Clinical research

Pentoxifylline Reduces Subclinical Atherosclerosis in Patients with Type 2 Diabetes and Chronic Kidney Disease Key Findings: Pentoxifylline (PTF) shows positive effects on the progression of subclinical atherosclerosis (SA) in patients with type 2 diabetes mellitus and chronic kidney disease (CKD). Practical Solutions: PTF treatment resulted in improved carotid intima-media thickness (CIMT), increased levels of the cardiovascular health protein Klotho (KL) in blood cells, and reduced inflammation. Value: PTF treatment, along with variations in KL expression and changes in HDL, were significant determinants for CIMT progression, independently of traditional risk factors. PTF demonstrates potential as a protective factor against the worsening… ➡️➡️➡️

Study Title The effects of combining remimazolam with estazolam on postoperative hemodynamics and pain intensity in patients undergoing laparoscopic gastrointestinal surgery Published in BMC Surgery, August 24, 2024 PMID: 39182049 | DOI: 10.1186/s12893-024-02527-8 Objective This study aimed to investigate the effects of combining remimazolam with estazolam on hemodynamics and pain levels after laparoscopic gastrointestinal surgery. Methods A total of 184 patients undergoing laparoscopic gastrointestinal surgery were enrolled in a double-blind randomized controlled trial. They were divided into four groups: Study Group 1 (Remimazolam), Study Group 2 (Estazolam), Study Group 3 (Remimazolam + Estazolam), and Control Group. Hemodynamic parameters, stress responses,… ➡️➡️➡️

Community-Engaged Trial to Increase COVID-19 Vaccine Uptake in Black Individuals with Rheumatic Conditions Published in BMJ Open, August 24, 2024 Background: In the US, there are disparities in COVID-19 infection and vaccine uptake among historically marginalized racial and ethnic groups. People with rheumatic conditions, especially those who are immunocompromised, are at higher risk for severe infection, with significant racial inequities in outcomes and vaccine uptake. Structural racism and misinformation contribute to these inequities. Method: A community-based trial comparing the effectiveness of training trusted community leaders with rheumatic conditions using a racial justice vs a biomedical framework to increase COVID-19 vaccine… ➡️➡️➡️

Interim Analysis of Beta-blocker Use in Traumatic Brain Injury Key Highlights This interim analysis explores the impact of early administration of beta-blockers on adrenergic surge, pro-inflammatory cytokines, and traumatic brain injury (TBI) biomarkers. Patients with positive high-sensitivity troponin T (HsTnT) levels received propranolol, while those with negative test were randomized to receive propranolol or placebo. Propranolol administration showed a significant reduction in cytokine levels and TBI biomarkers, particularly among patients with positive HsTnT, indicating a potential role in modulating inflammation post-TBI. Practical Solutions and Value This study provides valuable insights into the potential benefits of early beta-blocker administration in TBI… ➡️➡️➡️

Kinetic Profiling of RAS Mutations in Metastatic Colorectal Cancer Study Overview Researchers tracked RAS mutation status in metastatic colorectal cancer patients over time using circulating tumor DNA (ctDNA) sequencing during the CO.26 trial, which assessed durvalumab + tremelimumab treatment in heavily pretreated patients. Key Findings Among the patients with RAS mutations, a small percentage (3.2%-6.3%) showed transient loss of RAS mutations in ctDNA, with most cases (67%) experiencing subsequent re-emergence of the mutations. Patients with transient RAS mutation disappearance had a lower likelihood of having multiple lesions at trial baseline compared to those with persistent RAS mutations. Clinical Implications The… ➡️➡️➡️

Shared Decision-Making in Colorectal Cancer Screening for Older Adults: A Secondary Analysis of a Cluster Randomized Clinical Trial Summary Deciding whether to stop colorectal cancer (CRC) screening tests in older adults can be challenging. This study evaluated the impact of physician training in shared decision-making (SDM) and electronic previsit reminders on the receipt of patient-preferred CRC screening approaches and overall screening rates for older adults. Key Findings Physicians in the intervention group completed an SDM training course and received previsit reminders, while those in the comparator group received reminders only. The study found that approximately half of older patients received… ➡️➡️➡️

Characterizing HIV Drug Resistance in Vertical Transmission Cases Study Overview The VESTED trial compared the safety and effectiveness of three different antiretroviral treatment regimens in pregnant and postpartum women with HIV. The study aimed to evaluate the occurrence of vertical HIV transmission (VT) in infants born to these women and to assess HIV drug resistance (HIVDR) and other risk factors in these cases. Study Methods Pregnant women with HIV were enrolled at 22 international sites and followed with their infants through 50 weeks postpartum. HIV sequences were analyzed from VT cases for HIVDR using single genome amplification (SGA) from longitudinally… ➡️➡️➡️

