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https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#1
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28436599/metformin-as-targeted-treatment-in-fragile-x-syndrome
#2
Angel Belle C Dy, Flora Tassone, Marwa Eldeeb, María J Salcedo-Arellano, Nicole Tartaglia, Randi Hagerman
Individuals with Fragile X Syndrome (FXS) may be affected by several comorbid conditions, both behavioral and medical. Growth findings suggest that they are at an increased risk for obesity and overeating. The Prader-Willi phenotype (PWP) of FXS occurs in less than 10% of patients but it is associated with severe hyperphagia, lack of satiation and morbid obesity. Metformin is a drug used in individuals with high risk for diabetes type 2, obesity or impaired glucose tolerance. It has had a strong safety profile in children and adults with type 2 diabetes and obesity...
April 24, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28436552/systematic-review-with-meta-analysis-the-efficacy-and-safety-of-tenofovir-to-prevent-mother-to-child-transmission-of-hepatitis-b-virus
#3
REVIEW
M H Hyun, Y-S Lee, J H Kim, J H Je, Y J Yoo, J E Yeon, K S Byun
BACKGROUND: Preventing mother to child transmission of chronic hepatitis B infection in the setting of a high maternal viral load is challenging. The idea has emerged from antepartum tenofovir treatment with combination immunoprophylaxis. AIMS: To demonstrate the efficacy and safety of tenofovir to prevent mother to child transmission of hepatitis B virus. METHODS: PubMed, EMBASE, and Cochrane databases were searched through August 16, 2016...
April 24, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28436380/tenofovir-disoproxil-fumarate-monotherapy-is-superior-to-entecavir-adefovir-combination-therapy-in-patients-with-suboptimal-response-to-lamivudine-adefovir-therapy-for-nucleoside-resistant-hbv-a-96-week-prospective-multicenter-trial
#4
Sae Hwan Lee, Gab Jin Cheon, Hong Soo Kim, Sang Gyune Kim, Young Seok Kim, Soung Won Jeong, Jae Young Jang, Boo Sung Kim, Baek Gyu Jun, Young Don Kim, Dae Won Jun, Joo Hyun Sohn, Tae Yeob Kim, Byung Seok Lee
BACKGROUND: A complete virologic response is closely related to the long-term outcome of patients with chronic hepatitis B and prevention of emerging hepatitis B virus (HBV) mutations. We aimed to evaluate the efficacy of tenofovir disoproxil fumarate (TDF) monotherapy compared to entecavir-adefovir dipivoxil (ETV-ADV) combination therapy in patients with suboptimal responses to long-term lamivudine-adefovir dipivoxil (LAM-ADV) therapy for nucleoside analogue-resistant chronic hepatitis B...
April 24, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28436232/safety-performance-and-satisfaction-outcomes-in-the-operating-room-a-literature-review
#5
Anjali Joseph, Sara Bayramzadeh, Zahra Zamani, Bill Rostenberg
OBJECTIVE: This review of empirical literature focuses on the design of operating rooms (ORs) by investigating the physical environmental features of ORs associated with patient and staff outcomes. BACKGROUND: Many ORs built more than 30 years ago remain operational today. However, most are inadequately designed to handle the equipment, processes, and people that a contemporary OR needs to accommodate. However, the evidence base for designing ORs has been sorely lacking, and little guidance exists on how OR design can improve safety and performance outcomes...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28436206/clinical-practice-guidelines-on-iron-therapy-a-critical-evaluation
#6
Lucia Del Vecchio, Francesco Locatelli
Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis-stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide. Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not uniform...
April 24, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28435240/risk-of-pneumonia-with-budesonide-containing-treatments-in-copd-an-individual-patient-level-pooled-analysis-of-interventional-studies
#7
Sally Hollis, Carin Jorup, Dan Lythgoe, Gunnar Martensson, Pontus Regnell, Göran Eckerwall
BACKGROUND: Concerns have been raised that treatment of COPD with inhaled corticosteroids may increase pneumonia risk. Responding to a request from the European Medicines Agency Pharmacovigilance Risk Assessment Committee, a pooled analysis of interventional studies compared pneumonia risk with inhaled budesonide-containing versus non-budesonide-containing treatments and the impact of other clinically relevant factors. METHODS: AstraZeneca-sponsored, parallel-group, double-blind, randomized controlled trials meeting the following criteria were included: >8 weeks' duration; ≥60 patients with COPD; inhaled budesonide treatment arm (budesonide/formoterol or budesonide); and non-budesonide-containing comparator arm (formoterol or placebo)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28434399/the-next-generation-of-immunotherapy-keeping-lung-cancer-in-check
#8
REVIEW
Ashwin Somasundaram, Timothy F Burns
Lung cancer is the deadliest malignancy with more cancer deaths per year than the next three cancers combined. Despite remarkable advances in targeted therapy, advanced lung cancer patients have not experienced a significant improvement in mortality. Lung cancer has been shown to be immunogenic and responsive to checkpoint blockade therapy. Checkpoint signals such as CTLA-4 and PD-1/PD-L1 dampen T cell activation and allow tumors to escape the adaptive immune response. Response rates in patients with pretreated, advanced NSCLC were much higher and more durable with PD-1 blockade therapy compared to standard-of-care, cytotoxic chemotherapy...
