Bevacizumab and paclitaxel-carboplatin chemotherapy and secondary cytoreduction in recurrent, platinum-sensitive ovarian cancer (NRG Oncology/Gynecologic Oncology Group study GOG-0213): a multicentre, open-label, randomised, phase 3 trial.

Background: Platinum-based chemotherapy doublets are a standard of care for women with ovarian cancer recurring 6 months after completion of initial therapy. In this study, we aimed to explore the roles of secondary surgical cytoreduction and bevacizumab in this population, and report the results of the bevacizumab component here.

Methods: The multicentre, open-label, randomised phase 3 GOG-0213 trial was done in 67 predominantly academic centres in the USA (65 centres), Japan (one centre), and South Korea (one centre).

Body Mass Index, Weight Loss, and Cause-Specific Mortality in Rheumatoid Arthritis.

Objective: To examine associations of body mass index (BMI) and weight loss with cause-specific mortality in rheumatoid arthritis (RA).

Methods: A cohort of US veterans with RA was followed until death or through 2013. BMI was categorized as underweight, normal, overweight, and obese.

Characterization of distinct coagulopathic phenotypes in injury: Pathway-specific drivers and implications for individualized treatment.

Background: International normalized ratio (INR) and partial thromboplastin time (PTT) are used interchangeably to diagnose acute traumatic coagulopathy but reflect disparate activation pathways. In this study, we identified injury/patient characteristics and coagulation factors that drive contact pathway, tissue factor pathway (TF), and common pathway dysfunction by examining injured patients with discordant coagulopathies. We hypothesized that patients with INR/PTT discordance reflect differing phenotypes representing contact versus tissue factor pathway perturbations and that characterization will provide targets to guide individualized resuscitation.

The history of risk: a review.

In the USA alone, around 22 million patients annually discuss the need for surgical procedure with their surgeon. On a global scale, more than 200 million patients are exposed to the risk of undergoing a surgical procedure every year. A crucial part of the informed consent process for surgery is the understanding of risk, the probability of complications, and the predicted occurrence of adverse events.

Sigmoid Volvulus Complicating Postpartum Period.

. Sigmoid volvulus is a rare complication of pregnancy and the puerperium. .

Chemoenzymatic synthesis of unmodified heparin oligosaccharides: cleavage of p-nitrophenyl glucuronide by alkaline and Smith degradation.

A heparin oligosaccharide having a completely natural structure was successfully synthesized through a chemoenzymatic approach using an unnatural glycosyl acceptor, p-nitrophenyl glucuronide (GlcA-pNP). The use of an inexpensive and commercially available GlcA-pNP acceptor facilitates oligosaccharide recovery and purification on C-18 resin during chemoenzymatic synthesis. Oligosaccharide chain extension and modification afforded a heptasaccharide with gluconic acid residues at its reducing and non-reducing ends.

The Geographic Distribution of Pediatric Anesthesiologists Relative to the US Pediatric Population.

Background: The geographic relationship between pediatric anesthesiologists and the pediatric population has potentially important clinical and policy implications. In the current study, we describe the geographic distribution of pediatric anesthesiologists relative to the US pediatric population (0-17 years) and a subset of the pediatric population (0-4 years).

Methods: The percentage of the US pediatric population that lives within different driving distances to the nearest pediatric anesthesiologist (0 to 25 miles, >25 to 50 miles, >50 to 100 miles, >100 to 250 miles, and >250 miles) was determined by creating concentric driving distance service areas surrounding pediatric anesthesiologist practice locations.

Body Mass Index and the Spontaneous Onset of Parturition.

Objective: To investigate the relationship between body mass index (BMI) and the onset of parturition throughout gestation.

Methods: This was a secondary analysis of the Maternal-Fetal Medicine Units Network Preterm Prediction Study. Time-to-spontaneous-birth-event (ie, "survival") methods were used to study the association of BMI with the timing of spontaneous onset of labor throughout gestation with indicated births censored at delivery.

Advising and Interview Patterns of Medical Students Pursuing Obstetrics and Gynecology Residency.

Objective: To describe the advising practices at medical schools and interview patterns among medical students pursuing obstetrics and gynecology residency training.

Methods: A voluntary, anonymous survey was distributed to all applicants interviewing for obstetrics and gynecology residency during the 2014-2015 cycle at the University of Colorado, University of Washington, University of California, San Francisco, and Loyola University. Demographic data were obtained.

The cell-stretcher: A novel device for the mechanical stimulation of cell populations.

Mechanical stimulation appears to be a critical modulator for many aspects of biology, both of living tissue and cells. The cell-stretcher, a novel device for the mechanical uniaxial stimulation of populations of cells, is described. The system is based on a variable stroke cam-lever-tappet mechanism which allows the delivery of cyclic stimuli with frequencies of up to 10 Hz and deformation between 1% and 20%.

Associations of Circulating Cytokines and Chemokines With Cancer Mortality in Men With Rheumatoid Arthritis.

Objective: To examine the potential of circulating cytokines and chemokines as biomarkers of cancer mortality risk in patients with rheumatoid arthritis (RA).

Methods: Male participants in the Veterans Affairs RA registry were followed up from the time of enrollment until death or December 2013. Cytokines and chemokines were measured in banked serum obtained at the time of enrollment, using a bead-based multiplex assay, and a previously developed cytokine score was calculated.

