JAMA : the journal of the American Medical Association
-
Randomized Controlled Trial Multicenter Study
Remote Ischemic Conditioning for Acute Stroke: The RESIST Randomized Clinical Trial.
Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke. ⋯ RIC initiated in the prehospital setting and continued in the hospital did not significantly improve functional outcome at 90 days in patients with acute stroke.
-
Meta Analysis
Estimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes: An Individual-Participant Data Meta-Analysis.
Chronic kidney disease (low estimated glomerular filtration rate [eGFR] or albuminuria) affects approximately 14% of adults in the US. ⋯ In this retrospective analysis of 114 cohorts, lower eGFR based on creatinine alone, lower eGFR based on creatinine and cystatin C, and more severe UACR were each associated with increased rates of 10 adverse outcomes, including adverse kidney outcomes, cardiovascular diseases, and hospitalizations.
-
Meta Analysis
Adherence to CPAP Treatment and the Risk of Recurrent Cardiovascular Events: A Meta-Analysis.
The effect of continuous positive airway pressure (CPAP) on secondary cardiovascular disease prevention is highly debated. ⋯ Adherence to CPAP was associated with a reduced MACCE recurrence risk, suggesting that treatment adherence is a key factor in secondary cardiovascular prevention in patients with OSA.
-
Clinical Trial
Reducing Unnecessary Oophorectomies for Benign Ovarian Neoplasms in Pediatric Patients.
Although most ovarian masses in children and adolescents are benign, many are managed with oophorectomy, which may be unnecessary and can have lifelong negative effects on health. ⋯ Unnecessary oophorectomies decreased with use of a preoperative risk stratification algorithm to identify lesions with a high likelihood of benign pathology that are appropriate for ovary-sparing surgery. Adoption of this algorithm might prevent unnecessary oophorectomy during adolescence and its lifelong consequences. Further studies are needed to determine barriers to algorithm adherence.