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Effect of Early Surgery vs Physical Therapy on Knee Function in Nonobstructive Meniscal Tears

Mar, 02/10/2018 - 02:00
This noninferiority trial compares the effects of arthroscopic partial meniscectomy vs physical therapy on patient-reported knee function in patients with meniscal tears.

Association of Clinical and Social Factors With Hypertension Risk in Black vs White US Adults

Mar, 02/10/2018 - 02:00
This cohort study of black and white adults investigates demographic, physical, and lifestyle factors that might account for differences in incidence of hypertension in black vs white US adults.

Association of Thyroid Hormone Treatment of Subclinical Hypothyroidism With QOL and Patient Symptoms

Mar, 02/10/2018 - 02:00
This meta-analysis of randomized trials assesses the association of thyroid hormone therapy with quality of life (QOL) and thyroid-related symptoms in nonpregnant adults with subclinical hypothyroidism.

Diagnosis and Management of Rheumatoid Arthritis

Mar, 02/10/2018 - 02:00
This narrative review summarizes current evidence regarding the pathophysiology, diagnosis, and treatment of rheumatoid arthritis.

Diagnostic Testing for Elevated Cortisol in the Setting of an Adrenal Mass

Mar, 02/10/2018 - 02:00
An asymptomatic 66-year-old man had a 3.1-cm left adrenal mass detected on CT scan with normal vital signs, BMI of 37, normal physical examination, and an elevated cortisol level after an overnight 1-mg dexamethasone suppression test. What would you do next?

Ciprofloxacin Otic Suspension (Otiprio) for Acute Otitis Externa

Mar, 02/10/2018 - 02:00
This Medical Letter review summarizes clinical studies, adverse effects, dosage, and administration for a 6% otic suspension formulation of the fluoroquinolone antibiotic ciprofloxacin (Otiprio), approved by the US Food and Drug Administration in 2018 for single-dose treatment of acute otitis externa.

Electronic Cigarette Sales in the United States, 2013-2017

Mar, 02/10/2018 - 02:00
This study uses e-cigarette retail sales data to estimate estimate e-cigarette sales and market share of e-cigarette sales by manufacturer in the United States during 2013-2017.

High-Intensity Sweeteners in Popular Cigarillos

Mar, 02/10/2018 - 02:00
This Research Letter evaluates the amount of sugars found in cigarillos by brand.

Cardiologist Trades Stem Cells for Cell-Based Meat

Mar, 02/10/2018 - 02:00
Beef and poultry grown from animal cells rather than sourced from whole animals could be the future of meat production, a cardiologist-turned-biotech entrepreneur says in this Medical News article.

New Drug Treats Rare, Debilitating Neurotrophic Keratitis

Mar, 02/10/2018 - 02:00
A recently approved drug may offer complete corneal healing for some patients with neurotrophic keratitis.

Rare Infection Linked With SGLT-2 Inhibitor Use

Mar, 02/10/2018 - 02:00
Sodium-glucose cotransporter 2 (SGLT-2) inhibitors used to treat adults with type 2 diabetes have been linked with necrotizing fasciitis of the perineum, a serious rare infection also known as Fournier gangrene, the FDA has warned.

Tretinoin in New Lotion Formula

Mar, 02/10/2018 - 02:00
The FDA has approved the first lotion formulation of the acne drug tretinoin to help ward off dryness, peeling, and sensitivity that often are associated with topical retinoids.

Given Their Potential for Harm, It’s Time to Focus on the Safety of Supplements

Mar, 02/10/2018 - 02:00
Supplements, including vitamins, minerals, and herbal products, are a huge business in the United States. US consumers spend about $30 billion on them every year. Despite uncertain benefits and possible harm, their interest in supplement use, for children as well as adults, remains undeterred.

Gut Microbes May Account for the Anti-Seizure Effects of the Ketogenic Diet

Mar, 02/10/2018 - 02:00
The low-carbohydrate, high-fat ketogenic diet is an effective treatment for many patients who have epilepsy that fails to respond to existing anticonvulsant medications, but the detailed mechanisms behind the diet’s beneficial effects on brain activity and behavior remains to be fully elucidated. New research published in Cell points to a pivotal role for the gut microbiome in mediating the effects of the diet.

Glyburide vs Insulin for Gestational Diabetes

Mar, 02/10/2018 - 02:00
To the Editor Dr Sénat and colleagues conducted a randomized clinical trial investigating the effect of glyburide or insulin on perinatal complications among women with gestational diabetes. We wonder whether the study design can be applied to most women with gestational diabetes.

Glyburide vs Insulin for Gestational Diabetes—Reply

Mar, 02/10/2018 - 02:00
In Reply Our study included women with singleton pregnancies and gestational diabetes diagnosed between 24 and 34 weeks, since intervention studies have shown efficacy of treatment in preventing perinatal complications in this population. Type 2 diabetes and gestational diabetes diagnosed before 24 weeks were exclusion criteria, so our trial was not designed to compare the efficacy of insulin and glyburide in preventing perinatal complications in women with gestational diabetes before 24 weeks. We did not compare complications in women diagnosed earlier vs later in the 24- to 34-week period.

Acupuncture for Women Undergoing In Vitro Fertilization

Mar, 02/10/2018 - 02:00
To the Editor In a randomized clinical trial of women undergoing in vitro fertilization (IVF), acupuncture did not improve live birth rates, compared with sham acupuncture, and the authors concluded: “These findings do not support the use of acupuncture to improve the rate of live births among women undergoing IVF.” However, the treatment protocol was too short to draw such a conclusion. The study involved only 3 sessions of acupuncture (each for 25 minutes), the first between days 6 and 8 of ovarian stimulation, the second 1 hour before embryo transfer, and the third immediately after embryo transfer on the day of the IVF procedure. In addition to the short length of acupuncture intervention, 36.1% of the participants did not complete the full course of acupuncture treatment during the trial. Noncompliance may reduce the power of a study. A previous randomized clinical trial used a similar short length of treatment and found no statistically significant difference in pregnancy rate for women undergoing IVF or intracytoplasmic sperm injection (ICSI) treated with acupuncture vs sham acupuncture. The short treatment length and poor completion rate in this study are likely to have minimized any potentially positive effect of acupuncture.

Acupuncture for Women Undergoing In Vitro Fertilization

Mar, 02/10/2018 - 02:00
To the Editor Dr Smith and colleagues performed a large multicenter randomized clinical trial in which the efficacy of acupuncture during IVF on live births was compared with sham acupuncture. They found no significant difference in live birth rates between the acupuncture and sham acupuncture treatments.

Acupuncture for Women Undergoing In Vitro Fertilization—Reply

Mar, 02/10/2018 - 02:00
In Reply Dr Gu and Dr Chen and colleagues expressed concerns about the generalizability of the findings of our study. Our trial results confirm findings from a 2013 systematic review of no difference in live birth rates between acupuncture and a sham control.

Factors Associated With Variation in Outcomes in Bariatric Surgery Centers of Excellence

Mar, 02/10/2018 - 02:00
To the Editor The American College of Surgeons bariatric centers of excellence (COEs) were established with the aim of improving the quality of patient care and safety. The rigorous accreditation standards to become a COE include the evaluation of a center’s case volume, commitment to quality, appropriate use of equipment and instruments, clinical care support, continuum of care, data collection, and continuous quality improvement.