CIRC - "Effects of Ranolazine on Angina and Quality of Life After Percutaneous Coronary Intervention With Incomplete Revascularization"

 "Effects of Ranolazine on Angina and Quality of Life After Percutaneous Coronary Intervention With Incomplete Revascularization"

"Conclusions—Despite ICR following PCI, there was no incremental benefit in angina or QOL measures by adding ranolazine in this angiographically-identified population. These measures markedly improved within 1 month of PCI and persisted up to 1 year in both treatment arms."

http://circ.ahajournals.org/content/133/1/39.full

BMJ - "Long term trends in prevalence of neural tube defects in Europe: population based study"

"Long term trends in prevalence of neural tube defects in Europe: population based study"

"What this study adds In the absence of mandatory fortification, the prevalence of NTD has not decreased in Europe despite longstanding recommendations aimed at promoting peri-conceptional folic acid supplementation and existence of voluntary folic acid fortification."

http://www.bmj.com/content/351/bmj.h5949

NEJM - "Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection"

"Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection"

"CONCLUSIONS

In the context of a closed population receiving directly observed treatment for urogenital chlamydia infection, the efficacy of azithromycin was 97%, and the efficacy of doxycycline was 100%. The noninferiority of azithromycin was not established in this setting. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT00980148.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1502599 

JAMA - "Ovarian Suppression With Triptorelin During Adjuvant Breast Cancer Chemotherapy and Long-term Ovarian Function, Pregnancies, and Disease-Free Survival"

"Ovarian Suppression With Triptorelin During Adjuvant Breast Cancer Chemotherapy and Long-term Ovarian Function, Pregnancies, and Disease-Free Survival"

"Conclusions and Relevance  Among premenopausal women with either hormone receptor–positive or hormone receptor–negative breast cancer, concurrent administration of triptorelin and chemotherapy, compared with chemotherapy alone, was associated with higher long-term probability of ovarian function recovery, without a statistically significant difference in pregnancy rate. There was no statistically significant difference in DFS for women assigned to triptorelin and those assigned to chemotherapy alone, although study power was limited."


http://jama.jamanetwork.com/article.aspx?articleid=2478203

Weekly Guideline - "AHA Scientific Statement Cardiac Arrest in Pregnancy"

"AHA Scientific Statement Cardiac Arrest in Pregnancy"


http://circ.ahajournals.org/content/132/18/1747

JACC - "Bivalirudin Versus Heparin Anticoagulation in Transcatheter Aortic Valve Replacement"

"Bivalirudin Versus Heparin Anticoagulation in Transcatheter Aortic Valve Replacement"

"Conclusions  In this randomized trial of TAVR procedural pharmacotherapy, bivalirudin did not reduce rates of major bleeding at 48 h or net adverse cardiovascular events within 30 days compared with heparin. Although superiority was not shown, the noninferiority hypothesis was met with respect to the latter factor. Given the lower cost, heparin should remain the standard of care, and bivalirudin can be an alternative anticoagulant option in patients unable to receive heparin in TAVR"

http://content.onlinejacc.org/article.aspx?articleID=2461781 

BMJ - "Association between day of delivery and obstetric outcomes: observational study"

"Association between day of delivery and obstetric outcomes: observational study"

"What this study adds This study provides an evaluation of the “weekend effect” in obstetric care, covering a range of outcomes. The results would suggest approximately 770 perinatal deaths and 470 maternal infections per year above what might be expected if performance was consistent across women admitted, and babies born, on different days of the week."

http://www.bmj.com/content/351/bmj.h5774 

NEJM - "Hypothermia for Intracranial Hypertension after Traumatic Brain Injury"

"Hypothermia for Intracranial Hypertension after Traumatic Brain Injury"

"CONCLUSIONS

In patients with an intracranial pressure of more than 20 mm Hg after traumatic brain injury, therapeutic hypothermia plus standard care to reduce intracranial pressure did not result in outcomes better than those with standard care alone. (Funded by the National Institute for Health Research Health Technology Assessment program; Current Controlled Trials number, ISRCTN34555414.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1507581?query=featured_home

JAMA - "Effect of Transfusion of Red Blood Cells With Longer vs Shorter Storage Duration on Elevated Blood Lactate Levels in Children With Severe Anemia"

"Effect of Transfusion of Red Blood Cells With Longer vs Shorter Storage Duration on Elevated Blood Lactate Levels in Children With Severe Anemia"

"Conclusions and Relevance  Among children with lactic acidosis due to severe anemia, transfusion of longer-storage compared with shorter-storage RBC units did not result in inferior reduction of elevated blood lactate levels. These findings have relevance regarding the efficacy of stored RBC transfusion for patients with critical tissue hypoxia and lactic acidosis due to anemia."

http://jama.jamanetwork.com/article.aspx?articleid=2472941

Weekly Guideline -"2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction "

"2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction:
An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction "


http://circ.ahajournals.org/content/early/2015/10/20/CIR.0000000000000336

JACC - "Initial Surgical Versus Conservative Strategies in Patients With Asymptomatic Severe Aortic Stenosis"

"Initial Surgical Versus Conservative Strategies in Patients With Asymptomatic Severe Aortic Stenosis"

"Conclusions  The long-term outcome of asymptomatic patients with severe AS was dismal when managed conservatively in this real-world analysis and might be substantially improved by an initial AVR strategy. (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis Registry; UMIN000012140)"

http://content.onlinejacc.org/article.aspx?articleID=2457337

BMJ - "Association between use of warfarin with common sulfonylureas and serious hypoglycemic events: retrospective cohort analysis"

 "Association between use of warfarin with common sulfonylureas and serious hypoglycemic events: retrospective cohort analysis"

"What this study adds A substantial positive association was seen between use of warfarin with glipizide/glimepiride and hospital admission/emergency department visits for hypoglycemia and related diagnoses, particularly in patients starting warfarin. The findings suggest the possibility of a significant drug interaction between these medications."

