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https://www.readbyqxmd.com/read/27919491/comparing-outcomes-from-clinical-studies-of-oral-disease-modifying-therapies-dimethyl-fumarate-fingolimod-and-teriflunomide-in-relapsing-ms-assessing-absolute-differences-using-a-number-needed-to-treat-analysis
#1
Mark S Freedman, Xavier Montalban, Aaron E Miller, Catherine Dive-Pouletty, Steven Hass, Karthinathan Thangavelu, Thomas P Leist
Dimethyl fumarate (DMF), fingolimod, and teriflunomide are oral disease-modifying therapies (DMTs) indicated for the treatment of relapsing-remitting multiple sclerosis. Despite well-established limitations of cross-trial comparisons, DMTs are still frequently compared in terms of relative reductions in specific endpoints, most commonly annualized relapse rate. Consideration of absolute risk reduction and number needed to treat (NNT) provides an alternative approach to assess the magnitude of treatment effect and can provide valuable additional information on therapeutic gain...
November 2016: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/27919355/model-observational-bridging-study-on-the-effectiveness-of-ezetimibe-on-cardiovascular-morbidity-and-mortality-in-france-a-population-based-study
#2
Jean Ferrières, Jean Dallongeville, Michel Rossignol, Jacques Bénichou, J Jaime Caro, Denis Getsios, Luis Hernandez, Lucien Abenhaim, Lamiae Grimaldi-Bensouda
BACKGROUND: To evaluate the real-life impact of ezetimibe on cardiovascular (CV) morbidity and mortality in France. OBJECTIVE: To estimate the number of non-fatal and fatal CV events that could be prevented and corresponding number of patients needed to treat (NNT) with ezetimibe to prevent one CV event over 5 years. METHODS: Non-interventional 48-month follow-up cohort conducted in hypercholesterolemic patients starting on ezetimibe <3 months at study entry, either as monotherapy or combined with statins...
November 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27918754/interventions-to-improve-rates-of-successful-extubation-in-preterm-infants-a-systematic-review-and-meta-analysis
#3
Kristin N Ferguson, Calum T Roberts, Brett J Manley, Peter G Davis
Importance: Clinicians aim to extubate preterm infants as early as possible, to minimize the risks of mechanical ventilation. Extubation is often unsuccessful owing to lung disease or inadequate respiratory drive. Objective: To conduct a systematic review and meta-analysis of interventions to improve rates of successful extubation in preterm infants. Data Sources: Searches were undertaken in PubMed and The Cochrane Library. Study Selection: The review was conducted using the methods of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
December 5, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27913558/providing-additional-information-about-the-benefits-of-statins-in-a-leaflet-for-patients-with-coronary-heart-disease-a-qualitative-study-of-the-impact-on-attitudes-and-beliefs
#4
Rebecca Dickinson, David K Raynor, Peter Knapp, Jan MacDonald
OBJECTIVE: To explore the impact of providing additional information about the potential benefits of simvastatin in a patient leaflet on attitudes and beliefs. DESIGN: Interview-based study using a generic qualitative approach and framework analysis. PARTICIPANTS: 21 participants receiving a prescription for simvastatin were recruited from a general practitioner practice (from a total of 120). 8 participants were women; the age range was 55-92...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908345/determining-when-to-add-nonstatin-therapy-a-quantitative-approach
#5
Jennifer G Robinson, Roeland Huijgen, Kausik Ray, Jane Persons, John J P Kastelein, Michael J Pencina
BACKGROUND: Costs and uncertainty about the benefits of nonstatin therapies limit their use. OBJECTIVES: The authors sought to identify patients who might benefit from the addition of a nonstatin to background statin therapy. METHODS: We performed systematic reviews of subgroup analyses from randomized trials and observational studies with statin-treated participants to determine estimated 10-year absolute risk of atherosclerotic cardiovascular disease (ASCVD) and to define high-risk and very high-risk patients...
December 6, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27900627/extended-duration-versus-short-duration-pharmacological-thromboprophylaxis-in-acutely-ill-hospitalized-medical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
November 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27896681/financial-impact-of-direct-acting-oral-anticoagulants-in-medicaid-budgetary-assessment-based-on-number-needed-to-treat
#7
Kathleen A Fairman, Lindsay E Davis, Courtney R Kruse, David A Sclar
BACKGROUND: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. OBJECTIVE: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT)...
November 28, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27892723/optimization-and-stratification-of-multiple-sclerosis-treatment-in-fast-developing-economic-countries-a-perspective-from-qatar
#8
Dirk Deleu, Boulenouar Mesraoua, Hisham El Khider, Beatriz Canibano, Gayane Melikyan, Hassan Al Hail, Noha Mhjob, Anjushri Bhagat, Faiza Ibrahim, Yolande Hanssens
OBJECTIVE: The introduction of disease-modifying therapies (DMTs) - with varying degrees of efficacy for reducing annual relapse rate and disability progression - has considerably transformed the therapeutic landscape of relapsing-remitting multiple sclerosis (RRMS). We aim to develop rational evidence-based treatment recommendations and algorithms for the management of clinically isolated syndrome (CIS) and RRMS conform to the healthcare system in a fast-developing economic country such as Qatar...