April 24, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28434255/daratumumab-for-the-treatment-of-multiple-myeloma
#9
Cyrille Touzeau, Philippe Moreau
Proteasome inhibitors and immunomodulatory drugs have contributed to the dramatic improvement in survival for patients with myeloma over the past decades. However, the disease typically relapses and new classes of drugs are needed. In 2015, two monoclonal antibodies were approved for the treatment of patients with relapsed multiple myeloma, and immunotherapy has rapidly become indispensable in the management of myeloma patients. Areas covered: Here, the authors discuss the published data regarding the mechanism of action, safety and clinical efficacy of the CD38-targeted monoclonal antibody daratumumab for the treatment of patients with multiple myeloma...
April 24, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28433498/long-term-effectiveness-of-aripiprazole-once-monthly-for-schizophrenia-is-maintained-in-the-qualify-extension-study
#10
Dieter Naber, Ross A Baker, Anna Eramo, Carlos Forray, Karina Hansen, Christophe Sapin, Timothy Peters-Strickland, Anna-Greta Nylander, Peter Hertel, Simon Nitschky Schmidt, Jean-Yves Loze, Steven G Potkin
OBJECTIVE: To evaluate long-term safety and effectiveness of continued treatment with aripiprazole once-monthly 400mg (AOM 400) in patients with schizophrenia. METHODS: Patients who completed the QUALIFY study (NCT01795547) in the AOM 400 arm were eligible for 6 additional once-monthly injections of AOM 400 during an open-label, 24-week extension (NCT01959035). Safety data were collected at each visit. Effectiveness measures included change from baseline in health-related qualify of life and functioning on the Heinrichs-Carpenter Quality of Life scale (QLS) and Clinical Global Impression - Severity (CGI-S) scale...
April 19, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28433247/outpatient-laparoscopic-appendectomy-feasible-in-a-public-county-hospital
#11
David R Rosen, Kenji Inaba, Paul J Oh, Adam C Gutierrez, Aaron M Strumwasser, Subarna Biswas, Melody Cala, Glenn T Ault
BACKGROUND: Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. STUDY DESIGN: From 2014 to 2016, all patients undergoing laparoscopic appendectomy for acute, uncomplicated appendicitis were enrolled in a prospective observational trial. Standard baseline perioperative practice (control group) was documented for 1 year...
March 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#12
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28432387/yttrium-90-radioembolization-for-unresectable-combined-hepatocellular-cholangiocarcinoma
#13
Lauren S Chan, Daniel Y Sze, George A Poultsides, John D Louie, Mohammed A Abdelrazek Mohammed, David S Wang
PURPOSE: Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare mixed cell type primary liver cancer with limited data to guide management. Transarterial radioembolization with yttrium-90 microspheres (RE) is an emerging treatment option for both hepatocellular carcinoma and intrahepatic cholangiocarcinoma. This study explored the safety and efficacy of RE for unresectable cHCC-CC. METHODS: Patients with histopathologically confirmed cHCC-CC treated with RE were retrospectively evaluated...
April 21, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28431130/safety-concerns-with-thoracoabdominal-acupuncture-experience-at-a-tertiary-care-emergency-department
#14
Hak Jin Lee, Youn-Jung Kim, Won Young Kim
Objective.:  To evaluate serious complications caused by acupuncture treatment and to increase awareness of this complication. Design.:  A retrospective observational study. Setting. : At the emergency department of a tertiary hospital in an urban area during a five-year period (2010-2014) in Seoul, Korea. Subjects.:  Patients with postacupuncture mechanical complications in the thoracoabdominal region. Methods...
April 19, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28430878/cosmetic-liposuction-preoperative-risk-factors-major-complication-rates-and-safety-of-combined-procedures
#15
Christodoulos Kaoutzanis, Varun Gupta, Julian Winocour, John Layliev, Roberto Ramirez, James C Grotting, Kent Higdon
Background: Liposuction is among the most commonly performed aesthetic procedures, and is being performed increasingly as an adjunct to other procedures. Objectives: To report the incidence and risk factors of significant complications after liposuction, and to determine whether adding liposuction to other cosmetic surgical procedures impacts the complication risk. Methods: A prospective cohort of patients who underwent liposuction between 2008 and 2013 was identified from the CosmetAssure database...
