Safety profile

Possible Protective Effect of Rosuvastatin in Chemotherapy-Induced Cardiotoxicity in HER2 Positive Breast Cancer Patients: A Randomized Controlled Trial Summary Chemotherapy in HER2 positive breast cancer patients can lead to cardiotoxicity. This study investigated the potential protective effect of rosuvastatin against chemotherapy-induced cardiotoxicity. The results showed that rosuvastatin-treated group had significantly lower decline in LVEF, lower levels of hs-cTnI, IL-6, and MPO, and no cases of cardiotoxicity compared to the control group. This suggests that rosuvastatin may be a promising protective agent against chemotherapy-induced cardiotoxicity. Practical Solutions and Value Clinical trials are essential for developing safe and effective treatments. Our AI-driven… ➡️➡️➡️

Duloxetine Effectiveness in Preventing Taxane-Related Neuropathy Key Findings Paclitaxel chemotherapy can lead to long-lasting neuropathy. However, a double-blind randomized trial revealed that duloxetine is a potentially effective medication for preventing both subjective and objective neuropathy in breast cancer patients undergoing paclitaxel treatment. Practical Solutions The study found that daily administration of duloxetine at specific doses during the first and second weeks of each chemotherapy cycle significantly reduced the occurrence and severity of neuropathic symptoms and objective neurophysiological measures. This suggests a practical and promising intervention to prevent taxane-related neuropathy in breast cancer patients undergoing paclitaxel chemotherapy. Value in Healthcare The… ➡️➡️➡️

Frontloading Home Physical Therapy Visits for Patients With Heart Failure: A Multi-center Randomized Controlled Trial Abstract Frontloading home care visits were investigated for their impact on function in persons with heart failure (HF) in a prospective multi-center randomized controlled trial. A total of 82 ambulatory patients participated, with one group receiving frontloaded visits and another receiving standard care over a 4-week period. Functional measures including the 2-minute step test, 2-minute walk test, gait speed, Timed Up and Go test, and 30-second chair rise test were collected at different time points. The study found significant improvements in function for individuals with… ➡️➡️➡️

Frequency of Red Blood Cell Allo-Immunization in Patients Undergoing Blood Transfusion at the Uganda Cancer Institute ABSTRACT There is limited data on red blood cell (RBC) alloimmunization in patients with cancer in sub-Saharan Africa (SSA). We examined the frequency of RBC alloimmunization in transfused patients with cancers in Uganda. METHODS A randomized control trial was conducted on participants at the Uganda Cancer Institute. Eligible participants were age ≥15 years and required blood transfusion. Participants were randomized to receive either leucoreduced or non-leucoreduced blood transfusion. Participants’ plasma samples were screened for RBC alloantibodies at enrolment and 3-4 weeks after blood transfusion… ➡️➡️➡️

Study Summary Comparison of Sedation Drugs in Elderly Patients During Gastrointestinal Endoscopy Researchers compared the use of remimazolam besylate and a combination of etomidate and propofol for sedation in elderly patients undergoing gastrointestinal endoscopy. The study aimed to assess the effectiveness and safety of these sedation methods. Key Findings Remimazolam besylate showed comparable safety and efficacy to the etomidate and propofol combination, making it a safe option for sedation during gastrointestinal endoscopy in elderly patients with ASA I-II. However, careful monitoring is necessary to address the occurrence of hiccups. Practical Solutions and Value Remimazolam besylate demonstrated a shorter post-anesthesia care… ➡️➡️➡️

Phase I Thorough QT/QTc Study of Avacopan in Healthy Participants Study Details A phase I thorough QTc study evaluated avacopan’s effect on cardiac repolarization in healthy participants. The study included both therapeutic and supratherapeutic doses of avacopan, as well as placebo and positive controls. Key Findings The study found that avacopan did not have a clinically meaningful effect on heart rate or cardiac conduction. The estimated population slopes showed a shallow relationship, which was not statistically significant. The drug appeared to be generally well tolerated in the study population. Practical Solutions and Value Clinical trials play a crucial role in… ➡️➡️➡️

Digital Technology Revolutionizing Mandibular Fracture Treatment Comparative Analysis of Patient-Specific Plates and Conventional Titanium Plates Objective: To assess the clinical effectiveness of patient-specific plates utilizing digital technology in treating mandibular fractures compared to conventional titanium plates. Materials and Methods: Twenty patients with mandibular fractures were included and randomly assigned to study or control groups. The study group underwent surgery with patient-specific plates generated through virtual surgery planning, while the control group had surgery with conventional titanium plates. Assessment criteria included malunion, infection, sensory disturbance, subjective occlusal disturbance, and occlusal force in functional maximum intercuspation (MICP). Results: There were no statistically… ➡️➡️➡️

