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Effectiveness of potent topical corticosteroids versus mild ones in primary care for children with moderate flare-ups of atopic dermatitis; results of a randomised controlled trial.
BMJ Open
December 2024
Department Dermatology, Center of Pediatric Dermatology, Erasmus MC University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
Objective: To assess the effectiveness of a potent topical corticosteroid (TCS) as an initial treatment in primary care for children with moderate flare-ups of atopic dermatitis (AD), compared to starting on a mild TCS.
Design: An observational prospective cohort study with an embedded pragmatic multicentre open-label randomised controlled trial.
Setting: A total of 53 general practices in the southwest of the Netherlands took part in the study.
Multicentre study conducted across centres in the USA, Europe and Australia to assess the safety and effectiveness of a bilateral hypoglossal nerve stimulation system for the treatment of obstructive sleep apnoea in adults: a protocol for a pivotal, multicentre, open-label, single-arm study.
BMJ Open
December 2024
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Introduction: Obstructive sleep apnoea (OSA) is characterised by blood oxygen desaturations and sleep disruptions manifesting undesirable consequences. Existing treatments including oral appliances, positive airway pressure (PAP) therapy and surgically altering the anatomy of the pharynx have drawbacks including poor long-term adherence or often involving irreversible, invasive procedures. Bilateral hypoglossal nerve stimulation (HNS) is a new treatment for managing OSA, and this study is intended to determine whether an HNS system is a safe and effective treatment option for adults with OSA.
View Article and Find Full Text PDFEchocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial.
Cardiovasc Diabetol
January 2025
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Background: Diabetic myocardial disorder (DbMD, evidenced by abnormal echocardiography or cardiac biomarkers) is a form of stage B heart failure (SBHF) at high risk for progression to overt HF. SBHF is defined by abnormal LV morphology and function and/or abnormal cardiac biomarker concentrations.
Objective: To compare the evolution of four DbMD groups based on biomarkers alone, systolic and diastolic dysfunction alone, or their combination.
Comparison of the adequacies of the OSCE and vOSCE to assess the competencies required under Brazilian medical curriculum guidelines: a multicenter study.
BMC Med Educ
January 2025
University of São Paulo, São Paulo, Brazil.
Background: The COVID-19 pandemic has led to the popularization of information and communication technology in medical education. This study aimed to compare the objective structured clinical examination (OSCE) and the virtual objective structured clinical examination (vOSCE), based on expert opinion, as tools for assessing the competencies needed under medical curriculum guidelines in Brazil.
Methods: In this multicenter study, the suitability levels of the OSCE and vOSCE for assessing the competencies needed under the Brazilian National Curriculum Guidelines (DCNs) were compared.
Ventilator-Associated Pneumonia in Low- and Middle-Income vs. High-Income Countries: The Role of Ventilator Bundle, Ventilation Practices, and Healthcare Staffing.
Chest
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Electronic address:
Background: Ventilator-associated pneumonia (VAP) rates are higher in low- and middle-income countries (LMICs) than in high-income countries (HICs).
Research Question: Could differences in ventilator bundle adherence, ventilation practices, and critical care staffing be driving variations in VAP risk between LMICs and HICs?
Study Design And Methods: This secondary analysis of the multicenter, international CERTAIN study included mechanically ventilated patients at risk for VAP from eleven LMICs and five HICs. We included oral care, head-of-bed elevation, spontaneous breathing assessments, and sedation breaks in the ventilator bundle.
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