however, few theory-driven social media-based health promotion interventions have been described in the literature...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28446419/the-smartphone-peer-physical-activity-counseling-sppac-program-for-manual-wheelchair-users-protocol-of-a-pilot-randomized-controlled-trial
#5
Krista L Best, François Routhier, Shane N Sweet, Kelly P Arbour-Nicitopoulos, Jaimie F Borisoff, Luc Noreau, Kathleen A Martin Ginis
BACKGROUND: Physical activity (PA) must be performed regularly to accrue health benefits. However, the majority of manual wheelchair users do not meet PA recommendations. Existing community-based PA programs for manual wheelchair users appear to work, but effect sizes are small and retention is low. Existing PA programs may not fully implement some psychosocial factors that are strongly linked with PA (eg, autonomy). The use of peers and mobile phone technology in the Smartphone Peer PA Counseling (SPPAC) program represents a novel approach to cultivating a PA-supportive environment for manual wheelchair users...
April 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28284515/no-342-hepatitis-b-and-pregnancy
#6
REVIEW
Eliana Castillo, Kellie Murphy, Julie van Schalkwyk
OBJECTIVE: To review the epidemiology, natural history, evaluation, and treatment of hepatitis B virus (HBV) infection during pregnancy. This will aid obstetric care providers in counseling their patients regarding perinatal risks and management options available to pregnant women with hepatitis B. OUTCOMES: Outcomes evaluated include thresholds for HBV anti-viral treatment for prevention of perinatal transmission and for invasive procedures during pregnancy for women with hepatitis B infection...
March 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28241927/no-341-diagnosis-and-management-of-adnexal-torsion-in-children-adolescents-and-adults
#7
Sari Kives, Suzy Gascon, Élise Dubuc, Nancy Van Eyk
OBJECTIVE: To review the evidence and provide recommendations on the diagnosis and management of adnexal torsion in children, adolescents, and women. OUTCOMES: Elements evaluated include the risk factors, diagnostic accuracy, management options, and outcomes of adnexal torsion. EVIDENCE: Published literature was retrieved through searches of MEDLINE, Embase, CINAHL, and the Cochrane Library using appropriate controlled vocabulary and key words ("adnexal torsion," "ovarian torsion")...
February 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28140322/comprehensive-review-of-the-impact-of-dairy-foods-and-dairy-fat-on-cardiometabolic-risk
#8
REVIEW
Jean-Philippe Drouin-Chartier, Julie Anne Côté, Marie-Ève Labonté, Didier Brassard, Maude Tessier-Grenier, Sophie Desroches, Patrick Couture, Benoît Lamarche
Because regular-fat dairy products are a major source of cholesterol-raising saturated fatty acids (SFAs), current US and Canadian dietary guidelines for cardiovascular health recommend the consumption of low-fat dairy products. Yet, numerous randomized controlled trials (RCTs) have reported rather mixed effects of reduced- and regular-fat dairy consumption on blood lipid concentrations and on many other cardiometabolic disease risk factors, such as blood pressure and inflammation markers. Thus, the focus on low-fat dairy in current dietary guidelines is being challenged, creating confusion within health professional circles and the public...
