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https://www.readbyqxmd.com/read/28230312/five-year-cost-effectiveness-of-patient-empowerment-programme-pep-for-type-2-diabetes-mellitus-in-primary-care
#1
J X Lian, Sarah M McGhee, C So, J Chau, Carlos Kh Wong, William Cw Wong, Cindy Lk Lam
This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. The outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a five-year follow-up and the number needed to treat (NNT) to avoid one event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT...
February 23, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28225220/efficacy-of-ruscus-extract-hmc-and-vitamin-c-constituents-of-cyclo-3-fort%C3%A2-on-improving-individual-venous-symptoms-and-edema-a-systematic-review-and-meta-analysis-of-randomized-double-blind-placebo-controlled-trials
#2
Stavros K Kakkos, François A Allaert
INTRODUCTION: Venoactive drugs (VADs) are considered an important component of the medical (conservative) treatment of chronic venous disorders (CVDs). However, the efficacy of certain VADs on one or more individual leg symptoms may have not been extensively studied to justify a high level or grade of recommendation in guidelines on CVD. The aim of the present systematic review and meta-analysis was to study the effectiveness of VADs containing Ruscus across the spectrum of defined venous symptoms...
April 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28213170/non-response-at-week-4-as-clinically-useful-indicator-for-antidepressant-combination-in-major-depressive-disorder-a-sequential-rct
#3
Masaki Kato, Yoshiteru Takekita, Yosuke Koshikawa, Shiho Sakai, Hiroki Bandou, Keiichiro Nishida, Naotaka Sunada, Ai Onohara, Yoshiyuki Hatashita, Alessandro Serretti, Toshihiko Kinoshita
We aimed to compare the efficacy and tolerability of mirtazapine versus SSRIs and to assess whether "non-response at week 4" may be a clinical indicator for combining mirtazapine and SSRIs for subsequent treatment. One-hundred fifty-four outpatients with MDD were randomized to receive mirtazapine or SSRIs in step I (4 weeks). Non-responders in step I were randomly assigned to either mirtazapine or SSRIs monotherapy or their combination in step IIa while responders in step I continued the same monotherapy in step IIb for 4 weeks...
February 3, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28209488/postoperative-maintenance-levonorgestrel-releasing-intrauterine-system-and-endometrioma-recurrence-a-randomized-controlled-study
#4
Yi-Jen Chen, Teh-Fu Hsu, Ben-Shian Huang, Hsiao-Wen Tsai, Yen-Hou Chang, Peng-Hui Wang
BACKGROUND: According to three randomized trials, levonorgestrel-releasing intrauterine system significantly reduced recurrent endometriosis- related pelvic pain at postoperative year 1. Only a few studies have evaluated the long-term effectiveness of the devicefor preventing endometrioma recurrence, and the effects of a levonorgestrel-releasing intrauterine system as a maintenance therapy remain unclear. OBJECTIVES: To evaluate whether a maintenance levonorgestrel-releasing intrauterine system is effective for preventing postoperative endometrioma recurrence...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28185319/gabapentenoids-in-pain-management-in-urological-chronic-pelvic-pain-syndrome-gabapentin-or-pregabalin
#5
Mayank Mohan Agarwal, Mudelin Elsi Sy
AIMS: To compare efficacy of gabapentin and pregabalin in patients with urological chronic pelvic-pain syndrome (UCPPS). METHODS: Design-retrospective, setting-urology outpatient services of a secondary-care private hospital, inclusion criteria-men 18-50 years, presenting with pelvic pain (lower abdomen, groin, scrotum, perineum, low-back, hip) with or without lower urinary tract symptoms for at least 3 months duration. Hospital database was searched using keywords for neuropathic pain (ICD9-729...