http://www.bmj.com/content/351/bmj.h6223 

NEJM - "Endobronchial Valves for Emphysema without Interlobar Collateral Ventilation"

"Endobronchial Valves for Emphysema without Interlobar Collateral Ventilation"

"CONCLUSIONS

Endobronchial-valve treatment significantly improved pulmonary function and exercise capacity in patients with severe emphysema characterized by an absence of interlobar collateral ventilation. (Funded by the Netherlands Organization for Health Research and Development and the University Medical Center Groningen; Netherlands Trial Register number, NTR2876.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1507807?query=featured_home

JAMA - "Comparative Risk of Anaphylactic Reactions Associated With Intravenous Iron Products"

"Comparative Risk of Anaphylactic Reactions Associated With Intravenous Iron Products"

"Conclusions and Relevance  Among patients in the US Medicare nondialysis population with first exposure to IV iron, the risk of anaphylaxis was highest for iron dextran and lowest for iron sucrose.

http://jama.jamanetwork.com/article.aspx?articleid=2470447

Weekly Guideline - "2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care"

http://content.onlinejacc.org/article.aspx?articleid=2463473

CIRC - "Extracorporeal-Cardiopulmonary Resuscitation (E-CPR) During Pediatric In-Hospital Cardiopulmonary Arrest is Associated with Improved Survival to Discharge: A Report from the American Heart Association's Get With the Guidelines® - Resuscitation Registry"

"Extracorporeal-Cardiopulmonary Resuscitation (E-CPR) During Pediatric In-Hospital Cardiopulmonary Arrest is Associated with Improved Survival to Discharge: A Report from the American Heart Association's Get With the Guidelines® - Resuscitation Registry"

"Conclusions—For children with in-hospital CPR ≥ 10 minutes duration, E-CPR was associated with improved survival to hospital discharge and survival with favorable neurologic outcome when compared to C-CPR."

http://circ.ahajournals.org/content/early/2015/12/03/CIRCULATIONAHA.115.016082.abstract

BMJ - "Safety of live attenuated influenza vaccine in young people with egg allergy: multicentre prospective cohort study"

"Safety of live attenuated influenza vaccine in young people with egg allergy: multicentre prospective cohort study"

"Study answer and limitations No systemic allergic reactions occurred (upper 95% confidence interval for population 0.47% and in participants with anaphylaxis to egg 1.36%). Nine participants (1.2%, 95% CI 0.5% to 2.2%) experienced mild symptoms, potentially consistent with a local, IgE mediated allergic reaction. Delayed events potentially related to the vaccine were reported in 221 participants. 62 participants (8.1%, 95% CI for population 6.3% to 10.3%) experienced lower respiratory tract symptoms within 72 hours, including 29 with parent reported wheeze. No participants were admitted to hospital. No increase in lower respiratory tract symptoms occurred in the four weeks after vaccination (assessed with asthma control test). The study cohort may represent young people with more severe allergy requiring specialist input, since they were recruited from secondary and tertiary allergy centres.

What this study adds LAIV is associated with a low risk of systemic allergic reactions in young people with egg allergy. The vaccine seems to be well tolerated in those with well controlled asthma or recurrent wheeze."

http://www.bmj.com/content/351/bmj.h6291

NEJM - "Isosorbide Mononitrate in Heart Failure with Preserved Ejection Fraction"

"Isosorbide Mononitrate in Heart Failure with Preserved Ejection Fraction"

"CONCLUSIONS

Patients with heart failure and a preserved ejection fraction who received isosorbide mononitrate were less active and did not have better quality of life or submaximal exercise capacity than did patients who received placebo. (Funded by the National Heart, Lung, and Blood Institute; ClinicalTrials.gov number, NCT02053493.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1510774?query=featured_home

JAMA - "Effect of Vericiguat, a Soluble Guanylate Cyclase Stimulator, on Natriuretic Peptide Levels in Patients With Worsening Chronic Heart Failure and Reduced Ejection Fraction"

"Effect of Vericiguat, a Soluble Guanylate Cyclase Stimulator, on Natriuretic Peptide Levels in Patients With Worsening Chronic Heart Failure and Reduced Ejection Fraction"

"Conclusions and Relevance  Among patients with worsening chronic HF and reduced LVEF, compared with placebo, vericiguat did not have a statistically significant effect on change in NT-proBNP level at 12 weeks but was well-tolerated. Further clinical trials of vericiguat based on the dose-response relationship in this study are needed to determine the potential role of this drug for patients with worsening chronic HF.

Trial Registration  clinicaltrials.gov Identifier: NCT01951625"

http://jama.jamanetwork.com/article.aspx?articleid=2469195

Weekly Guideline - "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 7: Adult Advanced Cardiovascular Life Support"

"2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Part 7: Adult Advanced Cardiovascular Life Support"

http://circ.ahajournals.org/content/132/18_suppl_2/S444.full

CIRC - "Association of Fruit and Vegetable Consumption During Early Adulthood With the Prevalence of Coronary Artery Calcium After 20 Years of Follow-Up"

"Association of Fruit and Vegetable Consumption During Early Adulthood With the Prevalence of Coronary Artery Calcium After 20 Years of Follow-Up"

"Conclusions—In this longitudinal cohort study, higher intake of F/V during young adulthood was associated with lower odds of prevalent coronary artery calcium after 20 years of follow-up. Our results reinforce the importance of establishing a high intake of F/V as part of a healthy dietary pattern early in life."

http://circ.ahajournals.org/content/132/21/1990.full

BMJ - "Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents: Cochrane systematic review with meta-analyses and trial sequential analyses of randomised clinical trials"

"Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents: 
Cochrane systematic review with meta-analyses and trial sequential analyses of randomised clinical trials"

