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