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https://www.readbyqxmd.com/read/28324671/dose-de-escalation-of-intrapleural-tissue-plasminogen-activator-therapy-for-pleural-infection-the-adapt-project
#1
Natalia Popowicz, Oliver Bintcliffe, Duneesha De Fonseka, Kevin G Blyth, Nicola A Smith, Francesco Piccolo, Geoffrey Martin, Donny Wong, Anthony Edey, Nick Maskell, Y C Gary Lee
RATIONALE: Intrapleural therapy with a combination of tissue plasminogen activator (tPA) 10mg and deoxyribonuclease (DNase) 5mg administered twice daily has been shown in randomized and open-label studies to enable adequate drainage of over 90% of infected pleural effusions without surgery. Potential bleeding risks associated with intrapleural tPA and the drug costs remain important concerns. The ongoing ADAPT (Alteplase Dose Assessment for Pleural infection Therapy) project aims to investigate the efficacy and safety of dose de-escalation for intrapleural tPA...
March 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28324627/hospitalized-opioid-dependent-patients-exploring-predictors-of-buprenorphine-treatment-entry-and-retention-after-discharge
#2
Christina S Lee, Jane M Liebschutz, Bradley J Anderson, Michael D Stein
OBJECTIVES: Few studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization. METHODS: This secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid-dependent patients (n = 72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT)...
March 21, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28324318/botulinum-neurotoxin-type-a-for-the-treatment-of-pain-not-just-in-migraine-and-trigeminal-neuralgia
#3
Giorgio Sandrini, Roberto De Icco, Cristina Tassorelli, Nicola Smania, Stefano Tamburin
BACKGROUND: Despite their huge epidemiological impact, primary headaches, trigeminal neuralgia and other chronic pain conditions still receive suboptimal medical approach, even in developed countries. The limited efficacy of current pain-killers and prophylactic treatments stands among the main reasons for this phenomenon. Botulinum neurotoxin (BoNT) represents a well-established and licensed treatment for chronic migraine, but also an emerging treatment for other types of primary headache, trigeminal neuralgia, neuropathic pain, and an increasing number of pain conditions...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28324049/piloting-a-remission-strategy-in-type-2-diabetes-results-of-a-randomized-controlled-trial
#4
Natalia McInnes, Ada Smith, Rose Otto, Jeffrey Vandermey, Zubin Punthakee, Diana Sherifali, Kumar Balasubramanian, Stephanie Hall, Hertzel C Gerstein
Context: Medical strategies targeting remission of type 2 diabetes have not been systematically studied. Objective: This trial assessed the feasibility, safety and potential to induce remission of a short-term intensive metabolic strategy. Design: A randomized, parallel, open-label pilot trial in 83 participants followed for 52 weeks. Setting: Ambulatory care. Participants: Patients with type 2 diabetes of up to 3 years in duration...
March 15, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323989/preconception-low-dose-aspirin-restores-diminished-pregnancy-and-live-birth-rates-in-women-with-low-grade-inflammation-a-secondary-analysis-of-a-randomized-trial
#5
Lindsey A Sjaarda, Rose G Radin, Robert M Silver, Emily Mitchell, Sunni L Mumford, Brian Wilcox, Noya Galai, Neil J Perkins, Jean Wactawski-Wende, Joseph B Stanford, Enrique F Schisterman
Context: Inflammation is linked to causes of infertility. Low dose aspirin (LDA) may improve reproductive success in women with chronic, low-grade inflammation. Objective: To investigate the effect of preconception-initiated LDA on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy. Design: Stratified secondary analysis of a multi-center, block-randomized, double-blind, placebo-controlled trial. Setting: Four U...