April 20, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28430820/cardiovascular-safety-of-tiotropium-respimat-vs-handihaler-in-the-routine-clinical-practice-a-population-based-cohort-study
#16
Francesco Trotta, Stefania Spila-Alegiani, Roberto Da Cas, Maja Rajevic, Valentino Conti, Mauro Venegoni, Mariangela Rossi, Giuseppe Traversa
The cardiovascular safety of tiotropium Respimat formulation in the routine clinical practice is still an open issue. Our aim was to compare the risk of acute myocardial infarction and heart rhythm disorders in incident users of either tiotropium Respimat or HandiHaler. The study population comprises patients aged ≥45 years, resident in two Italian regions with a first prescription of tiotropium (HandiHaler or Respimat) between 01/07/2011-30/11/2013. The cohort was identified through the database of prescriptions reimbursed by the Italian National Health Service...
2017: PloS One
https://www.readbyqxmd.com/read/28430558/lower-esophageal-sphincter-augmentation-for-gastroesophageal-reflux-disease-the-safety-of-a-modern-implant
#17
C Daniel Smith, Robert A Ganz, John C Lipham, Reginald C Bell, David W Rattner
INTRODUCTION: Use of the magnetic sphincter augmentation device (MSAD) for gastroesophageal reflux disease (GERD) is increasing. As this innovative treatment for GERD gains widespread use and adoption, an assessment of its safety since U.S. market introduction is presented. METHODS: Events were collected from the Manufacturer and User Facility Device Experience (MAUDE) database, which reports events submitted to the Food and Drug Administration (FDA) of suspected device-associated deaths, serious injuries, and malfunctions...
April 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28429927/endovascular-correction-in-acute-bleeding-after-femoropopliteal-bypass-a-single-centre-experience
#18
Giulia Mazzitelli, Mariagnese Mele, Francesco Setacci, Giuseppe Galzerano, Gianmarco DE Donato, Domenico Benevento, Massimiliano W Guerrieri, Carlo Setacci
INTRODUCTION: The endovascular correction (EC) has emerged in recent years as a possible alternative to surgical revision (SR) in case of bleeding complications after peripheral bypass (PB) . The purpose of this study is to evaluate the efficacy and safety of EC compared to SR in case of bleeding complications of PB. METHODS: From January 2004 to December 2014, we have submitted 32 patients to surgery for acute bleeding in previous PB (25 venous bypass, in situ or reversed, 6 PTFE bypass and 1 composite bypass)...
April 21, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28429860/safety-tolerability-and-efficacy-of-lixisenatide-in-combination-with-oral-antidiabetic-treatment-in-japanese-patients-with-type-2-diabetes-an-open-label-multicenter-study
#19
Yutaka Seino, Aleksandra Stjepanovic, Akane Takami, Hiroki Takagi
AIM/INTRODUCTION: To assess overall safety and efficacy of lixisenatide in combination with background oral antidiabetic drug treatment in Japanese patients with type 2 diabetes, as required by Japanese guidelines. MATERIALS AND METHODS: A Phase 3, multicenter, uncontrolled, open-label, four-arm, parallel-group study in Japanese outpatients with type 2 diabetes; patients received once-daily lixisenatide in combination with biguanide, thiazolidinedione, alpha-glucosidase inhibitors, or glinide (NCT01940965)...
April 21, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28429537/preliminary-findings-on-the-safety-of-1-5-and-3-tesla-magnetic-resonance-imaging-in-cardiac-pacemaker-patients
#20
V F van Dijk, P P H M Delnoy, J J J Smit, R A Ramdat Misier, A Elvan, H W van Es, B J W M Rensing, G Raciti, L V A Boersma
INTRODUCTION: Modern pacemakers are designed to allow patients to undergo Magnetic Resonance Imaging(MRI) under a set of specific conditions. Aim of this study is to provide confirmatory evidence of safety and performance of a new pacing system (ImageReady™, Boston Scientific) in patients undergoing 1.5 and 3 Tesla(T) MRI. METHODS AND RESULTS: Two prospective, non-randomized, single-arm studies were designed to provide confirmatory data of no impact of MRI on device function, lead parameters and patient conditions in subjects implanted with the system undergoing a clinically non-indicated 1...
April 21, 2017: Journal of Cardiovascular Electrophysiology
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