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https://www.readbyqxmd.com/read/28742435/the-role-of-transversus-abdominis-plane-blocks-in-eras-pathways-for-open-and-laparoscopic-colorectal-surgery
#1
Alexander J Kim, Robert Jason Yong, Richard D Urman
INTRODUCTION: The concepts of Enhanced Recovery After Surgery (ERAS(®)) have steadily increased in usage, with benefits in patient outcomes and hospital length of stay. One important component of successful implementation of ERAS protocol is optimized pain control, via the multimodal approach, which includes neuraxial or regional anesthesia techniques and reduction of opioid use as the primary analgesic. Transversus abdominis plane (TAP) block is one such regional anesthesia technique, and it has been widely studied in abdominal surgery...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28737291/nucleoside-reverse-transcriptase-inhibitor-reducing-strategies-in-hiv-treatment-assessing-the-evidence
#2
REVIEW
C Orkin, J M Llibre, S Gallien, A Antinori, Gmn Behrens, A Carr
Antiretroviral (ARV) therapy, comprising a backbone of two nucleos(t)ide reverse transcriptase inhibitors (NRTIs) plus another ARV, is the recognized standard of care (SOC), which has helped extend life expectancy in people living with HIV. In a quest to reduce lifelong drug exposure and minimize or avoid the toxicity of NRTIs, "NRTI-reducing" regimens have been investigated. This descriptive review assessing the results of NRTI-reducing strategies from the largest randomized trials focuses on virological efficacy, resistance, regimen safety (in terms of bone mineral density, renal function, lipids and central nervous system function) and simplicity...
July 24, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28734927/4-dimensionally-guided-3-dimensional-color-doppler-ultrasonography-quantifies-carotid-artery-stenosis-with-high-reproducibility-and-accuracy
#3
Roland Richard Macharzina, Sascha Kocher, Steven R Messé, Thomas Rutkowski, Fabian Hoffmann, Matthias Vogt, Werner Vach, Nian Fan, Aljoscha Rastan, Franz-Josef Neumann, Thomas Zeller
OBJECTIVES: The purpose was to analyze the agreement and binary accuracy of the degree of internal carotid artery stenosis (ICAS) as determined by 4-dimensionally (4D) real-time gray-scale guided 3-dimensional (3D) color-Doppler ultrasonography (3DC-US) (4D/3DC-US) compared with catheter angiography (CA) and duplex ultrasonography (DUS). This study hypothesized that 4D/3DC-US is noninferior to CA and DUS in grading ICAS in selected patients. BACKGROUND: Clinical stratification in patients with ICAS largely depends on a patient's symptomatic status and the degree of stenosis...
July 13, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28726810/a-randomized-controlled-trial-of-disclosing-genetic-risk-information-for-alzheimer-disease-via-telephone
#4
Kurt D Christensen, Wendy R Uhlmann, J Scott Roberts, Erin Linnenbringer, Peter J Whitehouse, Charmaine D M Royal, Thomas O Obisesan, L Adrienne Cupples, Melissa B Butson, Grace-Ann Fasaye, Susan Hiraki, Clara A Chen, Uwe Siebert, Robert Cook-Deegan, Robert C Green
PurposeTelephone disclosure of genetic test results can improve access to services. To date, studies of its impact have focused on return of Mendelian risk information, principally hereditary cancer syndromes.MethodsIn a multisite trial of Alzheimer disease genetic risk disclosure, asymptomatic adults were randomized to receive test results in person or via telephone. Primary analyses examined patient outcomes 12 months after disclosure.ResultsData from 257 participants showed that telephone disclosure occurred 7...
July 20, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28723374/urodynamics-before-surgery-for-stress-urinary-incontinence
#5
Suneetha Rachaneni, Pallavi Latthe
Following three noninferiority randomised controlled trials from different countries showing exactly the same results, it is time to translate this evidence into practice. In women undergoing primary surgery for pure stress urinary incontinence or stress-predominant mixed urinary incontinence without voiding difficulties, careful office evaluation including uroflowmetry and postvoid residual urine can replace invasive investigations such as cystometry, saving patients from embarrassment and a risk of urinary infection...
