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COMPARATIVE STUDY
Jordan Fulcher, Rachel O'Connell, Merryn Voysey, Jonathan Emberson, Lisa Blackwell, Borislava Mihaylova, John Simes, Rory Collins, Adrienne Kirby, Helen Colhoun, Eugene Braunwald, John La Rosa, T R Pedersen, Andrew Tonkin, Barry Davis, Peter Sleight, Maria Grazia Franzosi, Colin Baigent, Anthony Keech
BACKGROUND: Whether statin therapy is as effective in women as in men is debated, especially for primary prevention. We undertook a meta-analysis of statin trials in the Cholesterol Treatment Trialists' (CTT) Collaboration database to compare the effects of statin therapy between women and men. METHODS: We performed meta-analyses on data from 22 trials of statin therapy versus control (n=134,537) and five trials of more-intensive versus less-intensive statin therapy (n=39,612)...
April 11, 2015: Lancet
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JOURNAL ARTICLE
Mikhail Petrov, Yan Yatsynovich, Catalina Lionte
Rhabdomyolysis is a rare phenomenon that may be challenging to recognize in an emergency setting. Drugs are one of the common causes. Trimethoprim-sulfamethoxazole is a commonly used antibiotic effective in the treatment of upper and lower respiratory tract infections as well as renal, urinary, and gastrointestinal tract infections. It has variable side effects, ranging from mild symptoms of fatigue and insomnia to a potentially life-threatening Steven-Johnson syndrome and renal failure. Rhabdomyolysis is a rare complication of therapy with this drug and is commonly seen in immunocompromised patients or those with an allogenic stem cell transplant...
January 2015: American Journal of Emergency Medicine
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JOURNAL ARTICLE
Amitkumar R Patel, Frank J Zadravecz, Robert S Young, Mark V Williams, Matthew M Churpek, Dana P Edelson
No abstract text is available yet for this article.
March 2015: JAMA Internal Medicine
#24
JOURNAL ARTICLE
Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects.
Hiroaki Nakashima, Yasutsugu Yukawa, Kota Suda, Masatsune Yamagata, Takayoshi Ueta, Fumihiko Kato
STUDY DESIGN: Cross-sectional study. OBJECTIVE: The purpose of this study was to determine the prevalence and distribution of abnormal findings on cervical spine magnetic resonance image (MRI). SUMMARY OF BACKGROUND DATA: Neurological symptoms and abnormal findings on MR images are keys to diagnose the spinal diseases. To determine the significance of MRI abnormalities, we must take into account the (1) frequency and (2) spectrum of structural abnormalities, which may be asymptomatic...
March 15, 2015: Spine
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REVIEW
Curtis J Donskey, Sirisha Kundrapu, Abhishek Deshpande
Asymptomatic carriage of toxigenic strains of Clostridium difficile is common in health care facilities and the community. However, infection control efforts have traditionally focused almost entirely on symptomatic patients. There is now growing concern that asymptomatic carriers may be an underappreciated source of transmission. This article provides an overview of the pathogenesis and epidemiology of C difficile colonization, reviews the evidence that asymptomatic carriers shed spores and contribute to transmission, and examines practical issues related to prevention of transmission from carriers...
March 2015: Infectious Disease Clinics of North America
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JOURNAL ARTICLE
Robert Dunlea, Leslie Lenert
BACKGROUND: A specialty referral is a common but complex decision that often requires a primary care provider to balance his or her own interests with those of the patient. OBJECTIVE: To examine the factors that influence a patient's choice of a specialist for consultation for an asymptomatic condition and better understand the tradeoffs that patients are and are not willing to make in this decision. DESIGN: Stratified cross-sectional convenience sample of subjects selected to parallel US population demographics...
January 14, 2015: Medical Decision Making: An International Journal of the Society for Medical Decision Making
#27
REVIEW
Nazmus Saquib, Juliann Saquib, John P A Ioannidis
BACKGROUND: Several popular screening tests, such as mammography and prostate-specific antigen, have met with wide controversy and/or have lost their endorsement recently. We systematically evaluated evidence from randomized controlled trials (RCTs) as to whether screening decreases mortality from diseases where death is a common outcome. METHODS: We searched three sources: United States Preventive Services Task Force (USPSTF), Cochrane Database of Systematic Reviews, and PubMed...
February 2015: International Journal of Epidemiology
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COMMENT
Paul G Shekelle
No abstract text is available yet for this article.
