"CMX001 to Prevent Cytomegalovirus Disease in Hematopoietic-Cell Transplantation"
NEJM Sep 26
http://www.nejm.org/doi/full/10.1056/NEJMoa1303688
"CONCLUSIONS

Treatment with oral CMX001 at a dose of 100 mg twice weekly significantly reduced the incidence of CMV events in recipients of hematopoietic-cell transplants. Diarrhea was dose-limiting in this population at a dose of 200 mg twice weekly. (Funded by Chimerix; CMX001-201 ClinicalTrials.gov number, NCT00942305.)"

"Repeat Bone Mineral Density Screening and Prediction of Hip and Major Osteoporotic Fracture" 
JAMA Sep 25
http://jama.jamanetwork.com/article.aspx?articleid=1741821 
"Conclusions and Relevance  In untreated men and women of mean age 75 years, a second BMD measure after 4 years did not meaningfully improve the prediction of hip or major osteoporotic fracture. Repeating a BMD measure within 4 years to improve fracture risk stratification may not be necessary in adults this age untreated for osteoporosis. . . . "

"Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease"
Annals Sep 24
http://annals.org/article.aspx?articleid=1740759
"Conclusion: Long-term exposure to low to moderate arsenic levels was associated with cardiovascular disease incidence and mortality."

"Impact of Periprocedural Bleeding on Incidence of Contrast-Induced Acute Kidney Injury in Patients Treated With Percutaneous Coronary Intervention"
JACC Oct 2013
http://content.onlinejacc.org/article.aspx?articleid=1699333
"Conclusions  Periprocedural bleeding was significantly associated with CI-AKI, with CI-AKI incidence correlating with bleeding severity."

"Fractional Flow Reserve–Guided Versus Angiography-Guided Coronary Artery Bypass Graft Surgery"
Circ Aug 28
http://circ.ahajournals.org/content/128/13/1405.abstract
"Conclusions—FFR-guided coronary artery bypass graft surgery was associated with a lower number of graft anastomoses and a lower rate of on-pump surgery compared with angiography-guided coronary artery bypass graft surgery. This did not result in a higher event rate during up to 36 months of follow-up and was associated with a lower rate of angina."

"Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study"
Lancet Aug 23
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70163-4/fulltext 
"Interpretation

Implementation of WHO's hand-hygiene strategy is feasible and sustainable across a range of settings in different countries and leads to significant compliance and knowledge improvement in health-care workers, supporting recommendation for use worldwide."

"Type of stress ulcer prophylaxis and risk of nosocomial pneumonia in cardiac surgical patients: cohort study"
BMJ Sep 19
http://www.bmj.com/content/347/bmj.f5416 
"Conclusions Patients treated with proton pump inhibitors for stress ulcer had a small increase in the risk of postoperative pneumonia compared with patients treated with H2receptor antagonists; this risk remained after confounding was accounted for using multiple analytic approaches."

"Long-Term Colorectal-Cancer Incidence and Mortality after Lower Endoscopy" 
NEJM Sept 19
http://www.nejm.org/doi/full/10.1056/NEJMoa1301969
"CONCLUSIONS

Colonoscopy and sigmoidoscopy were associated with a reduced incidence of cancer of the distal colorectum; colonoscopy was also associated with a modest reduction in the incidence of proximal colon cancer. Screening colonoscopy and sigmoidoscopy were associated with reduced colorectal-cancer mortality; only colonoscopy was associated with reduced mortality from proximal colon cancer. Colorectal cancer diagnosed within 5 years after colonoscopy was more likely than cancer diagnosed after that period or without prior endoscopy to have CIMP and microsatellite instability. (Funded by the National Institutes of Health and others.)"

"Chronic Care Management for Dependence on Alcohol and Other Drugs"
JAMA Sep 18
http://jama.jamanetwork.com/article.aspx?articleid=1738895
"Conclusions and Relevance  Among persons with alcohol and other drug dependence, CCM compared with a primary care appointment but no CCM did not increase self-reported abstinence over 12 months. Whether more intensive or longer-duration CCM is effective requires further investigation."

"Cost-Effectiveness of Tolvaptan in Autosomal Dominant Polycystic Kidney Disease" 
Annals Sept 17
http://annals.org/article.aspx?articleid=1738493
"Conclusion: Assuming that the benefits of tolvaptan persist in the longer term, the drug may slow progression to ESRD and reduce mortality rates. However, barring an approximately 95% reduction in price, cost-effectiveness does not compare favorably with many other commonly accepted medical interventions."