August 2016: European Urology Focus
https://www.readbyqxmd.com/read/28721892/capecitabine-with-mitomycin-reduces-acute-hematologic-toxicity-and-treatment-delays-in-patients-undergoing-definitive-chemoradiation-using-intensity-modulated-radiation-therapy-for-anal-cancer
#6
Karyn A Goodman, Diana Julie, Andrea Cercek, Lajhem Cambridge, Kaitlin M Woo, Zhigang Zhang, Abraham J Wu, Diane L Reidy, Neil H Segal, Zsofia K Stadler, Leonard B Saltz
PURPOSE: To assess the impact on acute toxicity of replacing 5-fluorouracil (5-FU) with capecitabine in definitive chemoradiation for patients with anal squamous cell carcinoma (ASCC). METHODS AND MATERIALS: We retrospectively reviewed the records of 107 consecutive patients with nonmetastatic ASCC treated with definitive chemoradiation from January 2009 to May 2014. In 2011, based on the noninferiority of capecitabine versus 5-FU, our institutional practice shifted to use capecitabine instead of 5-FU for ASCC...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28721081/insulin-glargine-300-u-ml-for-basal-insulin-therapy-in-type-1-and-type-2-diabetes-mellitus
#7
REVIEW
Ip Tim Lau, Ka Fai Lee, Wing Yee So, Kathryn Tan, Vincent Tok Fai Yeung
OBJECTIVE: To review published clinical studies on the efficacy and safety of new insulin glargine 300 units/mL (Gla-300), a new long-acting insulin analog, for the treatment of type 1 and type 2 diabetes mellitus (T1DM, T2DM). MATERIALS AND METHODS: Data sources comprised primary research articles on Gla-300, including pharmacodynamic, pharmacokinetic, and clinical studies. RESULTS: In pharmacodynamic and pharmacokinetic studies, Gla-300 showed a flatter time-action profile and longer duration of action than Gla-100...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28714534/adjustable-thermoplastic-oral-appliance-versus-positive-airway-pressure-for-obstructive-sleep-apnea
#8
Wish Banhiran, Paraya Assanasen, Cherdchai Nopmaneejumrudlers, Nongyoaw Nujchanart, Wimontip Srechareon, Cheerasook Chongkolwatana, Choakchai Metheetrairut
OBJECTIVES/HYPOTHESIS: To compare outcomes of continuous positive airway pressure (CPAP) and the adjustable thermoplastic mandibular advancement splint (AT-MAS) for obstructive sleep apnea treatment. STUDY DESIGN: Randomized crossover, noninferiority, tertiary center setting. METHODS: Fifty patients with a mean age of 49.5 ± 10.6 years were enrolled. Inclusion criteria were age ≥18 years, apnea-hypopnea index (AHI) ≥5 events/hour, and oxygen saturation ≥70%...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28708817/innovating-cystic-fibrosis-clinical-trial-designs-in-an-era-of-successful-standard-of-care-therapies
#9
Donald R VanDevanter, Nicole Mayer-Hamblett
PURPOSE OF REVIEW: Evolving cystic fibrosis 'standards of care' have influenced recent cystic fibrosis clinical trial designs for new therapies; care additions/improvements will require innovative trial designs to maximize feasibility and efficacy detection. RECENT FINDINGS: Three cystic fibrosis therapeutic areas (pulmonary exacerbations, Pseudomonas aeruginosa airway infections, and reduced cystic fibrosis transmembrane conductance regulator [CFTR] protein function) differ with respect to the duration for which recognized 'standards of care' have been available...
July 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28693531/warm-needling-acupuncture-and-medicinal-cake-separated-moxibustion-for-hyperlipidemia-study-protocol-for-a-randomized-controlled-trial
#10
Mailan Liu, Qian Zhang, Shan Jiang, Mi Liu, Guoshan Zhang, Zenghui Yue, Qin Chen, Jie Zhou, Yifan Zou, Dan Li, Mingzhu Ma, Guobin Dai, Huan Zhong, Zhihong Wang, Xiaorong Chang
BACKGROUND: Acupuncture and moxibustion has been widely applied to hyperlipidemia treatment in clinical practice in China, serving as an alternative treatment to statins. Warm-needling acupuncture and medicinal cake-separated moxibustion have been separately reported with potential therapeutic effects on hyperlipidemia treatment in several studies but with limitations in study methodology. Combining these two modalities may provide a more advantageous strategy in treating hyperlipidemia...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28692484/meta-analysis-of-prophylactic-hydration-versus-no-hydration-on-contrast-induced-acute-kidney-injury
#11
Yufeng Jiang, Min Chen, Yiqing Zhang, Nannan Zhang, Huajia Yang, Jialu Yao, Yafeng Zhou
BACKGROUND: Guidelines recommend prophylactic hydration for all patients with compromised renal function undergoing contrast exposure. However, the AMACING study published recently showed a noninferior result of hydration compared with no prophylaxis in high-risk patients and led to a heat discussion. This study aimed to validate the effectiveness of prophylactic hydration in different subsets of patients undergoing a contrast procedure. METHODS: We carried out a meta-analysis of randomized-controlled trials to assess pooled estimates of relative risk (RR) and 95% confidence intervals (CIs) for incidences of contrast-induced acute kidney injury (CI-AKI), in-hospital all-cause mortality, and need for dialysis...
