Diagnosis and Management of Atopic Dermatitis for Primary Care Providers.

Objective: To provide primary care providers an up-to-date approach to the diagnosis and management of atopic dermatitis (AD).

Quality Of Evidence: PubMed, Cochrane, and MEDLINE databases were searched for relevant meta-analyses, randomized controlled trials, systematic reviews, and observational studies about the diagnosis and management of AD.

Main Message: AD is a common chronic skin disease characterized by immune dysregulation and skin barrier dysfunction.

Association of Natriuretic Peptide Levels After Transcatheter Aortic Valve Replacement With Subsequent Clinical Outcomes.

Importance: Among those with aortic stenosis, natriuretic peptide levels can provide risk stratification, predict symptom onset, and aid decisions regarding the timing of valve replacement. Less is known about the prognostic significance and potential clinical utility of natriuretic peptide levels measured after valve replacement.

Objective: To determine the associations of elevated B-type natriuretic peptide (BNP) levels after transcatheter aortic valve replacement (TAVR) and change in BNP levels between follow-up time points with risk of subsequent clinical outcomes.

Improving Equity Through Primary Care: Proceedings of the 2019 Toronto International Conference on Quality in Primary Care.

Health equity allows people to reach their full health potential and receive high-quality care that is appropriate for them and their needs, no matter where they live, what they have, or who they are. It is a core element of quality in health care. Around the world, there are many efforts to improve equity through primary care.

Preclinical and clinical investigation of intratumoral chemotherapy pharmacokinetics in DIPG using gemcitabine.

Background: Hundreds of systemic chemotherapy trials in diffuse intrinsic pontine glioma (DIPG) have not improved survival, potentially due to lack of intratumoral penetration, which has not previously been assessed in humans.

Methods: We used gemcitabine as a model agent to assess DIPG intratumoral pharmacokinetics (PK) using mass spectrometry.

Results: In a phase 0 clinical trial of i.

Genomic and Transcriptomic Characterisation of Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer.

Standard treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiotherapy (NACRT), followed by surgical resection. However, >70% of patients do not achieve a complete pathological response and have higher rates of relapse and death. There are no validated pre- or on-treatment factors that predict response to NACRT besides tumour stage and size.

Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone.

We have evaluated dietary recommendations for people diagnosed with familial hypercholesterolaemia (FH), a genetic condition in which increased low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk for coronary heart disease (CHD). Recommendations for FH individuals have emphasised a low saturated fat, low cholesterol diet to reduce their LDL-C levels. The basis of this recommendation is the 'diet-heart hypothesis', which postulates that consumption of food rich in saturated fat increases serum cholesterol levels, which increases risk of CHD.

Simple Laboratory Test-Based Risk Scores in Coronary Catheterization: Development, Validation, and Comparison to Conventional Risk Factors.

Background: We developed and validated laboratory test-based risk scores (i.e., lab risk scores) to reclassify mortality risk among patients undergoing their first coronary catheterization.

Assessing the costs of historical inaction on climate change.

We consider alternative history scenarios in which explicit climate mitigation begins before the present day, estimating the total costs to date of delayed action. Considering a 2(1.5) degree Celsius stabilization target, peak costs are greater and reached sooner with a later start to mitigation, reaching 15(17)% of global GDP in 2085(2070) for a 1990 start and 18(35)% in 2080(2035) for a 2020 start.

Mucoactive agent use in adult UK Critical Care Units: a survey of health care professionals' perception, pharmacists' description of practice, and point prevalence of mucoactive use in invasively mechanically ventilated patients.

Background: Mechanical ventilation for acute respiratory failure is one of the most common indications for admission to intensive care units (ICUs). Airway mucus clearance is impaired in these patients medication, impaired mucociliary motility, increased mucus production etc. and mucoactive agents have the potential to improve outcomes.

Mapping global urban land for the 21st century with data-driven simulations and Shared Socioeconomic Pathways.

Urban land expansion is one of the most visible, irreversible, and rapid types of land cover/land use change in contemporary human history, and is a key driver for many environmental and societal changes across scales. Yet spatial projections of how much and where it may occur are often limited to short-term futures and small geographic areas. Here we produce a first empirically-grounded set of global, spatial urban land projections over the 21st century.

Embolization of Basilar Tip Aneurysm via Ascending Cervical Artery.

Background: Unusual vascular anatomy can present treatment challenges as traditional approaches may be unfeasible.

Case Description: In this case we describe a patient who presented with subarachnoid hemorrhage due to a ruptured basilar apex aneurysm, with an occluded left vertebral artery and severely stenotic right vertebral artery. Coil embolization was performed via catheterization of an ascending cervical artery, with a successful clinical and radiographic outcome.

Novel use of fused cardiac computed tomography and transesophageal echocardiography for left atrial appendage closure.

