Weekly Guideline Update: Evidence Review

"Ultrasonography Screening for Abdominal Aortic Aneurysms: A Systematic Evidence Review for the U.S. Preventive Services Task Force"
Annals
http://annals.org/article.aspx?articleid=1817257
"Conclusion: One-time invitation for AAA screening in men aged 65 years or older was associated with decreased AAA rupture and AAA-related mortality rates but had little or no effect on all-cause mortality rates."


USPSTF Draft
http://www.uspreventiveservicestaskforce.org/draftrec.htm

"Clinical Outcomes With Bioabsorbable Polymer- Versus Durable Polymer-Based Drug-Eluting and Bare-Metal Stents"
JACC
http://content.onlinejacc.org/article.aspx?articleID=1765162
"Conclusions  In this large-scale network meta-analysis, BP-BES were associated with superior clinical outcomes compared with BMS and first-generation DES and similar rates of cardiac death/MI, MI, and TVR compared with second-generation DP-DES but higher rates of definite ST than CoCr-EES."

"First trimester fetal growth restriction and cardiovascular risk factors in school age children: population based cohort study"
BMJ  
http://www.bmj.com/content/348/bmj.g14 
"Conclusions Impaired first trimester fetal growth is associated with an adverse cardiovascular risk profile in school age children. Early fetal life might be a critical period for cardiovascular health in later life."

"A Trial of Mass Isoniazid Preventive Therapy for Tuberculosis Control"
NEJM
http://www.nejm.org/doi/full/10.1056/NEJMoa1214289
"CONCLUSIONS

Mass screening and treatment for latent tuberculosis had no significant effect on tuberculosis control in South African gold mines, despite the successful use of isoniazid in preventing tuberculosis during treatment. (Funded by the Consortium to Respond Effectively to the AIDS TB Epidemic and others; Thibela TB Current Controlled Trials number, ISRCTN63327174.)"  

"FDA Approval of Cardiac Implantable Electronic Devices via Original and Supplement Premarket Approval Pathways, 1979-2012"
JAMA
http://jama.jamanetwork.com/article.aspx?articleid=1817796
"Conclusions and Relevance  Many CIED models currently used by clinicians were approved via the PMA supplement process, not as original PMAs. Most new device models are deemed safe and effective without requiring new clinical data, reinforcing the importance of rigorous postapproval surveillance of these devices."

Weekly Guideline Update: 2014 AAFP Lung Cancer Screening

2014 AAFP Lung Cancer Screening
"The AAFP concludes that the evidence is insufficient to recommend for or against screening for lung cancer with low-dose computed tomography (LDCT) in persons at high risk for lung cancer based on age and smoking history."
http://www.aafp.org/patient-care/clinical-recommendations/all/lung-cancer.html

"Evidence Lacking to Support or Oppose Low-dose CT Screening for Lung Cancer, Says AAFP"
http://www.aafp.org/news-now/health-of-the-public/20140113aafplungcarec.html

"Efficacy and Safety of Longer-Term Administration of Evolocumab (AMG 145) in Patients With Hypercholesterolemia"
http://circ.ahajournals.org/content/129/2/234.abstract
"Conclusion—Evolocumab dosed every 4 weeks demonstrated continued efficacy and encouraging safety and tolerability over 1 year of treatment in the largest and longest evaluation of a PCSK9 inhibitor in hypercholesterolemic patients to date."

"Prenatal exposure to antidepressants and persistent pulmonary hypertension of the newborn: systematic review and meta-analysis"
BMJ
http://www.bmj.com/content/348/bmj.f6932
"Conclusions The risk of persistent pulmonary hypertension of the newborn seems to be increased for infants exposed to SSRIs in late pregnancy, independent of the potential moderator variables examined. A significant relation for exposure to SSRIs in early pregnancy was not evident. Although the statistical association was significant, clinically the absolute risk of persistent pulmonary hypertension of the newborn remained low even in the context of late exposure to SSRIs."

"Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes"
NEJM
http://www.nejm.org/doi/full/10.1056/NEJMoa1304501
"CONCLUSIONS

We observed a J-shaped association between BMI and mortality among all participants and among those who had ever smoked and a direct linear relationship among those who had never smoked. We found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal-weight counterparts, or of an obesity paradox. (Funded by the National Institutes of Health and the American Diabetes Association.)"

"Effect of 3 to 5 Years of Scheduled CEA and CT Follow-up to Detect Recurrence of Colorectal Cancer"
JAMA
http://jama.jamanetwork.com/article.aspx?articleid=1814213
"Conclusions and Relevance  Among patients who had undergone curative surgery for primary colorectal cancer, intensive imaging or CEA screening each provided an increased rate of surgical treatment of recurrence with curative intent compared with minimal follow-up; there was no advantage in combining CEA and CT. If there is a survival advantage to any strategy, it is likely to be small."