July 7, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28688951/non-contrast-enhanced-3d-mr-portography-within-a-breath-hold-using-compressed-sensing-acceleration-a-prospective-noninferiority-study
#12
Ayako Ono, Shigeki Arizono, Koji Fujimoto, Thai Akasaka, Rikiya Yamashita, Akihiro Furuta, Hiroyoshi Isoda, Kaori Togashi
PURPOSE: To evaluate images of non-contrast-enhanced 3D MR portography within a breath-hold (BH) using compressed sensing (CS) compared to standard respiratory-triggered (RT) sequences. MATERIALS AND METHODS: Fifty-nine healthy volunteers underwent MR portography using two sequences of balanced steady-state free-precession (bSSFP) with time-spatial labeling inversion pulses (Time-SLIP): BH bSSFP-CS and RT bSSFP. Two radiologists independently scored the diagnostic acceptability to delineate the portal branches (MPV: main portal vein; RPV: right portal vein; LPV: left portal vein; RPPV: right posterior portal vein; and P4 and P8: portal branch of segment 4 and segment 8, respectively) and the overall image quality on a four-point scale...
July 5, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28679598/mucuna-pruriens-in-parkinson-disease-a-double-blind-randomized-controlled-crossover-study
#13
Roberto Cilia, Janeth Laguna, Erica Cassani, Emanuele Cereda, Nicolò G Pozzi, Ioannis U Isaias, Manuela Contin, Michela Barichella, Gianni Pezzoli
OBJECTIVE: To investigate whether Mucuna pruriens (MP), a levodopa-containing leguminous plant growing in all tropical areas worldwide, may be used as alternative source of levodopa for indigent individuals with Parkinson disease (PD) who cannot afford long-term therapy with marketed levodopa preparations. METHODS: We investigated efficacy and safety of single-dose intake of MP powder from roasted seeds obtained without any pharmacologic processing. Eighteen patients with advanced PD received the following treatments, whose sequence was randomized: (1) dispersible levodopa at 3...
July 5, 2017: Neurology
https://www.readbyqxmd.com/read/28676065/prior-balloon-valvuloplasty-versus-direct-transcatheter-aortic-valve-implantation-directavi-study-protocol-for-a-randomized-controlled-trial
#14
Florence Leclercq, Pierre Robert, Jessica Labour, Benoit Lattuca, Mariama Akodad, Jean-Christophe Macia, Richard Gervasoni, Francois Roubille, Thomas Gandet, Laurent Schmutz, Erika Nogue, Nicolas Nagot, Bernard Albat, Guillaume Cayla
BACKGROUND: Balloon predilatation of the aortic valve has been regarded as an essential step during the transcatheter aortic valve implantation (TAVI) procedure. However, recent evidence has suggested that aortic valvuloplasty may cause complications and that high success rates may be obtained without prior dilatation of the valve. We hypothesize that TAVI performed without predilatation of the aortic valve and using new-generation balloon-expandable transcatheter heart valves is associated with a better net clinical benefit than TAVI performed with predilatation...
July 4, 2017: Trials
https://www.readbyqxmd.com/read/28672316/effect-of-insulin-degludec-vs-insulin-glargine-u100-on-hypoglycemia-in-patients-with-type-1-diabetes-the-switch-1-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Wendy Lane, Timothy S Bailey, Gregg Gerety, Janusz Gumprecht, Athena Philis-Tsimikas, Charlotte Thim Hansen, Thor S S Nielsen, Mark Warren
Importance: Hypoglycemia, common in patients with type 1 diabetes, is a major barrier to achieving good glycemic control. Severe hypoglycemia can lead to coma or death. Objective: To determine whether insulin degludec is noninferior or superior to insulin glargine U100 in reducing the rate of symptomatic hypoglycemic episodes. Design, Setting, and Participants: Double-blind, randomized, crossover noninferiority trial involving 501 adults with at least 1 hypoglycemia risk factor treated at 84 US and 6 Polish centers (January 2014-January 12, 2016) for two 32-week treatment periods, each with a 16-week titration and a 16-week maintenance period...