"What this study adds The results suggest that among children and adolescents with a diagnosis of ADHD, methylphenidate may improve teacher reported symptoms of ADHD and general behaviour and parent reported quality of life. However, given the risk of bias in the included studies, and the very low quality of outcomes, the magnitude of the effects is uncertain. Methylphenidate is associated with an increased risk of non-serious but not serious adverse events."

http://www.bmj.com/content/351/bmj.h5203 

NEJM - "A Randomized Trial of Intensive versus Standard Blood-Pressure Control"

"A Randomized Trial of Intensive versus Standard Blood-Pressure Control"

"CONCLUSIONS

Among patients at high risk for cardiovascular events but without diabetes, targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, resulted in lower rates of fatal and nonfatal major cardiovascular events and death from any cause, although significantly higher rates of some adverse events were observed in the intensive-treatment group. (Funded by the National Institutes of Health; ClinicalTrials.gov number,NCT01206062.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1511939

JAMA - "Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy"

"Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy"

"Conclusions and Relevance  Among eyes with proliferative diabetic retinopathy, treatment with ranibizumab resulted in visual acuity that was noninferior to (not worse than) PRP treatment at 2 years. Although longer-term follow-up is needed, ranibizumab may be a reasonable treatment alternative, at least through 2 years, for patients with proliferative diabetic retinopathy."  

http://jama.jamanetwork.com/article.aspx?articleid=2469891

Weekly Guideline - "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 6: Alternative Techniques and Ancillary Devices for Cardiopulmonary Resuscitation"

"2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Part 6: Alternative Techniques and Ancillary Devices for Cardiopulmonary Resuscitation"

http://circ.ahajournals.org/content/132/18_suppl_2/S436.full

CIRC - "Efficacy and Safety of Vorapaxar With and Without a Thienopyridine for Secondary Prevention in Patients With Previous Myocardial Infarction and No History of Stroke or Transient Ischemic Attack"

"Efficacy and Safety of Vorapaxar With and Without a Thienopyridine for Secondary Prevention in Patients With Previous Myocardial Infarction and No History of Stroke or Transient Ischemic Attack"

"Conclusions—Vorapaxar reduced cardiovascular death, MI, or stroke in stable patients with a history of previous MI, whether treated concomitantly with a thienopyridine or not. The relative risk of moderate or severe bleeding was similarly increased irrespective of thienopyridine use."

http://circ.ahajournals.org/content/132/20/1871.abstract

BMJ - "Development and validation of risk prediction equations to estimate future risk of blindness and lower limb amputation in patients with diabetes: cohort study"

 "Development and validation of risk prediction equations to estimate future risk of blindness and lower limb amputation in patients with diabetes: cohort study"

"What this study adds Patients with type 1 or type 2 diabetes are at increased risk of blindness and amputation but generally do not have accurate assessments of the magnitude of their individual risks. The new algorithms calculate the absolute risk of developing these complications over a 10 year period in patients with diabetes, taking account of their individual risk factors."

http://www.bmj.com/content/351/bmj.h5441 

NEJM - "Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk"

"Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk"

"CONCLUSIONS

Among patients at high risk for bleeding who underwent PCI, a polymer-free umirolimus-coated stent was superior to a bare-metal stent with respect to the primary safety and efficacy end points when used with a 1-month course of dual antiplatelet therapy. (Funded by Biosensors Europe; LEADERS FREE ClinicalTrials.gov number,NCT01623180.)" 

http://www.nejm.org/doi/full/10.1056/NEJMoa1503943

JAMA - "Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations"

"Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations"

"Conclusions and Relevance  Both the incidence of early-stage prostate cancer and rates of PSA screening have declined and coincide with 2012 USPSTF recommendation to omit PSA screening from routine primary care for men. Longer follow-up is needed to see whether these decreases are associated with trends in mortality."

http://jama.jamanetwork.com/article.aspx?articleid=2470446

Weekly Guideline - "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality"

"2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality"

http://circ.ahajournals.org/content/132/18_suppl_2/S414.full

CIRC - "Relation of Smoking With Total Mortality and Cardiovascular Events Among Patients With Diabetes Mellitus"

"Relation of Smoking With Total Mortality and Cardiovascular Events Among Patients With Diabetes Mellitus"

"Conclusions—Active smoking is associated with significantly increased risks of total mortality and cardiovascular events among diabetic patients, whereas smoking cessation is associated with reduced risks in comparison with current smoking. The findings provide strong evidence for the recommendation of quitting smoking among diabetic patients."

http://circ.ahajournals.org/content/132/19/1795.full

BMJ - "Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial"

"Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial"

"What this study adds Supported cCBT does not substantially improve depression outcomes compared with usual GP care alone. In this study, neither a commercially available nor free to use computerised CBT intervention was superior to usual GP care."

http://www.bmj.com/content/351/bmj.h5627 

NEJM - "Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease"

"Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease"

"CONCLUSIONS

During an extended-follow-up of up to 15 years, we did not find a difference in survival between an initial strategy of PCI plus medical therapy and medical therapy alone in patients with stable ischemic heart disease. (Funded by the VA Cooperative Studies Program and others; COURAGE ClinicalTrials.gov number, NCT00007657.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1505532

JAMA - "Endovascular Thrombectomy for Acute Ischemic Stroke A Meta-analysis"

"Endovascular Thrombectomy for Acute Ischemic Stroke A Meta-analysis"

"Conclusions and Relevance  Among patients with acute ischemic stroke, endovascular therapy with mechanical thrombectomy vs standard medical care with tPA was associated with improved functional outcomes and higher rates of angiographic revascularization, but no significant difference in symptomatic intracranial hemorrhage or all-cause mortality at 90 days."   

http://jama.jamanetwork.com/article.aspx?articleid=2467553

Weekly Guideline: "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 4: Systems of Care and Continuous Quality Improvement"

"2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 4: Systems of Care and Continuous Quality Improvement"

http://circ.ahajournals.org/content/132/18_suppl_2/S397.full

CIRC - "Dose–Response Relationship Between Physical Activity and Risk of Heart Failure A Meta-Analysis"

