Guidelines Feb 2016

Feb 26, 2016

"2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations 

Part 3: Adult Basic Life Support and Automated External Defibrillation"

http://circ.ahajournals.org/content/132/16_suppl_1/S51.full

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Feb 19, 2016

"2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations 
Part 2: Evidence Evaluation and Management of Conflicts of Interest"

http://circ.ahajournals.org/content/132/16_suppl_1/S40.full

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Feb 12, 2016

"2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations 
Part 1: Executive Summary"

http://circ.ahajournals.org/content/132/16_suppl_1/S2.full

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Feb 5, 2016
2015 AHA / ACC:
"Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: 

Task Force 5: 
Valvular Heart Disease: A Scientific Statement From the American Heart Association and American College of Cardiology"
http://circ.ahajournals.org/content/132/22/e292.full.pdf+html

Research Review - Feb 2016

JAMA

"Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents"

http://www.nejm.org/doi/full/10.1056/NEJMoa1506699?query=featured_home

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NEJM

NEJM - "National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training"   
http://www.nejm.org/doi/full/10.1056/NEJMoa1515724?query=featured_home

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BMJ / Lancet

Lancet - "Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial"   

http://lancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00723-0.pdf

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CIRC

CIRC - "Atrial Fibrillation Begets Heart Failure and Vice Versa"   
http://circ.ahajournals.org/content/133/5/484.abstract

Guidelines - Jan 2016

Jan 29, 2016

"AHA/ACC Scientific Statement 
Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: 
Task Force 4: Congenital Heart Disease"

http://circ.ahajournals.org/content/132/22/e281.full

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Jan 22, 2016
"AHA/ACC Scientific Statement 
Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: 
Task Force 3: Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Other Cardiomyopathies, and Myocarditis"

http://circ.ahajournals.org/content/132/22/e273.full

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Jan 15, 2016

"AHA/ACC Scientific Statement Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities:
 Task Force 2: Preparticipation Screening for Cardiovascular Disease in Competitive Athletes"

http://circ.ahajournals.org/content/132/22/e267.full

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Jan 8, 2016

"AHA/ACC Scientific Statement
Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities:
Task Force 1: Classification of Sports: Dynamic, Static, and Impact"

http://circ.ahajournals.org/content/132/22/e262

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Jan 1, 2016

"AHA Scientific Statement 
The Agenda for Familial Hypercholesterolemia"  

http://circ.ahajournals.org/content/132/22/2167

Research Review - Jan 2016

JAMA

"Autologous Hematopoetic Stem Cell Transplantation for Refractory Crohn Disease"
"Conclusions and Relevance  Among adult patients with refractory Crohn disease not amenable to surgery who had impaired quality of life, HSCT, compared with conventional therapy, did not result in a statistically significant improvement in sustained disease remission at 1 year and was associated with significant toxicity. These findings do not support the widespread use of HSCT for patients with refractory Crohn disease."
http://jama.jamanetwork.com/article.aspx?articleid=2475462

 "Frozen vs Fresh Fecal Microbiota Transplantation and Clinical Resolution of Diarrhea in Patients With Recurrent Clostridium difficile Infection" "Conclusions and Relevance Among adults with recurrent or refractory CDI, the use of frozen compared with fresh FMT did not result in worse proportion of clinical resolution of diarrhea. Given the potential advantages of providing frozen FMT, its use is a reasonable option in this setting." 
http://jama.jamanetwork.com/article.aspx?articleid=2481003   


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NEJM

"Sofosbuvir and Velpatasvir for HCV Genotype 1, 2, 4, 5, and 6 Infection"
"CONCLUSIONS

Once-daily sofosbuvir–velpatasvir for 12 weeks provided high rates of sustained virologic response among both previously treated and untreated patients infected with HCV genotype 1, 2, 4, 5, or 6, including those with compensated cirrhosis. (Funded by Gilead Sciences; ClinicalTrials.gov number, NCT02201940.)"   http://www.nejm.org/doi/full/10.1056/NEJMoa1512610?query=featured_home

REVIEW:
"Relationship between Nonmedical Prescription-Opioid Use and Heroin Use"
 "The nonmedical use of prescription opioids is a major public health issue in the United States, both because of the overall high prevalence and because of marked increases in associated morbidity and mortality.1 In 2014, a total of 10.3 million persons reported using prescription opioids nonmedically (i.e., using medications that were not prescribed for them or were taken only for the experience or feeling that they caused).2 Emergency department visits involving misuse or abuse of prescription opioids increased 153% between 2004 and 2011, and admissions to substance-abuse treatment programs linked to prescription opioids more than quadrupled between 2002 and 2012.3,4Most troubling, between 2000 and 2014 the rates of death from prescription-opioid overdose nearly quadrupled (from 1.5 to 5.9 deaths per 100,000 persons) (Figure 1)." 
http://www.nejm.org/doi/full/10.1056/NEJMra1508490?query=featured_home

