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https://www.readbyqxmd.com/read/28329389/radial-versus-femoral-access-in-patients-with-acute-coronary-syndromes-with-or-without-st-segment-elevation-a-pre-specified-analysis-from-the-randomized-minimizing-adverse-haemorrhagic-events-by-transradial-access-site-and-systemic-implementation-of-angiox
#1
Pascal Vranckx, Enrico Frigoli, Martina Rothenbühler, Francesco Tomassini, Stefano Garducci, Giuseppe Andò, Andrea Picchi, Paolo Sganzerla, Anita Paggi, Fabrizio Ugo, Arturo Ausiello, Gennaro Sardella, Nicoletta Franco, Marco Nazzaro, Nicoletta de Cesare, Paolo Tosi, Camillo Falcone, Carlo Vigna, Pietro Mazzarotto, Emilio Di Lorenzo, Claudio Moretti, Gianluca Campo, Carlo Penzo, Giampaolo Pasquetto, Dik Heg, Peter Jüni, Stephan Windecker, Marco Valgimigli
Aims: To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods and results: In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 2009 femoral) and NSTE-ACS (2196 radial, 2198 femoral)...
February 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329300/personalising-the-decision-for-prolonged-dual-antiplatelet-therapy-development-validation-and-potential-impact-of-prognostic-models-for-cardiovascular-events-and-bleeding-in-myocardial-infarction-survivors
#2
Laura Pasea, Sheng-Chia Chung, Mar Pujades-Rodriguez, Alireza Moayyeri, Spiros Denaxas, Keith A A Fox, Lars Wallentin, Stuart J Pocock, Adam Timmis, Amitava Banerjee, Riyaz Patel, Harry Hemingway
Aims: The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms. Methods and results: Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 year after acute myocardial infarction (MI), we developed (n = 12 694 patients) and validated (n = 5613) prognostic models for cardiovascular (cardiovascular death, MI or stroke) events and three different bleeding endpoints...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28324047/functional-imaging-in-the-follow-up-of-enteropancreatic-neuroendocrine-tumors-clinical-usefulness-and-indications
#3
Elettra Merola, Marianne E Pavel, Francesco Panzuto, Gabriele Capurso, Noemi Cicchese, Anja Rinke, Thomas M Gress, Elsa Iannicelli, Daniela Prosperi, Patrizia Pizzichini, Vikas Prasad, Patrizia Kump, Rainer Lipp, Stefano Partelli, Massimo Falconi, Bertram Wiedenmann, Gianfranco Delle Fave
Context: Functional imaging tests (FITs) detecting somatostatin receptors expression (i.e., Somatostatin Receptor Scintigraphy, 68Ga-DOTA-peptide positron emission tomography/computed tomography) have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), while their indication during follow-up still needs to be clarified. Objective: Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams...
January 13, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28319004/updated-risk-factors-should-be-used-to-predict-development-of-diabetes
#4
Mary Angelyn Bethel, Kristen A Hyland, Antonio R Chacra, Prakash Deedwania, Gregory R Fulcher, Rury R Holman, Trond Jenssen, Naomi S Levitt, John J V McMurray, Eleni Boutati, Laine Thomas, Jie-Lena Sun, Steven M Haffner
AIMS: Predicting incident diabetes could inform treatment strategies for diabetes prevention, but the incremental benefit of recalculating risk using updated risk factors is unknown. We used baseline and 1-year data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) Trial to compare diabetes risk prediction using historical or updated clinical information. METHODS: Among non-diabetic participants reaching 1year of follow-up in NAVIGATOR, we compared the performance of the published baseline diabetes risk model with a "landmark" model incorporating risk factors updated at the 1-year time point...
March 2, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28318850/safety-and-efficacy-of-hyperosmolar-irrigation-solution-in-shoulder-arthroscopy
#5
Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J Smith
BACKGROUND: A hyperosmolar irrigation solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar solution were compared with a standard isotonic solution when used for shoulder arthroscopy. METHODS: A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) irrigation solutions used for arthroscopic rotator cuff repair...
