Clinical research

Increased Risk of Kidney Failure in Patients with Genetic Kidney Disorders Practical Solutions and Value Highlights Recent study published in J Clin Invest revealed that patients with genetic kidney disorders are at higher risk of kidney failure. The study assessed three patient cohorts and found that monogenic kidney disorders and high-risk APOL1 genotypes were associated with increased risk of kidney failure, faster decline in kidney function, and lower rates of disease remission. The study highlights the potential for early identification and intervention based on molecular diagnosis, offering practical solutions for improving patient care. Key Findings Monogenic kidney disorders linked to… ➡️➡️➡️

Lessons from the EQUAL Trial: Tailoring Weight Loss Interventions for Cancer Survivors Key Takeaways: Despite challenges, the EQUAL trial sheds light on the need for tailored, remotely delivered weight loss interventions for cancer survivors, particularly those with acute lymphoblastic leukemia (ALL). Key differences in study populations and intervention contexts contributed to the trial’s null results, emphasizing the importance of well-fitted approaches. Engaging unique survivor populations and involving primary care physicians are essential for the success of weight management interventions. Remote interventions have shown efficacy for weight loss among cancer survivors, but the lack of qualitative assessment and tailored integration in… ➡️➡️➡️

Effect of Blue Light Emitting Diode Therapy on Recurrent Vulvovaginal Candidiasis: A Randomized Assessor-Blinded Controlled Trial Objective Vulvovaginal Candidiasis (VVC) is a common genital infection in women and requires effective non-drug therapies. This study aimed to investigate the effect of blue light emitting diode (LED) therapy as an alternative treatment for recurrent VVC due to its proven antimicrobial properties. LED therapy is safe and non-invasive, making it a promising option for sensitive tissue applications. Materials and Methods 60 women with confirmed VVC were recruited for this randomized controlled trial. They were divided into two groups: Group A received standard antifungal… ➡️➡️➡️

Efficacy and Safety of Methotrexate Plus Hydroxychloroquine Combination Therapy vs. Methotrexate Monotherapy in the Treatment of Rheumatoid Arthritis: A Randomized Controlled Clinical Trial Key Findings: Combining methotrexate (MTX) with hydroxychloroquine (HCQ) showed a more significant reduction in pain, disease activity, and inflammatory factors compared to MTX monotherapy. The quality of life was also higher in the MTX + HCQ group. Both treatment options demonstrated improvements in symptoms and quality of life for rheumatoid arthritis patients. The combination therapy outperformed MTX monotherapy across all measures, indicating its potential as the preferred initial treatment for rheumatoid arthritis. Practical Solutions and Value: Clinical… ➡️➡️➡️

Exploring the Effect of Exercise versus Metformin on Insulin Resistance amongst Nigerians with Pre-diabetes: A Randomised Controlled Trial ABSTRACT Pre-diabetes is a significant risk factor for type 2 diabetes in Nigeria. This study aimed to compare the impact of moderate exercise and metformin interventions on insulin resistance among participants with pre-diabetes. Using a randomised placebo-controlled design, 54 Nigerians with pre-diabetes were selected and offered metformin, moderate exercise, or placebo treatment for 12 weeks. Both exercise and metformin interventions significantly decreased insulin resistance compared to placebo. However, moderate exercise improved insulin resistance more than metformin. Clinical trials are crucial for developing… ➡️➡️➡️

Reduced-dose chemotherapy and blinatumomab as induction treatment for newly diagnosed Ph-negative B-cell precursor acute lymphoblastic leukemia: a phase 2 trial Abstract Blinatumomab has shown promise in improving the initial treatment of acute B-cell precursor lymphoblastic leukemia (BCP-ALL). To reduce side effects and improve effectiveness, we conducted a phase 2 trial using reduced-dose chemotherapy (RDC) followed by blinatumomab for newly diagnosed patients with Ph-negative BCP-ALL. The trial resulted in a high rate of complete remission and measurable residual disease negativity, supporting the approach of using RDC followed by blinatumomab as an effective and well-tolerated induction regimen. Clinical Trial Results Of the… ➡️➡️➡️

