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