November 28, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27881024/the-use-of-atorvastatin-for-chronic-subdural-haematoma-a-retrospective-cohort-comparison-study
#9
David Yuen Chung Chan, Danny Tat Ming Chan, Tin Fung David Sun, Stephanie Chi Ping Ng, George Kwok Chu Wong, Wai Sang Poon
Chronic subdural haematoma (CSDH) is a common neurosurgical condition. Burr-hole for drainage is an effective treatment. However, recurrence can be up to 8-33% and is associated with morbidities and mortalities. The underlying pathogenesis was postulated to be localised inflammation and pathological aberrant vessels formation. Atorvastatin, an HMG-CoA reductase inhibitor, is a type of lipid-lowering medication. In animal studies and a preliminary clinical trial, Atorvastatin was shown to be effective in the treatment of CSDH...
November 23, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27879326/effects-of-levothyroxine-treatment-on-pregnancy-outcomes-in-pregnant-women-with-autoimmune-thyroid-disease
#10
Sima Nazarpour, Fahimeh Ramezani Tehrani, Masoumeh Simbar, Maryam Tohidi, Hamid Alavi Majd, Fereidoun Azizi
BACKGROUND: Despite some studies indicating that thyroid antibody positivity during pregnancy has been associated with adverse pregnancy outcomes, evidence regarding the effects of levothyroxine (LT4) treatment of euthyroid/subclinical hypothyroid pregnant women with autoimmune thyroid disease on pregnancy outcome is limited. We aimed to assess whether pregnant women with autoimmune thyroid disease, but without overt thyroid dysfunction are affected by higher rates of adverse pregnancy outcomes...
November 22, 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27878050/suboptimal-use-of-pelvic-lymph-node-dissection-differences-in-guideline-adherence-between-robot-assisted-and-open-radical-prostatectomy
#11
Jonas Schiffmann, Alessandro Larcher, Maxine Sun, Zhe Tian, Jérémie Berdugo, Ion Leva, Hugues Widmer, Jean-Baptiste Lattouf, Kevin C Zorn, Shahrokh F Shariat, Francesco Montorsi, Markus Graefen, Fred Saad, Pierre I Karakiewicz
INTRODUCTION: Our aim was to assess adherence to National Comprehensive Cancer Network (NCCN) and American Urological Association (AUA) guidelines for pelvic lymph node dissection (PLND) at the time of either robot-assisted (RARP) or open radical prostatectomy (ORP). METHODS: We relied on the Surveillance, Epidemiology, and End Results-Medicare linked database and focused on localized prostate cancer (PCa) patients who were treated with either RARP or ORP between October 2008 and December 2009...
August 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/27873499/assessment-of-coronary-artery-calcium-scoring-for-statin-treatment-strategy-according-to-acc-aha-guidelines-in-asymptomatic-korean-adults
#12
Donghee Han, Bríain Ó Hartaigh, Ji Hyun Lee, Asim Rizvi, Hyo Eun Park, Su Yeon Choi, Jidong Sung, Hyuk Jae Chang
PURPOSE: The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol management guidelines advocate the use of statin treatment for prevention of cardiovascular disease. We aimed to assess the usefulness of coronary artery calcium (CAC) for stratifying potential candidates of statin use among asymptomatic Korean individuals. MATERIALS AND METHODS: A total of 31375 subjects who underwent CAC scoring as part of a general health examination were enrolled in the current study...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27865945/episiotomy-in-vacuum-assisted-delivery-affects-the-risk-of-obstetric-anal-sphincter-injury-a-systematic-review-and-meta-analysis
#13
REVIEW
Ninna S Lund, Lisa K G Persson, Hanna Jangö, Ditte Gommesen, Hanne B Westergaard
The risk of obstetric anal sphincter injury (OASIS) is increased in vacuum-assisted delivery. However, it remains unclear whether episiotomy may protect against OASIS in this type of delivery. The objective of this study was to assess whether mediolateral or lateral episiotomy affects the risk of OASIS in vacuum-assisted delivery among primiparous women. Data were found searching The PubMed, Cochrane library and Embase databases electronically. Studies investigating the risk of OASIS in vacuum-assisted delivery with and without the use of mediolateral or lateral episiotomy were considered for inclusion...
