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Margrit Löbner, Alexander Pabst, Janine Stein, Marie Dorow, Herbert Matschinger, Melanie Luppa, Astrid Maroß, Anette Kersting, Hans-Helmut König, Steffi G Riedel-Heller
BACKGROUND: Self-guided computerized cognitive behavior therapy (cCBT) has the potential to be a feasible alternative to current first-step treatment approaches for depression. Yet, research regarding the effectiveness and acceptability of self-guided cCBT as an adjunct element of GP care is controversial. METHODS: Primary care patients with symptoms of mild to moderately severe depression (N = 647) were recruited from 112 GP practices within a cluster randomized controlled trial...
June 5, 2018: Journal of Affective Disorders
Daniele Giacoppo, Nicola Caronna, Antonio H Frangieh, Jonathan Michel, Giuseppe Andò, Giuseppe Tarantini, Albert M Kasel, Davide Capodanno, Robert A Byrne
AIMS: Although three recent trials showed a significant stroke risk reduction after tPFOc, the impact on pooled evidence deserves attention and individual statistical power is limited. We aimed to pool available randomised clinical trials (RCT) to assess whether tPFOc is more effective and safe than antithrombotic therapy alone (ATA). METHODS AND RESULTS: Major electronic databases and tangential sources were searched and 6 trials (3560 patients) identified. At a median follow-up of 3...
June 12, 2018: EuroIntervention
Jeffrey Bortman, Yanick Baribeau, Jelliffe Jeganathan, Yannis Amador, Faraz Mahmood, Marc Shnider, Muneeb Ahmed, Philip Hess, Robina Matyal
BACKGROUND AND OBJECTIVES: Advanced haptic simulators for neuraxial training are expensive, have a finite life, and are not patient specific. We sought to demonstrate the feasibility of developing a custom-made, low-cost, 3-dimensionally printed thoracic spine simulator model from patient computed tomographic scan data. This study assessed the model's practicality, efficiency as a teaching tool, and the transfer of skill set into patient care. METHODS: A high-fidelity, patient-specific thoracic spine model was used for the study...
June 11, 2018: Regional Anesthesia and Pain Medicine
Sophie E C M van de Vijfeijken, Tijmen J A G Münker, Rene Spijker, Luc H E Karssemakers, William P Vandertop, Alfred G Becking, Dirk T Ubbink
BACKGROUND: Currently, various materials are routinely used for cranioplasty after decompressive craniectomy, each with their own features, potential benefits, and harms. OBJECTIVES: To systematically review available literature about safety (infection, resorption, and removal) of different materials used for cranioplasty for any indication. METHODS: A comprehensive search in MEDLINE, EMBASE and the Cochrane library was performed for relevant studies published up to January 2017...
June 4, 2018: World Neurosurgery
Vasileios Chortis, Angela E Taylor, Craig L Doig, Mark D Walsh, Eirini Meimaridou, Carl Jenkinson, Giovanny Rodriguez-Blanco, Cristina L Ronchi, Alisha Jafri, Louise A Metherell, Daniel Hebenstreit, Warwick B Dunn, Wiebke Arlt, Paul A Foster
Adrenocortical Carcinoma (ACC) is an aggressive malignancy with poor response to chemotherapy. Here we evaluated a potential new treatment target for ACC, focusing on the mitochondrial NADPH generator Nicotinamide Nucleotide Transhydrogenase (NNT). NNT has a central role within mitochondrial antioxidant pathways, protecting cells from oxidative stress. Inactivating human NNT mutations result in congenital adrenal insufficiency. We hypothesized NNT silencing in ACC cells will induce toxic levels of oxidative stress...
April 20, 2018: Endocrinology
Laura Policardo, Giuseppe Seghieri, Elisa Gualdani, Flavia Franconi
PURPOSE: To investigate whether the hospitalization rate for bacterial infections was modified by statin therapy in a population retrospectively followed up, over years 2011 to 2015. METHODS: By using administrative databases, the 5-year hospitalization rate due to bacterial infections in population living in Tuscany, Italy exposed to statin therapy (n = 52,049) was stratified by 5 prescribed daily doses classes (0%-20%, 20%-50%, 50%-80%, 80%-100%, ≥100% of DDD) and subsequently compared with that of a population of untreated individuals (n = 3 300 ,675), matched through a propensity score accounting for all available covariates potentially able to modulate risk of infections such as age, gender, previous hospitalizations for infections, cardiovascular events, previous co-morbidities, diabetes, as well as general practitioners' proactive behaviour of care delivery according to current guidelines...
