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https://www.readbyqxmd.com/read/29351716/effect-of-metformin-on-glycemic-control-in-patients-with-type-1-diabetes-a-meta-analysis-of-randomized-controlled-trials
#1
Haiyang Meng, Ailing Zhang, Yan Liang, Jie Hao, Xiaojian Zhang, Jingli Lu
BACKGROUND: For T1D patients, adding metformin to insulin therapies is thought to improve blood glucose levels, but current evidence does not support this clinical benefit. Additional data from large clinical trials are now available; therefore, we conducted a meta-analysis of studies on assessing the efficacy and adverse effects of metformin. METHODS: We searched the MEDLINE, EMBASE and Cochrane Library databases for data from randomized controlled trials (RCTs)...
January 19, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29351705/percutaneous-endoscopic-rendezvous-procedure-for-the-management-of-bile-duct-injuries-after-cholecystectomy-short-and-long-term-outcomes
#2
Anne Marthe Schreuder, Klaske A C Booij, Philip R de Reuver, Otto M van Delden, Krijn P van Lienden, Marc G Besselink, Olivier R Busch, Dirk J Gouma, Erik A J Rauws, Thomas M van Gulik
BACKGROUND:  Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous procedure. METHODS:  All consecutive patients with BDI referred to our tertiary referral center between 1995 and 2016 were analyzed. A rendezvous procedure was performed when endoscopic or radiologic intervention failed, and when deemed feasible by a dedicated multidisciplinary team including hepatopancreaticobiliary surgeons, gastrointestinal endoscopists, and interventional radiologists...
January 19, 2018: Endoscopy
https://www.readbyqxmd.com/read/29351704/safety-of-cold-snare-polypectomy-for-duodenal-adenomas-in-familial-adenomatous-polyposis-a-prospective-exploratory-study
#3
Kenta Hamada, Yoji Takeuchi, Hideki Ishikawa, Yasumasa Ezoe, Masamichi Arao, Sho Suzuki, Taro Iwatsubo, Minoru Kato, Yusuke Tonai, Satoki Shichijo, Yasushi Yamasaki, Noriko Matsuura, Hiroko Nakahira, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Noriya Uedo, Ryu Ishihara, Hiroyuki Okada, Hiroyasu Iishi
BACKGROUND:  Cold snare polypectomy (CSP) to remove multiple duodenal adenomas (MDAs) in patients with familial adenomatous polyposis (FAP) could be an effective and less invasive method than more extensive surgery. The aim of the present study was to determine the safety of this procedure. METHODS:  This prospective exploratory study included 10 consecutive patients with FAP and MDAs who underwent CSP for as many as 50 duodenal adenomas. The primary outcome was the incidence of severe adverse events...
January 19, 2018: Endoscopy
https://www.readbyqxmd.com/read/29351313/effectiveness-and-safety-of-early-medication-abortion-provided-in-pharmacies-by-auxiliary-nurse-midwives-a-non-inferiority-study-in-nepal
#4
Corinne H Rocca, Mahesh Puri, Prabhakar Shrestha, Maya Blum, Dev Maharjan, Daniel Grossman, Kiran Regmi, Philip D Darney, Cynthia C Harper
BACKGROUND: Expanding access to medication abortion through pharmacies is a promising avenue to reach women with safe and convenient care, yet no pharmacy provision interventions have been evaluated. This observational non-inferiority study investigated the effectiveness and safety of mifepristone-misoprostol medication abortion provided at pharmacies, compared to government-certified public health facilities, by trained auxiliary nurse-midwives in Nepal. METHODS: Auxiliary nurse-midwives were trained to provide medication abortion through twelve pharmacies and public facilities as part of a demonstration project in two districts...
2018: PloS One
https://www.readbyqxmd.com/read/29351311/the-quality-of-voluntary-medical-male-circumcision-done-by-mid-level-workers-in-tshwane-district-south-africa-a-retrospective-analysis
#5
Sanele Ngcobo, Jacqueline Elizabeth Wolvaardt, Martin Bac, Elize Webb
BACKGROUND: Voluntary medical male circumcision (VMMC) reduces the acquisition of human immunodeficiency virus (HIV) in heterosexual men by up to 60%. One HIV infection is averted for every 5 to 15 VMMCs. To conduct VMMCs in large populations, large numbers of trained healthcare professionals are needed. Countries in Sub-Saharan Africa have a high burden of HIV and a shortage of healthcare professionals, creating a healthcare conundrum. To bridge this gap, South Africa launched a new cadre of mid-level medical worker called Clinical Associates (CA)...