Weekly Guideline Update

2008 ACP:
"Evidence-Based Interventions to Improve the Palliative Care of Pain, Dyspnea, and Depression at the End of Life: A Clinical Practice Guideline from the American College of Physicians "
http://annals.org/article.aspx?articleid=738967

"Lower Levels of Sodium Intake and Reduced Cardiovascular Risk"    
Circ  
http://circ.ahajournals.org/content/early/2014/01/10/CIRCULATIONAHA.113.006032.abstract 
"Conclusions—Results from the TOHP studies, which overcome the major methodological challenges of prior studies, are consistent with overall health benefits of reducing sodium intake to the 1500 to 2300 mg/day range in the majority of the population, in agreement with current dietary guidelines."  

"Failure rate of cemented and uncemented total hip replacements"  
http://www.bmj.com/content/348/bmj.f7592   
"Conclusion The survival of cemented implants for total hip replacement was higher than that of uncemented implants in patients aged 65 years or older. The increased use of uncemented implants in this age group is not supported by these data. However, because our dataset includes only basic information common to all national registers there is potential for residual confounding."  

"Risk of Intussusception after Monovalent Rotavirus Vaccination"
http://www.nejm.org/doi/full/10.1056/NEJMoa1311738?query=featured_home
"CONCLUSIONS

In this prospective postlicensure study of more than 200,000 doses of monovalent rotavirus vaccine, we observed a significant increase in the rate of intussusception after vaccination, a risk that must be weighed against the benefits of preventing rotavirus-associated illness. (Funded by the Centers for Disease Control and Prevention.)"

"Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012"  
http://jama.jamanetwork.com/article.aspx?articleid=1812960 
"Conclusions and Relevance  Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the world’s population, intensified efforts to control its use are needed."

Weekly Guideline Update

2012 Endocrine Society: "Evaluation and Treatment  of Hypertriglyceridemia"
http://www.endocrine.org/~/media/endosociety/Files/Publications/Clinical%20Practice%20Guidelines/082312_Hypertriglyceridemia_FinalA.PDF

"Predictors of Long-Term Outcomes in Patients with Significant Myxomatous Mitral Regurgitation Undergoing Exercise Echocardiography"  
Circ  
http://circ.ahajournals.org/content/early/2014/01/03/CIRCULATIONAHA.113.005287.abstract 
"Conclusions—In patients with ≥III+ myxomatous MR undergoing ExEc, lower %age-gender predicted METS, lower HRR, atrial fibrillation, lower LV ejection fraction and high resting RVSP predicted worse outcomes."

"Evaluation of pre-hospital administration of adrenaline (epinephrine) by emergency medical services for patients with out of hospital cardiac arrest in Japan"
BMJ
http://www.bmj.com/content/347/bmj.f6829
"Conclusions Pre-hospital administration of adrenaline by emergency medical services improves the long term outcome in patients with out of hospital cardiac arrest, although the absolute increase of neurologically intact survival was minimal."

"Distracted Driving and Risk of Road Crashes among Novice and Experienced Drivers"
NEJM
http://www.nejm.org/doi/full/10.1056/NEJMsa1204142?query=featured_home 
"CONCLUSIONS

The risk of a crash or near-crash among novice drivers increased with the performance of many secondary tasks, including texting and dialing cell phones."

"Effect of Vitamin E and Memantine on Functional Decline in Alzheimer Disease"
JAMA  
http://jama.jamanetwork.com/article.aspx?articleid=1810379 
"Conclusions and Relevance  Among patients with mild to moderate AD, 2000 IU/d of alpha tocopherol compared with placebo resulted in slower functional decline. There were no significant differences in the groups receiving memantine alone or memantine plus alpha tocopherol. These findings suggest benefit of alpha tocopherol in mild to moderate AD by slowing functional decline and decreasing caregiver burden."

Weekly Guideline Update

"Screening for Lung Cancer: U.S. Preventive Services Task Force Recommendation Statement"  
Annals  
http://annals.org/article.aspx?articleid=1809422   
"Recommendation: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation)"

"Comparison of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography in Women with Suspected Coronary Artery Disease from the CE-MARC Trial"
Circ
http://circ.ahajournals.org/content/early/2013/12/19/CIRCULATIONAHA.112.000071.abstract 
"Conclusions—In both sexes, CMR has greater sensitivity than SPECT. Unlike SPECT, there are no significant gender differences in the diagnostic performance of CMR. These findings plus an absence of ionising radiation exposure, mean that CMR should be more widely adopted in women with suspected CAD."

"Association between change in daily ambulatory activity and cardiovascular events in people with impaired glucose tolerance (NAVIGATOR trial): a cohort analysis"
Lancet
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62061-9/fulltext 
"Interpretation

In individuals at high cardiovascular risk with impaired glucose tolerance, both baseline levels of daily ambulatory activity and change in ambulatory activity display a graded inverse association with the subsequent risk of a cardiovascular event."