"Dose–Response Relationship Between Physical Activity and Risk of Heart Failure A Meta-Analysis"

"Conclusions—There is an inverse dose–response relationship between PA and HF risk. Doses of PA in excess of the guideline-recommended minimum PA levels may be required for more substantial reductions in HF risk."

http://circ.ahajournals.org/content/132/19/1786.full

BMJ - "Physician spending and subsequent risk of malpractice claims: observational study"

"Physician spending and subsequent risk of malpractice claims: observational study"

"What this study adds Within specialty and after adjustment for patient characteristics, higher resource use by physicians is associated with fewer malpractice claims."

http://www.bmj.com/content/351/bmj.h5516-0 

NEJM - "Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma"

 "Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma"

"CONCLUSIONS

Among patients with previously treated advanced renal-cell carcinoma, overall survival was longer and fewer grade 3 or 4 adverse events occurred with nivolumab than with everolimus. (Funded by Bristol-Myers Squibb; CheckMate 025 ClinicalTrials.gov number,NCT01668784.)"   

http://www.nejm.org/doi/full/10.1056/NEJMoa1510665

JAMA "Trends in Prescription Drug Use Among Adults in the United States From 1999-2012"

"Trends in Prescription Drug Use Among Adults in the United States From 1999-2012"

"Conclusions and Relevance  In this nationally representative survey, significant increases in overall prescription drug use and polypharmacy were observed. These increases persisted after accounting for changes in the age distribution of the population. The prevalence of prescription drug use increased in the majority of, but not all, drug classes."
http://jama.jamanetwork.com/article.aspx?articleid=2467552

Weekly Guideline - "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 3: Ethical Issues"

"2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 3: Ethical Issues"

http://circ.ahajournals.org/content/132/18_suppl_2/S383.full

CIRC - "Use of the Wearable Cardioverter Defibrillator in High-Risk Cardiac Patients"

CIRC - "Use of the Wearable Cardioverter Defibrillator in High-Risk Cardiac Patients"

"Conclusions—The WEARIT-II Registry demonstrates a high rate of sustained ventricular tachyarrhythmias at 3 months in at-risk patients who are not eligible for an implantable cardioverter defibrillator, and suggests that the WCD can be safely used to protect patients during this period of risk assessment."

http://circ.ahajournals.org/content/132/17/1613.abstract 

BMJ - "Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomised clinical trial (MDI Liraglutide trial)"

BMJ - "Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomised clinical trial (MDI Liraglutide trial)"

"What this study adds Adding liraglutide to multiple daily insulin injections in people with type 2 diabetes improves glycaemic control without an increased risk of hypoglycaemia, reduces body weight, and enables patients to lower their insulin doses."

http://www.bmj.com/content/351/bmj.h5364 

NEJM - "A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention"

NEJM  - "A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention"

"CONCLUSIONS

Oral nicotinamide was safe and effective in reducing the rates of new nonmelanoma skin cancers and actinic keratoses in high-risk patients. (Funded by the National Health and Medical Research Council; ONTRAC Australian New Zealand Clinical Trials Registry number, ACTRN12612000625875.)"  

http://www.nejm.org/doi/full/10.1056/NEJMoa1506197 

JAMA - "Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit The SPLIT Randomized Clinical Trial"

JAMA - "Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit The SPLIT Randomized Clinical Trial"

"Conclusions and Relevance  Among patients receiving crystalloid fluid therapy in the ICU, use of a buffered crystalloid compared with saline did not reduce the risk of AKI. Further large randomized clinical trials are needed to assess efficacy in higher-risk populations and to measure clinical outcomes such as mortality."
http://jama.jamanetwork.com/article.aspx?articleid=2454911 

Weekly Guideline - "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 2: Evidence Evaluation and Management of Conflicts of Interest"

"2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 2: Evidence Evaluation and Management of Conflicts of Interest"

http://circ.ahajournals.org/content/132/18_suppl_2/S368.full

CIRC - "Rate-Control Treatment and Mortality in Atrial Fibrillation"

"Rate-Control Treatment and Mortality in Atrial Fibrillation"

"Conclusions—In this nationwide atrial fibrillation cohort, the risk of mortality was lower for patients receiving rate-control treatment with β-blockers or calcium channel blockers, and the use of β-blockers was associated with the largest risk reduction. Digoxin use was associated with greater mortality. Prospective, randomized trials are necessary to confirm these findings."
http://circ.ahajournals.org/content/132/17/1604.abstract

BMJ - "Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)"

 "Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)"

"What this study adds The study provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality. Although high dose rate exposures are thought to be more dangerous than low dose rate exposures, the risk per unit of radiation dose for cancer among radiation workers was similar to estimates derived from studies of Japanese atomic bomb survivors. Quantifying the cancer risks associated with protracted radiation exposures can help strengthen the foundation for radiation protection standards."

http://www.bmj.com/content/351/bmj.h5359

NEJM - "A Randomized, Controlled Trial of Total Knee Replacement"

NEJM - "A Randomized, Controlled Trial of Total Knee Replacement"

"CONCLUSIONS

In patients with knee osteoarthritis who were eligible for unilateral total knee replacement, treatment with total knee replacement followed by nonsurgical treatment resulted in greater pain relief and functional improvement after 12 months than did nonsurgical treatment alone. However, total knee replacement was associated with a higher number of serious adverse events than was nonsurgical treatment, and most patients who were assigned to receive nonsurgical treatment alone did not undergo total knee replacement before the 12-month follow-up. (Funded by the Obel Family Foundation and others; MEDIC ClinicalTrials.gov number, NCT01410409.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1505467

JAMA - (REVIEW) "Evaluation and Treatment of Pericarditis A Systematic Review"

JAMA - (REVIEW)  "Evaluation and Treatment of Pericarditis A Systematic Review"