February 10, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28176964/efficacy-and-safety-of-biological-and-targeted-synthetic-dmards-a-systematic-literature-review-informing-the-2016-update-of-the-asas-eular-recommendations-for-the-management-of-axial-spondyloarthritis
#6
Alexandre Sepriano, Andrea Regel, Désirée van der Heijde, Jürgen Braun, Xenofon Baraliakos, Robert Landewé, Filip Van den Bosch, Louise Falzon, Sofia Ramiro
OBJECTIVES: To update the evidence for the efficacy and safety of (b)biological and (ts)targeted-synthetic disease-modifying anti-rheumatic drugs (DMARDs) in patients with axial spondyloarthritis (axSpA) to inform the 2016 update of the Assessment of SpondyloArthritis international Society/European League Against Rheumatism (ASAS/EULAR) recommendations for the management of axSpA. METHODS: Systematic literature review (2009-2016) for randomised controlled trials (RCT), including long-term extensions, strategy trials and observational studies (the latter was only for safety assessment and a comparator was required)...
2017: RMD Open
https://www.readbyqxmd.com/read/28176189/number-needed-to-treat-in-multiple-sclerosis-clinical-trials
#7
REVIEW
Macaulay Okwuokenye, Annie Zhang, Amy Pace, Karl E Peace
Clinicians are expected to select a therapy based on their appraisal of evidence on benefit-to-risk profiles of therapies. In the management of relapsing-remitting multiple sclerosis (RRMS), evidence is typically expressed in terms of risk (proportion) of event, risk reduction, relative and hazard rate reduction, or relative reduction in the mean number of magnetic resonance imaging lesions. Interpreting treatment effect using these measures from a RRMS clinical trial is fairly reliable; however, this might not be the case when treatment effect is expressed in terms of the number needed to treat (NNT)...
February 7, 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/28167118/indomethacin-and-diclofenac-in-the-prevention-of-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis-of-prospective-controlled-trials
#8
REVIEW
Árpád Patai, Norbert Solymosi, László Mohácsi, Árpád V Patai
BACKGROUND AND AIMS: Diclofenac and indomethacin are the most studied drugs for preventing post-ERCP pancreatitis (PEP). However, there are no prospective, randomized multicenter trials with sufficient number of patients for the correct evaluation of their efficacy. Our aim was to evaluate of all trials published in full text and studied efficacy of diclofenac or indomethacin prospective controlled with placebo or non-treatment for the prevention of PEP in adult patients undergoing ERCP...
February 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28165675/intratracheal-administration-of-budesonide-surfactant-in-prevention-of-bronchopulmonary-dysplasia-in-very-low-birth-weight-infants-a-systematic-review-and-meta-analysis
#9
REVIEW
Rohini Venkataraman, Majeeda Kamaluddeen, Shabih U Hasan, Helen Lee Robertson, Abhay Lodha
Despite the near universal adaptation of gentle mechanical ventilation, surfactant use and non-invasive respiratory support, bronchopulmonary dysplasia (BPD) remains one of the most common respiratory morbidities in very low birth weight (VLBW) infants. Thus, the objective of this review was to evaluate the efficacy of intra-tracheal administration of budesonide-surfactant mixture in preventing bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants. MEDLINE, EMBASE, and PubMed were searched for randomized clinical trials in which intra-tracheal administration of budesonide-surfactant was used to prevent BPD in infants...
February 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28157466/is-ipt-more-effective-in-high-burden-settings-modelling-the-effect-of-tuberculosis-incidence-on-ipt-impact
#10
R Ragonnet, J M Trauer, E S McBryde, R M G J Houben, J T Denholm, A Handel, T Sumner
SETTING: Isoniazid preventive therapy (IPT) is effective for preventing active tuberculosis (TB), although its mechanism of action is poorly understood and the optimal disease burden for IPT use has not been defined. OBJECTIVE: To describe the relationship between TB incidence and IPT effectiveness. METHODS: We constructed a model of TB transmission dynamics to investigate IPT effectiveness under various epidemiological settings. The model structure was intended to be highly adaptable to uncertainty in both input parameters and the mechanism of action of IPT...