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BMJ / Lancet
 BMJ: "Nosocomial transmission of avian influenza A (H7N9) virus in China: epidemiological investigation"
 "What this study adds
Nosocomial H7N9 transmission might be possible between two unrelated individuals. Surveillance on patients with influenza-like illness in hospitals as well as chickens in live poultry markets should be enhanced to monitor transmissibility and pathogenicity of the virus."
http://www.bmj.com/content/351/bmj.h5765

Lancet: "Continued versus discontinued cannabis use in patients with psychosis: a systematic review and meta-analysis" 
"Interpretation Continued cannabis use after onset of psychosis predicts adverse outcome, including higher relapse rates, longer hospital admissions, and more severe positive symptoms than for individuals who discontinue cannabis use and those who are non-users. These findings point to reductions in cannabis use as a crucial interventional target to improve outcome in patients with psychosis."  http://lancet.com/journals/lanpsy/article/PIIS2215-0366(15)00363-6/abstract

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CIRC 

"Hypertrophic Cardiomyopathy in Children, Adolescents, and Young Adults Associated With Low Cardiovascular Mortality With Contemporary Management Strategies"
 "Conclusions—In a large hospital-based cohort of young HCM patients, representing an age group considered at greatest risk, low mortality rates can be achieved with the application of contemporary cardiovascular treatment strategies, largely because of reliable identification of high-risk patients who benefited from implantable cardioverter-defibrillators for sudden death prevention, thereby creating the opportunity for extended longevity and good quality of life."  
http://circ.ahajournals.org/content/133/1/62.abstract 

"Physical Activity and Risk of Coronary Heart Disease and Stroke in Older Adults The Cardiovascular Health Study"
"Conclusions—These data provide empirical evidence supporting PA recommendations, in particular, walking, to reduce the incidence of CVD among older adults." http://circ.ahajournals.org/content/133/2/147.abstract 

Weekly Guideline

"2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Part 3: Adult Basic Life Support and Automated External Defibrillation"

http://circ.ahajournals.org/content/132/16_suppl_1/S51.full

CIRC - "Herpesvirus Infections and Childhood Arterial Ischemic Stroke Results of the VIPS Study"

"Herpesvirus Infections and Childhood Arterial Ischemic Stroke Results of the VIPS Study"

"Conclusions—Herpesviruses may act as a trigger for childhood AIS, even if the infection is subclinical. Antivirals like acyclovir might have a role in the prevention of recurrent stroke if further studies confirm a causal relationship."

http://circ.ahajournals.org/content/133/8/732.full

BMJ - "Oral fluoroquinolone use and serious arrhythmia: bi-national cohort study"

BMJ - "Oral fluoroquinolone use and serious arrhythmia: bi-national cohort study"

"Conclusions
Contrary to previous reports, oral fluoroquinolone treatment was not associated with an increased risk of serious arrhythmia in the general adult populations of Denmark and Sweden. Given the statistical power of the study, even small increases in relative and absolute risk could be ruled out. Since ciprofloxacin was the most commonly used fluoroquinolone in our study, we cannot exclude that intraclass differences influence the risk of serious arrhythmia associated with other less frequently used fluoroquinolones."

http://www.bmj.com/content/352/bmj.i843  

NEJM - "Effects of Testosterone Treatment in Older Men"

"Effects of Testosterone Treatment in Older Men"

"CONCLUSIONS

In symptomatic men 65 years of age or older, raising testosterone concentrations for 1 year from moderately low to the mid-normal range for men 19 to 40 years of age had a moderate benefit with respect to sexual function and some benefit with respect to mood and depressive symptoms but no benefit with respect to vitality or walking distance. The number of participants was too few to draw conclusions about the risks of testosterone treatment. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number,NCT00799617.)

http://www.nejm.org/doi/full/10.1056/NEJMoa1506119

JAMA - "Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices"

JAMA - "Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices"

"Conclusions and Relevance  Among primary care practices, the use of accountable justification and peer comparison as behavioral interventions resulted in lower rates of inappropriate antibiotic prescribing for acute respiratory tract infections."

http://jama.jamanetwork.com/article.aspx?articleid=2488307

Weekly Guideline

 "2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations
Part 2: Evidence Evaluation and Management of Conflicts of Interest"

http://circ.ahajournals.org/content/132/16_suppl_1/S40.full

CIRC - "Periodontitis Increases the Risk of a First Myocardial Infarction"

