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Impactful clinical trials

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https://www.readbyqxmd.com/read/28917688/a-randomized-trial-of-pocket-echocardiography-integrated-mobile-health-device-assessments-in-modern-structural-heart-disease-clinics
#1
Sanjeev P Bhavnani, Srikanth Sola, David Adams, Ashwin Venkateshvaran, P K Dash, Partho P Sengupta
OBJECTIVES: This study sought to determine whether mobile health (mHealth) device assessments used as clinical decision support tools at the point-of-care can reduce the time to treatment and improve long-term outcomes among patients with rheumatic and structural heart diseases (SHD). BACKGROUND: Newly developed smartphone-connected mHealth devices represent promising methods to diagnose common diseases in resource-limited areas; however, the impact of technology-based care on long-term outcomes has not been rigorously evaluated...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28917381/uncovering-burden-disparity-a-comparative-analysis-of-the-impact-of-moderate-to-severe-psoriasis-and-hidradenitis-suppurativa
#2
Iltefat H Hamzavi, Murali Sundaram, Cynthia Nicholson, Marko Zivkovic, Angela Parks-Miller, Jianyi Lee, Jingbo Yi, Yihua Gu, Martin M Okun, Arijit Ganguli, Steve R Arikian
BACKGROUND: Psoriasis and hidradenitis suppurativa (HS) exhibit distinct clinical features, but no studies have directly compared the health-related quality of life (HRQoL) in patients with moderate-to-severe manifestations of these conditions. OBJECTIVE: To determine which disease is associated with more severe HRQoL impairment. METHODS: Weighted averages of each of the following baseline HRQoL measures were determined and compared between HS and psoriasis populations from 5 clinical trials: Visual Analog Scale (VAS) for pain, Total Work Productivity Impairment, Dermatology Life Quality Index; EuroQOL 5D VAS, and Short Form-36 Health Survey...
September 13, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28917371/cannabinoids-for-spasticity-due-to-multiple-sclerosis-or-paraplegia-a-systematic-review-and-meta-analysis-of-randomized-clinical-trials
#3
REVIEW
Victoria P da Rovare, Gabriel P A Magalhães, Guilherme D A Jardini, Matheus L Beraldo, Mariel O Gameiro, Arnav Agarwal, Gustavo José Luvizutto, Lucas Paula-Ramos, Samira Esteves Afonso Camargo, Luciane Dias de Oliveira, Rodrigo Bazan, Regina El Dib
OBJECTIVES: Spasticity remains highly prevalent in patients with spinal cord injury and multiple sclerosis. To summarize the effects of cannabinoids compared with usual care, placebo for spasticity due to multiple sclerosis (MS) or paraplegia. METHODS: Searches of MEDLINE, EMBASE, CENTRAL and LILACS to March 2017 were performed to identify randomized controlled trials. The primary outcomes were spasticity and spasm frequency. The criteria were any patient with MS and spasticity affecting upper or lower limbs or both, and that had a confirmed diagnosis of MS based on validated criteria, or however defined by the authors of the included studies...
October 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28917219/reuma-pt-contribution-to-the-knowledge-of-immune-mediated-systemic-rheumatic-diseases
#4
Maria José Santos, Helena Canhão, Ana Filipa Mourão, Filipa Oliveira Ramos, Cristina Ponte, Cátia Duarte, Anabela Barcelos, Fernando Martins, José António Melo Gomes
Patient registries are key instruments aimed at a better understanding of the natural history of diseases, at assessing the effectiveness of therapeutic interventions, as well as identifying rare events or outcomes that are not captured in clinical trials. However, the potential of registries goes far beyond these aspects. For example, registries promote the standardization of clinical practice, can also provide information on domains that are not routinely collected in clinical practice and can support decision-making...