May 28, 2018: Pharmacoepidemiology and Drug Safety
Yaqing Huang, Junyu Shi, Yun Xu
Ovarian cancer is a markedly heterogeneous malignancy characterized by various histological subtypes. Molecular biomarkers have been indicated to serve significant functions in the early diagnosis and treatment of early-stage ovarian cancer. However, the detailed mechanism underlying the tumorigenesis of ovarian cancer remains unclear. The present study aimed to identify a novel long non-coding RNA in patients with ovarian cancer. Nicotinamide nucleotide transhydrogenase-antisense 1 (NNT-AS1) was markedly downregulated in patients with ovarian cancer and in cultured human ovarian cancer cells...
June 2018: Oncology Letters
Marco Solmi, Giorgio Pigato, John M Kane, Christoph U Correll
Aim: The aim of this study was to summarize the characteristics, efficacy, and safety of vesicular monoamine transporter-2 (VMAT-2) inhibitors for treating tardive dyskinesia (TD). Materials and methods: We conducted a literature search in PubMed, Cochrane Database, and, screening for systematic reviews, meta-analyses or double-blind, randomized, placebo-controlled trials (DBRPCTs) reporting efficacy or safety data of VMAT-2 inhibitors (tetrabenazine, deutetrabenazine, and valbenazine) in patients with TD...
2018: Drug Design, Development and Therapy
Bhawan Garg, Anju Bansal, Nandkishor Kabra
BACKGROUND: Neonatal sepsis is one of the most common cause of neonatal morbidity and mortality. Selenium has antioxidant and immune-modulating properties. AIM: The aim of this systematic review is to evaluate role of selenium supplementation in the prevention of late onset sepsis (LOS) among very low birth weight (VLBW) neonates. METHODS: We searched literature for this review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) electronic PubMed, Embase and Google Scholar...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
Angel Brea, Jesús Millán, Juan F Ascaso, Mariano Blasco, Angel Díaz, Antonio Hernández-Mijares, Teresa Mantilla, Juan C Pedro-Botet, Xavier Pintó
Fibrates are drugs that reduce triglycerides, elevate high-density lipoproteins, as well as decrease small, dense LDL particles. The results of a study have recently been published by the Cochrane Collaboration on fibrates efficacy and safety in the primary prevention of cardiovascular disease. This study includes a systematic review and a meta-analysis of 6 studies (16,135 patients) that evaluated the clinical benefits of fibrates compared to placebo use or other lipid-lowering drugs. This review showed evidence of a protective effect of the fibrates compared with placebo as regards a reduction 16% of a compound objective of death due to cardiovascular disease, non-fatal myocardial infarction, or non-fatal cerebrovascular accident (NNT: 112), and that reduce coronary morbidity and mortality by 21% (NNT: 125)...
May 19, 2018: Clínica e Investigación en Arteriosclerosis
Maxine Sun, Lorenzo Marconi, Tim Eisen, Bernard Escudier, Rachel H Giles, Naomi B Haas, Lauren C Harshman, David I Quinn, James Larkin, Sumanta K Pal, Thomas Powles, Christopher W Ryan, Cora N Sternberg, Robert Uzzo, Toni K Choueiri, Axel Bex
CONTEXT: Contradictory data exist with regard to adjuvant vascular endothelial growth factor receptor (VEGFR)-targeted therapy in surgically managed patients for localized renal cell carcinoma (RCC). OBJECTIVE: To systematically evaluate the current evidence regarding the therapeutic benefit (disease-free survival [DFS] and overall survival [OS]) and grade 3-4 adverse events (AEs) for adjuvant VEGFR-targeted therapy for resected localized RCC. EVIDENCE ACQUISITION: A critical review of PubMed/Medline, Embase, and the Cochrane Library in January 2018 according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement was performed...
May 18, 2018: European Urology
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
Annie C Lajoie, Sébastien Bonnet, Yves Lacasse, Jean-Christophe Lega, Steeve Provencher
Because of scepticism concerning study results when relying solely on relative effect estimates, the number needed to treat (NNT) has been used extensively to quantify the net clinical benefit of an intervention, and is reported increasingly in randomised trials and observational studies. This method is a simple measure representing the number of patients who would need to be treated to prevent one additional adverse event. However, like relative risk, the NNT is an inherently time-dependent measure. Thus, its calculation may lead to misleading interpretations, especially for studies involving varying follow-up times or recurrent outcomes...
