2015 ADA Diabetes Standards - Summary of Revisions

"Standards of Medical Care in Diabetes—2015: Summary of Revisions"

http://care.diabetesjournals.org/content/38/Supplement_1/S4.full

CIRC - Nitrate and Exercise Capacity in Heart Failure

"Effect of Inorganic Nitrate on Exercise Capacity in Heart Failure With Preserved Ejection Fraction"

"Conclusions—NO₃⁻ increased exercise capacity in heart failure with preserved ejection fraction by targeting peripheral abnormalities. Efficiency did not change as a result of parallel increases in total work and O_2. NO₃⁻ increased exercise vasodilatory and cardiac output reserves. NO₃⁻ also reduced arterial wave reflections, which are linked to left ventricular diastolic dysfunction and remodeling."  

http://circ.ahajournals.org/content/131/4/371.full

BMJ - Financial incentives for smoking cessation in pregnancy

"Financial incentives for smoking cessation in pregnancy: randomised controlled trial"

"Conclusion This phase II randomised controlled trial provides substantial evidence for the efficacy of incentives for smoking cessation in pregnancy; as this was only a single centre trial, incentives should now be tested in different types of pregnancy cessation services and in different parts of the United Kingdom."   

http://www.bmj.com/content/350/bmj.h134

NEJM - Death in Premature Infants

"Causes and Timing of Death in Extremely Premature Infants from 2000 through 2011"

"CONCLUSIONS

We found that from 2000 through 2011, overall mortality declined among extremely premature infants. Deaths related to pulmonary causes, immaturity, infection, and central nervous system injury decreased, while necrotizing enterocolitis–related deaths increased. (Funded by the National Institutes of Health.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1403489

JAMA - Pneumonia Hospitalization and CVD Risk

"Association Between Hospitalization for Pneumonia and Subsequent Risk of Cardiovascular Disease"

"Conclusions and Relevance  Hospitalization for pneumonia was associated with increased short-term and long-term risk of CVD, suggesting that pneumonia may be a risk factor for CVD."

http://jama.jamanetwork.com/article.aspx?articleid=2091304

Weekly Guideline - 2015 ADA Standards of Diabetic Care - Full

"Standards of Medical Care in Diabetes—2015"

http://care.diabetesjournals.org/content/38/Supplement_1

CIRC - Vit D Therapy in HTN

"Vitamin D Therapy in Individuals With Prehypertension or Hypertension The DAYLIGHT Trial"

"Conclusions—Vitamin D supplementation did not reduce blood pressure in individuals with prehypertension or stage I hypertension and vitamin D deficiency. Our findings suggest that the association between vitamin D status and elevated blood pressure noted in observational studies is not causal."   

http://circ.ahajournals.org/content/131/3/254.abstract  

BMJ - Troponin for Dx of MI in Women

"High sensitivity cardiac troponin and the under-diagnosis of myocardial infarction in women: prospective cohort study"  

"Conclusions
Although having little effect in men, a high sensitivity troponin assay with sex specific diagnostic thresholds may double the diagnosis of myocardial infarction in women and identify those at high risk of reinfarction and death. Whether use of sex specific diagnostic thresholds will improve outcomes and tackle inequalities in the treatment of women with suspected acute coronary syndrome requires urgent attention."   


http://www.bmj.com/content/350/bmj.g7873   

NEJM - Sodium Zirconium Cyclosilicate for Hyper-K+

"Sodium Zirconium Cyclosilicate in Hyperkalemia"

"CONCLUSIONS

Patients with hyperkalemia who received ZS-9, as compared with those who received placebo, had a significant reduction in potassium levels at 48 hours, with normokalemia maintained during 12 days of maintenance therapy. (Funded by ZS Pharma; ClinicalTrials.gov number, NCT01737697.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1411487?query=featured_home 

JAMA - Breast Cancer Stage and Survival

"Differences in Breast Cancer Stage at Diagnosis and Cancer-Specific Survival by Race and Ethnicity in the United States"

"Conclusions and Relevance  Among US women diagnosed with invasive breast cancer, the likelihood of diagnosis at an early stage, and survival after stage I diagnosis, varied by race and ethnicity. Much of the difference could be statistically accounted for by intrinsic biological differences such as lymph node metastasis, distant metastasis, and triple-negative behavior of tumors."


http://jama.jamanetwork.com/article.aspx?articleid=2089353 

Weekly Guideline - 2014 AHA "Approaches to Enhancing Radiation Safety in Cardiovascular Imaging"

2014 AHA "Approaches to Enhancing Radiation Safety in Cardiovascular Imaging"


http://circ.ahajournals.org/content/130/19/1730.full.pdf+html  

CIRC - Bleeding with Dabigatran or Warfarin A Fib

"Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated With Dabigatran or Warfarin for Nonvalvular Atrial Fibrillation"

"Conclusions—In general practice settings, dabigatran was associated with reduced risk of ischemic stroke, intracranial hemorrhage, and death and increased risk of major gastrointestinal hemorrhage compared with warfarin in elderly patients with nonvalvular atrial fibrillation. These associations were most pronounced in patients treated with dabigatran 150 mg twice daily, whereas the association of 75 mg twice daily with study outcomes was indistinguishable from warfarin except for a lower risk of intracranial hemorrhage with dabigatran."  