February 2015: International Journal of Epidemiology
#29
REVIEW
Adrian M Agius, Anshul Sama
PURPOSE OF REVIEW: To review the present knowledge and the recent publications on the cause, characteristics, course and treatment of chronic and recurring facial pain and headaches. Facial pain is amongst the commonest complaints in ear, nose and throat clinics. Recent articles have presented important evidence-based approach to this common problem. RECENT FINDINGS: Recent publications in the fields of otolaryngology and neurology have better defined the differences between rhinogenic and nonrhinogenic facial pain, and place this symptom in the context of rhinosinusitis...
February 2015: Current Opinion in Otolaryngology & Head and Neck Surgery
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JOURNAL ARTICLE
Steen Vigh Buch, Frederik Philip Treschow, Jesper Brink Svendsen, Bjarne Skjødt Worm
BACKGROUND AND AIMS: This study investigated the effectiveness of two different levels of e-learning when teaching clinical skills to medical students. MATERIALS AND METHODS: Sixty medical students were included and randomized into two comparable groups. The groups were given either a video- or text/picture-based e-learning module and subsequently underwent both theoretical and practical examination. A follow-up test was performed 1 month later. RESULTS: The students in the video group performed better than the illustrated text-based group in the practical examination, both in the primary test (P<0...
2014: Advances in Medical Education and Practice
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JOURNAL ARTICLE
Markus Krautter, Sven Andreesen, Nadja Köhl-Hackert, Katja Hoffmann, Wolfgang Herzog, Christoph Nikendei
BACKGROUND: Peer-assisted learning (PAL) has become a well-accepted teaching method within medical education. However, descriptions of on-ward PAL programs are rare. A focus group analysis of a newly established PAL program on an internal medicine ward was conducted to provide insights into PAL teaching from a student perspective. PURPOSE: To provide insights into students' experiences regarding their on-ward training with and without accompanying PAL tutors. METHODS: A total of N=168 medical students in their sixth semester participated in the investigation (intervention group: N=88; control group: N=80)...
2014: Advances in Medical Education and Practice
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JOURNAL ARTICLE
Annette Burgess, Debra Nestel
Peer assisted learning (PAL) is well documented in the medical education literature. In this paper, the authors explored the role of PAL in a graduate entry medical program with respect to the development of professional identity. The paper draws on several publications of PAL from one medical school, but here uses the theoretical notion of legitimate peripheral participation in a medical school community of practice to shed light on learning through participation. As medical educators, the authors were particularly interested in the development of educational expertise in medical students, and the social constructs that facilitate this academic development...
2014: Advances in Medical Education and Practice
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JOURNAL ARTICLE
Dipak Kotecha, Jane Holmes, Henry Krum, Douglas G Altman, Luis Manzano, John G F Cleland, Gregory Y H Lip, Andrew J S Coats, Bert Andersson, Paulus Kirchhof, Thomas G von Lueder, Hans Wedel, Giuseppe Rosano, Marcelo C Shibata, Alan Rigby, Marcus D Flather
BACKGROUND: Atrial fibrillation and heart failure often coexist, causing substantial cardiovascular morbidity and mortality. β blockers are indicated in patients with symptomatic heart failure with reduced ejection fraction; however, the efficacy of these drugs in patients with concomitant atrial fibrillation is uncertain. We therefore meta-analysed individual-patient data to assess the efficacy of β blockers in patients with heart failure and sinus rhythm compared with atrial fibrillation...
December 20, 2014: Lancet
#34
JOURNAL ARTICLE
Lotta Wikström, Kerstin Eriksson, Kristofer Årestedt, Bengt Fridlund, Anders Broström
AIM: To describe how healthcare professionals perceive the use of pain scales in postoperative care. BACKGROUND: Pain scales are important but not an obvious choice to use in postoperative care. No study has explored how healthcare professionals experience the use of pain scales. METHODS: An explorative design with a phenomenographic approach was used. The sample consisted of 25 healthcare professionals. Semistructured interviews were performed...
