ResearchPad - online-first https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Facedown Positioning Following Surgery for Large Full-Thickness Macular Hole]]> https://www.researchpad.co/article/elastic_article_8846 This randomized clinical trial examines the effect of postoperative facedown positioning on outcomes for large macular holes.

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<![CDATA[Clinical Effectiveness of Intravitreal Therapy With Ranibizumab vs Aflibercept vs Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion]]> https://www.researchpad.co/article/N8f28c822-11fb-4230-83c3-a2d1f8840b49

This randomized clinical trial compares the clinical effectiveness of intravitreal therapy with ranibizumab vs aflibercept vs bevacizumab for the management of macular edema secondary to central retinal vein occlusion.

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<![CDATA[Variation in the Heritability of Child Body Mass Index by Obesogenic Home Environment]]> https://www.researchpad.co/article/5c9bc314d5eed0c484ee4dcb

This cohort study investigates the association between obesogenic home environment and heritability of body mass index among children.

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<![CDATA[Association of Body Mass Index and Age With Subsequent Breast Cancer Risk in Premenopausal Women]]> https://www.researchpad.co/article/5c16cd7ed5eed0c484526aba

Key Points

Question

What is the association between body mass index and risk for breast cancer diagnosed before menopause?

Finding

In this large pooled analysis of data on 758 592 premenopausal women, an inverse association of breast cancer risk with body mass index at 18 through 54 years of age was found, most strongly for body mass index at ages 18 through 24 years. The inverse association was strongest for hormone receptor–positive breast cancer, was evident across the entire distribution of body mass index, and did not materially vary by attained age or other characteristics of women.

Meaning

Increased adiposity, in particular during early adulthood, may be associated with reductions in the risk of premenopausal breast cancer.

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<![CDATA[Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016]]> https://www.researchpad.co/article/5c16cd80d5eed0c484526b46

This systematic analysis evaluates the cancer burden over time at the global and national levels measured in incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years.

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<![CDATA[Immunogenicity and Safety of Monovalent Acellular Pertussis Vaccine at Birth]]> https://www.researchpad.co/article/5c16cd84d5eed0c484526bf7

Importance

An alternative option to maternal vaccination to prevent severe pertussis in infants is vaccination at birth. Data are needed on the immunogenicity and safety of a birth dose of monovalent acellular pertussis (aP) vaccine.

Objective

To compare IgG antibody responses to vaccine antigens at 6, 10, 24, and 32 weeks of age between newborn infants receiving the aP vaccine and hepatitis B vaccine (HBV) or HBV alone.

Design, Setting, and Participants

A randomized clinical trial was conducted at 4 sites in Australia (Sydney, Melbourne, Adelaide, and Perth) between June 11, 2010, and March 14, 2013, among 440 healthy term (>36 weeks’ gestation) infants aged less than 5 days at recruitment. Statistical analysis was performed from March 1, 2015, to June 2, 2016.

Intervention

Newborns received HBV and, after stratification by maternal receipt of adult-formulated aP-containing vaccine (tetanus toxoid, reduced diphtheria toxoid, and pertussis antigen content [Tdap]) prior to pregnancy, were block randomized to receive the aP vaccine (without diphtheria or tetanus) within 5 days of birth or not. At 6, 16, and 24 weeks, infants received a hexavalent vaccine with pediatric-formulated diphtheria, tetanus and pertussis antigens (DTaP), Haemophilus influenzae type b (Hib), HBV, and polio vaccine, as well as the 10-valent pneumococcal conjugate vaccine.

Main Outcomes and Measures

Detectable (>5 enzyme-linked immunosorbent assay units per milliliter) and geometric mean concentrations of IgG antibody to pertussis toxin (PT), pertactin, and filamentous hemagglutinin at 6, 10, and 24 weeks stratified by maternal Tdap history, and antibody at 32 weeks to HBV, Hib, polio, diphtheria, tetanus, and pneumococcal serotypes. The primary outcome was detectable IgG to both PT and pertactin at 10 weeks.

Results

A total of 440 infants (207 girls and 233 boys; median gestation, 39.2 weeks) were randomized to receive the aP vaccine plus HBV (n = 221) or HBV only (control group; n = 219). At 10 weeks, 192 of 206 infants who received the aP vaccine (93.2%) had detectable antibodies to both PT and pertactin vs 98 of 193 infants in the control group (50.8%) (P < .001), with the geometric mean concentration for PT IgG 4-fold higher among the group that received the aP vaccine. At age 32 weeks, all infants (n = 181 with sera available for testing) who received the aP vaccine at birth had detectable PT IgG and significantly lower IgG geometric mean concentrations for Hib, hepatitis B, diphtheria, and tetanus antibodies. Local and systemic adverse events were similar between both groups at all time points.

Conclusions and Relevance

The monovalent aP vaccine is immunogenic and safe in neonates and, if licensed and available, would be valuable for newborns whose mothers did not receive the Tdap vaccine during pregnancy.

Trial Registration

http://anzctr.org.au Identifier: ACTRN12609000905268

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<![CDATA[Medical Attention Seeking After Transient Ischemic Attack and Minor Stroke Before and After the UK Face, Arm, Speech, Time (FAST) Public Education Campaign]]> https://www.researchpad.co/article/5c15fb3cd5eed0c4842f2cd4

This population-based study investigates the association of public education with improving delays and failure in seeking medical attention among consecutive patients with first transient ischemic attack or stroke.