September 14, 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/28916584/novel-insights-into-the-clinical-phenotype-and-pathophysiology-underlying-low-vwf-levels
#5
Michelle Lavin, Sonia Aguila, Sonja Schneppenheim, Niall Dalton, Kenneth L Jones, Jamie M O'Sullivan, Niamh M O'Connell, Kevin Ryan, Barry White, Mary Byrne, Marie Rafferty, Mairead M Doyle, Margaret Nolan, Roger J S Preston, Ulrich Budde, Paula James, Jorge Di Paola, James S O'Donnell
Critical clinical questions remain unanswered regarding diagnosis and management of patients with Low VWF levels (30-50 IU/dL). To address these questions, the Low VWF Ireland Cohort (LoVIC) study investigated 126 patients registered with Low VWF. Interestingly, despite their marginally reduced plasma VWF levels, ISTH BAT and Condensed MCMDM-1 VWD scores both confirmed significant bleeding phenotypes in the majority of LoVIC patients. For example, among female patients with Low VWF, 77% had ISTH BAT scores ≥6...
September 15, 2017: Blood
https://www.readbyqxmd.com/read/28916571/effect-of-soy-and-soy-isoflavones-on-obesity-related-anthropometric-measures-a-systematic-review-and-meta-analysis-of-randomized-controlled-clinical-trials
#6
REVIEW
Masoumeh Akhlaghi, Morteza Zare, Fatemeh Nouripour
Soy may be a suitable food for anti-obesity efforts because of its high protein and isoflavone content. We conducted this meta-analysis to evaluate potential effects of soy and soy isoflavones on weight, waist circumference, and fat mass. PubMed, MEDLINE, Scopus, EMBASE, and Cochrane databases were searched. Twenty-four trials with soy and 17 trials with isoflavones passed the eligibility stage. According to the results, soy showed no overall statistically significant effect on weight, waist circumference, or fat mass, but a significant increasing effect on weight was observed in some circumstances: for instance, in obese subjects [mean difference (MD): 0...
September 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28916239/effect-of-body-mass-index-on-clinical-events-after-acute-coronary-syndromes
#7
Pablo Lamelas, Jon-David Schwalm, Ibrahim Quazi, Shamir Mehta, P J Devereaux, Sanjit Jolly, Salim Yusuf
The association between body mass index (BMI) and major clinical events after acute coronary syndrome (ACS) remains controversial. We investigated the impact of BMI on major clinical events after ACS in a large individual patient data meta-analysis. Data on 81,553 patients from 45 different countries with ACS enrolled in 8 large randomized clinical trials were included, followed up for a median of 171 days. The mean age was 63.4 ± 11.7, 70% were male, and the mean BMI was 27.3 ± 4.7 kg/m(2). Compared with upper-normal-weight participants (BMI 21...
July 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28916198/treatment-outcome-and-quality-of-life-of-1239-patients-with-advanced-non-small-cell-lung-cancer-final-results-from-the-prospective-german-tlk-cohort-study
#8
Ulla von Verschuer, Roland Schnell, Hans Werner Tessen, Jochen Eggert, Adrian Binninger, Lisa Spring, Martina Jänicke, Norbert Marschner
OBJECTIVES: Real-life data on advanced non-small cell lung cancer (NSCLC) are centrally important to complement the results from clinical trials and to improve the standard of care. We present data on the choice of systemic first- and second-line treatment, number of treatment lines, survival and longitudinal data on health-related quality of life (HRQOL) of patients treated by medical oncologists in Germany. MATERIALS AND METHODS: 1239 patients with advanced NSCLC were recruited at start of first-line therapy into the prospective German clinical cohort study TLK (Tumour Registry Lung Cancer) by 107 sites between February 2010 and December 2013 and followed-up until January 2016...
August 22, 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28915815/designing-an-implementation-intervention-with-the-behaviour-change-wheel-for-health-provider-smoking-cessation-care-for-australian-indigenous-pregnant-women
#9
Gillian S Gould, Yael Bar-Zeev, Michelle Bovill, Lou Atkins, Maree Gruppetta, Marilyn J Clarke, Billie Bonevski
BACKGROUND: Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS...
September 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28914623/prevalence-and-prognosis-impact-of-patient-ventilator-asynchrony-in-early-phase-of-weaning-according-to-two-detection-methods
#10
Camille Rolland-Debord, Côme Bureau, Tymothee Poitou, Lisa Belin, Marc Clavel, Sébastien Perbet, Nicolas Terzi, Achille Kouatchet, Thomas Similowski, Alexandre Demoule
BACKGROUND: Patient-ventilator asynchrony is associated with a poorer outcome. The prevalence and severity of asynchrony during the early phase of weaning has never been specifically described. The authors' first aim was to evaluate the prognosis impact and the factors associated with asynchrony. Their second aim was to compare the prevalence of asynchrony according to two methods of detection: a visual inspection of signals and a computerized method integrating electromyographic activity of the diaphragm...