2018: PloS One
https://www.readbyqxmd.com/read/29351138/the-effect-of-melatonin-upon-postacute-withdrawal-among-males-in-a-residential-treatment-program-m-paws-a-randomized-double-blind-placebo-controlled-trial
#6
Corry D Bondi, Khalid M Kamal, David A Johnson, Paula A Witt-Enderby, Vincent J Giannetti
OBJECTIVE: Assess the effect of melatonin (5 mg) compared with placebo as an adjuvant treatment along with current behavioral and pharmacotherapy for 28 days on weekly self-reported severity of anxiety, depression, stress, and sleep complaints, and also how sleep is affecting daily life in males 18 years of age and older in recovery from substance use at a residential program in south-western Pennsylvania. BACKGROUND: Individuals in recovery experience a variety of symptoms including, but are not limited to, anxiety, depression, sleep difficulties, and stress...
January 18, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29351129/impact-of-pulmonary-rehabilitation-on-exercise-tolerance-and-quality-of-life-in-patients-with-idiopathic-pulmonary-fibrosis-a-systematic-review-and-meta-analysis
#7
Mansueto Gomes-Neto, Cassio Magalhães Silva, Diego Ezequiel, Cristiano Sena Conceição, Micheli Saquetto, Adelmir Souza Machado
BACKGROUND: Patients with pulmonary fibrosis are living longer and present with an increasing number of comorbidities over time. Pulmonary rehabilitation, as a nonpharmacological approach, may be promising in these patients, although there is limited information on the impact of pulmonary rehabilitation on exercise tolerance and quality of life. Thus, conducting a systematic review and meta-analysis, the purpose of this study was to determine the effects of pulmonary rehabilitation on exercise tolerance and quality of life in patients with idiopathic pulmonary fibrosis...
January 18, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29351111/novel-bronchoscopic-management-of-airway-bleeding-with-absorbable-gelatin-and-thrombin-slurry
#8
A Rolando Peralta, Mohit Chawla, Robert P Lee
BACKGROUND: Airway bleeding, either spontaneous or as a result of bronchoscopy, is associated with significant morbidity and mortality. Multiple bronchoscopic techniques are available to achieve complete hemostasis or as a bridge to definitive therapies. METHODS: We report our experience on the feasibility of endobronchial instillation of an absorbable gelatin and thrombin slurry (GTS) for the treatment of spontaneous hemoptysis and procedure-related bleeding. RESULTS: We identified 13 cases in which GTS was used for endobronchial hemostasis when standard bronchoscopic measures like cold saline, epinephrine, and in some cases balloon occlusion were not successful...
January 18, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29351097/effect-of-epidural-infusion-bolus-delivery-rate-on-the-duration-of-labor-analgesia-a-randomized-clinical-trial
#9
Elizabeth M S Lange, Cynthia A Wong, Paul C Fitzgerald, Wilmer F Davila, Suman Rao, Robert J McCarthy, Paloma Toledo
BACKGROUND: Programmed intermittent boluses of local anesthetic have been shown to be superior to continuous infusions for maintenance of labor analgesia. High-rate epidural boluses increase delivery pressure at the catheter orifice and may improve drug distribution in the epidural space. We hypothesized that high-rate drug delivery would improve labor analgesia and reduce the requirement for provider-administered supplemental boluses for breakthrough pain. METHODS: Nulliparous women with a singleton pregnancy at a cervical dilation of less than or equal to 5 cm at request for neuraxial analgesia were eligible for this superiority-design, double-blind, randomized controlled trial...
January 19, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29350840/a-phase-3-trial-of-mometasone-furoate-sinus-implants-for-chronic-sinusitis-with-recurrent-nasal-polyps
#10
Robert C Kern, J Pablo Stolovitzky, Stacey L Silvers, Ameet Singh, Jivianne T Lee, David M Yen, Alfred M C Iloreta, Francis P J Langford, Boris Karanfilov, Keith E Matheny, James W Stambaugh, Anna K Gawlicka
BACKGROUND: Topical intranasal corticosteroid sprays (INCSs) are standard treatment for nasal polyps (NPs), but their efficacy is reduced by poor patient compliance and impaired access of drug to the sinus mucosa. A corticosteroid-eluting sinus implant was designed to address these limitations in patients with recurrent polyposis after sinus surgery by delivering 1350 μg of mometasone furoate (MF) directly to the ethmoid sinus mucosa over approximately 90 days. METHODS: A randomized, sham-controlled, double-blind trial was undertaken in 300 adults with refractory chronic rhinosinusitis with NPs (CRSwNP), who were candidates for repeat surgery...