February 2014: Applied Nursing Research: ANR
#35
RANDOMIZED CONTROLLED TRIAL
Enrique Quintero, Antoni Castells, Luis Bujanda, Joaquín Cubiella, Dolores Salas, Ángel Lanas, Montserrat Andreu, Fernando Carballo, Juan Diego Morillas, Cristina Hernández, Rodrigo Jover, Isabel Montalvo, Juan Arenas, Eva Laredo, Vicent Hernández, Felipe Iglesias, Estela Cid, Raquel Zubizarreta, Teresa Sala, Marta Ponce, Mercedes Andrés, Gloria Teruel, Antonio Peris, María-Pilar Roncales, Mónica Polo-Tomás, Xavier Bessa, Olga Ferrer-Armengou, Jaume Grau, Anna Serradesanferm, Akiko Ono, José Cruzado, Francisco Pérez-Riquelme, Inmaculada Alonso-Abreu, Mariola de la Vega-Prieto, Juana Maria Reyes-Melian, Guillermo Cacho, José Díaz-Tasende, Alberto Herreros-de-Tejada, Carmen Poves, Cecilio Santander, Andrés González-Navarro
BACKGROUND: Colonoscopy and fecal immunochemical testing (FIT) are accepted strategies for colorectal-cancer screening in the average-risk population. METHODS: In this randomized, controlled trial involving asymptomatic adults 50 to 69 years of age, we compared one-time colonoscopy in 26,703 subjects with FIT every 2 years in 26,599 subjects. The primary outcome was the rate of death from colorectal cancer at 10 years. This interim report describes rates of participation, diagnostic findings, and occurrence of major complications at completion of the baseline screening...
February 23, 2012: New England Journal of Medicine
#36
RANDOMIZED CONTROLLED TRIAL
Eva-Luise Hobl, Thomas Stimpfl, Josef Ebner, Christian Schoergenhofer, Ulla Derhaschnig, Raute Sunder-Plassmann, Petra Jilma-Stohlawetz, Christine Mannhalter, Martin Posch, Bernd Jilma
OBJECTIVES: This study sought to examine the possible drug-drug interactions between clopidogrel and morphine. BACKGROUND: Because morphine-the recommended treatment for pain of myocardial infarction-is associated with poor clinical outcome, we hypothesized that morphine lowers the plasma levels of clopidogrel active metabolite as well as its effects on platelets. METHODS: Twenty-four healthy subjects received a loading dose of 600 mg clopidogrel together with placebo or 5 mg morphine intravenously in a randomized, double-blind, placebo-controlled, cross-over trial...
February 25, 2014: Journal of the American College of Cardiology
#37
REVIEW
Rajiv Chowdhury, Samantha Warnakula, Setor Kunutsor, Francesca Crowe, Heather A Ward, Laura Johnson, Oscar H Franco, Adam S Butterworth, Nita G Forouhi, Simon G Thompson, Kay-Tee Khaw, Dariush Mozaffarian, John Danesh, Emanuele Di Angelantonio
BACKGROUND: Guidelines advocate changes in fatty acid consumption to promote cardiovascular health. PURPOSE: To summarize evidence about associations between fatty acids and coronary disease. DATA SOURCES: MEDLINE, Science Citation Index, and Cochrane Central Register of Controlled Trials through July 2013. STUDY SELECTION: Prospective, observational studies and randomized, controlled trials. DATA EXTRACTION: Investigators extracted data about study characteristics and assessed study biases...
March 18, 2014: Annals of Internal Medicine
#38
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
AIMS: Niacin has potentially favourable effects on lipids, but its effect on cardiovascular outcomes is uncertain. HPS2-THRIVE is a large randomized trial assessing the effects of extended release (ER) niacin in patients at high risk of vascular events. METHODS AND RESULTS: Prior to randomization, 42 424 patients with occlusive arterial disease were given simvastatin 40 mg plus, if required, ezetimibe 10 mg daily to standardize their low-density lipoprotein (LDL)-lowering therapy...
May 2013: European Heart Journal
#39
JOURNAL ARTICLE
Hyunsoon Cho, Carrie N Klabunde, K Robin Yabroff, Zhuoqiao Wang, Angela Meekins, Iris Lansdorp-Vogelaar, Angela B Mariotto
BACKGROUND: Many guidelines recommend considering health status and life expectancy when making cancer screening decisions for elderly persons. OBJECTIVE: To estimate life expectancy for elderly persons without a history of cancer, taking into account comorbid conditions. DESIGN: Population-based cohort study. SETTING: A 5% sample of Medicare beneficiaries in selected geographic areas, including their claims and vital status information...
November 19, 2013: Annals of Internal Medicine
#40
EDITORIAL
David A Bluemke
No abstract text is available yet for this article.
August 19, 2014: Circulation
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