"Findings  The etiology of pericarditis may be infectious (eg, viral and bacterial) or noninfectious (eg, systemic inflammatory diseases, cancer, and post–cardiac injury syndromes). Tuberculosis is a major cause of pericarditis in developing countries but accounts for less than 5% of cases in developed countries, where idiopathic, presumed viral causes are responsible for 80% to 90% of cases. The diagnosis is based on clinical criteria including chest pain, a pericardial rub, electrocardiographic changes, and pericardial effusion. Certain features at presentation (temperature >38°C [>100.4°F], subacute course, large effusion or tamponade, and failure of nonsteroidal anti-inflammatory drug [NSAID] treatment) indicate a poorer prognosis and identify patients requiring hospital admission. The most common treatment for idiopathic and viral pericarditis in North America and Europe is NSAID therapy. Adjunctive colchicine can ameliorate the initial episode and is associated with approximately 50% lower recurrence rates. Corticosteroids are a second-line therapy for those who do not respond, are intolerant, or have contraindications to NSAIDs and colchicine. Recurrences may occur in 30% of patients without preventive therapy.

Conclusions and Relevance  Pericarditis is the most common form of pericardial disease worldwide and may recur in as many as one-third of patients who present with idiopathic or viral pericarditis. Appropriate triage and treatment with NSAIDs may reduce readmission rates for pericarditis. Treatment with colchicine can reduce recurrence rates."

http://jama.jamanetwork.com/article.aspx?articleid=2456172

Weekly Guideline "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care"

 "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care"

"Part 1: Executive Summary"

http://circ.ahajournals.org/content/132/18_suppl_2/S315.full

CIRC - "Prognostic Value of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Cardiac Amyloidosis"

CIRC - "Prognostic Value of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Cardiac Amyloidosis"

"Conclusions—There is a continuum of cardiac involvement in systemic AL and ATTR amyloidosis. Transmural LGE is determined reliably by PSIR and represents advanced cardiac amyloidosis. The PSIR technique provides incremental information on outcome even after adjustment for known prognostic factors."

http://circ.ahajournals.org/content/132/16/1570.full 

BMJ - "Calcium intake and risk of fracture: systematic review"

BMJ - "Calcium intake and risk of fracture: systematic review"

"Conclusions Dietary calcium intake is not associated with risk of fracture, and there is no clinical trial evidence that increasing calcium intake from dietary sources prevents fractures. Evidence that calcium supplements prevent fractures is weak and inconsistent."

http://www.bmj.com/content/351/bmj.h4580 

NEJM - "A Trial of Calcium and Vitamin D for the Prevention of Colorectal Adenomas"

NEJM - "A Trial of Calcium and Vitamin D for the Prevention of Colorectal Adenomas"

"CONCLUSIONS

Daily supplementation with vitamin D3 (1000 IU), calcium (1200 mg), or both after removal of colorectal adenomas did not significantly reduce the risk of recurrent colorectal adenomas over a period of 3 to 5 years. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT00153816.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1500409

JAMA - "Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain A Randomized Clinical Trial"

JAMA - "Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain A Randomized Clinical Trial"

"Conclusions and Relevance  Among adults with recent-onset LBP, early physical therapy resulted in statistically significant improvement in disability, but the improvement was modest and did not achieve the minimum clinically important difference compared with usual care."

http://jama.jamanetwork.com/article.aspx?articleid=2456165

Weekly Guideline - 2015 AHA "Infective Endocarditis in Childhood: 2015 Update"

"AHA Scientific Statement
Infective Endocarditis in Childhood: 2015 Update"

http://circ.ahajournals.org/content/132/15/1487

CIRC - "Cryoballoon Versus Open Irrigated Radiofrequency Ablation in Patients With Paroxysmal Atrial Fibrillation"

"Cryoballoon Versus Open Irrigated Radiofrequency Ablation in Patients With Paroxysmal Atrial Fibrillation"

"Conclusion—This large, prospective, randomized, controlled study demonstrates noninferiority of CB ablation versus RF ablation for treating patients with paroxysmal atrial fibrillation."  

http://circ.ahajournals.org/content/132/14/1311.full

BMJ - "Frequency of discrepancies in retracted clinical trial reports versus unretracted reports: blinded case-control study"

"Frequency of discrepancies in retracted clinical trial reports versus unretracted reports: blinded case-control study"

"Conclusions Discrepancies in published trial reports should no longer be assumed to be unimportant. Scientists, blinded to retraction status and with no specialist skill in the field, identify significantly more discrepancies in retracted than unretracted reports of clinical trials. Discrepancies could be an early and accessible signal of unreliability in clinical trial reports."

http://www.bmj.com/content/351/bmj.h4708 

NEJM - "Calcium intake and bone mineral density: systematic review and meta-analysis"

"Calcium intake and bone mineral density: systematic review and meta-analysis"

"Conclusions Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD, which are unlikely to lead to a clinically significant reduction in risk of fracture."

http://www.bmj.com/content/351/bmj.h4183 

JAMA - "Rehabilitation After Immobilization for Ankle Fracture The EXACT Randomized Clinical Trial"

"Rehabilitation After Immobilization for Ankle Fracture The EXACT Randomized Clinical Trial"

"Conclusions and Relevance  A supervised exercise program and advice did not confer additional benefits in activity limitation or quality of life compared with advice alone for patients with isolated and uncomplicated ankle fracture. These findings do not support the routine use of supervised exercise programs after removal of immobilization for patients with isolated and uncomplicated ankle fracture."

http://jama.jamanetwork.com/article.aspx?articleid=2449186

Weekly Guideline - 2015 AHA Endocarditis

"AHA Scientific Statement Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications"

http://circ.ahajournals.org/content/early/2015/09/15/CIR.0000000000000296

CIRC - "How Does Cardiovascular Disease First Present in Women and Men?"