January 19, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29350580/development-and-evaluation-of-a-yoga-intervention-program-for-parkinson-s-disease
#11
Catherine Justice, Corjena Cheung, Amy Samson-Burke
Preliminary research indicates that yoga could be a valuable tool for people suffering from Parkinson's disease (PD). However, little has been published about the process by which the yoga interventions were designed and evaluated. This study elaborates on the process of developing and testing a bi-weekly, 12-week yoga program to determine its safety and feasibility for people with PD. The lead yoga teacher used input from a focused literature review to design an initial draft of the intervention program. This draft was reviewed by a group of yoga experts ( n = 6) to develop the final intervention program...
January 19, 2018: International Journal of Yoga Therapy
https://www.readbyqxmd.com/read/29350569/practice-pearl-liraglutide-and-cardiovascular-and-renal-events-in-type-2-diabetes
#12
Robert Guthrie
Review of: Marso S, Daniels G, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016; 375: 311-322. Mann J, Orsted D, Brown-Frandsen K, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med 2017; 377: 839-848. This comprehensive research project, LEADER, led to two reports, one focusing on the effect of liraglutide on cardiovascular events, and the second one reporting on the renal effects on the same study population. The study group included 9340 patients with type 2 diabetes...
January 19, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29350565/safety-and-efficacy-of-denosumab-in-osteoporotic-patients-previously-treated-with-other-medications-a-systematic-review-and-meta-analysis
#13
Andreas Fontalis, Kenanidis Eustathios, Efthymia Prousali, Potoupnis Michael, Tsiridis Eleftherios
Denosumab is a monoclonal antibody that received approval by the FDA for the treatment of osteoporosis in 2010. Available higher level research evidence concerns the treatment of patients that have not received any anti-osteoporotic medication in the past. Further investigation is warranted, since clinicians often face the challenge of administering the most efficacious drug in patients, pretreated with other medications. Areas Covered: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of denosumab compared to other active anti-osteoporotic agents in patients formerly receiving other treatments...
January 19, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29350541/using-cell-phone-technology-to-investigate-a-deliberate-bacillus-anthracis-release-scenario
#14
Arik Eisenkraft, Amichay Afriat, Yechiel Hubary, Ron Lev, Hayim Shaul, Ran D Balicer
Unusual biological events and outbreaks require rapid epidemiologic investigation and contact tracing procedures, allowing optimal handling of resources. Currently, these are resource intensive, time consuming, and extremely complex, requiring large teams of trained and prepared personnel. The goal of this study was to determine whether a technological alternative to the classic systems, based on the use of mobile phones and a unique algorithm, could perform a complete epidemiologic investigation in a setting of a bioterrorism scenario...
January 19, 2018: Health Security
https://www.readbyqxmd.com/read/29350493/bleeding-and-thrombotic-complications-of-pediatric-liver-transplant
#15
Alexandra J Borst, Debra L Sudan, Laura A Wang, Michael J Neuss, Jennifer A Rothman, Thomas L Ortel
BACKGROUND: Pediatric patients undergoing liver transplant are at significant risk for bleeding and thrombotic complications due to the complex nature of rebalanced hemostasis in patients with liver disease. METHODS/OBJECTIVES: We reviewed records of 92 pediatric liver and multivisceral transplant cases at Duke University Medical Center between January 2009 and December 2015. The goal was to define the nature and incidence of bleeding and thrombotic complications in this cohort and define potential risk factors...
January 19, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29350463/brim-p-a-phase-i-open-label-multicenter-dose-escalation-study-of-vemurafenib-in-pediatric-patients-with-surgically-incurable-braf-mutation-positive-melanoma
#16
Julia C Chisholm, Jozef Suvada, Ira J Dunkel, Michela Casanova, Weijiang Zhang, Natasha Ritchie, YounJeong Choi, Jane Park, Meghna Das Thakur, Stephen Simko, Nga Wan Rachel Tam, Andrea Ferrari
BACKGROUND: Vemurafenib, a selective inhibitor of BRAF kinase, is approved for the treatment of adult stage IIIc/IV BRAF V600 mutation-positive melanoma. We conducted a phase I, open-label, dose-escalation study in pediatric patients aged 12-17 years with this tumor type (NCT01519323). PROCEDURE: Patients received vemurafenib orally until disease progression. Dose escalation was conducted using a 3 + 3 design. Patients were monitored for dose-limiting toxicities (DLTs) during the first 28 days of treatment to determine the maximum tolerated dose (MTD)...
