Annals - Blood Pressure Reduction in Mild Hypertension

"Effects of Blood Pressure Reduction in Mild Hypertension: A Systematic Review and Meta-analysis"

"Conclusion: Blood pressure–lowering therapy is likely to prevent stroke and death in patients with uncomplicated grade 1 hypertension."  

http://annals.org/article.aspx?articleid=2085847 

NEJM - Progesterone for Acute Traumatic Brain Injury

"Very Early Administration of Progesterone for Acute Traumatic Brain Injury"

"CONCLUSIONS

This clinical trial did not show a benefit of progesterone over placebo in the improvement of outcomes in patients with acute TBI. (Funded by the National Institute of Neurological Disorders and Stroke and others; PROTECT III ClinicalTrials.gov number, NCT00822900.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1404304?query=featured_home 

JAMA - Cooling Among Neonates With Hypoxic Ischemic Encephalopathy

"Effect of Depth and Duration of Cooling on Deaths in the NICU Among Neonates With Hypoxic Ischemic Encephalopathy"

"Conclusions and Relevance  Among neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials."


http://jama.jamanetwork.com/article.aspx?articleid=2084890

Weekly Guideline - 2014 AHA Prevention of Stroke in Women

"AHA/ASA Guideline Guidelines for the Prevention of Stroke in Women"

http://stroke.ahajournals.org/content/45/5/1545

CIRC - Sexual Activity After Acute Myocardial Infarction

"Sexual Activity and Counseling in the First Month After Acute Myocardial Infarction Among Younger Adults in the United States and Spain"

"Conclusions—Very few patients reported counseling for sexual activity after AMI. Those who did were commonly given restrictions not supported by evidence or guidelines."

http://circ.ahajournals.org/content/130/25/2302.full

BMJ - TV Medical Talk Shows— Evidence of Recommendations

"Televised medical talk shows—what they recommend and the evidence to support their recommendations: a prospective observational study"

"Conclusions Recommendations made on medical talk shows often lack adequate information on specific benefits or the magnitude of the effects of these benefits. Approximately half of the recommendations have either no evidence or are contradicted by the best available evidence. Potential conflicts of interest are rarely addressed. The public should be skeptical about recommendations made on medical talk shows.

Additional details of methods used and changes made to study protocol"

http://www.bmj.com/content/349/bmj.g7346

NEJM - Cytisine v Nicotine for Smoking Cessation

""Cytisine versus Nicotine for Smoking Cessation"

"CONCLUSIONS

When combined with brief behavioral support, cytisine was found to be superior to nicotine-replacement therapy in helping smokers quit smoking, but it was associated with a higher frequency of self-reported adverse events. (Funded by the Health Research Council of New Zealand; Australian New Zealand Clinical Trials Registry number,ACTRN12610000590066.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1407764

JAMA - Glycemic Index and CVD Risk Factors

"Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity The OmniCarb Randomized Clinical Trial "

"Conclusions and Relevance  In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. In the context of an overall DASH-type diet, using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance."

http://jama.jamanetwork.com/article.aspx?articleid=2040224

AHA - "Cervical Arterial Dissections and Association With Cervical Manipulative Therapy"

"AHA/ASA Scientific Statement
Cervical Arterial Dissections and Association With Cervical Manipulative Therapy"

http://stroke.ahajournals.org/content/45/10/3155

CIRC - Endovascular Treatment of Mycotic Aortic Aneurysm

"Endovascular Treatment of Mycotic Aortic Aneurysms A European Multicenter Study"

"Conclusions—Endovascular treatment of MAA is feasible and for most patients a durable treatment option. Late infections do occur, are often lethal, and warrant long-term antibiotic treatment and follow-up. Patients with non-Salmonella–positive blood cultures were more likely to die from late infection." 

http://circ.ahajournals.org/content/130/24/2136.abstract

BMJ - Non-publication of Surgical Trials

"Discontinuation and non-publication of surgical randomised controlled trials: observational study"

"Conclusions One in five surgical randomised controlled trials are discontinued early, one in three completed trials remain unpublished, and investigators of unpublished studies are frequently not contactable. This represents a waste of research resources and raises ethical concerns regarding hidden clinical data and futile participation by patients with its attendant risks. To promote future efficiency and transparency, changes are proposed to research governance frameworks to overcome these concerns."  


http://www.bmj.com/content/349/bmj.g6870

NEJM - Angiotensin Blockade in PKD

"Angiotensin Blockade in Late Autosomal Dominant Polycystic Kidney Disease"

"CONCLUSIONS

Monotherapy with an ACE inhibitor was associated with blood-pressure control in most patients with ADPKD and stage 3 chronic kidney disease. The addition of an ARB did not alter the decline in the estimated GFR. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; HALT-PKD [Study B] ClinicalTrials.gov number, NCT01885559.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1402686

JAMA - Resident Duty Hours & Mortality and Readmissions

"Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients"

"Conclusions and Relevance  Among Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation."


http://jama.jamanetwork.com/article.aspx?articleid=2020371

Weekly Guideline - 2014 ESC "Hypertrophic Cardiomyopathy"

2014 ESC "Hypertrophic Cardiomyopathy"

http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/hypertrophic-cardiomyopathy.aspx

