Weekly Guideline Update - Type 1 DM and CV Disease

"Type 1 Diabetes Mellitus and Cardiovascular Disease: A Scientific Statement From the American Heart Association and American Diabetes Association"

http://circ.ahajournals.org/content/early/2014/08/11/CIR.0000000000000034

CIRC - (ahead of print) ASA for Recurent VTE

"Aspirin for the Prevention of Recurrent Venous Thromboembolism: The INSPIRE Collaboration"

"Conclusions—Aspirin after anticoagulant treatment reduces the overall risk of recurrence by more than a third in a broad cross-section of patients with a first unprovoked VTE, without significantly increasing the risk of bleeding."
http://circ.ahajournals.org/content/early/2014/08/12/CIRCULATIONAHA.114.008828.abstract

BMJ - Clarithromycin and roxithromycin and risk of cardiac death

"Use of clarithromycin and roxithromycin and risk of cardiac death: cohort study"

"Conclusions This large cohort study found a significantly increased risk of cardiac death associated with clarithromycin. No increased risk was seen with roxithromycin. Given the widespread use of clarithromycin, these findings call for confirmation in independent populations."
http://www.bmj.com/content/349/bmj.g4930

NEJM - Transfusions for Silent Cerebral Infarcts in Sickle Cell Anemia

"Controlled Trial of Transfusions for Silent Cerebral Infarcts in Sickle Cell Anemia"

"CONCLUSIONS

Regular blood-transfusion therapy significantly reduced the incidence of the recurrence of cerebral infarct in children with sickle cell anemia. (Funded by the National Institute of Neurological Disorders and Stroke and others; Silent Cerebral Infarct Multi-Center Clinical Trial ClinicalTrials.gov number, NCT00072761, and Current Controlled Trials number, ISRCTN52713285.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1401731 

JAMA - Oximetry & Hospitalization in Infant Bronchiolitis

"Effect of Oximetry on Hospitalization in Bronchiolitis"

"Conclusions and Relevance  Among infants presenting to an emergency department with mild to moderate bronchiolitis, those with an artificially elevated pulse oximetry reading were less likely to be hospitalized within 72 hours or to receive active hospital care for more than 6 hours than those with unaltered oximetry readings. This suggests that oxygen saturation should not be the only factor in the decision to admit, and its use may need to be reevaluated."

http://jama.jamanetwork.com/article.aspx?articleid=1896981

Weekly Guideline - 2014 AHA Exercise Testing by Nonphysicians

"Supervision of Exercise Testing by Nonphysicians: A Scientific Statement From the American Heart Association"
http://circ.ahajournals.org/content/early/2014/08/18/CIR.0000000000000101.full.pdf+html

CIRC - Exercise Capacity & Mortality

"Age-Specific Exercise Capacity Threshold for Mortality Risk Assessment in Male Veterans"

"Conclusion—We defined age-specific exercise capacity thresholds to guide assessment of mortality risk in individuals undergoing a clinical exercise test."

http://circ.ahajournals.org/content/130/8/653.abstract

BMJ - QBleed Scores for Anticoagulants

"Predicting risk of upper gastrointestinal bleed and intracranial bleed with anticoagulants: cohort study to derive and validate the QBleed scores"

"Conclusion The QBleed algorithms provided valid measures of absolute risk of gastrointestinal and intracranial bleed in patients with and without anticoagulation as shown by the performance of the algorithms in a separate validation cohort. Further research is needed to evaluate the clinical outcomes and the cost effectiveness of using these algorithms in primary care."


http://www.bmj.com/content/349/bmj.g4606

NEJM - Sodium & CV Mortality

"Global Sodium Consumption and Death from Cardiovascular Causes"

"CONCLUSIONS

In this modeling study, 1.65 million deaths from cardiovascular causes that occurred in 2010 were attributed to sodium consumption above a reference level of 2.0 g per day. (Funded by the Bill and Melinda Gates Foundation.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1304127?query=featured_home

JAMA - Flex Sig for Colon CA

"Effect of Flexible Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality"