Enhancing Positive Adaptation of Immigrant Families in Hong Kong: Clinical Trial Results Overview Our research team conducted a randomized controlled trial to enhance positive adaptation among immigrant parents and children in Hong Kong. We developed two parallel interventions aiming to address psychological and sociocultural adaptation difficulties faced by immigrant families. Interventions Two interventions were conducted: the emotion regulation (ER) arm focused on psychological adaptation by reducing parent-child conflicts and improving emotions, while the information provision (IP) arm targeted sociocultural adaptation by increasing participants’ knowledge about Hong Kong. Findings Results showed that parents in the ER arm exhibited improved positive affect,… ➡️➡️➡️

Streamlined Genetic Education and Cascade Testing in Hereditary Cancer Families: Key Findings Introduction When a pathogenic BRCA1 or BRCA2 mutation is found in a family, it is important for family members to undergo cascade genetic testing to guide screening and treatment decisions. However, men are less likely than women to pursue cascade testing. To address this, we developed a Web-based genetic education tool tailored to overcome barriers to cascade testing and streamline the process. Methods We conducted a randomized trial with 63 untested men from hereditary cancer families, comparing Web-based genetic education (WGE) to enhanced usual care (EUC). WGE participants… ➡️➡️➡️

Study Title: A gut microbiota rheostat forecasts responsiveness to PD-L1 and VEGF blockade in mesothelioma Nature Communications, August 21, 2024 Key Findings: Malignant mesothelioma, a rare cancer linked to asbestos exposure, has limited treatment options and poor prognosis. A multi-center phase II clinical trial (MiST4, NCT03654833) evaluated atezolizumab and bevacizumab (AtzBev) in relapsed mesothelioma patients, achieving a 50% disease control rate at 12 weeks with tolerable treatment. Tumor intrinsic resistance factors including aneuploidy, homologous recombination deficiency (HRD), epithelial-mesenchymal transition, and inflammation were identified. The gut-resident microbial genera correlated positively with treatment response and CD8+ T cell infiltration, while inversely correlated… ➡️➡️➡️

HSD3B1 Genotype and Outcomes in Metastatic Prostate Cancer Practical Solutions and Value Highlights HSD3B1 genotype plays a role in metastatic hormone-sensitive prostate cancer (mHSPC) outcomes. The AP allele is linked to castration resistance, particularly in low-volume tumors, affecting post-progression mortality and treatment-emergent adverse events. Enzalutamide plus androgen deprivation therapy (ADT) in men with mHSPC showed clinical benefit in a phase 3 trial. Enzalutamide significantly improves radiographic progression-free survival and overall survival vs. placebo regardless of HSD3B1 status. Despite differences in adverse events based on genotype, enzalutamide is beneficial for men with mHSPC independent of HSD3B1 genotype. Inherited polymorphisms of HSD3B1… ➡️➡️➡️

Effect of Narrative Photography on Physical Therapy Students’ Learning Outcomes in Heart Transplantation Nursing and Health Sciences, September 2024, Volume 26, Issue 3, Article e13155 Physical therapy students need to understand how to care for patients undergoing heart transplantation, including their emotional and practical needs. This study compared the effectiveness of a narrative photography (NP) program with traditional learning (TL) in improving students’ knowledge, satisfaction, empathy, and moral sensitivity. The two-armed assessor-blinded randomized controlled trial involved 117 physical therapy students, with 56 in the NP group and 61 in the TL group. Results showed that the NP group demonstrated a… ➡️➡️➡️

Comparison of Two Symptom Checkers (Ada and Symptoma) in the Emergency Department: Randomized, Crossover, Head-to-Head, Double-Blinded Study ABSTRACT Emergency departments (EDs) are often overcrowded, and nonurgent patients frequently seek care there. Symptom checkers (SCs) provide immediate access to disease suggestions and recommended actions, potentially improving patient flow. However, there is a lack of evidence supporting their direct use by patients. This study aimed to compare the diagnostic accuracy, safety, usability, and acceptance of two SCs, Ada and Symptoma. A randomized, crossover, head-to-head, double-blinded study was conducted at University Hospital Erlangen. Adult patients completed both SCs, Ada and Symptoma. The primary… ➡️➡️➡️

