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1.
Ann Intern Med ; 177(5): JC51, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38710079

RESUMO

SOURCE CITATION: Giamarellos-Bourboulis EJ, Siampanos A, Bolanou A, et al. Clarithromycin for early anti-inflammatory responses in community-acquired pneumonia in Greece (ACCESS): a randomised, double-blind, placebo-controlled trial. Lancet Respir Med. 2024;12:294-304. 38184008.


Assuntos
Antibacterianos , Claritromicina , Infecções Comunitárias Adquiridas , Humanos , Claritromicina/administração & dosagem , Claritromicina/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Método Duplo-Cego , Administração Oral , Pneumonia/tratamento farmacológico , Masculino , Feminino , Pneumonia Bacteriana/tratamento farmacológico , Pessoa de Meia-Idade , Quimioterapia Combinada
2.
Ann Intern Med ; 176(6): JC64, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37276602

RESUMO

SOURCE CITATION: Paton NI, Cousins C, Suresh C, et al; TRUNCATE-TB Trial Team. Treatment strategy for rifampin-susceptible tuberculosis. N Engl J Med. 2023;388:873-887. 36808186.


Assuntos
Antituberculosos , Tuberculose , Humanos , Antituberculosos/uso terapêutico , Tuberculose/tratamento farmacológico , Rifampina/uso terapêutico , Quimioterapia Combinada
3.
Ann Intern Med ; 175(4): JC40, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35377719

RESUMO

SOURCE CITATION: Jayk Bernal A, Gomes da Silva MM, Musungaie DB, et al. Molnupiravir for oral treatment of Covid-19 in nonhospitalized patients. N Engl J Med. 2022;386:509-20. 34914868.


Assuntos
COVID-19 , Adulto , Citidina/análogos & derivados , Hospitalização , Humanos , Hidroxilaminas/efeitos adversos , SARS-CoV-2
4.
Ann Intern Med ; 175(12): JC143, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36469928

RESUMO

SOURCE CITATION: Thornhill MH, Gibson TB, Yoon F, et al. Antibiotic prophylaxis against infective endocarditis before invasive dental procedures. J Am Coll Cardiol. 2022;80:1029-41. 35987887.


Assuntos
Endocardite Bacteriana , Endocardite , Adulto , Humanos , Antibioticoprofilaxia , Odontologia
5.
Am J Ind Med ; 65(2): 117-131, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34825393

RESUMO

BACKGROUND: The World Trade Center (WTC) general responder cohort (GRC) was exposed to environmental toxins possibly associated with increased risk of developing autoimmune conditions. OBJECTIVES: Two study designs were used to assess incidence and risks of autoimmune conditions in the GRC. METHODS: Three clinically trained professionals established the status of possible GRC cases of autoimmune disorders adhering to diagnostic criteria, supplemented, as needed, by specialists' review of consenting responders' medical records. Nested case-control analyses using conditional logistic regression estimated the risk associated with high WTC exposure (being in the 9/11/2001 dust cloud or ≥median days' response worked) compared with low WTC exposure (all other GRC members'). Four controls were matched to each case on age at case diagnosis (±2 years), sex, race/ethnicity, and year of program enrollment. Sex-specific and sensitivity analyses were performed. GRC age- and sex-adjusted standardized incidence ratios (SIRs) were compared with the Rochester Epidemiology Project (REP). Complete REP inpatient and outpatient medical records were reviewed by specialists. Conditions meeting standardized criteria on ≥2 visits were classified as REP confirmed cases. RESULTS: Six hundred and twenty-eight responders were diagnosed with autoimmune conditions between 2002 and 2017. In the nested case-control analyses, high WTC exposure was not associated with autoimmune domains and conditions (rheumatologic domain odds ratio [OR] = 1.03, 95% confidence interval [CI] = 0.77, 1.37; rheumatoid arthritis OR = 1.12, 95% CI = 0.70, 1.77). GRC members had lower SIR than REP. Women's risks were generally greater than men's. CONCLUSIONS: The study found no statistically significant increased risk of autoimmune conditions with WTC exposures.


Assuntos
Doenças Autoimunes , Socorristas , Exposição Ocupacional , Ataques Terroristas de 11 de Setembro , Doenças Autoimunes/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Cidade de Nova Iorque , Exposição Ocupacional/efeitos adversos
6.
Ann Intern Med ; 174(11): JC124, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34724399

RESUMO

SOURCE CITATION: Heath PT, Galiza EP, Baxter DN, et al. Safety and efficacy of NVX-CoV2373 Covid-19 vaccine. N Engl J Med. 2021;385:1172-83. 34192426.


Assuntos
COVID-19 , Vacinas , Vacinas contra COVID-19 , Humanos , SARS-CoV-2
7.
Ann Intern Med ; 174(7): JC75, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34224270

RESUMO

SOURCE CITATION: Sadoff J, Gray G, Vandebosch A, et al. Safety and efficacy of single-dose Ad26.COV2.S vaccine against Covid-19. N Engl J Med. 2021. [Epub ahead of print.] 33882225.