January 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28152678/brentuximab-vedotin-bv-consolidation-post-autologous-stem-cell-transplant-asct-in-patients-pts-with-hodgkin-lymphoma-hl-at-risk-of-residual-disease-number-needed-to-treat-nnt-analysis
#11
Dirk Huebner, Yanyan Zhu, Esprit Ma, Shih-Yuan Lee, Erin Zagadailov, Jeremy Teasell, Akshara Richhariya, Vijayveer Bonthapally
: 20 Background: AETHERA (NCT01100502) is a randomized Phase 3 study of BV and best supportive care (BSC) vs placebo (PBO) and BSC in the treatment of pts at risk of residual HL post-ASCT. BV consolidation therapy post-ASCT significantly improved progression-free survival (PFS) by independent review vs PBO (HR = 0.57, P = 0.001) and was FDA approved. Most common grade ≥ 3 adverse events were neutropenia (29% BV vs 10% PBO) and peripheral sensory neuropathy (10% vs 1%). The aim of this study was to determine the NNT with BV to avoid 1 additional event, disease progression/death...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28141932/an-expanded-portfolio-of-survival-metrics-for-assessing-anticancer-agents
#12
Jennifer Karweit, Srividya Kotapati, Samuel Wagner, James W Shaw, Steffan W Wolfe, Amy P Abernethy
OBJECTIVES: With the introduction of more effective anticancer agents that prolong survival, there is a need for new methods to define the clinical value of treatments. The objective of this preliminary qualitative and quantitative analysis was to assess the utility of an expanded portfolio of survival metrics to differentiate the value of anticancer agents. STUDY DESIGN: A literature review was conducted of phase 3 trial data, reported in regulatory submissions within the last 10 years of agents for 6 metastatic cancers (breast cancer, colorectal cancer [CRC], melanoma, non-small cell lung cancer [NSCLC], prostate cancer [PC], and renal cell cancer [RCC])...
January 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28138002/high-fat-feeding-unmasks-variable-insulin-responses-in-male-c57bl-6-mouse-substrains
#13
Rebecca L Hull, Joshua R Willard, Matthias D Struck, Breanne M Barrow, Gurkirat S Brar, Sof Andrikopoulos, Sakeneh Zraika
Mouse models are widely used for elucidating mechanisms underlying type 2 diabetes. Genetic background profoundly affects metabolic phenotype; therefore selecting the appropriate model is critical. While variability in metabolic responses between mouse strains is now well-recognized, it also occurs within C57BL/6 mice, of which several substrains exist. This within-strain variability is poorly understood, and could emanate from genetic and/or environmental differences. To better define the within-strain variability, we performed the first comprehensive comparison of insulin secretion from C57BL/6 substrains 6J, 6JWehi, 6NJ, 6NHsd, 6NTac and 6NCrl...
January 30, 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28137247/a-randomised-controlled-trial-of-dietary-improvement-for-adults-with-major-depression-the-smiles-trial
#14
Felice N Jacka, Adrienne O'Neil, Rachelle Opie, Catherine Itsiopoulos, Sue Cotton, Mohammedreza Mohebbi, David Castle, Sarah Dash, Cathrine Mihalopoulos, Mary Lou Chatterton, Laima Brazionis, Olivia M Dean, Allison M Hodge, Michael Berk
BACKGROUND: The possible therapeutic impact of dietary changes on existing mental illness is largely unknown. Using a randomised controlled trial design, we aimed to investigate the efficacy of a dietary improvement program for the treatment of major depressive episodes. METHODS: 'SMILES' was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician...
January 30, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28129502/likelihood-of-being-helped-or-harmed-as-a-measure-of-clinical-outcomes-in-psychopharmacology
#15
Chittaranjan Andrade
The likelihood of being helped or harmed (LHH) ratio is an indirect measure of effect size. It tells the reader how much as likely a patient is to benefit from a treatment as to suffer from an adverse outcome with that treatment; larger values for LHH indicate more favorable treatment outcomes. The numerator for LHH is usually a measure of response or remission with a treatment, and the denominator is usually a measure of all-cause discontinuation or discontinuation due to adverse events; so, there can be more than 1 LHH statistic for a study...