Evaluating the Efficacy of a Digital Therapeutic (CT-152) as an Adjunct to Antidepressant Treatment in Adults With Major Depressive Disorder: Protocol for the MIRAI Remote Study ABSTRACT Major depressive disorder (MDD) is a common and highly disabling condition. Many individuals with MDD do not experience full symptom relief with current treatments, so new options are needed. This study describes a phase 3 trial evaluating the efficacy of a smartphone app-based digital therapeutic (CT-152) as an additional treatment for adults with MDD who have not responded adequately to antidepressant therapy. OBJECTIVE The study aimed to assess the effectiveness of CT-152 as… ➡️➡️➡️

Study Highlights Speech-related temporal parameters (SRTPs) may be sensitive indicators of the efficacy of acetylcholinesterase (AChE) inhibitor therapy in mild Alzheimer’s disease. Automatic speech recognition in the Speech-Gap Test® revealed improvements in filled pause duration ratio, count ratio, and frequency after 12 and 24 weeks of donepezil treatment. ADAS-Cog total scores showed slight improvement, with significant improvement observed only in the orientation subtest after 24 weeks of donepezil treatment. Examining and evaluating speech parameters could play an important role in determining the effects of pharmacological treatment of mild AD. The study is novel in its application of linguistic parameters as… ➡️➡️➡️

Efficacy of a Mobile App-Based Intervention for Young Adults With Anxiety Disorders: A Randomized Clinical Trial ABSTRACT Young adults often face undertreatment for anxiety disorders. Maya, a mobile cognitive behavioral therapy (CBT) intervention, was tested in a randomized clinical trial. The study aimed to assess the efficacy and engagement with the intervention, comparing the effects of 3 incentive conditions. Participants received a 6-week program of the intervention and were randomized to one of three different text message-based incentive conditions (gain-framed, loss-framed, or gain-social support). The primary outcome was the change in anxious symptoms from baseline to the end of treatment,… ➡️➡️➡️

Efficacy and Feasibility of Combined Treatment for Neurodermatitis Objective To assess the effectiveness and practicality of using compound fluocinolone acetonide cream and guaiazulene in treating neurodermatitis. Methods A study was conducted on 92 neurodermatitis patients, dividing them into control and experimental groups. The control group received compound fluocinolone acetonide cream, while the experimental group also took oral guaiazulene tablets. Various parameters were monitored and compared between the two groups. Results The experimental group showed significant improvement in skin symptoms and signs, with lower scores compared to the control group. They also experienced reduced pain and itching, faster treatment onset, and… ➡️➡️➡️

Multivitamin Compliance Reduces Injuries of Female Recruits at Air Force Basic Training: A Randomized Controlled Cohort Study ABSTRACT Introduction: Basic military training (BMT) for U.S. Air Force and Space Force recruits is critical, but musculoskeletal injuries (MSKI) can threaten success. Trainees with nutritional deficiencies are at higher risk, so efforts to mitigate issues include providing multivitamins (MVI) to female recruits. However, compliance has been low, questioning the effectiveness of this intervention. This study evaluated the impact of different educational approaches on compliance and injury rates. Materials and Methods: This study involved a randomized controlled cohort of female trainees at BMT.… ➡️➡️➡️

Effect of Early Administration of Tetracosactide on Mortality and Host Response in Critically Ill Patients Requiring Rescue Surgery Summary Early administration of tetracosactide (TCS10) in critically ill patients undergoing rescue surgery significantly reduced 30-day mortality and improved hemostatic disorders. The drug targeted melanocortin receptors (MCRs) and showed promising results in a phase 3 randomized controlled trial. Key Findings 30-day mortality was significantly lower in the TCS10 group compared to the control group (0 vs. 8 deaths, P < 0.0001). Baseline levels of certain cytokines and lactate were associated with bleeding episodes, independent of TCS10 treatment. TCS10 treatment was associated with… ➡️➡️➡️

Ultrasound Radiomics for Forecasting Adverse Cardiovascular Events Objective Assessing the effectiveness of ultrasound-based radiomics in predicting major adverse cardiovascular events (MACE) within 1 year after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) patients. Methods 161 ACS patients who underwent PCI were included, with 114 in the training set and 47 in the validation set. Echocardiography was conducted 3-7 days after PCI, and patients were followed up for 1 year. Radiomics features related to MACE were extracted to create the RAD score. An ultrasound personalized model was developed, incorporating RAD score, LVEF, LVGLS, and NT-ProBNP. The model’s predictive capacity… ➡️➡️➡️