Assuntos
COVID-19 , Vacinas , Vacinas contra COVID-19 , Humanos , SARS-CoV-2
8.
Pediatr Surg Int ; 38(3): 365-375, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35006367

RESUMO

PURPOSE: The optimal age for minimally invasive repair of pectus excavatum (MIRPE) is unclear; this study investigates the differences in complication rates among different age groups undergoing repair. METHODS: PubMed and Embase databases were searched from inception to October 2020. To assess age as a risk factor for complications, odds ratios from relevant studies were analyzed using the Mantel-Haenszel method with a random-effects model for younger vs older patients. Specific complication rates were compared between the two cohorts using a chi-squared test. RESULTS: Of the 4448 studies retrieved, 25 studies stratified complication data by age groups. From these studies, ten studies compared groups at ages < 18 and ≥ 18 and four studies compared ages < 20 and ≥ 20, and one study compared ages < 19 and ≥ 19. These fifteen studies reported on 5978 patients, with 1188 complications, for a complication rate of 19.87%. Older patients were more likely to have complications in a pooled analysis of studies comparing older vs younger patients (OR = 1.66, 95% CI = 1.28-2.14, heterogeneity I2 = 49%). Specifically, older patients were significantly more likely to experience pneumothorax, pleural effusion, wound infection, bar displacement, and reoperations. CONCLUSION: Increased age is a risk factor for complications of MIRPE. This supports repair of pectus excavatum prior to late adolescence.


Assuntos
Tórax em Funil , Toracoplastia , Adolescente , Tórax em Funil/epidemiologia , Tórax em Funil/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Complicações Pós-Operatórias/epidemiologia , Reoperação , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
9.
Ann Intern Med ; 173(8): JC47, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33075255

RESUMO

SOURCE CITATION: Riccò M, Ferraro P, Gualerzi G, et al. Point-of-care diagnostic tests for detecting SARS-CoV-2 antibodies: a systematic review and meta-analysis of real-world data. J Clin Med. 2020;9:1515. 32443459.

11.
Clin Infect Dis ; 66(1): 20-28, 2018 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-29020200

RESUMO

Background: The objective of this study was to assess differences in hepatitis C virus (HCV) incidence by sex in people who inject drugs (PWID), using a large international multicohort set of pooled biological and behavioral data from prospective observational studies of incident human immunodeficiency virus (HIV) and HCV infections in high-risk cohorts (the InC3 Collaborative). Methods: HCV infection date was estimated based on a hierarchy of successive serological (anti-HCV), virological (HCV RNA), and clinical (symptoms and/or liver function tests) data. We used a Cox proportional hazards model to calculate the crude and adjusted female to male (F:M) hazard ratio (HR) for HCV incidence using biological sex as the main exposure. Results: A total of 1868 PWID were observed over 3994 person-years of observation (PYO). Unadjusted F:M HR was 1.38 (95% confidence interval [CI], 1.15-1.65) and remained significant after adjusting for behavioral and demographic risk factors (1.39 [95% CI, 1.12-1.72]). Although syringe and equipment sharing were associated with the highest HCV incidence rate in women (41.62 and 36.83 PYO, respectively), we found no sex differences attributed to these risk factors. Conclusions: Our findings indicate that women who inject drugs may be at greater risk of HCV acquisition than men, independent of demographic characteristics and risk behaviors. Multiple factors, including biological (hormonal), social network, and differential access to prevention services, may contribute to increased HCV susceptibility in women who inject drugs.


Assuntos
Hepatite C/epidemiologia , Fatores Sexuais , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Feminino , Humanos , Incidência , Masculino , Estudos Prospectivos , Fatores de Risco
12.
Value Health ; 19(4): 391-403, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27325331

RESUMO

BACKGROUND: The economic value of robotic-assisted laparoscopic prostatectomy (RALP) in the United States is still not well understood because of limited view analyses. OBJECTIVES: The objective of this study was to examine the costs and benefits of RALP versus retropubic radical prostatectomy from an expanded view, including hospital, payer, and societal perspectives. METHODS: We performed a model-based cost comparison using clinical outcomes obtained from a systematic review of the published literature. Equipment costs were obtained from the manufacturer of the robotic system; other economic model parameters were obtained from government agencies, online resources, commercially available databases, an advisory expert panel, and the literature. Clinical point estimates and care pathways based on National Comprehensive Cancer Network guidelines were used to model costs out to 3 years. Hospital costs and costs incurred for the patients' postdischarge complications, adjuvant and salvage radiation treatment, incontinence and potency treatment, and lost wages during recovery were considered. Robotic system costs were modeled in two ways: as hospital overhead (hospital overhead calculation: RALP-H) and as a function of robotic case volume (robotic amortization calculation: RALP-R). All costs were adjusted to year 2014 US dollars. RESULTS: Because of more favorable clinical outcomes over 3 years, RALP provided hospital ($1094 savings with RALP-H, $341 deficit with RALP-R), payer ($1451), and societal ($1202) economic benefits relative to retropubic radical prostatectomy. CONCLUSIONS: Monte-Carlo probabilistic sensitivity analysis demonstrated a 38% to 99% probability that RALP provides cost savings (depending on the perspective). Higher surgical consumable costs are offset by a decreased hospital stay, lower complication rate, and faster return to work.


Assuntos
Custos Hospitalares/estatística & dados numéricos , Prostatectomia/economia , Prostatectomia/métodos , Neoplasias da Próstata/economia , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/economia , Custos e Análise de Custo , Custos de Cuidados de Saúde , Humanos , Laparoscopia/economia , Masculino , Metanálise como Assunto , Modelos Econômicos , Complicações Pós-Operatórias/economia , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do Tratamento , Estados Unidos
16.
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