"Effects of Nesiritide and Predictors of Urine Output in Acute Decompensated Heart Failure"
JACC Sep 2013
http://content.onlinejacc.org/article.aspx?articleid=1697391
"Conclusions  Nesiritide did not increase urine output in patients with ADHF. Higher diuretic dose was a strong predictor of higher urine output, but neurohormonal activation (as evidenced by blood urea nitrogen concentration) and lower blood pressure limited diuresis."

"Risk of Lower and Upper Gastrointestinal Bleeding, Transfusions, and Hospitalizations with Complex Antithrombotic Therapy in Elderly Patients"
Circ Sep 11
http://circ.ahajournals.org/content/early/2013/09/11/CIRCULATIONAHA.113.004747.abstract
"Conclusions—Among the elderly, CAT-related LGIE and UGIE is a clinically relevant risk resulting in increased hospitalizations and transfusions."

"Preoperative prediction of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a retrospective cohort study"
Lancet Sep 13
http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70070-6/fulltext 
"Interpretation

The DiaRem score is a novel preoperative method to predict the probability of remission of type 2 diabetes after RYGB surgery."

"Efficacy and safety outcomes of oral anticoagulants and antiplatelet drugs in the secondary prevention of venous thromboembolism: systematic review and network meta-analysis"
BMJ Aug 30
http://www.bmj.com/content/347/bmj.f5133
"Conclusions All oral anticoagulants and antiplatelet agents investigated in this analysis were associated with a reduced recurrence of venous thromboembolism compared with placebo or observation, although acetylsalicylic acid was associated with the lowest risk reduction. Vitamin K antagonists given at a standard adjusted dose was associated with the greatest risk reduction in recurrent venous thromboembolism, but also the greatest risk of major bleeding."

"Panitumumab–FOLFOX4 Treatment and RAS Mutations in Colorectal Cancer" 
NEJM Sep 12
http://www.nejm.org/doi/full/10.1056/NEJMoa1305275?query=featured_home
"CONCLUSIONS

Additional RAS mutations predicted a lack of response in patients who received panitumumab–FOLFOX4. In patients who had metastatic colorectal cancer without RAS mutations, improvements in overall survival were observed with panitumumab–FOLFOX4 therapy. (Funded by Amgen and others; PRIME ClinicalTrials.gov number,NCT00364013.)"

"Prednisolone With vs Without Pentoxifylline and Survival of Patients With Severe Alcoholic Hepatitis"
JAMA Sep 11
http://jama.jamanetwork.com/article.aspx?articleid=1737041
"Conclusion and Relevance  In patients with alcoholic hepatitis, 4-week treatment with pentoxifylline and prednisolone, compared with prednisolone alone, did not result in improved 6-month survival. The study may have been underpowered to detect a significant difference in incidence of hepatorenal syndrome, which was less frequent in the group receiving pentoxifylline."

"Methylprednisolone Injections for the Carpal Tunnel Syndrome"
Annals Sep 3
http://annals.org/article.aspx?articleid=1733275
"Conclusion: Methylprednisolone injections for CTS have significant benefits in relieving symptoms at 10 weeks and reducing the rate of surgery 1 year after treatment, but 3 out of 4 patients had surgery within 1 year."

"Early and 1-Year Results From the ACCESS-EU, A Prospective, Multicenter, Nonrandomized Post-Approval Study of the MitraClip Therapy in Europe"
JACC Sep 2013
http://content.onlinejacc.org/article.aspx?articleid=1697385
"Conclusions  In the real-world, post-approval experience in Europe, patients undergoing the MitraClip therapy are high-risk, elderly patients, mainly affected by functional MR. In this patient population, the MitraClip procedure is effective with low rates of hospital mortality and adverse events."

"High-Density Lipoprotein Cholesterol, Size, Particle Number, and Residual Vascular Risk After Potent Statin Therapy" 
Circ Sep 3 (online)
http://circ.ahajournals.org/content/128/11/1189.abstract
"Conclusions—In the setting of potent statin therapy, HDL particle number may be a better marker of residual risk than chemically measured HDL-C or apoA-I. This has potential implications for evaluating novel therapies targeting HDL."

"Risk score for prediction of 10 year dementia risk in individuals with type 2 diabetes: a cohort study" 
Lancet Aug 20  
http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70048-2/fulltext 
"Interpretation

To the best of our knowledge, this is the first risk score for the prediction of 10 year dementia risk in patients with type 2 diabetes mellitus. The risk score can be used to increase vigilance for cognitive deterioration and for selection of high-risk patients for participation in clinical trials."