March 15, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28298564/proteomic-analysis-of-sera-from-individuals-with-diffuse-cutaneous-systemic-sclerosis-reveals-a-multianalyte-signature-associated-with-clinical-improvement-during-imatinib-mesylate-treatment
#6
D James Haddon, Hannah E Wand, Justin A Jarrell, Robert F Spiera, Paul J Utz, Jessica K Gordon, Lorinda S Chung
OBJECTIVE: Imatinib has been investigated for the treatment of systemic sclerosis (SSc) because of its ability to inhibit the platelet-derived growth factor receptor and transforming growth factor-β signaling pathways, which have been implicated in SSc pathogenesis. In a 12-month open-label clinical trial assessing the safety and efficacy of imatinib in the treatment of diffuse cutaneous SSc (dcSSc), significant improvements in skin thickening were observed. Here, we report our analysis of sera collected during the clinical trial...
March 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28298057/defining-the-substantial-clinical-benefit-after-arthroscopic-treatment-of-femoroacetabular-impingement
#7
Benedict U Nwachukwu, Brenda Chang, Kara Fields, Brian J Rebolledo, Danyal H Nawabi, Bryan T Kelly, Anil S Ranawat
BACKGROUND: The minimal clinically important difference (MCID) has been defined in orthopaedics and is the smallest change that a patient considers meaningful. Less is known about improvements that the patient perceives as clinically considerable, or the substantial clinical benefit (SCB). For the young, highly functioning patient cohort with femoroacetabular impingement (FAI), the SCB is an important measure of clinical success. PURPOSE: To derive the SCB for FAI treatment and identify outcome score thresholds and patient variables predictive of the SCB...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28296727/prognostic-nomogram-for-patients-with-hepatocellular-carcinoma-underwent-adjuvant-transarterial-chemoembolization-following-curative-resection
#8
Chu-Yu Jing, Yi-Peng Fu, Su-Su Zheng, Yong Yi, Hu-Jia Shen, Jin-Long Huang, Xin Xu, Jia-Jia Lin, Jian Zhou, Jia Fan, Zheng-Gang Ren, Shuang-Jian Qiu, Bo-Heng Zhang
Adjuvant transarterial chemoembolization (TACE) is a major option for postoperative hepatocellular carcinoma (HCC) patients with recurrence risk factors. However, individualized predictive models for subgroup of these patients are limited. This study aimed to develop a prognostic nomogram for patients with HCC underwent adjuvant TACE following curative resection.A cohort comprising 144 HCC patients who received adjuvant TACE following curative resection in the Zhongshan Hospital were analyzed. The nomogram was formulated based on independent prognostic indicators for overall survival (OS)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28291727/bivalirudin-versus-heparin-in-women-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis-of-randomized-clinical-trials
#9
Marwan Saad, Ramez Nairooz, Ahmed Rashed, Hesham K Abdelaziz, Amgad Mentias, J Dawn Abbott
BACKGROUND: The anticoagulant of choice during percutaneous coronary intervention (PCI) in women is not well established. METHODS: An electronic search was conducted for trials that randomized patients undergoing PCI to bivalirudin versus heparin, and reported outcomes of interest in women. Random effects DerSimonian-Laird risk ratios (RR) were calculated. Main outcome was net adverse clinical events (NACE) at 30-days. Other outcomes included major adverse cardiac events (MACE), all-cause mortality, myocardial infarction (MI), target vessel revascularization (TVR), and major bleeding at 30-days...