Effects of Discontinuing Antihypertensive Treatment in Nursing Home Residents with Dementia Key Findings Discontinuing antihypertensive treatment in nursing home residents with dementia did not significantly reduce neuropsychiatric symptoms or improve quality of life compared to usual care. Study Details The study involved 205 participants with moderate-to-severe dementia and systolic blood pressure ≤160 mmHg. They were randomized to either discontinue antihypertensive treatment or receive usual care. Results At the 16-week follow-up, no significant differences were found between the two groups in terms of neuropsychiatric symptoms or quality of life. Serious adverse events occurred in 36% of the discontinuation group and 24%… ➡️➡️➡️

Effect of Metformin on Gut Microbiota Imbalance in T2DM Patients and the Value of Probiotic Supplementation ABSTRACT PURPOSE: This study aimed to investigate the impact of metformin on gut microbiota imbalance in patients with type 2 diabetes mellitus (T2DM) and the potential benefits of probiotic supplementation. METHODS: 84 newly diagnosed T2DM patients were randomly assigned to probiotics, metformin, or control groups. Blood glucose control, islet function, gut microbiota, and inflammatory factors were compared among the three groups. RESULTS: After 3 months of treatment, both the probiotics and metformin groups showed significant reductions in fasting plasma glucose (FPG), 2-hour postprandial plasma… ➡️➡️➡️

Clinical Trial Results: Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Ovarian Cysts Key Findings The study aimed to assess the safety and feasibility of using transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for managing ovarian cysts. The results showed that vNOTES was not inferior to conventional laparoscopy (CL) in terms of adnexectomy or ovarian cystectomy. vNOTES was found to be a safe, feasible, and less invasive treatment option, leading to reduced postoperative pain, faster recovery, and absence of visible incisions. Practical Solutions and Value These findings highlight the potential of vNOTES as a more minimally invasive surgical approach, offering practical… ➡️➡️➡️

Participants’ Perspectives on Weight Loss Intervention Trial Before Colorectal Cancer Surgery Key Findings Patients with excess weight awaiting colorectal cancer surgery were motivated by the offer of structured weight loss support that could potentially improve their surgical outcomes. However, concerns about the potential unpalatability of the intervention diet and side effects were also expressed. Positive attitudes of clinicians towards the trial facilitated recruitment, but participants were disappointed when they were randomized to usual care due to clinical teams’ overemphasis on the benefits of losing weight. Practical Solutions and Value The study highlights the importance of balanced communication of equipoise to… ➡️➡️➡️

Maintenance Therapy with Anlotinib for Advanced Non-Small-Cell Lung Cancer Key Findings Maintenance therapy with anlotinib after platinum-based chemotherapy showed a median progression-free survival of 5.95 months and a median overall survival of 18.60 months in patients with advanced non-small cell lung cancer. Results Out of 23 patients, 19 had stable disease, 1 had a partial response, and 3 had progressive disease. The objective response rate was 4.35%, and the disease control rate was 86.96%. The incidence of adverse events of grade ≥ 3 was 21.7%. Conclusion Anlotinib offers a new option for maintenance treatment in patients with locally advanced or… ➡️➡️➡️

Effectiveness of HIV Self-Testing in Assisted Partner Services (APS-HIVST Study) Practical Solutions and Value Assisted partner services (APS) is a successful strategy for increasing HIV testing, new diagnoses, and linkage to care among partners of people living with HIV (PLWH). However, it can be resource intensive. This study aimed to assess the effectiveness of offering HIV self-testing (HIVST) as an option for partner testing within APS. Methods: A trial compared provider-delivered HIV testing (Standard APS) with offering partners the option of provider-delivered testing or HIVST (APS+HIVST) at 24 health facilities in Western Kenya. The study analyzed the impact on HIV… ➡️➡️➡️