"Risk of colorectal cancer after initiation of orlistat: matched cohort study"  BMJ
http://www.bmj.com/content/347/bmj.f5039 
"Conclusions
This study found no evidence of an increased risk of colorectal cancer after the initiation of orlistat. It is limited by the relatively short follow-up time, and the possibility of adverse effects of long term orlistat use on risk of colorectal cancer cannot be excluded."

"Behavioral and Dietary Risk Factors for Noncommunicable Diseases"
NEJM Sep 5
http://www.nejm.org/doi/full/10.1056/NEJMra1203528?query=featured_home 
"Except in eastern Europe and parts of Africa, mortality among adults has declined in most countries for decades.1 Lower rates of death from infectious diseases were the early driver of this improvement, but there have been subsequent declines in mortality from cardiovascular disease and some cancers.2,3 There have also been important trends in various cancers2 — for example, the rise and subsequent decline in lung-cancer incidence and mortality among men in many high-income countries, a decline in stomach-cancer incidence and mortality as economies develop, and the worldwide increase in breast-cancer incidence."

"Effects of a Fixed-Dose Combination Strategy on Adherence and Risk Factors in Patients With or at High Risk of CVD"  
JAMA Sep 4
http://jama.jamanetwork.com/article.aspx?articleid=1734704 
"Conclusions and Relevance   Among patients with or at high risk of CVD, use of an FDC strategy for blood pressure, cholesterol, and platelet control vs usual care resulted in significantly improved medication adherence at 15 months and statistically significant but small improvements in SBP and LDL-C."

"Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment With the Ankle–Brachial Index in Adults: U.S. Preventive Services Task Force Recommendation Statement" 
Annals Sep 3
http://annals.org/article.aspx?articleid=1733279 
"Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for PAD and CVD risk assessment with the ABI in adults."

"Benefits Of Statins In Elderly Subjects Without Established Cardiovascular Disease. A Meta-Analysis"

"Benefits Of Statins In Elderly Subjects Without Established Cardiovascular Disease. A Meta-Analysis"
JACC Aug 2013
http://content.onlinejacc.org/article.aspx?articleid=1732396
"Conclusions  In elderly subjects at high CV risk without established CV disease, statins significantly reduce the incidence of MI and stroke, but do not significantly prolong survival in the short-term."

"Stent Thrombosis With Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes"
Circ Jul 30 (online)
http://circ.ahajournals.org/content/128/10/1055.abstract 
"Conclusion—Ticagrelor compared with clopidogrel reduces the incidence of stent thrombosis in patients with acute coronary syndromes, with consistent benefit across a broad range of patient, stent, and treatment characteristics."

"Early time-limited antiretroviral therapy versus deferred therapy in South African infants infected with HIV: results from the children with HIV early antiretroviral (CHER) randomised trial"
Lancet Aug 22
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61409-9/fulltext
"Interpretation

Early time-limited ART had better clinical and immunological outcomes than deferred ART, with no evidence of excess disease progression during subsequent treatment interruption and less overall ART exposure than deferred ART. Longer time on primary ART permits longer subsequent interruption, with marginally better outcomes"

"Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies"
BMJ Aug 29
http://ww w.bmj.com/content/347/bmj.f5001 
"Conclusion Our findings suggest the presence of heterogeneity in the associations between individual fruit consumption and risk of type 2 diabetes. Greater consumption of specific whole fruits, particularly blueberries, grapes, and apples, is significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk."

"Dabigatran versus Warfarin in Patients with Mechanical Heart Valves"
NEJM Sep 1
http://www.nejm.org/doi/full/10.1056/NEJMoa1300615?query=featured_home
"CONCLUSIONS

The use of dabigatran in patients with mechanical heart valves was associated with increased rates of thromboembolic and bleeding complications, as compared with warfarin, thus showing no benefit and an excess risk."

"Association Between Cholecystectomy With vs Without Intraoperative Cholangiography and Risk of Common Duct Injury"JAMA Aug 28
http://jama.jamanetwork.com/article.aspx?articleid=1733717 
"Conclusions and Relevance   When confounders were controlled with instrumental variable analysis, there was no statistically significant association between intraoperative cholangiography and common duct injury. Intraoperative cholangiography is not effective as a preventive strategy against common duct injury during cholecystectomy."