September 14, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28914592/effect-of-topically-applied-hyaluronic-acid-on-pain-and-palatal-epithelial-wound-healing-an-examiner-blind-randomized-controlled-clinical-trial
#11
Selin Yıldırım, Hafize Öztürk Özener, Başak Doğan, Bahar Kuru
BACKGROUND: This study aimed to evaluate the effects of two different concentrations of topical hyaluronic-acid on post-operative patient discomfort and wound healing of palatal donor sites following free gingival graft (FGG) surgery. METHODS: Thirty-six patients requiring FGG were randomly assigned into three groups in an examiner-blind, randomized-controlled clinical trial. After harvesting palatal grafts, 0.2% and 0.8% hyaluronic-acid gels were used in the test-1 and -2 groups, respectively...
September 15, 2017: Journal of Periodontology
https://www.readbyqxmd.com/read/28914085/development-of-a-patient-centered-conceptual-model-of-the-impact-of-living-with-autism-spectrum-disorder
#12
Fiona McDougall, Thomas Willgoss, Steve Hwang, Federico Bolognani, Lorraine Murtagh, Evdokia Anagnostou, Diana Rofail
The aim of this study was to generate a patient-centered conceptual model of the impact of living with autism spectrum disorder, which can be used to support the selection of outcome measures for clinical trials. Following an initial literature review to identify preliminary concepts and inform an interview guide, in-depth face-to-face interviews were conducted with adolescents and adults with autism spectrum disorder (IQ ⩾ 70) (n = 10), as well as parents of children, adolescents, and adults with autism spectrum disorder (IQ ⩾ 70) (n = 26)...
September 1, 2017: Autism: the International Journal of Research and Practice
https://www.readbyqxmd.com/read/28913825/a-nursing-intervention-increases-quality-of-life-and-self-efficacy-in-migraine-a-1-year-prospective-controlled-trial
#13
Elizabeth Leroux, Line Beaudet, Guy Boudreau, Marzieh Eghtesadi, Luc Marchand, Heather Pim, Miguel Chagnon
OBJECTIVES: To compare the impact of a combined nursing and medical approach to a medical follow-up only on headache outcomes, quality of life, and self-efficacy in a cohort of migraineurs. BACKGROUND: Interdisciplinary approaches have been proposed for migraine management. A nursing intervention could improve patient outcomes. METHODS: We prospectively studied new patients referred to our tertiary headache center for migraine. The control group was followed by a physician; the active group was also followed by a nurse with a personalized intervention including adaptation of the lifestyle...
September 15, 2017: Headache
https://www.readbyqxmd.com/read/28913136/clinical-analyses-of-successful-and-previously-failed-intracytoplasmic-sperm-injection-cycle-parameters-in-patients-with-poor-ovarian-reserve
#14
Tayfun Kutlu, Enis Özkaya, Pınar Kumru, Habibe Ayvacı, Belgin Devranoğlu, İlhan Sanverdi, Yavuz Şahin, Beyhan Sağlam, Ateş Karateke
OBJECTIVE: To determine some major characteristic differences between two consecutive successful and unsuccessful intracytoplasmic sperm injection (ICSI) cycles in poor responders. MATERIALS AND METHODS: Sixty women with poor ovarian response as determined using the Bologna criteria underwent ICSI cycles following an unsuccessful trial. Some parameters of both cycles including age, body mass index (BMI), serum follicle-stimulating hormone (FSH) and estradiol levels, antral follicle count, gonadotropin dosage, duration of stimulation, antagonist starting day, duration of antagonist administration, endometrial thickness at trigger day, number of total and fertilized oocytes, embryo transfer day, number of embryo cells, and fertilization rate were compared in the same patients to identify predictors of cycles with clinical pregnancy...