January 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28114607/effects-of-delayed-umbilical-cord-clamping-vs-early-clamping-on-anemia-in-infants-at-8-and-12-months-a-randomized-clinical-trial
#16
Ashish Kc, Nisha Rana, Mats Målqvist, Linda Jarawka Ranneberg, Kalpana Subedi, Ola Andersson
Importance: Delayed umbilical cord clamping has been shown to improve iron stores in infants to 6 months of age. However, delayed cord clamping has not been shown to prevent iron deficiency or anemia after 6 months of age. Objective: To investigate the effects of delayed umbilical cord clamping, compared with early clamping, on hemoglobin and ferritin levels at 8 and 12 months of age in infants at high risk for iron deficiency anemia. Design, Setting, and Participants: This randomized clinical trial included 540 late preterm and term infants born vaginally at a tertiary hospital in Kathmandu, Nepal, from October 2 to November 21, 2014...
January 17, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28087333/nicotinamide-nucleotide-transhydrogenase-activity-impacts-mitochondrial-redox-balance-and-the-development-of-hypertension-in-mice
#17
Igor Leskov, Amber Neville, Xinggui Shen, Sibile Pardue, Christopher G Kevil, D Neil Granger, David M Krzywanski
Oxidant stress contributes to the initiation and progression of hypertension (HTN) by enhancing endothelial dysfunction and/or causing perturbations in nitric oxide homeostasis. Differences in mitochondrial function may augment this process and provide insight into why age of onset and clinical outcomes differ among individuals from distinct ethnic groups. We have previously demonstrated that variation in normal mitochondrial function and oxidant production exists in endothelial cells from individuals of Caucasian and African-American ethnicity and that this variation contributes to endothelial dysfunction...
December 16, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28078350/efficacy-and-safety-of-extended-thromboprophylaxis-for-medically-ill-patients-a-meta-analysis-of-randomised-controlled-trials
#18
Francesco Dentali, Nicola Mumoli, Domenico Prisco, Andrea Fontanella, Matteo Nicola Dario Di Minno
Compelling evidence suggests that the risk of pulmonary embolism (PE) and deep-vein thrombosis (DVT) persists after hospital discharge in acutely-ill medical patients. However, no studies consistently supported the routine use of extended-duration thromboprophylaxis (ET) in this setting. We performed a meta-analysis to assess efficacy and safety of ET in acutely-ill medical patients. Efficacy outcome was defined by the prevention of symptomatic DVT, PE, venous thromboembolism (VTE) and VTE-related mortality...
January 12, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28076735/reducing-medication-errors-in-hospital-discharge-summaries-a-randomised-controlled-trial
#19
Erica Y Tong, Cristina P Roman, Biswadev Mitra, Gary S Yip, Harry Gibbs, Harvey H Newnham, De Villiers Smit, Kirsten Galbraith, Michael J Dooley
OBJECTIVES: To evaluate whether pharmacists completing the medication management plan in the medical discharge summary reduced the rate of medication errors in these summaries. DESIGN: Unblinded, cluster randomised, controlled investigation of medication management plans for patients discharged after an inpatient stay in a general medical unit. SETTING: The Alfred Hospital, an adult major referral hospital in metropolitan Melbourne, with an annual emergency department attendance of about 60000 patients...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28069650/evidence-to-support-continuation-of-statin-therapy-in-patients-with-staphylococcus-aureus-bacteremia
#20
Aisling R Caffrey, Tristan T Timbrook, Eunsun Noh, George Sakoulas, Steven M Opal, Victor Nizet, Kerry L LaPlante
In addition to cholesterol lowering capabilities, statins possess antiinflammatory and immunomodulatory effects. We sought to quantify the real-world impact of different statin exposure patterns on clinical outcomes in Staphylococcus aureus bacteremia. We conducted a retrospective cohort study among hospitalized patients with positive S. aureus blood cultures receiving appropriate antibiotics within 48 hours of culture collection (Veterans Affairs hospitals, 2002-2013). Three statin exposure groups were compared to non-users: pretreated statin users initiating therapy in the 30 days prior to culture and either (1) continuing statin therapy after culture, or (2) not continuing after culture, and (3) de novo users initiating at culture...
January 9, 2017: Antimicrobial Agents and Chemotherapy
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