February 3, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323986/chronic-intranasal-insulin-does-not-affect-hepatic-lipids-but-lowers-circulating-bcaas-in-healthy-male-subjects
#6
Thomas Scherer, Peter Wolf, Sabina Smajis, Melania Gaggini, Martina Hackl, Amalia Gastaldelli, Peter Klimek, Elisa Einwallner, Rodrig Marculescu, Anton Luger, Clemens Fürnsinn, Siegfried Trattnig, Christoph Buettner, Martin Krššák, Michael Krebs
Context: Non-alcoholic fatty liver disease and elevated circulating branched-chain amino acids (BCAAs) are common characteristics of obesity and type 2 diabetes. In rodents, brain insulin signaling controls both hepatic triglyceride secretion and BCAA catabolism. Whether brain insulin signaling controls similar metabolic pathways in humans is unknown. Objective: Here we assessed if intranasal insulin, a method to preferentially deliver insulin to the central nervous system, is able to modulate hepatic lipid content and plasma BCAAs in humans...
January 16, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323822/effectiveness-and-safety-of-traditional-chinese-medical-bath-therapy-combined-with-ultraviolet-irradiation-in-the-treatment-of-psoriasis-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
Jingzhi Guan, Shaofei Yuan, Hanqimuge Wu, Risu Na, Xueqin Wu, Xin Wang, Shan Bao
BACKGROUND AND OBJECTIVE: To systematically evaluate the clinical effects and safety of traditional Chinese medical bath therapy (TCMBT) combined with ultraviolet irradiation in the treatment of psoriasis. METHODS: Electronic database retrieval was utilized. The foreign retrieval databases consulted included those of the Cochrane Library, PubMed and EMBASE; the domestic retrieval databases included the Chinese Biomedical Literature Database (Sino-Med), the China National Knowledge Infrastructure (CNKI), VIP and the WangFang Database...
2017: PloS One
https://www.readbyqxmd.com/read/28320075/a-cost-utility-analysis-of-high-molecular-weight-hyaluronic-acid-for-knee-osteoarthritis-in-everyday-clinical-care-in-patients-in-the-working-age-an-economic-evaluation-of-a-randomized-clinical-trial
#8
Job Hermans, Max Reijman, Lucas Ma Goossens, Hennie Verburg, Sita Ma Bierma-Zeinstra, Marc A Koopmanschap
Objectives Knee osteoarthritis (OA) is associated with high medical costs and especially with high productivity costs, in particular in patients in their working years. High molecular weight (HMW) hyaluronic acid (HA) is an alternative treatment for non-steroidal anti-inflammatory drugs (NSAIDs), which are known for their serious side-effects. The cost-utility of intra-articular HMW-HA treatment in these patients is unknown though and was assessed in this study. Methods Secondary care patients between 18 and 65 with knee OA were randomized to usual care (UC) + HMW-HA (intervention group) or UC only (control group)...
March 20, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28319848/treatment-of-premenstrual-dysphoric-disorder-with-the-gabaa-receptor-modulating-steroid-antagonist-sepranolone-uc1010-a-randomized-controlled-trial
#9
Marie Bixo, Karin Ekberg, Inger Sundström Poromaa, Angelica Lindén Hirschberg, Aino Fianu Jonasson, Lotta Andréen, Erika Timby, Marianne Wulff, Agneta Ehrenborg, Torbjörn Bäckström
CONTEXT: Allopregnanolone is a metabolite from progesterone and a positive modulator of the GABAA receptor. This endogenous steroid may induce negative mood in sensitive women when present in serum levels comparable to the premenstrual phase. Its endogenous isomer, isoallopregnanolone, has been shown to antagonize allopregnanolone effects in experimental animal and human models. OBJECTIVE: The objective was to test whether inhibition of allopregnanolone by treatment with the GABAA modulating steroid antagonist (GAMSA) Sepranolone (UC1010) during the premenstrual phase could reduce symptoms of the premenstrual dysphoric disorder (PMDD)...
March 1, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28319753/the-impact-of-cannabis-and-cannabinoids-for-medical-conditions-on-health-related-quality-of-life-a-systematic-review-and-meta-analysis
#10
REVIEW
Matthew Goldenberg, Mark William Reid, Waguih William IsHak, Itai Danovitch
INTRODUCTION: The use of cannabis or cannabinoids to treat medical conditions and/or alleviate symptoms is increasingly common. However, the impact of this use on patient reported outcomes, such as health-related quality of life (HRQoL), remains unclear. METHODS: We conducted a systematic review and meta-analysis, employing guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We categorized studies based on design, targeted disease condition, and type of cannabis or cannabinoid used...
