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