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28912707/methodological-choices-in-muscle-synergy-analysis-impact-differentiation-of-physiological-characteristics-following-stroke
#15
Caitlin L Banks, Mihir M Pai, Theresa E McGuirk, Benjamin J Fregly, Carolynn Patten
Muscle synergy analysis (MSA) is a mathematical technique that reduces the dimensionality of electromyographic (EMG) data. Used increasingly in biomechanics research, MSA requires methodological choices at each stage of the analysis. Differences in methodological steps affect the overall outcome, making it difficult to compare results across studies. We applied MSA to EMG data collected from individuals post-stroke identified as either responders (RES) or non-responders (nRES) on the basis of a critical post-treatment increase in walking speed...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28911288/impact-of-thrombelastography-in-paediatric-intensive-care
#16
B G Carter, E Carland, P Monagle, S B Horton, W Butt
We assessed the clinical impact of thrombelastography (TEG®) results (TEG® 5000, Haemonetics Corporation, Braintree, MA, USA) by measuring their ability to cause changes in a theoretical treatment plan and contribute to the understanding of haemostasis. We prospectively included paediatric intensive care unit (PICU) patients who had standard tests of haemostasis and TEG ordered and had an arterial catheter or extracorporeal access port in situ. Blood for standard tests and TEG was taken simultaneously. Independent of patient care, general patient information and results of standard laboratory tests were presented to five clinicians who were asked to document their theoretical treatment plan...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28911202/pathogenicity-of-a-novel-missense-variant-associated-with-choroideremia-and-its-impact-on-gene-replacement-therapy
#17
Simona Torriano, Nejla Erkilic, Valérie Faugère, Krishna Damodar, Christian P Hamel, Anne-Francoise Roux, Vasiliki Kalatzis
Choroideremia (CHM) is an inherited retinal dystrophy characterised by progressive degeneration of photoreceptors, retinal pigment epithelium (RPE) and underlying choroid. It is caused by loss-of-function mutations in CHM, which has an X-linked inheritance, and is thus an ideal candidate for gene replacement strategies. CHM encodes REP1, which plays a key role in the prenylation of Rab GTPases. We recently showed that an induced pluripotent stem cell (iPSc)-derived RPE model for CHM is fully functional and reproduces the underlying prenylation defect...
September 15, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28911072/oncologist-use-and-perception-of-large-panel-next-generation-tumor-sequencing
#18
A M Schram, D Reales, J Galle, R Cambria, R Durany, D Feldman, E Sherman, J Rosenberg, G D'Andrea, S Baxi, Y Janjigian, W Tap, M Dickler, J Baselga, B S Taylor, D Chakravarty, J Gao, N Schultz, D B Solit, M F Berger, D M Hyman
Background: Genomic profiling is increasingly incorporated into oncology research and the clinical care of cancer patients. We sought to determine physician perception and use of enterprise-scale clinical sequencing at our center, including whether testing changed management and the reasoning behind this decision-making. Patients and methods: All physicians who consented patients to MSK-IMPACT, a next-generation hybridization capture assay, in tumor types where molecular profiling is not routinely performed were asked to complete a questionnaire for each patient...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28910802/effects-of-expanded-hemodialysis-therapy-on-clinical-outcomes
#19
Sandip Mitra, Kunaal Kharbanda
The invention of dialysis has been a phenomenal advance in the treatment of kidney failure. The introduction of artificial kidneys in clinical care remains one of the most successful lifesaving interventions in modern medicine. Its glory, however, has been tempered by poor long-term outcomes and a negative qualitative impact on the lives of patients who suffer from an extremely complex, burdensome, and restricted life on dialysis. There remains a huge gap in patient well-being and outcomes between artificial kidney treatments and kidney transplantation...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910786/the-evolving-patterns-of-uremia-unmet-clinical-needs-in-dialysis
#20
Xueqing Yu
End-stage renal disease (ESRD) has become a challenging health problem worldwide. Currently, ESRD patients treated with hemodialysis mainly undergo low-flux hemodialysis, high-flux hemodialysis (HF-HD), or hemodiafiltration (HDF). The clearance of middle and large molecules is, however, quite insufficient as regards HF-HD, HDF, and on-line HDF. An unsatisfactory prognosis has led to improved dialysis technology and materials; both protein-leaking membranes and high cut-off membranes increase the clearance of uremic toxin, but in clinical application they may induce albumin loss...
2017: Contributions to Nephrology
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