"Conclusions and Relevance  In Norway, once-only flexible sigmoidoscopy screening or flexible sigmoidoscopy and FOBT reduced colorectal cancer incidence and mortality on a population level compared with no screening. Screening was effective both in the 50- to 54-year and the 55- to 64-year age groups."

http://jama.jamanetwork.com/article.aspx?articleid=1895247

Weekly Guideline Update - Hep C

2014+ (continually updated) IDSA "Recommendations for Testing, Managing, and Treating Hepatitis C"
http://www.hcvguidelines.org/full-report-view

"Prognostic Value of Fasting Versus Nonfasting Low-Density Lipoprotein Cholesterol Levels on Long-Term Mortality"

"Conclusions—Nonfasting LDL-C has prognostic value similar to that of fasting LDL-C. National and international agencies should consider reevaluating the recommendation that patients fast before obtaining a lipid panel."

http://circ.ahajournals.org/content/130/7/546.abstract

"Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety"

"Conclusions Tranexamic acid was effective in reducing the need for blood transfusions while not increasing the risk of complications, including thromboembolic events and renal failure. Thus our data provide incremental evidence of the potential effectiveness and safety of tranexamic acid in patients requiring orthopedic surgery."  

http://www.bmj.com/content/349/bmj.g4829 

NEJM - Pay for Performance & Mortality

"Long-Term Effect of Hospital Pay for Performance on Mortality in England"

"CONCLUSIONS

Short-term relative reductions in mortality for conditions linked to financial incentives in hospitals participating in a pay-for-performance program in England were not maintained."  

http://www.nejm.org/doi/full/10.1056/NEJMoa1400962?query=featured_home 

JAMA - High-Protein Enteral Nutrition and Nosocomial Infections in the ICU

"High-Protein Enteral Nutrition Enriched With Immune-Modulating Nutrients vs Standard High-Protein Enteral Nutrition and Nosocomial Infections in the ICU"

"Conclusions and Relevance  Among adult patients breathing with the aid of mechanical ventilation in the ICU, IMHP compared with HP did not improve infectious complications or other clinical end points and may be harmful as suggested by increased adjusted mortality at 6 months. These findings do not support the use of IMHP nutrients in these patients."

http://jama.jamanetwork.com/article.aspx?articleid=1892247

Weekly Guideline - Perioperative Cardiovascular Evaluation for Noncardiac Surgery

"2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery: Executive Summary"

http://circ.ahajournals.org/content/early/2014/07/31/CIR.0000000000000105.full.pdf+html

Circ - MRI & Sudden Death in HCM

"Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy"

"Conclusions—Extensive LGE measured by quantitative contrast enhanced CMR provides additional information for assessing SCD event risk among HCM patients, particularly patients otherwise judged to be at low risk."

http://circ.ahajournals.org/content/130/6/484.abstract 

BMJ - Fruit and vegetable consumption and mortality

"Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies"

"Conclusions This meta-analysis provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality."

http://www.bmj.com/content/349/bmj.g4490

NEJM - Spiroindolone KAE609 for Falciparum and Vivax Malaria

"Spiroindolone KAE609 for Falciparum and Vivax Malaria"
"CONCLUSIONS

KAE609, at dose of 30 mg daily for 3 days, cleared parasitemia rapidly in adults with uncomplicated P. vivax or P. falciparum malaria. (Funded by Novartis and others; ClinicalTrials.gov number,NCT01524341.)" 

http://www.nejm.org/doi/full/10.1056/NEJMoa1315860

JAMA - Male Circumcision in Kenya

"Effect of Providing Conditional Economic Compensation on Uptake of Voluntary Medical Male Circumcision in Kenya"

"Conclusions and Relevance  Among uncircumcised men in Kenya, compensation in the form of food vouchers worth approximately US $8.75 or US $15.00, compared with lesser or no compensation, resulted in a modest increase in the prevalence of circumcision after 2 months. The effects of more intense promotion or longer implementation require further investigation. 
http://jama.jamanetwork.com/article.aspx?articleid=1890398 

Weekly Guideline - IHD Update

"2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis  and Management of Patients With Stable Ischemic Heart Disease"

http://circ.ahajournals.org/content/early/2014/07/25/CIR.0000000000000095.full.pdf+html