"How Does Cardiovascular Disease First Present in Women and Men?
Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1 937 360 People"

http://circ.ahajournals.org/content/132/14/1320.full

BMJ - "Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis"

"Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis"

"Conclusion Comparison of different eradication treatments for H pylori showed that concomitant treatments, 10 or 14 days of probiotic supplemented triple treatment, 10 or 14 days of levofloxacin based triple treatment, 14 days of hybrid treatment, and 10 or 14 days of sequential treatment might be better alternatives for the eradication of H pylori."


http://www.bmj.com/content/351/bmj.h4052

NEJM - schemic Preconditioning for Heart Surgery

"A Multicenter Trial of Remote Ischemic Preconditioning for Heart Surgery"

"CONCLUSIONS

Upper-limb RIPC performed while patients were under propofol-induced anesthesia did not show a relevant benefit among patients undergoing elective cardiac surgery. (Funded by the German Research Foundation; RIPHeart ClinicalTrials.gov number,NCT01067703.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1413579?query=featured_home

JAMA - "Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia"

"Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia"

"Conclusions and Relevance  In this preliminary 10-week phase 2 randomized clinical trial of patients with probable Alzheimer disease, combination dextromethorphan-quinidine demonstrated clinically relevant efficacy for agitation and was generally well tolerated."

http://jama.jamanetwork.com/article.aspx?articleid=2442936

Weekly Guideline - "2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society"

"2015 ACC/AHA/HRS Guideline
for the Management of Adult Patients With Supraventricular Tachycardia:
A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society"

http://circ.ahajournals.org/content/early/2015/09/22/CIR.0000000000000311.full.pdf+html

CIRC - "Impact of Institutional Volume on Outcomes of Catheter Directed Thrombolysis in the Treatment of Acute Proximal Deep Vein Thrombosis A 6-Year US Experience (2005–2010)"

"Impact of Institutional Volume on Outcomes of Catheter Directed Thrombolysis in the Treatment of Acute Proximal Deep Vein Thrombosis A 6-Year US Experience (2005–2010)"

"Conclusions—In this observational study, we found that an increase in institutional volume of CDT was associated with lower in-hospital mortality and lower intracranial hemorrhage rates. Further studies are needed to assess whether standardization of CDT protocols across all institutions in the United States improves outcomes."  

http://circ.ahajournals.org/content/132/12/1127.abstract

BMJ - "Frequency of discrepancies in retracted clinical trial reports versus unretracted reports: blinded case-control study"

 "Frequency of discrepancies in retracted clinical trial reports versus unretracted reports: blinded case-control study"

"Conclusions Discrepancies in published trial reports should no longer be assumed to be unimportant. Scientists, blinded to retraction status and with no specialist skill in the field, identify significantly more discrepancies in retracted than unretracted reports of clinical trials. Discrepancies could be an early and accessible signal of unreliability in clinical trial reports."
http://www.bmj.com/content/351/bmj.h4708 

NEJM - "Intravascular Complications of Central Venous Catheterization by Insertion Site"

"Intravascular Complications of Central Venous Catheterization by Insertion Site"

"CONCLUSIONS

In this trial, subclavian-vein catheterization was associated with a lower risk of bloodstream infection and symptomatic thrombosis and a higher risk of pneumothorax than jugular-vein or femoral-vein catheterization. (Funded by the Hospital Program for Clinical Research, French Ministry of Health; ClinicalTrials.gov number,NCT01479153.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1500964?query=featured_home 

JAMA - "Alignment of Do-Not-Resuscitate Status With Patients’ Likelihood of Favorable Neurological Survival After In-Hospital Cardiac Arrest"

"Alignment of Do-Not-Resuscitate Status With Patients’ Likelihood of Favorable Neurological Survival After In-Hospital Cardiac Arrest"

"Conclusions and Relevance  Although DNR orders after in-hospital cardiac arrest were generally aligned with patients’ likelihood of favorable neurological survival, only one-third of patients with the worst prognosis had DNR orders. Patients with DNR orders had lower survival than those without DNR orders, including those with the best prognosis."

http://jama.jamanetwork.com/article.aspx?articleid=2442939 

Weekly Guideline - "Risk Stratification for Arrhythmic Events in Patients With Asymptomatic Pre-Excitation: A Systematic Review for the 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia"

"Risk Stratification for Arrhythmic Events in Patients With Asymptomatic Pre-Excitation: A Systematic Review for the 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia"

http://circ.ahajournals.org/content/early/2015/09/22/CIR.0000000000000309.full.pdf+html

CIRC - "Combination of the Immune Modulator Fingolimod With Alteplase in Acute Ischemic Stroke A Pilot Trial"

"Combination of the Immune Modulator Fingolimod With Alteplase in Acute Ischemic Stroke A Pilot Trial"

"Conclusions—In this pilot study, combination therapy of fingolimod and alteplase was well tolerated, attenuated reperfusion injury, and improved clinical outcomes in patients with acute ischemic stroke. These findings need to be tested in further clinical trials."

http://circ.ahajournals.org/content/132/12/1104.abstract 

BMJ - "Consumption of spicy foods and total and cause specific mortality: population based cohort study"

"Consumption of spicy foods and total and cause specific mortality: population based cohort study"

"Conclusion In this large prospective study, the habitual consumption of spicy foods was inversely associated with total and certain cause specific mortality, independent of other risk factors of death."

http://www.bmj.com/content/351/bmj.h3942 

NEJM - "Cyclosporine before PCI in Patients with Acute Myocardial Infarction"

"Cyclosporine before PCI in Patients with Acute Myocardial Infarction"

"CONCLUSIONS

In patients with anterior STEMI who had been referred for primary PCI, intravenous cyclosporine did not result in better clinical outcomes than those with placebo and did not prevent adverse left ventricular remodeling at 1 year. (Funded by the French Ministry of Health and NeuroVive Pharmaceutical; CIRCUS ClinicalTrials.gov number,NCT01502774; EudraCT number, 2009-013713-99.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1505489