The Insertion and Management of External Ventricular Drains: An Evidence-Based Consensus Statement : A Statement for Healthcare Professionals from the Neurocritical Care Society.

External ventricular drains (EVDs) are commonly placed to monitor intracranial pressure and manage acute hydrocephalus in patients with a variety of intracranial pathologies. The indications for EVD insertion and their efficacy in the management of these various conditions have been previously addressed in guidelines published by the Brain Trauma Foundation, American Heart Association and combined committees of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. While it is well recognized that placement of an EVD may be a lifesaving intervention, the benefits can be offset by procedural and catheter-related complications, such as hemorrhage along the catheter tract, catheter malposition, and CSF infection.

Update on the Affordable Care Act. King v. Burwell and Obergefell v. Hodge.

Patients with respiratory diseases, critical illness, or sleep disorders who lack health insurance endure disparities in access to care and worse health outcomes. These disparities were partly addressed in the United States in 2010 by passage of the Affordable Care Act. Low- and moderate-income individuals and families with incomes between 138 and 400% of the federal poverty level are eligible for insurance premium subsidies when purchasing policies on the health insurance marketplace exchanges.

Cause-Specific Mortality in Male US Veterans With Rheumatoid Arthritis.

Objective: There has been limited investigation into cause-specific mortality and the associated risk factors in men with rheumatoid arthritis (RA). We investigated all-cause and cause-specific mortality in men with RA, examining determinants of survival.

Methods: Men from a longitudinal RA registry were followed from enrollment until death or through 2013.

Validation of a vaginal birth after cesarean delivery prediction model in women with two prior cesarean deliveries.

Objective: To evaluate whether an existing vaginal birth after cesarean delivery (VBAC) prediction model validated for women with one prior cesarean delivery also accurately predicts the likelihood of VBAC in women with two prior cesarean deliveries.

Methods: We performed a secondary analysis of all women attempting trial of labor after cesarean delivery (TOLAC) with a term singleton pregnancy and two prior cesarean deliveries in the Maternal-Fetal Medicine Units Network (MFMU) Cesarean Registry. Probability of VBAC was calculated for each participant using the MFMU VBAC prediction model.

A systematic review of randomized controlled trials of interventions to improve the health of persons during imprisonment and in the year after release.

We systematically reviewed randomized controlled trials of interventions to improve the health of people during imprisonment or in the year after release. We searched 14 biomedical and social science databases in 2014, and identified 95 studies. Most studies involved only men or a majority of men (70/83 studies in which gender was specified); only 16 studies focused on adolescents.

Evolving beyond the vicious triad: Differential mediation of traumatic coagulopathy by injury, shock, and resuscitation.

Background: A subset of trauma patients with critical injury present with coagulopathy, portending markedly worse outcomes. Clinical practice is evolving to treat the classical risk factors of hypothermia, hemodilution, and acidosis; however, coagulopathy persists even in the absence of these factors. We sought to determine the relative importance of injury- and shock-specific factors compared with resuscitation-associated factors in coagulopathy after trauma.

5-Lipoxygenase activating protein (FLAP) dependent leukotriene biosynthesis inhibition (MK591) attenuates Lipid A endotoxin-induced inflammation.

The Lipid A moiety of endotoxin potently activates TLR-4 dependent host innate immune responses. We demonstrate that Lipid-A mediated leukotriene biosynthesis regulates pathogen-associated molecular patterns (PAMP)-dependent macrophage activation. Stimulation of murine macrophages (RAW264.

Prevalence of guideline-directed medical therapy among patients receiving cardiac resynchronization therapy defibrillator implantation in the National Cardiovascular Data Registry during the years 2006 to 2008.

Cardiac resynchronization therapy (CRT) reduces morbidity and mortality among selected patients with left ventricular systolic dysfunction and severe heart failure symptoms despite guideline-directed medical therapy (GDMT). Contemporaneous guidelines provided clear recommendations regarding selection of patients for CRT, including that all patients should first receive GDMT with β blockers and renin-angiotensin axis antagonists. Prevalence of GDMT among real-world patients receiving CRT defibrillators (CRT-D) has not been well studied.

Temporal trends of postinjury multiple-organ failure: still resource intensive, morbid, and lethal.

Background: While the incidence of postinjury multiple-organ failure (MOF) has declined during the past decade, temporal trends of its morbidity, mortality, presentation patterns, and health care resources use have been inconsistent. The purpose of this study was to describe the evolving epidemiology of postinjury MOF from 2003 to 2010 in multiple trauma centers sharing standard treatment protocols.

Methods: "Inflammation and Host Response to Injury Collaborative Program" institutions that enrolled more than 20 eligible patients per biennial during the 2003 to 2010 study period were included.

Chronic starvation secondary to anorexia nervosa is associated with an adaptive suppression of resting energy expenditure.

Background: Chronic starvation is accompanied by a reduction in resting energy expenditure (REE). It is not clear whether this is due mainly to a reduction in body mass or also involves a significant reduction in the cellular metabolic rate of the fat-free mass (FFM).

Objectives: The main goal was to compare measured REE (REEm) with REE predicted by dual-energy X-ray absorptiometry modeling of organ-tissue mass (REEp) in malnourished patients with severe anorexia nervosa (AN) and in healthy lean control subjects.