February 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28288018/cost-effectiveness-of-the-13-valent-pneumococcal-conjugate-vaccine-in-children-in-portugal
#10
Miguel Gouveia, Francesca Fiorentino, Gonçalo Jesus, João Costa, Margarida Borges
INTRODUCTION: Pneumococcal infections are the leading cause of vaccine-preventable death in children. In June 2015, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the Portuguese Immunization Program. We evaluate the cost-effectiveness of children vaccination with PCV13 versus no vaccination for preventing pneumococcal diseases (PD). METHOD: A cohort simulation model for 2014 Portuguese newborns was used, considering a lifetime horizon and existence of herd effect on adults...
March 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28284499/the-optimal-discontinuation-of-dual-antiplatelet-therapy-in-patients-undergoing-percutaneous-coronary-intervention-with-drug-eluting-stents-a-meta-analysis-of-randomized-trials
#11
Wei Wang, Jing Liu, Jingxue Fang, Yang Liu, Tong An, Meijuan Zou, Gang Cheng
BACKGROUND: Current guidelines recommend prolonged dual antiplatelet therapy (DAPT) for patients with drug-eluting stents (DES) implantation. Nevertheless, optimal discontinuation of DAPT remains a controversy. We performed a meta-analysis of all randomized controlled trials (RCTs) that evaluate optimal discontinuation of DAPT in patients undergoing percutaneous coronary intervention (PCI) with DES. METHODS: We searched electronic databases including PubMed, Cochrane Library, EMBASE and ClinicalTrials...
February 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28281050/a-cost-utility-analysis-of-risk-model-guided-versus-physician-s-choice-antiemetic-prophylaxis-in-patients-receiving-chemotherapy-for-early-stage-breast-cancer-a-net-benefit-regression-approach
#12
Kednapa Thavorn, Doug Coyle, Jeffrey S Hoch, Lisa Vandermeer, Sasha Mazzarello, Zhou Wang, George Dranitsaris, Dean Fergusson, Mark Clemons
PURPOSE: We assessed the cost-effectiveness of a risk model-guided (RMG) antiemetic prophylaxis strategy compared with the physician's choice (PC) strategy in patients receiving chemotherapy for early-stage breast cancer. METHODS: We conducted a cost-utility analysis based on a published randomized controlled trial of 324 patients with early-stage breast cancer undergoing chemotherapy at two Canadian cancer centers. Patients were randomized to receive their antiemetic treatments according to either predefined risk scores or the treating physician's preference...
March 9, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28279836/autologous-hematopoietic-stem-cell-transplantation-in-systemic-lupus-erythematosus-and-antiphospholipid-syndrome-a-systematic-review
#13
REVIEW
Alessia Leone, Massimo Radin, Ahlam M Almarzooqi, Jamal Al-Saleh, Dario Roccatello, Savino Sciascia, Munther Khamashta
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) has been proposed as a therapeutic option for patients with Systemic Lupus Erythematosus (SLE) refractory to standard therapy. This therapeutic approach has been applied to other severe autoimmune diseases refractory to standard therapy with promising results. AIM: To systematically review the literature and analyze the available evidence on HSCT therapy in patients with SLE and antiphospholipid syndrome (APS), with a focus on therapy efficacy and occurrence of adverse events...
March 7, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#14
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28279072/aspirin-in-older-adults
#15
Mandi Sehgal, Sarah K Wood, Joseph G Ouslander, Charles H Hennekens
In the treatment or secondary prevention of cardiovascular disease (CVD), there is general consensus that the absolute benefits of aspirin far outweigh the absolute risks. Despite evidence from randomized trials and their meta-analyses, older adults, defined as aged 65 years or older, are less likely to be prescribed aspirin than their middle-aged counterparts. In primary prevention, the optimal utilization of aspirin is widely debated. There is insufficient randomized evidence among apparently healthy participants at moderate to high risk of a first CVD event, so general guidelines seem premature...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28276598/clinical-utility-of-using-lumbar-spine-trabecular-bone-score-to-adjust-fracture-probability-the-manitoba-bmd-cohort
#16
P Martineau, W D Leslie, H Johansson, A Oden, E V McCloskey, D Hans, J A Kanis
Decreased lumbar spine trabecular bone score (TBS), a DXA-derived image texture measurement, is a risk factor for major osteoporotic fracture (MOF) and hip fracture (HF) independent of ten-year fracture probability estimated using FRAX(R) . We determined how often applying the TBS adjustment to fracture probability altered treatment qualification. Using a population-based registry containing all clinical DXA results for Manitoba, Canada, we identified 34,316 women with baseline spine and hip DXA, FRAX-based fracture probability measurements (computed with femoral neck bone mineral density), lumbar spine TBS, and minimum 5 years of observation (mean 8...