July 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28670234/comparison-of-efficacy-of-multimatrix-mesalazine-4-8-g-day-once-daily-with-other-high-dose-mesalazine-in-active-ulcerative-colitis-a-randomized-double-blind-study
#16
Haruhiko Ogata, Nobuo Aoyama, Seiichi Mizushima, Atsushi Hagino, Toshifumi Hibi
BACKGROUND/AIMS: This study assessed the efficacy and safety of high-dose multimatrix mesalazine once-daily (QD) compared to another form of high-dose mesalazine. METHODS: In this multicenter, randomized, double-blind study, 280 patients with mildly to moderately active ulcerative colitis (UC) received multimatrix mesalazine 4.8 g/day QD or pH-dependent-release mesalazine 3.6 g/day three times daily for 8 weeks. The primary endpoint was the change in the UC-Disease Activity Index (UC-DAI) at the end of the treatment period...
July 2017: Intestinal Research
https://www.readbyqxmd.com/read/28670233/comparison-of-efficacies-of-once-daily-dose-multimatrix-mesalazine-and-multiple-dose-mesalazine-for-the-maintenance-of-remission-in-ulcerative-colitis-a-randomized-double-blind-study
#17
Haruhiko Ogata, Akihiro Ohori, Haruo Nishino, Seiichi Mizushima, Atsushi Hagino, Toshifumi Hibi
BACKGROUND/AIMS: This study compared the efficacy of once-daily administration of multimatrix mesalazine 2.4 g/day with multiple-dose mesalazine for the maintenance of remission. METHODS: In this multicenter, randomized, double-blind study, 203 patients with ulcerative colitis in remission received multimatrix mesalazine 2.4 g/day once-daily or time-dependent (controlled-release) mesalazine 2.25 g/day 3 times-daily for 48 weeks. The primary efficacy endpoint was the proportion of patients without rectal bleeding...
July 2017: Intestinal Research
https://www.readbyqxmd.com/read/28669789/self-directed-interactive-video-based-instruction-versus-instructor-led-teaching-for-myanmar-house-surgeons-a-randomized-noninferiority-trial
#18
Albert Thein Lwin, Thein Lwin, Phyu Naing, Yee Oo, David Kidd, Marcelo Cerullo, Joshua Posen, Kyaw Hlaing, Gayane Yenokyan, Kyi Kyi Thinn, Zaw Wai Soe, Kent A Stevens
OBJECTIVE: To compare self-directed interactive video-based instruction (IVBI) with instructor-led teaching in the acquisition of basic surgical skills by House Surgeons at University of Medicine 1, Yangon. DESIGN: A prospective, 1:1 randomized controlled trial was conducted. Participants were randomized into 2 teaching arms: (1) self-directed IVBI or (2) instructor-led teaching. Self-directed IVBI participants were provided with a portable DVD player that could play, fast forward, rewind, and skip through skills modules...
June 29, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28664385/pazopanib-a-review-in-advanced-renal-cell-carcinoma
#19
REVIEW
James E Frampton
Pazopanib (Votrient®), an orally administered multi-targeted tyrosine kinase inhibitor that predominantly inhibits vascular endothelial growth factor receptor-1, -2 and -3, platelet-derived growth factor receptor-α and -β, and the stem cell factor receptor c-Kit, is approved in the EU, the USA and other countries for the treatment of advanced renal cell carcinoma (RCC). In randomized controlled trials in patients with advanced, predominantly clear-cell RCC, pazopanib significantly improved progression-free survival (PFS) compared with placebo in both treatment-naïve and cytokine-pretreated patients and, as a first-line therapy, was noninferior to intermittent sunitinib with respect to PFS...
August 2017: Targeted Oncology
https://www.readbyqxmd.com/read/28663267/comparison-of-gadoterate-meglumine-and-gadobutrol-in-the-mri-diagnosis-of-primary-brain-tumors-a-double-blind-randomized-controlled-intraindividual-crossover-study-the-remind-study
#20
K R Maravilla, D San-Juan, S J Kim, G Elizondo-Riojas, J R Fink, W Escobar, A Bag, D R Roberts, J Hao, C Pitrou, A J Tsiouris, E Herskovits, J B Fiebach
BACKGROUND AND PURPOSE: Effective management of patients with brain tumors depends on accurate detection and characterization of lesions. This study aimed to demonstrate the noninferiority of gadoterate meglumine versus gadobutrol for overall visualization and characterization of primary brain tumors. MATERIALS AND METHODS: This multicenter, double-blind, randomized, controlled intraindividual, crossover, noninferiority study included 279 patients. Both contrast agents (dose = 0...
June 29, 2017: AJNR. American Journal of Neuroradiology
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