January 19, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29350402/effectiveness-and-safety-of-original-and-generic-sofosbuvir-for-the-treatment-of-chronic-hepatitis-c-a-real-world-study
#17
Sebastián Marciano, Leila Haddad, María Virginia Reggiardo, Mirta Peralta, Cecilia Vistarini, Mónica Marino, Valeria Inés Descalzi, Claudia D'Amico, Sebastián Figueroa Escuti, Luis Alejandro Gaite, Roberto Pérez Ravier, Cristina Longo, Silvia Mabel Borzi, Omar Andrés Galdame, Fernando Bessone, Hugo Alberto Fainboim, Silvia Frías, Mariano Cartier, Adrián Carlos Gadano
We report the first real-world prospective multicenter cohort study that evaluated the effectiveness and safety of original or generic sofosbuvir-based regimens in patients with chronic hepatitis C in Latin America. The main endpoints were assessment of sustained virological response and serious adverse events rates. A total of 321 patients with chronic hepatitis C treated with the following regimens were included: sofosbuvir plus daclatasvir for 12 (n = 34) or 24 (n = 135) weeks, sofosbuvir plus daclatasvir plus ribavirin for 12 (n = 84) or 24 (n = 56) weeks, or sofosbuvir plus ribavirin for 12 (n = 8) or 24 (n = 2) weeks...
January 19, 2018: Journal of Medical Virology
https://www.readbyqxmd.com/read/29350380/patients-treated-with-bivalirudin-still-at-higher-risk-of-stent-thrombosis-a-comprehensive-meta-analysis-of-randomized-clinical-trials-of-bivalirudin-and-heparin-for-percutaneous-coronary-interventions
#18
Stefan Grajek, Michał Michlak, Adrian Gwizdała, Aleksander Araszkiewicz, Marek Grygier, Jarosław Hiczkiewicz, Maciej Lesiak
BACKGROUND: Although the current practice guidelines recommend using both heparin and bivalirudin for percutaneous coronary interventions (PCI), the research data are ambiguous. AIM: To compare the impact of bivalirudin- and heparin on major clinical endpoints in PCI patients with particular emphasis on periprocedural stent thrombosis. METHODS: Total of 18 randomised clinical trials involving 41752 subjects were included. The endpoints comprised: net adverse clinical event (NACE: death, myocardial infarction [MI], unscheduled revascularisation, major bleeding [MB]), major adverse cardiovascular event (MACE: death, MI or stroke), acute/subacute stent thrombosis (ST)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350177/antidepressant-medication-in-a-german-cohort-of-patients-with-alzheimer-s-disease%C3%A2
#19
Philipp Hessmann, Richard Dodel, Erika Baum, Matthias J Müller, Greta Paschke, Bernhard Kis, Jan Zeidler, Mike Klora, Jens-Peter Reese, Monika Balzer-Geldsetzer
OBJECTIVE: The use of antidepressant drugs in dementia patients is associated with the risk of adverse events, and the evidence for relevant effects is scarce. We aimed to determine the associations between the prescription of antidepressants and patients' sociodemographic (e.g., age, gender, living situation) and clinical characteristics (e.g., disease severity, neuropsychiatric symptoms). MATERIALS AND METHODS: We included 395 institutionalized and community-dwelling patients with Alzheimer's disease (AD) across all severity stages of dementia in a cross-sectional study design...
January 19, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29350109/tertiary-care-experience-of-sorafenib-in-the-treatment-of-progressive-radioiodine-refractory-differentiated-thyroid-carcinoma-a-korean-multicenter-study
#20
Mijin Kim, Tae Hyuk Kim, Dong Yeob Shin, Dong-Jun Lim, Eui Young Kim, Won Bae Kim, Jae Hoon Chung, YoungKee Shong, Bo Hyun Kim, Won Gu Kim
BACKGROUND: Sorafenib, a multi-kinase inhibitor, is approved for the treatment of patients with radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC). In this study, we evaluated the efficacy and safety of sorafenib in real-world clinical practice and compared the results with those of the DECISION trial. We also evaluated the clinical features associated with better clinical outcomes after sorafenib treatment. METHODS: This multicenter, retrospective cohort study evaluated 98 patients with progressive RAI-refractory DTC who were treated with sorafenib in six tertiary hospitals in Korea...
January 19, 2018: Thyroid: Official Journal of the American Thyroid Association
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