The use of the Watchman left atrial appendage occlusion device (Boston Scientific Inc.) is becoming increasingly frequent in patients with atrial fibrillation. Cardiac computed tomography (CT) for device sizing pre-procedure can help facilitate more accurate device selection compared with transesophageal echo (TEE) alone.

The prognostic value of initial serum lactate for survival in postcardiac arrest patients undergoing cardiac catheterization.

Objectives: We sought to investigate the prognostic value of serum lactate on survival in patients postcardiac arrest.

Background: Patients who experience cardiac arrest, in- or out-of-hospital, may have a poor outcome. Initial electrocardiograms may suggest ischemia as an underlying cause and urgent referral for catheterization occurs.

Loss of iRhom2 accelerates fat gain and insulin resistance in diet-induced obesity despite reduced adipose tissue inflammation.

Background: Low-grade inflammation and metabolic dysregulation are common comorbidities of obesity, both of which are associated with alterations in iRhom2-regulated pro-inflammatory cytokine and epidermal growth factor receptor (EGFR) ligand signaling.

Objective: Our objective was to determine the role of iRhom2 in the regulation of low-grade inflammation and metabolic dysregulation in a murine model of diet-induced obesity.

Methods: Wild type (WT) and iRhom2-deficient mice were fed normal chow (NC) or a high-fat diet (HFD) starting at 5 weeks of age for up to 33 weeks.

Factors associated with syrinx size in pediatric patients treated for Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium.

Objective: Factors associated with syrinx size in pediatric patients undergoing posterior fossa decompression (PFD) or PFD with duraplasty (PFDD) for Chiari malformation type I (CM-I) with syringomyelia (SM; CM-I+SM) are not well established.

Methods: Using the Park-Reeves Syringomyelia Research Consortium registry, the authors analyzed variables associated with syrinx radiological outcomes in patients (< 20 years old at the time of surgery) with CM-I+SM undergoing PFD or PFDD. Syrinx resolution was defined as an anteroposterior (AP) diameter of ≤ 2 mm or ≤ 3 mm or a reduction in AP diameter of ≥ 50%.

Identifying Priorities for Physiotherapy Research in the UK: the James Lind Alliance Physiotherapy Priority Setting Partnership.

Objectives: To identify unanswered questions for physiotherapy research and help set and prioritise the top 10 generic research priorities for the UK physiotherapy profession; updating previous clinical condition- specific priorities to include patient and carer perspectives, and reflect changes in physiotherapy practice, service provision and new technologies.

Design: The James Lind Alliance (JLA) Priority Setting Partnership (PSP) methodology was adopted, utilising evidence review, survey and consensus methods.

Participants: Anyone with experience and/or an interest in UK physiotherapy: patients, carers, members of the public, physiotherapists, student physiotherapists, other healthcare professionals, researchers, educators, service providers, commissioners and policy makers.

Final report from Intergroup NCCTG 86-72-51 (Alliance): a phase III randomized clinical trial of high-dose versus low-dose radiation for adult low-grade glioma.

Background: The optimal radiation dose for adult supratentorial low-grade glioma is unknown. The aim of this study was to provide a final update on oncologic and cognitive outcomes of high-dose versus low-dose radiation for low-grade glioma.

Methods: Between 1986 and 1994, 203 patients with supratentorial low-grade glioma were randomized (1:1) to 50.

How much would low- and middle-income countries benefit from addressing the key risk factors of road traffic injuries?

Despite strong advocacy, the UN Decade of Action for Road Safety (2011-2020) is ending with most low- and middle-income countries (LMICs) no closer to the Sustainable Development Goals target of reducing traffic mortality by half. In contrast, most high-income countries (HICs) have seen large benefits in recent decades from large-scale safety interventions. We aimed to assess how much LMICs would benefit from interventions that address six key risk factors related to helmet use, seatbelt use, speed control, drink driving, and vehicle design for safety of occupants and pedestrians.

Low and elevated B-type natriuretic peptide levels are associated with increased mortality in patients with preserved ejection fraction undergoing transcatheter aortic valve replacement: an analysis of the PARTNER II trial and registry.

Aims: B-type natriuretic peptide (BNP) is a cardiac neurohormone that is secreted in response to ventricular volume expansion and pressure overload. There are conflicting data regarding the association between BNP levels and outcomes after transcatheter aortic valve replacement (TAVR). We therefore sought to assess the association between baseline BNP and adverse outcomes in patients with symptomatic, severe aortic stenosis (AS), and left ventricular ejection fraction (LVEF) ≥50%, undergoing TAVR in the PARTNER 2 Trial and Registry.

What can we learn from the historic road safety performance of high-income countries?

Road traffic deaths in high-income countries (HICs) have been steadily declining for five decades, but are rising or stable in low- and middle-income countries (LMICs). We use time-series cross-sectional methods to assess how age- and sex- specific death rates evolved in 20 HICs during 1955-2015, controlling for income, population density and urbanization. Past work has attributed improvements in safety in HICs to income growth, suggesting that countries intervene when they become richer (Kuznets hypothesis).