"Periodontitis Increases the Risk of a First Myocardial Infarction"

"Conclusions—In this large case–control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI."
http://circ.ahajournals.org/content/133/6/576.abstract

BMJ - "Maternal use of oral contraceptives and risk of birth defects in Denmark: prospective, nationwide cohort study"

"Maternal use of oral contraceptives and risk of birth defects in Denmark: prospective, nationwide cohort study"

"What this study adds Oral contraceptive exposure just before or during pregnancy does not appear to be associated with an increased risk of major birth defects."

http://www.bmj.com/content/352/bmj.h6712

NEJM - "Incidence of Dementia over Three Decades in the Framingham Heart Study"

"Incidence of Dementia over Three Decades in the Framingham Heart Study"

""CONCLUSIONS

Among participants in the Framingham Heart Study, the incidence of dementia has declined over the course of three decades. The factors contributing to this decline have not been completely identified. (Funded by the National Institutes of Health.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1504327 

JAMA - "Association of Admission to Veterans Affairs Hospitals vs Non–Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia"

"Association of Admission to Veterans Affairs Hospitals vs Non–Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia"

"Conclusions and Relevance  Among older men with AMI, HF, or pneumonia, hospitalization at VA hospitals, compared with hospitalization at non-VA hospitals, was associated with lower 30-day risk-standardized all-cause mortality rates for AMI and HF, and higher 30-day risk-standardized all-cause readmission rates for all 3 conditions, both nationally and within similar geographic areas, although absolute differences between these outcomes at VA and non-VA hospitals were small."

http://jama.jamanetwork.com/article.aspx?articleid=2488309

Weekly Guideline - "2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Part 1: Executive Summary"

"2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations
Part 1: Executive Summary"

http://circ.ahajournals.org/content/132/16_suppl_1/S2.full

NEJM - "Metformin versus Placebo in Obese Pregnant Women without Diabetes Mellitus"

"Metformin versus Placebo in Obese Pregnant Women without Diabetes Mellitus"

""CONCLUSIONS

Among women without diabetes who had a BMI of more than 35, the antenatal administration of metformin reduced maternal weight gain but not neonatal birth weight. (Funded by the Fetal Medicine Foundation; ClinicalTrials.gov number, NCT01273584; EudraCT number, 2008-005892-83.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1509819

JAMA - "Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults"

JAMA  "Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults"

"Conclusions and Relevance  In cross-sectional analyses, moderate seafood consumption was correlated with lesser Alzheimer disease neuropathology. Although seafood consumption was also correlated with higher brain levels of mercury, these levels were not correlated with brain neuropathology."

https://jama.jamanetwork.com/article.aspx?articleid=2484683

Weekly Guideline - "Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 5: Valvular Heart Disease: A Scientific Statement From the American Heart Association and American College of Cardiology"

Weekly Guideline -

"Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities:

Task Force 5:
Valvular Heart Disease: A Scientific Statement From the American Heart Association and American College of Cardiology"
http://circ.ahajournals.org/content/132/22/e292.full.pdf+html

CIRC - "Atrial Fibrillation Begets Heart Failure and Vice Versa"

CIRC - "Atrial Fibrillation Begets Heart Failure and Vice Versa"

"Conclusions
—AF occurs in more than half of individuals with HF, and HF occurs in more than one third of individuals with AF. AF precedes and follows HF with both preserved and reduced ejection fraction, with some differences in temporal association and prognosis. Future studies focused on underlying mechanisms of these dual conditions are warranted."
http://circ.ahajournals.org/content/133/5/484.abstract

Lancet - "Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial"

Lancet - "Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial"

"Interpretation

Management of NYHA Class III heart failure based on home transmission of pulmonary artery pressure with an implanted pressure sensor has significant long-term benefit in lowering hospital admission rates for heart failure."

http://lancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00723-0.pdf

NEJM - "National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training"

NEJM - "National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training"

"CONCLUSIONS

As compared with standard duty-hour policies, flexible, less-restrictive duty-hour policies for surgical residents were associated with noninferior patient outcomes and no significant difference in residents’ satisfaction with overall well-being and education quality. (FIRST ClinicalTrials.gov number, NCT02050789.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1515724?query=featured_home 

JAMA "Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents"

"Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents"

"CONCLUSIONS

In this multicenter, prospective study of bariatric surgery in adolescents, we found significant improvements in weight, cardiometabolic health, and weight-related quality of life at 3 years after the procedure. Risks associated with surgery included specific micronutrient deficiencies and the need for additional abdominal procedures. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; Teen-LABS ClinicalTrials.gov number, NCT00474318.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1506699?query=featured_home