JAMA - "Outcomes After Hip Fracture Surgery Compared With Elective Total Hip Replacement"

"Outcomes After Hip Fracture Surgery Compared With Elective Total Hip Replacement"

"Conclusions and Relevance  In a large cohort of French patients, hip fracture surgery compared with elective THR was associated with a higher risk of in-hospital mortality after adjustment for age, sex, and measured comorbidities. Further studies are needed to define the causes for these differences."

http://jama.jamanetwork.com/article.aspx?articleid=2441262

Weekly Guideline - 2015 AHA "Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations"

"Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations"

http://circ.ahajournals.org/content/132/5/457

CIRC - "Risk of Cardiomyopathy in Younger Persons With a Family History of Death from Cardiomyopathy"

"Risk of Cardiomyopathy in Younger Persons With a Family History of Death from Cardiomyopathy"

"Conclusions—A family history of premature cardiomyopathy death was associated with an increase in risk of cardiomyopathy ranging from 6- to 400-fold, depending on age, kinship, gender and number of affected family members. Our general population-based results support recommendations for presymptomatic screening of relatives of cardiomyopathy patients."
http://circ.ahajournals.org/content/132/11/1013.abstract

BMJ - "Effect of bivalent human papillomavirus vaccination on pregnancy outcomes: long term observational follow-up in the Costa Rica HPV Vaccine Trial"

"Effect of bivalent human papillomavirus vaccination on pregnancy outcomes: long term observational follow-up in the Costa Rica HPV Vaccine Trial"

"Conclusions
There is no evidence that bivalent HPV vaccination affects the risk of miscarriage for pregnancies conceived less than 90 days from vaccination. The increased risk estimate for miscarriages in a subgroup of pregnancies conceived any time after vaccination may be an artifact of a thorough set of sensitivity analyses, but since a genuine association cannot totally be ruled out, this signal should nevertheless be explored further in existing and future studies."

http://www.bmj.com/content/351/bmj.h4358 

NEJM - "Bivalirudin or Unfractionated Heparin in Acute Coronary Syndromes"

"Bivalirudin or Unfractionated Heparin in Acute Coronary Syndromes"

"RESULTS

The rate of major adverse cardiovascular events was not significantly lower with bivalirudin than with heparin (10.3% and 10.9%, respectively; relative risk, 0.94; 95% confidence interval [CI], 0.81 to 1.09; P=0.44), nor was the rate of net adverse clinical events (11.2% and 12.4%, respectively; relative risk, 0.89; 95% CI, 0.78 to 1.03; P=0.12). Post-PCI bivalirudin infusion, as compared with no infusion, did not significantly decrease the rate of urgent target-vessel revascularization, definite stent thrombosis, or net adverse clinical events (11.0% and 11.9%, respectively; relative risk, 0.91; 95% CI, 0.74 to 1.11; P=0.34)."

http://www.nejm.org/doi/full/10.1056/NEJMoa1507854

JAMA - "Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy"

"Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy"

"Conclusions and Relevance  Among patients with diabetic nephropathy, most receiving an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker, the addition of finerenone compared with placebo resulted in improvement in the urinary albumin-creatinine ratio. Further trials are needed to compare finerenone with other active medications."

http://jama.jamanetwork.com/article.aspx?articleid=2432163

Weekly Guideline - 2015 AHA / ADA "Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence"

"Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence"

http://circ.ahajournals.org/content/132/8/691

CIRC - "Utility of Nontraditional Risk Markers in Individuals Ineligible for Statin Therapy According to the 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines"

"Utility of Nontraditional Risk Markers in Individuals Ineligible for Statin Therapy According to the 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines"

"Conclusions—In this generally low-risk population sample, a large proportion of ASCVD events occurred among adults with a 10-year cPCE risk <7.5%. We found that the coronary artery calcium score, high-sensitivity C-reactive protein, family history of ASCVD, and ankle-brachial index recommendations by the American College of Cardiology/American Heart Association cholesterol guidelines (Class IIB) identify small subgroups of asymptomatic population with a 10-year cPCE risk <7.5% but with observed ASCVD event rates >7.5% who may warrant statin therapy considerations."

http://circ.ahajournals.org/content/132/10/916.full 

BMJ - "Diagnostic prediction models for suspected pulmonary embolism: systematic review and independent external validation in primary care"

"Diagnostic prediction models for suspected pulmonary embolism: systematic review and independent external validation in primary care"

"Conclusions
Five diagnostic pulmonary embolism prediction models that are easily applicable in primary care were validated in this setting. Whereas efficiency was comparable for all rules, the Wells rules gave the best performance in terms of lower failure rates."

http://www.bmj.com/content/351/bmj.h4438 

NEJM - "Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy"

"Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy"

"CONCLUSIONS

Patients with takotsubo cardiomyopathy had a higher prevalence of neurologic or psychiatric disorders than did those with an acute coronary syndrome. This condition represents an acute heart failure syndrome with substantial morbidity and mortality. (Funded by the Mach-Gaensslen Foundation and others; ClinicalTrials.gov number,NCT01947621.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1406761

JAMA - "Association Between Blood Pressure Control and Risk of Recurrent Intracerebral Hemorrhage"

"Association Between Blood Pressure Control and Risk of Recurrent Intracerebral Hemorrhage"

"Conclusions and Relevance  In this observational single-center cohort study of ICH survivors, reported BP measurements suggesting inadequate BP control during follow-up were associated with higher risk of both lobar and nonlobar ICH recurrence. These data suggest that randomized clinical trials are needed to address the benefits and risks of stricter BP control in ICH survivors."

http://jama.jamanetwork.com/article.aspx?articleid=2432164

Weekly Guideline - 2015 "NASPGHAN Guideline for the Diagnosis and Treatment of Celiac Disease in Children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition"