http://circ.ahajournals.org/content/131/2/157.abstract

BMJ - Blood Glucose and Pancreatic CA

"Blood glucose concentration and risk of pancreatic cancer: systematic review and dose-response meta-analysis"

"Conclusions Every 0.56 mmol/L increase in fasting blood glucose is associated with a 14% increase in the rate of pancreatic cancer. As prediabetes can be improved or even reversed through lifestyle changes, early detection of prediabetes coupled with lifestyle changes could represent a viable strategy to curb the increasing incidence of pancreatic cancer."


http://www.bmj.com/content/349/bmj.g7371 

NEJM - HER2-Positive Breast Cancer

"Adjuvant Paclitaxel and Trastuzumab for Node-Negative, HER2-Positive Breast Cancer"

"CONCLUSIONS

Among women with predominantly stage I HER2-positive breast cancer, treatment with adjuvant paclitaxel plus trastuzumab was associated with a risk of early recurrence of about 2%; 6% of patients withdrew from the study because of protocol-specified adverse events. (Funded by Genentech; ClinicalTrials.gov number, NCT00542451.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1406281?query=featured_home

JAMA - Bariatric Surgery and Survival

"Association Between Bariatric Surgery and Long-term Survival"

"Conclusions and Relevance  Among obese patients receiving care in the VA health system, those who underwent bariatric surgery compared with matched control patients who did not have surgery had lower all-cause mortality at 5 years and up to 10 years following the procedure. These results provide further evidence for the beneficial relationship between surgery and survival that has been demonstrated in younger, predominantly female populations."

http://jama.jamanetwork.com/article.aspx?articleid=2088854

Weekly Guideline - ESC 2014 PE

"2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism"


http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/acute-pulmonary-embolism.aspx

JACC - Bivalirudin vs Heparin for STEMI and PCI

"Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention"

"Conclusions  Despite increased acute stent thrombosis, primary PCI with bivalirudin improved 30-day net clinical outcomes, with significant reductions in major bleeding, thrombocytopenia, and transfusions compared with heparin ± GPI, results that were consistent with evolution in PCI technique and pharmacotherapy. (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction [HORIZONS-AMI]; NCT00433966) (European Ambulance Acute Coronary Syndrome Angiography [EUROMAX]; NCT01087723)


http://content.onlinejacc.org/article.aspx?articleID=2087926

Lancet

"Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study"

"Interpretation

Our data indicate that CME surgery is associated with better disease-free survival than is conventional colon cancer resection for patients with stage I–III colon adenocarcinoma. Implementation of CME surgery might improve outcomes for patients with colon cancer."

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(14)71168-4/abstract

NEJM - Leptin and Early-Onset Obesity

"Biologically Inactive Leptin and Early-Onset Extreme Obesity"

"Mutations in the gene encoding leptin (LEP) typically lead to an absence of circulating leptin and to extreme obesity. We describe a 2-year-old boy with early-onset extreme obesity due to a novel homozygous transversion (c.298G→T) in LEP, leading to a change from aspartic acid to tyrosine at amino acid position 100 (p.D100Y) and high immunoreactive levels of leptin. Overexpression studies confirmed that the mutant protein is secreted but neither binds to nor activates the leptin receptor. The mutant protein failed to reduce food intake and body weight in leptin-deficient ob/ob mice. Treatment of the patient with recombinant human leptin (metreleptin) rapidly normalized eating behavior and resulted in weight loss."


http://www.nejm.org/doi/full/10.1056/NEJMoa1406653?query=featured_home

JAMA - Micronutrient vs Iron–Folic Acid Supplements on Infant Mortality

"Effect of Maternal Multiple Micronutrient vs Iron–Folic Acid Supplementation on Infant Mortality and Adverse Birth Outcomes in Rural Bangladesh"

"Conclusions and Relevance  In Bangladesh, antenatal multiple micronutrient compared with iron–folic acid supplementation did not reduce all-cause infant mortality to age 6 months but resulted in a non–statistically significant reduction in stillbirths and significant reductions in preterm births and low birth weight."

http://jama.jamanetwork.com/article.aspx?articleid=2084892

Weekly Guideline - 2014 AHA Stroke and Swelling

"AHA/ASA Scientific Statement Recommendations for the Management of Cerebral and Cerebellar Infarction With Swelling"


http://stroke.ahajournals.org/content/45/4/1222

JACC - CABG v Stent for Prox LAD

"Coronary Artery Bypass Graft Surgery Versus Drug-Eluting Stents for Patients With Isolated Proximal Left Anterior Descending Disease"  

"Conclusions  Despite the higher rating in current guidelines of CABG (Class IIa vs. Class IIb) for patients with isolated PLAD disease, there were no differences in mortality or mortality, MI, and/or stroke, although CABG patients had significantly lower repeat revascularization rates."  


http://content.onlinejacc.org/article.aspx?articleID=2085765