November 2016: Advances in Nutrition
https://www.readbyqxmd.com/read/28063544/the-prevention-of-early-onset-neonatal-group-b-streptococcal-disease
#9
Deborah Money, Victoria M Allen
OBJECTIVE: To review the evidence in the literature and to provide recommendations on the management of pregnant women in labour for the prevention of early-onset neonatal group B streptococcal disease. The key revisions in this updated guideline include changed recommendations for regimens for antibiotic prophylaxis, susceptibility testing, and management of women with pre-labour rupture of membranes. OUTCOMES: Maternal outcomes evaluated included exposure to antibiotics in pregnancy and labour and complications related to antibiotic use...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28026713/a-family-centered-lifestyle-intervention-for-obese-six-to-eight-year-old-children-results-from-a-one-year-randomized-controlled-trial-conducted-in-montreal-canada
#10
RANDOMIZED CONTROLLED TRIAL
Tamara R Cohen, Tom J Hazell, Catherine A Vanstone, Celia Rodd, Hope A Weiler
OBJECTIVES: Childhood obesity interventions should be family-centered and focused on lifestyle behaviours that achieve sustainable reductions in adiposity. The primary objective of this randomized controlled trial was to test a family-centered lifestyle intervention using Canada's Food and Physical Activity (PA) Guidelines to reduce body mass index-for-age z-scores (BAZ) in overweight and obese (OW/OB) children. METHODS: Children (n = 78; ages 6-8.5 years) were randomized to standard (StnTx) or modified (ModTx) interventions or control (Ctrl)...
December 27, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/27927658/aneurysmal-subarachnoid-hemorrhage-red-blood-cell-transfusion-and-outcome-sahara-a-pilot-randomised-controlled-trial-protocol
#11
Shane W English, D Fergusson, M Chassé, A F Turgeon, F Lauzier, D Griesdale, A Algird, A Kramer, A Tinmouth, C Lum, J Sinclair, S Marshall, D Dowlatshahi, A Boutin, G Pagliarello, L A McIntyre
INTRODUCTION: Anaemia is common in aneurysmal subarachnoid haemorrhage (aSAH) and is a potential critical modifiable factor affecting secondary injury. Despite physiological evidence and management guidelines that support maintaining a higher haemoglobin level in patients with aSAH, current practice is one of a more restrictive approach to transfusion. The goal of this multicentre pilot trial is to determine the feasibility of successfully conducting a red blood cell (RBC) transfusion trial in adult patients with acute aSAH and anaemia (Hb ≤100 g/L), comparing a liberal transfusion strategy (Hb ≤100 g/L) with a restrictive strategy (Hb ≤80 g/L) on the combined rate of death and severe disability at 12 months...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#12
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27871502/screening-for-abdominal-aortic-aneurysm-in-asymptomatic-adults
#13
REVIEW
Muhammad Usman Ali, Donna Fitzpatrick-Lewis, John Miller, Rachel Warren, Meghan Kenny, Diana Sherifali, Parminder Raina
BACKGROUND: This report was produced for the Canadian Task Force on Preventive Health Care to provide guidelines on screening for abdominal aortic aneurysm (AAA) with ultrasound scan. PURPOSE: The aim of this systematic review is to examine the evidence on benefits and harms of AAA screening. SEARCH STRATEGY: This systematic review considered studies from the most recent United States Preventive Services Task Force review on AAA screening and passed through the screening process with citations identified in our search up to April 2015 (PROSPERO Registration #CRD42015019047)...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27848024/-current-guidelines-on-anca-associated-vasculitides-common-features-and-differences
#14
B Hellmich
The results of a number of prospective randomized controlled clinical trials have led to changes in established strategies for the treatment of antineutrophil cytoplasmic antibody (ANCA) associated vasculitides (AAV) in recent years. Since 2014, a total of 4 scientific societies and study groups have systematically reviewed the new data and have formulated evidence-based recommendations for the management of AAV based on the analysis. These recommendations contain information on diagnosis, treatment (induction and maintenance), supportive care and monitoring of disease activity and resulting damage...
March 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27708674/a-randomized-trial-of-a-community-based-approach-to-dyslipidemia-management-pharmacist-prescribing-to-achieve-cholesterol-targets-rxact-study
#15
Ross T Tsuyuki, Meagen Rosenthal, Glen J Pearson
BACKGROUND: Dyslipidemia is an important risk factor for cardiovascular disease but is suboptimally managed. Pharmacists are accessible primary care professionals and with expanded scopes of practice (including prescribing), could identify and manage patients with dyslipidemia. We sought to evaluate the effect of pharmacist prescribing of dyslipidemia medications on the proportion of participants achieving target LDL-cholesterol (LDL-c) levels. METHODS: We conducted a randomized controlled trial in 14 community pharmacies in Alberta, Canada...