June 30, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Dirk Deleu, Boulenouar Mesraoua, Beatriz Canibaño, Gayane Melikyan, Hassan Al Hail, Lubna El-Sheikh, Musab Ali, Hassan Al Hussein, Faiza Ibrahim, Yolande Hanssens
The introduction of new disease-modifying therapies (DMTs) for remitting-relapsing multiple sclerosis (RRMS) have considerably transformed the landscape of therapeutic opportunities for this chronic disabling disease. Unlike injectable drugs, oral DMTs, promote patient satisfaction and increase therapeutic adherence. This article reviews the salient features about the mode of action, efficacy, safety and tolerability profile of approved oral DMTs in RRMS and reviews their place in clinical algorithms in the Middle East and North Africa (MENA) region...
May 15, 2018: Current Medical Research and Opinion
Bevin Croft, Nilüfer İsvan, Susan L Parish, Kevin J Mahoney
OBJECTIVE: In self-direction, participants control individual budgets, allocating service dollars according to needs and preferences within program parameters to meet self-defined recovery goals. Mental health self-direction is associated with enhanced wellness and recovery outcomes at lower or similar cost than traditional service arrangements. This study compared outcomes of housing independence and employment between individuals who participated in self-direction and those who did not...
May 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
J M Findlay, C P J Wood, C Cunningham
BACKGROUND: Previous meta-analyses of randomised controlled trials (RCTs) have suggested a reduction in parastomal hernias (PSH) with prophylactic mesh. However, concerns persist regarding variably supportive evidence and cost. We performed an updated systematic review and meta-analysis to inform a novel cost-effectiveness analysis. METHODS: The PubMed, EMBASE and Cochrane Centre Register of Controlled Trials databases were searched (February 2018). We included RCTs assessing mesh reinforcement during stoma formation...
May 7, 2018: Techniques in Coloproctology
J M Jones, N Bhutiani, D Wei, L Goldstein, C M Jones, R M Cannon
INTRODUCTION: This study sought to approximate the cost-effectiveness of tPA utilization for prevention of biliary strictures (PTBS) in donation after circulatory death liver transplantation (DCD-LT). METHODS: Previously-reported PTBS rates in DCD-LT with and without tPA were used to calculate the number needed to treat (NNT) for prevention of one PTBS. The incremental cost of PTBS was then used to determine the cost effectiveness of tPA for prevention of PTBS. RESULTS: The incidence of PTBS in the setting of tPA administration was 20%, while incidence in patients without tPA use was 43% (p < 0...
April 17, 2018: American Journal of Surgery
Yan Li, Min Lv, Ziyan Song, Zhi Lou, Ran Wang, Min Zhuang
Some evidences have been provided to verify the effects of lncRNA NNT-AS1 on cancer progression. However, the crucial impacts of NNT-AS1 on the malignancy of breast cancer have not been elaborated. This study aims to detect the expression pattern and functional effects of NNT-AS1 in breast cancer. qRT-PCR analysis was applied to detect the expression of NNT-AS1 in both BC tissues and matched normal tissues. Loss of function assay was carried out to detect the effects of silenced NNT-AS1 on proliferation, metastasis and EMT process of BC cells...
April 24, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Yonathan Freund, Hélène Goulet, Judith Leblanc, Jérôme Bokobza, Patrick Ray, Maxime Maignan, Sabine Guinemer, Jennifer Truchot, Anne-Laure Féral-Pierssens, Youri Yordanov, Anne-Laure Philippon, Edwin Rouff, Ben Bloom, Marine Cachanado, Alexandra Rousseau, Tabassome Simon, Bruno Riou
Importance: Emergency departments (ED) are environments that are at high risk for medical errors. Previous studies suggested that the proportion of medical errors may decrease when more than 1 physician is involved. Objective: To reduce the proportion of medical errors by implementing systematic cross-checking between emergency physicians. Design, Setting, and Participants: This cluster randomized crossover trial includes a random sample of 14 adult patients (age ≥18 years) per day during two 10-day period in 6 EDs (n = 1680 patients) in France...
April 23, 2018: JAMA Internal Medicine
M Gachabayov, C E Oberkofler, J J Tuech, D Hahnloser, R Bergamaschi
INTRODUCTION: It is still controversial whether the optimal operation for perforated diverticulitis with peritonitis is primary anastomosis (PRA) or nonrestorative resection (NRR). The aim of this systematic review and meta-analysis was to evaluate mortality and morbidity rates following emergency resection for perforated diverticulitis with peritonitis and ostomy reversal, as well as ostomy non-reversal rates. METHODS: The Pubmed, EMBASE, Cochrane Library, MEDLINE via Ovid, CINAHL, and Web of Science databases were systematically searched...
April 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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