March 9, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28264749/mace-versus-moca-equivalence-or-superiority-pragmatic-diagnostic-test-accuracy-study
#17
A J Larner
BACKGROUND: The Mini-Addenbrooke's Cognitive Examination (MACE) is a new brief cognitive screening instrument for dementia and mild cognitive impairment (MCI). Historical data suggest that MACE may be comparable to the Montreal Cognitive Assessment (MoCA), a well-established cognitive screening instrument, in secondary care settings, but no head-to-head study has been reported hitherto. METHODS: A pragmatic diagnostic accuracy study of MACE and MoCA was undertaken in consecutive patients referred over the course of one year to a neurology-led Cognitive Function Clinic, comparing their performance for the diagnosis of dementia and MCI using various test metrics...
March 7, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28246882/safety-of-multiple-repeated-cycles-of-177-lu-octreotate-in-patients-with-recurrent-neuroendocrine-tumour
#18
Anna Yordanova, Karin Mayer, Peter Brossart, Maria A Gonzalez-Carmona, Christian P Strassburg, Markus Essler, Hojjat Ahmadzadehfar
PURPOSE: Peptide receptor radionuclide therapy (PRRT) is an effective therapy in patients with a somatostatin receptor-positive neuroendocrine tumour (NET). Still unclear is how many cycles of (177)Lu-octreotate can be repeated while maintaining an acceptable toxicity profile. The purpose of this study was to assess the safety of repeated PRRT in patients with recurrent NET. METHODS: We retrospectively evaluated data from 15 patients treated with repeated PRRT between 2004 and 2015...
March 1, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28243682/an-allometric-pharmacokinetic-pharmacodynamics-model-for-bi-893923-a-novel-igf-1-receptor-inhibitor
#19
Melanie I Titze, Otmar Schaaf, Marco H Hofmann, Michael P Sanderson, Stephan K Zahn, Jens Quant, Thorsten Lehr
PURPOSE: BI 893923 is a novel IGF1R/INSR inhibitor with promising anti-tumor efficacy. Dose-limiting hyperglycemia has been observed for other IGF1R/INSR inhibitors in clinical trials. To counterbalance anti-tumor efficacy with the risk of hyperglycemia and to determine the therapeutic window, we aimed to develop a translational pharmacokinetic/pharmacodynamics model for BI 893923. This aimed to translate pharmacokinetics and pharmacodynamics from animals to humans by an allometrically scaled semi-mechanistic model...
February 27, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28237207/the-probabilistic-efficiency-frontier-a-framework-for-cost-effectiveness-analysis-in-germany-put-into-practice-for-hepatitis-c-treatment-options
#20
Axel C Mühlbacher, Andrew Sadler
BACKGROUND: The German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) adapted the efficiency frontier (EF) approach to conform to statutory provisions on cost-effectiveness analysis of health technologies. EF serves as a framework for evaluating cost-effectiveness and indirectly for pricing and reimbursement decisions. OBJECTIVES: To calculate an EF on the basis of single multidimensional benefit by taking patient preferences and uncertainty into account; to evaluate whether EF is useful to inform decision makers about cost-effectiveness of new therapies; and to find whether a treatment is efficient at given prices demonstrated through a case study on chronic hepatitis C...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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