Effect of Endothelin-1 on Blood Pressure Response to Hypoxia and Hyperoxia in Young Men Physiological Reports, 2024 Sep;12(17):e70004 Endothelin-1 (ET-1) and its receptors have been linked to increased sensitivity to hypoxic stress and the development of hypertension. This study aimed to investigate the effect of ET receptor antagonism on blood pressure (BP) response to chemoreflex stress. Twenty-four young men completed two study visits, one with a control and the other with bosentan. BP was assessed under normoxia, hypoxia, and hyperoxia conditions. Bosentan increased plasma ET-1, supporting receptor blockade. Resting diastolic and mean BP were reduced following bosentan compared to control,… ➡️➡️➡️

Effect of Intranasal Insulin on Perioperative Cognitive Function in Older Adults Key Findings: Administering intranasal insulin to older surgical patients showed significant improvement in postoperative cognitive function, reduced incidence of postoperative delirium, and inhibited certain inflammatory markers. Practical Solutions: Using intranasal insulin could be a potential therapy to enhance postoperative cognition in older surgical patients. Value: These results highlight the potential benefits of intranasal insulin in improving postoperative cognitive function, which could lead to better patient outcomes and reduced burden on medical care. ➡️➡️➡️

Assessment of MMP Levels and Clinical Success in Pulpitis and Pulpotomy Treatment Background Matrix metalloproteinases (MMPs) are crucial enzymes in dental pulp tissue function. However, their role in primary teeth remains limited. Further studies are needed to understand their contributions to pulpal defense in primary teeth. Additionally, the effectiveness of Biodentine in treating primary teeth requires further exploration. Aim The study aims to compare MMP-2, MMP-8, and MMP-9 levels in reversible and irreversible pulpitis. It also seeks to assess the success of Mineral Trioxide Aggregate (MTA) and Biodentine in pulpotomy treatments for primary molars. Design 63 primary molars were included… ➡️➡️➡️

The combined application of pulsed electromagnetic fields and platelet-rich plasma in the treatment of early-stage knee osteoarthritis: A randomized clinical trial Key Findings This study investigated the effectiveness of combining pulsed electromagnetic fields (PEMFs) and platelet-rich plasma (PRP) injections in treating early-stage knee osteoarthritis. The combined therapy was found to significantly reduce pain and improve joint function compared to single treatments. Treatment Groups The study included 48 patients with early-stage knee osteoarthritis, divided into three groups: the PRP group, the PEMFs group, and the PRP + PEMFs group. Each group received different treatment protocols. Results Patients in all three groups… ➡️➡️➡️

Effects of Laying on of Hands in Oncology Patients Study Details Published in Adv Mind Body Med. 2024 Summer;28(3):36-42. Conducted at the Center for Integrative and Complementary Practices of the Federal University of Triangulo Mineiro, MG, Brazil. Objective To investigate the effects of laying on of hands (LOH) with Spiritual connection (LHSP) and LOH without Spiritual connection (LHW) compared to a control group on oncology patients undergoing chemotherapy. Method Randomized, double-blinded clinical trial. Participants Cancer patients aged ≥18 years undergoing chemotherapy. Intervention Patients were allocated to LHSP, LHW, or a control group. Each LOH intervention lasted 5 minutes, and patients… ➡️➡️➡️

VATICAN Trial: Evaluating Antibiotic Treatment for Ventilator-Associated Tracheobronchitis Background: Ventilator-associated tracheobronchitis is a common condition in intensive care units, and the best treatment strategy is currently unknown. The VATICAN trial aims to compare watchful waiting with routine antibiotic treatment for this condition. Methods: The VATICAN trial is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis will be assigned to either a watchful waiting strategy or routine antimicrobial treatment for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, with ventilator-associated pneumonia-free survival as a key secondary outcome. Conclusion: The VATICAN trial will… ➡️➡️➡️

Efficacy and Safety of Reduced Dose Azacitidine in Elderly Patients with Myelodysplastic Syndromes Objective To analyze the efficacy and safety of low-dose azacitidine in treating elderly patients with myelodysplastic syndromes (MDS). Methods A total of 92 elderly MDS patients were divided into an observation group and a control group. The observation group received a low dose of azacitidine, while the control group received a standard dose. The clinical efficacy, overall survival, and adverse reactions of both groups were observed. Results After treatment, both groups showed significant improvement in hemoglobin and platelet levels. The total effective rate of the observation group… ➡️➡️➡️