October 26, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27863801/long-acting-injectable-antipsychotics-for-the-prevention-of-relapse-in-patients-with-recent-onset-psychotic-disorders-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
Taro Kishi, Kazuto Oya, Nakao Iwata
This meta-analysis of randomized controlled trials (RCTs) investigated the advantages of long-acting injectable antipsychotics (LAI-APs) over oral antipsychotics (OAPs) with regard to efficacy and safety for patients with recent-onset psychotic disorders. Effect sizes and 95% confidence intervals (95%CIs) were calculated. We identified five RCTs (1022 patients, mean study duration=18±7.59 months) that compared LAI-APs (paliperidone or risperidone) with OAPs. Pooled LAI-APs did not outperform OAPs in terms of the preventing of relapse (N=3, n=875)...
November 3, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27857965/stents-and-surgical-interventions-in-the-palliation-of-gastric-outlet-obstruction-a-systematic-review
#15
REVIEW
Mauricio Kazuyoshi Minata, Wanderley Marques Bernardo, Rodrigo Silva de Paula Rocha, Flavio Hiroshi Ananias Morita, Julio Cesar Martins Aquino, Spencer Cheng, Bruno Zilberstein, Paulo Sakai, Eduardo Guimarães Hourneaux de Moura
Background and study aims: Palliative treatment of gastric outlet obstruction can be done with surgical or endoscopic techniques. This systematic review aims to compare surgery and covered and uncovered stent treatments for gastric outlet obstruction (GOO). Patients and methods: Randomized clinical trials were identified in MEDLINE, Embase, Cochrane, LILACs, BVS, SCOPUS and CINAHL databases. Comparison of covered and uncovered stents included: technical success, clinical success, complications, obstruction, migration, bleeding, perforation, stent fracture and reintervention...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#16
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
November 16, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27843052/can-tavi-patients-receive-aspirin-monotherapy-as-patients-after-surgical-aortic-bioprosthesis-implantation-data-from-the-polish-registry-pol-tavi
#17
Katarzyna Czerwińska-Jelonkiewicz, Marian Zembala, Maciej Dąbrowski, Adam Witkowski, Andrzej Ochała, Janusz Kochman, Dariusz Dudek, Piotr Kübler, Dariusz Jagielak, Janina Stępińska
BACKGROUND: This observational analysis investigated in-hospital safety and efficacy of periprocedural antithrombotic/antiplatelet therapy used in TAVI patients included into the Polish Nationwide Cardiac Surgical and Cardiology Registry of Transcatheter Aortic Valve Implantation (POL-TAVI). METHODS AND RESULTS: All patients who underwent TAVI in the participating centers between 2013 and 2014 were included. The primary endpoints were: severe bleeding, vascular complications, thromboembolic events, myocardial infarction, 30-days mortality, defined according to Valve Academic Research Consortium scale 2...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27826771/the-health-gain-obtainable-from-pancreatic-resection-for-adenocarcinoma-in-the-elderly
#18
Alessandro Cucchetti, Giorgio Ercolani, Raffaele Pezzilli, Matteo Cescon, Giacomo Frascaroli, Antonio Daniele Pinna
BACKGROUND: In treating pancreatic ductal adenocarcinoma (PDAC), age does not represent a contraindication to surgery, even if aging is known to increase postoperative mortality and morbidity. Furthermore, long-term outcome remains poor and there is much debate on whether to operate or not in elderly patients. The aim of this study was to provide a general framework to evaluate the health gain obtainable from surgery for PDAC in relationship with age and tumor stage. METHODS: A Monte Carlo simulation model was built taking into consideration pertinent literature from population-based studies regarding surgical and non-surgical outcomes for stages I-II PDAC...
November 8, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27816944/plaque-imaging-to-refine-indications-for-emerging-lipid-lowering-drugs
#19
Mohammad Alkhalil, Joshua T Chai, Robin P Choudhury
Statins have been effective in reducing adverse cardiovascular events. Their benefits have been proportional to the level of plasma LDL-cholesterol reduction and seem to extend to patients with 'normal' levels of cholesterol at outset. Statins are also inexpensive and have a favourable side effect profile. As a result, they are used widely (almost indiscriminately) in patients with atherosclerotic vascular disease, and in those at risk of disease.Next generation lipid-modifying drugs seem unlikely to offer the same simplicity of application...
November 4, 2016: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/27813304/biomarker-based-risk-prediction-in-the-community
#20
Omar F AbouEzzeddine, Paul M McKie, Christopher G Scott, Richard J Rodeheffer, Horng H Chen, G Michael Felker, Allan S Jaffe, John C Burnett, Margaret M Redfield
AIMS: Guided by predictive characteristics of cardiovascular biomarkers, we explored the clinical implications of a simulated biomarker-guided heart failure (HF) and major adverse cardiovascular events (MACE) prevention strategy in the community. METHODS AND RESULTS: In a community cohort (n = 1824), the predictive characteristics for HF and MACE of galectin-3 (Gal-3), ST2, high-sensitivity cardiac troponin I (hscTnI), high-sensitivity C-reactive protein (hsCRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) were established...
November 2016: European Journal of Heart Failure
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