March 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28319725/antiestrogen-use-in-breast-cancer-patients-reduces-the-risk-of-subsequent-lung-cancer-a-population-based-study
#11
Sung-Chao Chu, Chia-Jung Hsieh, Tso-Fu Wang, Mun-Kun Hong, Tang-Yuan Chu
BACKGROUND: There is accumulating epidemiological and preclinical evidence that estrogen might be a driver of lung cancer. Breast cancer survivors can offer a unique patient cohort to examine the effect of antiestrogen therapy on lung cancer carcinogenesis because many of these women would have received long-term selective estrogen receptor modulators (SERMs) and/or aromatase inhibitors (AIs) as adjuvant treatment. Our hypothesis is that estrogens play a role in lung cancer development, and that antiestrogen therapy would affect the incidence of subsequent lung cancer among breast cancer survivors...
March 17, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/28319473/precision-medicine-in-asthma-the-role-of-bronchial-thermoplasty
#12
Amber J Oberle, Praveen Mathur
PURPOSE OF REVIEW: The inflammatory makeup of severe asthma is heterogeneous. Identification of the predominant cellular endotype via biomarkers can aid in the selection of more advanced therapies. This review is clinically focused on how to use these biomarkers to help select between biologic agents and/or bronchial thermoplasty. RECENT FINDINGS: Several Th2 biomarkers exist for the detection of eosinophilic disease; however, the best biomarker for clinical practice is debatable depending upon local resources...
March 17, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28319467/effects-of-iv-acetaminophen-on-core-body-temperature-and-hemodynamic-responses-in-febrile-critically-ill-adults-a-randomized-controlled-trial
#13
Hildy M Schell-Chaple, Kathleen D Liu, Michael A Matthay, Daniel I Sessler, Kathleen A Puntillo
OBJECTIVE: To determine the effects of IV acetaminophen on core body temperature, blood pressure, and heart rate in febrile critically ill patients. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: Three adult ICUs at a large, urban, academic medical center. PATIENTS: Forty critically ill adults with fever (core temperature, ≥ 38.3°C). INTERVENTION: An infusion of acetaminophen 1 g or saline placebo over 15 minutes...
March 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28319424/rivaroxaban-in-patients-with-atrial-fibrillation-from-rocket-af-to-everyday-practice
#14
Gonzalo Barón-Esquivias, Francisco Marín, Marcelo Sanmartín
Registries and non-interventional studies offer relevant and complementary information to clinical trials, since they have a high external validity. Areas covered: The information regarding the efficacy and safety of rivaroxaban compared with warfarin, or rivaroxaban alone in clinical practice was reviewed in this manuscript. For this purpose, a search on MEDLINE and EMBASE databases was performed. The MEDLINE and EMBASE search included both medical subject headings (MeSH) and keywords including: atrial fibrillation (AF) OR warfarin OR clinical practice OR ROCKET AF AND rivaroxaban...
March 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28319423/silexan-does-not-cause-withdrawal-symptoms-even-when-abruptly-discontinued
#15
M Gastpar, W E Müller, H P Volz, H J Möller, S Schläfke, A Dienel, S Kasper
OBJECTIVE: Subsequent to a randomised, double-blind, double dummy clinical trial assessing the efficacy of silexan compared to placebo and paroxetine in patients suffering from generalised anxiety disorder (GAD), a 1week follow-up phase was added in order to assess possible withdrawal symptoms of silexan after abrupt discontinuation. METHODS: Participants received silexan 80 mg/d, silexan 160 mg/d, paroxetine 20 mg/d, or placebo at a ratio of 1:1:1:1. Study medication was discontinued after the 10 week active treatment phase of the original trial...