Effect evaluation of outpatient long-term video EEGs for people with seizure disorders — study protocol of the ALVEEG project: a randomized controlled trial in Germany ABSTRACT Epilepsy and other seizure disorders have a significant impact in Germany. Timely diagnosis and accurate treatment are crucial, and the management of these disorders needs improvement. Outpatient long-term video EEGs (ALVEEGs) have shown potential to aid in the diagnosis and management of epilepsy and other seizure disorders. This study aims to evaluate the implementation of ALVEEGs as a new diagnostic pathway in eastern Germany and to assess their effectiveness compared to the current inpatient-monitoring… ➡️➡️➡️

Impact of Intervention Package on Antibiotic Prescriptions for Acute Febrile Illness Study Overview An intervention package including point-of-care diagnostic tests, a clinical algorithm, and adherence training was implemented in primary health facilities in Burkina Faso during the COVID-19 pandemic. The study aimed to assess the impact of this package on antibiotic prescriptions and clinical recovery for non-severe acute febrile illnesses. Key Findings The intervention led to a significant reduction in antibiotic prescriptions at Day 0, with 33.2% in the intervention arm compared to 58.1% under standard care. This reduction was particularly notable in children under 5 years, patients with non-malaria… ➡️➡️➡️

MRI Tumor Regression Response to Neoadjuvant Chemotherapy Alone without Radiation for Rectal Adenocarcinoma Summary This study investigated the accuracy of MRI in assessing pathologic complete response in patients with locally advanced rectal cancer (LARC) who underwent surgery after neoadjuvant chemotherapy (NCT) without radiation. The results show that MRI-based models were accurate for determining pathologic complete response in participants with LARC following NCT. The addition of diffusion-weighted imaging (DWI) improved the predictive performance of MRI-based assessment, achieving the highest accuracy among the evaluated methods. Practical Solutions and Value The findings of this study provide practical solutions for using MRI and DWI… ➡️➡️➡️

Management of the Axilla After Neoadjuvant Chemotherapy: Can Axillary Needle Biopsy Replace Sentinel Node Biopsy? Background The study aimed to determine if axillary needle biopsy could effectively evaluate the axilla after treatment in breast cancer patients who had received neoadjuvant chemotherapy (NAC) without the need for sentinel lymph node biopsy (SLNB). Patients and Methods The study included breast cancer patients with biopsy-proven axillary lymph node metastases who underwent neoadjuvant chemotherapy. Patients were divided into two groups and biopsy samples were obtained using fine needle aspiration (FNAB) in the first group and core needle biopsy (CNB) in the second group. The… ➡️➡️➡️

Evaluation of the Impact of an Online Video Game as an Educational Intervention on Sexual Health and the Prevention, Diagnosis, and Treatment of Sexually Transmitted Infection: A Randomized Controlled Trial Protocol Background The incidence of sexually transmitted infections (STIs) is increasing, especially among young people. There is a need for tools to improve knowledge about sex education and STI prevention and treatment. Gamification can be an effective training tool for both young people and health professionals. Methods/Design This study is a multicenter cluster randomized controlled trial. Groups of primary care professionals will receive an intervention (online video game on sex… ➡️➡️➡️

Impact of Telemonitoring on Multiple Myeloma Patients Practical Solutions and Value Multiple myeloma (MM) is a serious condition with significant impact on patients’ lives. To address the challenges of complex treatment regimens, the MM e-coach telemonitoring tool was developed and tested. This study aims to assess the impact of telemonitoring on medication adherence, complications, and quality of life in MM patients. During the study, 150 recently diagnosed MM patients will be recruited to compare the telemonitoring (MM e-coach) with standard MM care. The primary outcome will be adherence to treatment, with secondary outcomes including patient-reported measures, adverse events, and overall… ➡️➡️➡️

Lay-Led Intervention for War and Refugee Trauma: A Randomized Clinical Trial Importance The global refugee crisis disproportionately affects the Muslim world, leading to trauma-related mental health issues. Effective psychotherapy exists, but barriers to uptake by refugee groups and lack of culturally appropriate interventions remain. Objective To examine the efficacy of a brief, lay-led, mosque-based intervention, Islamic Trauma Healing (ITH), in improving mental health and well-being by adapting empirically supported cognitive behavioral principles. Design, Setting, and Participants In a randomized clinical trial, 101 participants received ITH or active assessment but delayed intervention (waiting list [WL]) in mosques and virtually in Seattle,… ➡️➡️➡️