"Guideline for the Diagnosis and Treatment of Celiac Disease in Children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition"

http://www.naspghan.org/files/documents/pdfs/cme/jpgn/Management_of_Ingested_Foreign_Bodies_in_Children_.28.pdf

CIRC - "Extracranial Systemic Embolic Events in Patients With Nonvalvular Atrial Fibrillation"

"Extracranial Systemic Embolic Events in Patients With Nonvalvular Atrial Fibrillation"

"Conclusions—SEE constituted 11.5% of clinically recognized thromboembolic events in patients with atrial fibrillation and was associated with high morbidity and mortality. SEE mortality was comparable to that of ischemic stroke and varied by anatomic site."


http://circ.ahajournals.org/content/132/9/796.abstract 

BMJ - "Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data"

"Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data"

"Conclusions Digoxin is associated with a neutral effect on mortality in randomised trials and a lower rate of admissions to hospital across all study types. Regardless of statistical analysis, prescription biases limit the value of observational data."

http://www.bmj.com/content/351/bmj.h4451 

NEJM - "Screening for Occult Cancer in Unprovoked Venous Thromboembolism"

"Screening for Occult Cancer in Unprovoked Venous Thromboembolism"

"CONCLUSIONS

The prevalence of occult cancer was low among patients with a first unprovoked venous thromboembolism. Routine screening with CT of the abdomen and pelvis did not provide a clinically significant benefit. (Funded by the Heart and Stroke Foundation of Canada; SOME ClinicalTrials.gov number, NCT00773448.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1506623 

JAMA - "Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes The SCALE Diabetes Randomized Clinical Trial"

"Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes The SCALE Diabetes Randomized Clinical Trial"

"Conclusions and Relevance  Among overweight and obese participants with type 2 diabetes, use of subcutaneous liraglutide (3.0 mg) daily, compared with placebo, resulted in weight loss over 56 weeks. Further studies are needed to evaluate longer-term efficacy and safety."

http://jama.jamanetwork.com/article.aspx?articleid=2428956

Weekly Guideline - 2015 AAP "The Role of the Pediatrician in Primary Prevention of Obesity"

"The Role of the Pediatrician in Primary Prevention of Obesity"

http://pediatrics.aappublications.org/content/136/1/e275.abstract?rss=1

http://pediatrics.aappublications.org/content/136/1/e275.full.pdf+html (PDF)

CIRC - "Apixaban in Comparison With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease"

"Apixaban in Comparison With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease"

"Conclusions
—More than a quarter of the patients in ARISTOTLE with nonvalvular atrial fibrillation had moderate or severe valvular heart disease. There was no evidence of a differential effect of apixaban over warfarin in reducing stroke or systemic embolism, causing less bleeding, and reducing death in patients with and without valvular heart disease."

http://circ.ahajournals.org/content/132/8/624.abstract

BMJ - "Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis"

"Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis"

"Conclusion
Comparison of different eradication treatments for H pylori showed that concomitant treatments, 10 or 14 days of probiotic supplemented triple treatment, 10 or 14 days of levofloxacin based triple treatment, 14 days of hybrid treatment, and 10 or 14 days of sequential treatment might be better alternatives for the eradication of H pylori."

http://www.bmj.com/content/351/bmj.h4052 

NEJM - "Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes The SCALE Diabetes Randomized Clinical Trial"

"Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes The SCALE Diabetes Randomized Clinical Trial"

"CONCLUSIONS

The prevalence of occult cancer was low among patients with a first unprovoked venous thromboembolism. Routine screening with CT of the abdomen and pelvis did not provide a clinically significant benefit. (Funded by the Heart and Stroke Foundation of Canada; SOME ClinicalTrials.gov number, NCT00773448.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1506623

JAMA - "Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence"

"Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence"

"Conclusions and Relevance  Among high school students in Los Angeles, those who had ever used e-cigarettes at baseline compared with nonusers were more likely to report initiation of combustible tobacco use over the next year. Further research is needed to understand whether this association may be causal."

http://jama.jamanetwork.com/article.aspx?articleid=2428954

Weekly Guideline - 2012 "NASPGHAN Practice Guidelines: Diagnosis and Management of Hepatitis C Infection in Infants, Children, and Adolescents"

"NASPGHAN Practice Guidelines: Diagnosis and Management of Hepatitis C Infection in Infants, Children, and Adolescents"

http://www.naspghan.org//files/documents/pdfs/position-papers/NASPGHAN_Practice_Guidelines___Diagnosis_and.30[1].pdf

CIRC - "Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death"

"Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death"

"Conclusions—MVP is an underestimated cause of arrhythmic SCD, mostly in young adult women. Fibrosis of the papillary muscles and inferobasal left ventricular wall, suggesting a myocardial stretch by the prolapsing leaflet, is the structural hallmark and correlates with ventricular arrhythmias origin. Contrast-enhanced cardiac magnetic resonance may help to identify in vivo this concealed substrate for risk stratification."

http://circ.ahajournals.org/content/132/7/556.full

BMJ - "Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies"

"Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies"

"Conclusions Saturated fats are not associated with all cause mortality, CVD, CHD, ischemic stroke, or type 2 diabetes, but the evidence is heterogeneous with methodological limitations. Trans fats are associated with all cause mortality, total CHD, and CHD mortality, probably because of higher levels of intake of industrial trans fats than ruminant trans fats. Dietary guidelines must carefully consider the health effects of recommendations for alternative macronutrients to replace trans fats and saturated fats."

http://www.bmj.com/content/351/bmj.h3978 

NEJM - "Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma"

"Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma"

"CONCLUSIONS

Patients with relapsed or refractory multiple myeloma who received a combination of elotuzumab, lenalidomide, and dexamethasone had a significant relative reduction of 30% in the risk of disease progression or death. (Funded by Bristol-Myers Squibb and AbbVie Biotherapeutics; ELOQUENT-2 ClinicalTrials.gov number,NCT01239797.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1505654