March 20, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28319269/withdrawn-trimetazidine-for-stable-angina
#16
REVIEW
Agustín Ciapponi, Rudolf Pizarro, Jeff Harrison
BACKGROUND: Patients with stable angina not controlled by monotherapy with nitrates, beta blockers, or calcium channel blockers are often treated with combinations of these drugs. There may be adverse effects from, or contraindications to, the use of combinations. In low risk groups, medical treatment appears to be as good an option as percutaneous transluminal coronary angioplasty in terms of averting myocardial infarction, death, or subsequent revascularization. Revascularization procedures are too costly or inaccessible for many patients in developing countries therefore effective and safe medical treatment is needed...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319243/association-of-antioxidant-supplement-use-and-dementia-in-the-prevention-of-alzheimer-s-disease-by-vitamin-e-and-selenium-trial-preadvise
#17
Richard J Kryscio, Erin L Abner, Allison Caban-Holt, Mark Lovell, Phyllis Goodman, Amy K Darke, Monica Yee, John Crowley, Frederick A Schmitt
Importance: Oxidative stress is an established dementia pathway, but it is unknown if the use of antioxidant supplements can prevent dementia. Objective: To determine if antioxidant supplements (vitamin E or selenium) used alone or in combination can prevent dementia in asymptomatic older men. Design, Setting, and Participants: The Prevention of Alzheimer's Disease by Vitamin E and Selenium (PREADViSE) trial began as a double-blind randomized clinical trial in May 2002, which transformed into a cohort study from September 2009 to May 2015...
March 20, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28318997/diastolic-blood-pressure-is-a-risk-factor-for-peri-procedural-stroke-following-carotid-endarterectomy-in-asymptomatic-patients
#18
D D de Waard, G J de Borst, R Bulbulia, A Huibers, A Halliday
OBJECTIVE/BACKGROUND: Carotid endarterectomy (CEA) prevents future stroke, but this benefit depends on detection and control of high peri-operative risk factors. In symptomatic patients, diastolic hypertension has been causally related to procedural stroke following CEA. The aim was to identify risk factors causing peri-procedural stroke in asymptomatic patients and to relate these to timing of surgery and mechanism of stroke. METHODS: In the first Asymptomatic Carotid Surgery Trial (ACST-1), 3,120 patients with severe asymptomatic carotid stenosis were randomly assigned to CEA plus medical therapy or to medical therapy alone...
March 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28318984/safety-and-efficacy-of-thrombectomy-in-acute-ischaemic-stroke-revascat-1-year-follow-up-of-a-randomised-open-label-trial
#19
Antoni Dávalos, Erik Cobo, Carlos A Molina, Angel Chamorro, M Angeles de Miquel, Luis San Román, Joaquín Serena, Elena López-Cancio, Marc Ribó, Mónica Millán, Xabier Urra, Pere Cardona, Alejandro Tomasello, Carlos Castaño, Jordi Blasco, Lucía Aja, Marta Rubiera, Meritxell Gomis, Arturo Renú, Blanca Lara, Joan Martí-Fàbregas, Brian Jankowitz, Neus Cerdà, Tudor G Jovin
BACKGROUND: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. METHODS: Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone...
March 16, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28318938/diabetes-nurse-case-management-in-a-canadian-tertiary-care-setting-results-of-a-randomized-controlled-trial
#20
Danni Li, Tom Elliott, Gerri Klein, Ehud Ur, Tricia S Tang
OBJECTIVES: To examine the effects of a 6-month nurse case manager (NCM) intervention compared to standard care (SC) on glycemic control and diabetes distress in a Canadian tertiary-care setting. METHODS: We recruited 140 adults with type 2 diabetes and glycated hemoglobin (A1C) levels >8% (64 mmol/mol) from 2 tertiary care facilities and randomized them to: 1) a 6-month NCM intervention in addition to SC or 2) SC by the primary endocrinologists. Assessments were conducted at baseline and at 6 months...
March 17, 2017: Canadian Journal of Diabetes
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