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<![CDATA[Rotavirus Vaccination and the Global Burden of Rotavirus Diarrhea Among Children Younger Than 5 Years]]> https://www.researchpad.co/article/5c15d64dd5eed0c4842874e9

This analysis of data from the Global Burden of Disease Study examines the extent of rotavirus infection and associated deaths among children younger than 5 years worldwide and whether the rotavirus vaccine has reduced the diarrhea-associated mortality.

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<![CDATA[Diagnosis of Kawasaki Disease Using a Minimal Whole-Blood Gene Expression Signature]]> https://www.researchpad.co/article/5c15d649d5eed0c48428747b

Key Points

Question

Can Kawasaki disease be accurately diagnosed on the basis of the pattern of host gene expression in whole blood?

Findings

In this case-control study of 606 children (404 in the discovery cohort; 202 in the validation cohort), a 13-transcript signature was identified that accurately discriminated Kawasaki disease from comparator febrile diseases in discovery and validation cohorts.

Meaning

A diagnostic blood test based on measurement of small numbers of host gene transcripts might enable early discrimination of Kawasaki disease from other infectious and inflammatory conditions.

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<![CDATA[Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling]]> https://www.researchpad.co/article/5c15d647d5eed0c484287439

Key Points

Question

Is a fall prevention–specific tai ji quan intervention clinically more effective in reducing falls among older adults at high risk of falling than a stretching intervention (control) or a standard multimodal exercise intervention?

Findings

In a randomized clinical trial involving 670 adults 70 years or older with a history of falls or impaired mobility, the therapeutic tai ji quan intervention effectively reduced falls by 58% compared with the stretching exercise (control intervention) and by 31% compared with a multimodal exercise intervention.

Meaning

For older adults at high risk of falling, a therapeutically tailored tai ji quan intervention was more effective than stretching or multimodal exercises in reducing the incidence of falls.

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<![CDATA[Characteristics and Outcomes of Surgical Patients With Solid Cancers Admitted to the Intensive Care Unit]]> https://www.researchpad.co/article/5c15d645d5eed0c4842873ec

Key Points

Question

How do features and outcomes vary for surgical patients with and without cancer admitted to the intensive care unit?

Findings

In this cohort study of 25 017 surgical admissions to general intensive care units in the West of Scotland, cancer was a common morbidity at 21.8% of all admissions. Intensive care unit and hospital mortality were lower in the group of intensive care unit patients with cancer; however, this survival advantage had reversed by 6 months.

Meaning

Cancer is present in 1 in 5 intensive care unit surgical admissions, and short-term survival for this group is favorable.

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<![CDATA[Cost-effectiveness and Benefit-to-Harm Ratio of Risk-Stratified Screening for Breast Cancer]]> https://www.researchpad.co/article/5c1326e7d5eed0c4849a31b5

This cost-effectiveness study uses a life-table model of a hypothetical cohort of 364 500 women to evaluate the cost-effectiveness and benefit to harm ratio of risk-stratified screening for breast cancer.

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<![CDATA[Association of Retinopathy of Prematurity With Low Levels of Arachidonic Acid]]> https://www.researchpad.co/article/5b5bb7c0463d7e22cde761d4

Key Points

Question

How are circulatory levels of ω-3 and ω-6 long-chain polyunsaturated fatty acids associated with retinopathy of prematurity?

Findings

In this secondary analysis of data from a randomized clinical trial of 78 infants, higher ω-6 polyunsaturated fatty acid arachidonic acid serum levels were associated with a lower risk of developing any retinopathy of prematurity, as well as sight-threatening retinopathy of prematurity.

Meaning

The ω-6 polyunsaturated fatty acid arachidonic acid is associated with a lower risk of developing retinopathy of prematurity; while these findings do not indicate a cause-and-effect relationship, they support testing the hypothesis of supplementation of arachidonic acid in extremely preterm infants to reduce the risk of developing retinopathy of prematurity.

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<![CDATA[Effect of Standard vs Intensive Blood Pressure Control on Cerebral Blood Flow in Small Vessel Disease]]> https://www.researchpad.co/article/5c05c79bd5eed0c484a389b6

Key Points

Question

Does intensive blood pressure lowering cause hypoperfusion in severe cerebral small vessel disease?

Findings

This randomized clinical trial used arterial spin labeling to examine the effect of standard (n = 33) vs intensive (n = 29) blood pressure treatment regimens on cerebral blood flow in patients with severe small vessel disease over 3 months. Change in whole-brain cerebral blood flow did not significantly differ between standard vs intensive groups.

Meaning

Intensive blood pressure lowering did not cause hypoperfusion in severe cerebral small vessel disease.

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<![CDATA[A Multicomponent, Preschool to Third Grade Preventive Intervention and Educational Attainment at 35 Years of Age]]> https://www.researchpad.co/article/5bfd4597d5eed0c48435f92b

This cohort study examines the association between a preschool to third grade intervention with educational attainment at midlife and differences by program duration, sex, and parental educational level.

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