Tag: trial
No IV Hydration for Contrast Nephropathy? AMACING Trial Challenges a Cornerstone of Prophylaxis
A Dutch study undercutting the established role of hydration in preventing kidney damage during procedures is raising eyebrows. Dutch researchers are calling into question one of the cornerstone practices of cath labs and... read more
Decreased cytokine production by mononuclear cells after severe gram-negative infections
Failure of circulating monocytes for adequate cytokine production is a trait of sepsis-induced immunosuppression; however, its duration and association with final outcome are poorly understood. Defective TNF-α production... read more
Dose-Adjusted DOACs: What Efficacy vs Warfarin?
The direct oral anticoagulants (DOACs) offer distinct advantages over warfarin - among them, dose adjustment is only needed in cases of impaired renal function, advanced age, low body weight, or potential for drug-drug interactions.... read more
Palliative care from diagnosis to death
Evidence is growing that people can benefit from palliative care earlier in their illness, say Scott Murray and colleagues, but care must be tailored to different conditions. Many people still associate palliative care with... read more
The Changing Face of Informed Consent
Informed consent for a research study brings to mind a paper document with a handwritten signature completed at a clinical research site. However, the paper, ink, and clinical site are not necessary. Sufficient information... read more
What’s new with stress ulcer prophylaxis in the ICU?
Critically ill patients are at risk of stress-related mucosal erosions. These are typically superficial and asymptomatic but may progress to ulceration and overt and clinically important gastrointestinal (GI) bleeding,... read more
A Primer on the Perils of Intravenous Fluids – Part 2
Critically-ill patients all likely have endothelial dysfunction to some degree. resuscitationThis perturbation in microvascular physiology may be underpinned by abnormal glycocalyx structure and function. Sepsis, trauma,... read more
Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy
Between June 17, 2014, and July 17, 2016, 660 consecutive patients were randomly assigned to receive no prophylaxis (n=332) or intravenous hydration (n=328). 2–6 day serum creatinine was available for 307 (92%) of 332 patients... read more
Vitamin D supplementation to prevent acute respiratory tract infections
Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit. 25 eligible... read more
POCT for emergency assessment of coagulation in patients treated with direct oral anticoagulants
Hemochron Signature Point-of-care testing (POCT) can be a fast and reliable alternative for guiding emergency treatment during rivaroxaban and dabigatran therapy. It allows the rapid identification of a relevant fraction... read more
Carotid Stenting Technology Has More Appeal
Ten-year follow-up from the CREST trial and 5-year follow-up from the ACT I study, presented at least year's International Stroke Conference, showed that carotid artery stenting (CAS) holds up well over the long term... read more
Candida Auris forms biofilms that enhance its virulence and resistance
In three separate trials, eight samples of each strain of C. auris grew biofilms that constitute a key driver of Candida pathogenicity. C. auris first attracted attention in 2009 because of its resistance to azoles and amphotericin... read more
Blood Thinner Also Effective for Artery Disease
A phase 3 trial evaluating the efficacy and safety of rivaroxaban (Xarelto, Bayer/Janssen), an oral anticoagulant, for the prevention of major adverse cardiac events (MACE) - including cardiovascular death, myocardial infarction,... read more
Interventions to improve antibiotic prescribing practices for hospital inpatients
This review includes 221 studies (58 RCTs, and 163 NRS). Most studies were from North America (96) or Europe (87). The remaining studies were from Asia (19), South America (8), Australia (8), and the East Asia (3). We found... read more
Crizanlizumab use lowers rates of sickle cell crises
Patients with sickle cell disease treated with high-dose crizanlizumab experienced lower annualized rates of sickle cell crisis compared to placebo treatment, regardless of their baseline use of hydroxyurea. Those treated... read more
Thromboprophylaxis after Knee Arthroscopy and Lower-Leg Casting
The results of our trials showed that prophylaxis with low-molecular-weight heparin for the 8 days after knee arthroscopy or during the full period of immobilization due to casting was not effective for the prevention of... read more
Six myths promoted by the new surviving sepsis guidelines
The Rivers trial and the Surviving Sepsis Campaign popularized sepsis protocols, which saved lives. Massive accomplishment. However, that doesn’t validate the individual components of early goal-directed therapy. Any protocol... read more
Benefits and harms of duloxetine for treatment of stress urinary incontinence
Duloxetine was significantly better than placebo in terms of percentage change in weekly incontinence episodes (mean difference - 13.56%, 95% confidence interval [CI] -21.59% to -5.53%) and change in Incontinence Quality... read more
The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the... read more
Effects of Video vs Direct Laryngoscopy on Successful Orotracheal Intubation in ICU Patients
Among patients in the ICU requiring intubation, video laryngoscopy compared with direct laryngoscopy did not improve first-pass orotracheal intubation rates and was associated with higher rates of severe life-threatening... read more
Magnet guidance reduces misplacement of subclavian vein catheter in internal jugular vein
The internal jugular vein (IJV) and subclavian vein (SCV) are the two most commonly used insertion sites for central venous catheterization (CVC). A multicenter clinical trial compared commonly used insertion sites and... read more
Better glycemic control with continuous glucose monitoring
This randomized clinical trial compares the effects of continuous glucose monitoring vs conventional treatment for glycemic control in adult patients with type 1 diabetes treated with multiple daily insulin injections.... read more