Bronchoscopy with and without Needle-Based Confocal Laser Endomicroscopy for Peripheral Lung Nodule Diagnosis: Protocol for a Multicentre Randomised Controlled Trial (CLEVER Trial) Introduction Despite technological advances, bronchoscopic peripheral lung nodule analysis still faces limitations due to frequent mispositioning. Needle-based confocal laser endomicroscopy (nCLE) provides real-time microscopic feedback on needle positioning, potentially improving sampling location and diagnostic yield. We aim to investigate if nCLE-imaging integrated with conventional bronchoscopy results in a higher diagnostic yield compared with conventional bronchoscopy without nCLE. Methods and Analysis This is a parallel-group randomised controlled trial conducted in multiple European countries and the USA. Patients with suspected… ➡️➡️➡️

HAP-FAST Feasibility Study Key Points: • Evaluating the clinical impact of low-dose CT scans and rapid molecular sputum analysis for suspected non-ventilator-associated hospital-acquired pneumonia (nv-HAP). • Incorporating a pilot trial, qualitative study, costing analysis, and immune-pathophysiology investigation. • Participants recruited from four acute hospitals in the Northwest of the UK. • Assessing trial processes, outcome measures, and patient/staff experiences to determine feasibility of a future trial. Practical Solutions and Value: • Utilizing AI-driven platform DocSym to consolidate ICD-11 standards, clinical protocols, and research for clinicians. • Streamlining operations with mobile apps for scheduling, treatment monitoring, and telemedicine to enhance patient… ➡️➡️➡️

Comparing Autologous Blood, Corticosteroid, and Combined Injection for Lateral Epicondylitis Treatment Background Lateral epicondylitis is a common forearm condition, and this study compared the effectiveness of autologous blood (AB) injection, corticosteroid (CS) injection, and a combined injection of both in treating the condition. Materials and Methods 120 patients were divided into three groups for different injections. Follow-up assessments were conducted on days 15, 30, and 90 using patient-rated tennis elbow evaluation (PRTEE) and hand grip strength (HGS) measurements. Results All groups showed significant PRTEE improvement by day 15, with CS group showing the most reduction. However, CS benefits deteriorated by… ➡️➡️➡️

Predictive Values of Pre-treatment Brain Age Models to rTMS Effects in Neurocognitive Disorder with Depression Introduction Developing personalized repetitive transcranial magnetic stimulation (rTMS) faces challenges due to high inter-individual treatment response variations. Brain morphometry may contribute to these variations. This study aimed to determine if an individual’s brain morphometry could predict rTMS responders and remitters. Methods This secondary analysis utilized data from a randomized clinical trial involving fifty-five patients over 60 with comorbid depression and neurocognitive disorder. Brain age was estimated from MRI scans using morphometric features and a support vector machine. Brain-predicted age difference (brain-PAD) was calculated as the… ➡️➡️➡️

Study Title: A mixed methods process evaluation of HIV prevention services in rural South Africa Background Combination prevention interventions integrated with community-based support have shown to benefit adolescent and young people’s sexual and reproductive health. The trial aimed to evaluate the delivery of HIV prevention and care among young people through integrated HIV and sexual and reproductive health (HIV/SRH) interventions with or without peer support. Methods The process evaluation used mixed methods including quantitative and qualitative approaches. Surveys, clinic and programmatic data were used to quantify intervention uptake and understand fidelity and reach. In-depth interviews were conducted to understand intervention… ➡️➡️➡️

Comparison of Ultrasound Probes for Lung Ultrasound in Neonates Key Findings: Study compared different ultrasound probes for lung ultrasound in neonates. Lower NPLUS scores with echo and microconvex probes compared to linear probe. Strong correlation between pulse oximetric saturation/fraction of inspired oxygen ratio and NPLUS score using microconvex probe. Practical Solutions and Value: Results confirm current recommendations and highlight the impact of using different probes. Caution needed in interpreting scores for guiding therapies and communicating prognoses. Correlation between NPLUS score and clinical parameters validates the use of this diagnostic tool. AI-Driven Clinical Support Practical Solutions and Value: DocSym platform consolidates… ➡️➡️➡️

Determining the optimal frequency of SARS-CoV-2 regular asymptomatic testing: A randomized feasibility trial in a home care setting Background The SARS-CoV-2 pandemic has posed challenges for caregivers in home care settings, as they can transmit the virus to their high-risk relatives. Regular asymptomatic testing of caregivers may help reduce transmission, but the best testing frequency is unknown. Methods We conducted a trial enrolling caregivers providing home-based care for a relative at least twice a week. Participants were randomly assigned to conduct saliva-based antigen self-testing once a week, twice a week, or every two days. They completed weekly questionnaires, and data… ➡️➡️➡️