September 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/27670710/management-of-spontaneous-labour-at-term%C3%A2-in-healthy-women
#16
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIVE: The purpose of this guideline is to provide guidance for the intrapartum management of spontaneous labour, whether normal or abnormal, in term, healthy women, and to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27591352/diabetes-in-pregnancy
#17
REVIEW
Howard Berger, Robert Gagnon, Mathew Sermer, Melanie Basso, Hayley Bos, Richard N Brown, Emmanuel Bujold, Stephanie L Cooper, Robert Gagnon, Katy Gouin, N Lynne McLeod, Savas M Menticoglou, William R Mundle, Anne Roggensack, Frank L Sanderson, Jennifer D Walsh
OBJECTIVE: This guideline reviews the evidence relating to the diagnosis and obstetrical management of diabetes in pregnancy. OUTCOMES: The outcomes evaluated were short- and long-term maternal outcomes, including preeclampsia, Caesarean section, future diabetes, and other cardiovascular complications, and fetal outcomes, including congenital anomalies, stillbirth, macrosomia, birth trauma, hypoglycemia, and long-term effects. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library using appropriate controlled vocabulary (MeSH terms "diabetes" and "pregnancy")...
July 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27443991/canadian-stroke-best-practice-recommendations-managing-transitions-of-care-following-stroke-guidelines-update-2016
#18
Jill I Cameron, Colleen O'Connell, Norine Foley, Katherine Salter, Rhonda Booth, Rosemary Boyle, Donna Cheung, Nancy Cooper, Helene Corriveau, Dar Dowlatshahi, Annie Dulude, Patti Flaherty, Ev Glasser, Gord Gubitz, Debbie Hebert, Jacquie Holzmann, Patrick Hurteau, Elise Lamy, Suzanne LeClaire, Taylor McMillan, Judy Murray, David Scarfone, Eric E Smith, Vivian Shum, Kim Taylor, Trudy Taylor, Catherine Yanchula, Robert Teasell, Patrice Lindsay
Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. For patients, families and caregivers, this can be a difficult time of adjustment. The 2016 update of the Canadian Managing Transitions of Care following Stroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by clinicians who provide care to patients following stroke across a broad range of settings. The focus of these recommendations is on support, education and skills training for patients, families and caregivers; effective discharge planning; interprofessional communication; adaptation in resuming activities of daily living; and transition to long-term care for patients who are unable to return to or remain at home...
October 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27418966/willingness-to-participate-in-a-randomized-trial-comparing-catheters-to-fistulas-for-vascular-access-in-incident-hemodialysis-patients-an-international-survey-of-nephrologists
#19
Krishna Poinen, Matthew J Oliver, Pietro Ravani, Sabine N Van der Veer, Kitty J Jager, Wim Van Biesen, Kevan R Polkinghorne, Aviva Rosenfeld, Adriane M Lewin, Mandeep Dulai, Robert R Quinn
BACKGROUND: Current guidelines favor fistulas over catheters as vascular access. Yet, the observational literature comparing fistulas to catheters has important limitations and biases that may be difficult to overcome in the absence of randomization. However, it is not clear if physicians would be willing to participate in a clinical trial comparing fistulas to catheters. OBJECTIVES: We also sought to elicit participants' opinions on willingness to participate in a future trial regarding catheters and fistulas...
2016: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/27228224/a-validated-case-definition-for-chronic-rhinosinusitis-in-administrative-data-a-canadian-perspective
#20
Luke Rudmik, Yuan Xu, Edward Kukec, Mingfu Liu, Stafford Dean, Hude Quan
BACKGROUND: Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD-9)-coded claims. METHODS: A random sample of 100 patients with a guideline-based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015...
May 26, 2016: International Forum of Allergy & Rhinology
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