CIRC - BMI & Mortality in DM-2

"Body Mass Index and the Risk of All-Cause Mortality Among Patients With Type 2 Diabetes Mellitus"

"Conclusions—The present study indicated a U-shaped association of BMI with all-cause mortality risk among black and white patients with type 2 diabetes mellitus. A significantly increased risk of all-cause mortality was observed among blacks with BMI <30 kg/m2 and ≥35 kg/m2 and among whites with BMI <25 kg/m2 and ≥40 kg/m2 compared with patients with BMI of 30 to 34.9 kg/m2."

http://circ.ahajournals.org/content/130/24/2143.full

BMJ - Press Releases and Medical News Exaggeration

"The association between exaggeration in health related science news and academic press releases: retrospective observational study"

"Conclusions Exaggeration in news is strongly associated with exaggeration in press releases. Improving the accuracy of academic press releases could represent a key opportunity for reducing misleading health related news."


http://www.bmj.com/content/349/bmj.g7015

NEJM - Factor XI ASO and Veonous Thrombosis

 "Factor XI Antisense Oligonucleotide for Prevention of Venous Thrombosis"

"RESULTS  

Around the time of surgery, the mean (±SE) factor XI levels were 0.38±0.01 units per milliliter in the 200-mg FXI-ASO group, 0.20±0.01 units per milliliter in the 300-mg FXI-ASO group, and 0.93±0.02 units per milliliter in the enoxaparin group. The primary efficacy outcome occurred in 36 of 134 patients (27%) who received the 200-mg dose of FXI-ASO and in 3 of 71 patients (4%) who received the 300-mg dose of FXI-ASO, as compared with 21 of 69 patients (30%) who received enoxaparin. The 200-mg regimen was noninferior, and the 300-mg regimen was superior, to enoxaparin (P<0.001). Bleeding occurred in 3%, 3%, and 8% of the patients in the three study groups, respectively."  

http://www.nejm.org/doi/full/10.1056/NEJMoa1405760?query=featured_home

JAMA - Sodium Zirconium Cyclosilicate for Hyper K+

"Effect of Sodium Zirconium Cyclosilicate on Potassium Lowering for 28 Days Among Outpatients With Hyperkalemia The HARMONIZE Randomized Clinical Trial"

"Conclusions and Relevance  Among outpatients with hyperkalemia, open-label sodium zirconium cyclosilicate reduced serum potassium to normal levels within 48 hours; compared with placebo, all 3 doses of zirconium cyclosilicate resulted in lower potassium levels and a higher proportion of patients with normal potassium levels for up to 28 days. Further studies are needed to evaluate the efficacy and safety of zirconium cyclosilicate beyond 4 weeks and to assess long-term clinical outcomes."   


http://jama.jamanetwork.com/article.aspx?articleid=1936753

Weekly Guideline - 2014 ESC Aortic Diseases

2014 ESC  "Aortic Diseases"

http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/aortic-dissection.aspx

CIRC - Coronary CTA in ED

"Clinician Update"
"Coronary Computed Tomographic Angiography Its Role in Emergency Department Triage"

"Conclusions

Coronary CTA is now an established, noninvasive technique that can rapidly exclude obstructive CAD and identify patients who can be safely discharged from the ED. Although CTA appears to lower ED costs and may lead to intensification in preventive therapies, concern remains about the potential for this test to increase invasive angiography and coronary revascularizations. Ultimately, appropriate patient selection will remain essential for ensuring optimal test use and patient management."

http://circ.ahajournals.org/content/130/23/2052.full

BMJ - Overweight in Pregnancy

"Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden"  

"Conclusions 
Maternal overweight and obesity are associated with increased risks of infant mortality due to increased mortality risk in term births and an increased prevalence of preterm births. Maternal overweight and obesity may be an important preventable risk factor for infant mortality in many countries." 

http://www.bmj.com/content/349/bmj.g6572 

NEJM - Ebola Vaccine

"Chimpanzee Adenovirus Vector Ebola Vaccine — Preliminary Report"

"CONCLUSIONS

Reactogenicity and immune responses to cAd3-EBO vaccine were dose-dependent. At the 2×1011 particle-unit dose, glycoprotein Zaire–specific antibody responses were in the range reported to be associated with vaccine-induced protective immunity in challenge studies involving nonhuman primates. Clinical trials assessing cAd3-EBO are ongoing. (Funded by the Intramural Research Program of the National Institutes of Health; VRC 207 ClinicalTrials.gov number,NCT02231866.)" 

http://www.nejm.org/doi/full/10.1056/NEJMoa1410863?query=featured_home

JAMA - Cost-effectiveness of Dalteparin vs Unfractionated Heparin

 "Cost-effectiveness of Dalteparin vs Unfractionated Heparin for the Prevention of Venous Thromboembolism in Critically Ill Patients"

"Conclusions and Relevance  From a health care payer perspective, the use of the LMWH dalteparin for VTE prophylaxis among critically ill medical-surgical patients was more effective and had similar or lower costs than the use of UFH. These findings were driven by lower rates of pulmonary embolus and heparin-induced thrombocytopenia and corresponding lower overall use of resources with LMWH."


http://jama.jamanetwork.com/article.aspx?articleid=1921813