The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) Trial

2018 ◽  
Author(s):  
Nikhil Gupta ◽  
Catherine Chiles
Keyword(s):  
Coronary Artery Disease ◽  
Clinical Case ◽  
Short Term ◽  
Interpersonal Therapy ◽  
Randomized Evaluation ◽  
Artery Disease ◽  
Study Intervention ◽  
Overall Health Status ◽  
Landmark Study

This chapter provides a summary of a landmark study in psychiatry in primary care to mediate the effect of depression on overall health status . In the treatment of patients with major depression and coronary artery disease, what is the short-term efficacy of a selective serotonin reuptake inhibitor (citalopram) and/or interpersonal therapy? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Outcomes Following Endovascular versus Open Repair of Abdominal Aortic Aneurysm

2017 ◽  
Author(s):  
SreyRam Kuy ◽  
Kai J. Yang ◽  
Anahita Dua
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Vascular Surgery ◽  
Clinical Case ◽  
Open Repair ◽  
Short Term ◽  
Abdominal Aortic ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in vascular surgery assessing whether endovascular repair of abdominal aortic aneurysm (AAA) improves short-term outcomes compared to traditional open repair. The OVER trial demonstrated comparable results at 2-year follow-up between the two groups. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

scholarly journals N-terminal Pro-brain Natriuretic Peptide plasma levels are Associated With a Short-Term Diagnosis of Cancer in Patients with Coronary Artery Disease

2020 ◽  
Author(s):  
José Tuñón ◽  
Álvaro Aceña ◽  
Ana Pello ◽  
Sergio Ramos-Cillán ◽  
Juan Martínez-Milla ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Plasma Levels ◽  
High Sensitivity ◽  
Short Term ◽  
Artery Disease

Abstract Background N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma levels are increased in patients with cancer. In this paper we test whether NT-proBNP may identify patients who are going to receive a future cancer diagnosis (CD) in the short term. Methods We studied 962 patients with stable coronary artery disease and free of cancer and heart failure at baseline. NT-proBNP, galectin-3, monocyte chemoattractant protein-1, high-sensitivity C-reactive protein, high-sensitivity cardiac troponin I (hsTnI), and calcidiol (vitamin D) plasma levels were assessed. The primary outcome was new CD. Results After 5.40 (2.81-6.94) years of follow-up, 59 patients received a CD. NT-proBNP [HR 1.036 CI (1.015-1.056) per increase in 100 pg/ml; p=0.001], previous atrial fibrillation [HR 3.140 CI (1.196-8.243); p=0.020], and absence of previous heart failure [HR 0.067 CI (0.006-0.802); p=0.033] were independent predictors of a receiving a CD in first three years of follow-up. None of the variables analyzed predicted a CD beyond this time. A previous history of heart failure was present in 3.3% of patients receiving a CD in the first three years of follow-up, in 0.0% of those receiving this diagnosis beyond three years, and in 12.3% of patients not developing cancer (p=0.036). Conclusions In patients with coronary artery disease, NT-proBNP is an independent predictor of CD in the first three years of follow-up but not later, suggesting that it could be detecting subclinical undiagnosed cancers. The existence of previous heart failure does not account for these differences. New studies in large populations are needed to confirm these findings.

Abstract P050: Association Between Glycemic Control and Short-term Mortality Varies Across the Spectrum of Coronary Artery Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sridharan Raghavan ◽  
Wenhui G Liu ◽  
P. Michael Ho ◽  
Mary E Plomondon ◽  
Anna E Baron ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Significant Risk ◽  
Short Term ◽  
Increased Risk ◽  
Short Term Mortality ◽  
Artery Disease

Background: Diabetes is a significant risk factor for cardiovascular disease, but optimal glycemic control strategies remain unclear. In particular, trials of intensive glycemic control have highlighted a tension between increased mortality risk and macrovascular benefits. In this study we aimed to assess whether the burden of coronary artery disease (CAD) modifies the association between glycemic control and short-term mortality. Methods: We studied veterans with diabetes who underwent elective cardiac catheterization between 2005 and 2013 in a retrospective analysis of data from the VA Clinical Assessment, Reporting, and Tracking (CART) Program. Primary exposures were time-varying HbA1c over two years of follow-up after index catheterization, categorized as <6%, 6-6.49%, 6.5-6.99%, 7-7.99%, 8-8.99%, and >=9%, and burden of CAD, categorized as no CAD, non-obstructive CAD, or obstructive CAD. Primary outcome was two-year all-cause mortality. A total of 17394 participants had, on average, five HbA1c measurements over two years of follow-up. We used multivariable Cox proportional hazards regression to estimate the association between HbA1c and mortality, adjusting for demographic and clinical covariates and CAD burden, and including a term for interaction between HbA1c and CAD burden. Results: In adjusted models with 6.5 ≤ HbA1c ≤ 6.99% as the reference category, HbA1c < 6% was associated with increased risk of mortality (HR 1.55 [1.25, 1.92]), whereas HbA1c categories above 7% were not. We observed significant interaction between glycemic control and CAD burden (interaction p=0.0005); the increased risk of short-term mortality at HbA1c < 6% was limited to individuals with non-obstructive and obstructive CAD (Figure 1). Conclusions: HbA1c below 6% was associated with increased risk of short-term mortality, but only in individuals with CAD. CAD burden may thus inform individualized diabetes management strategies, specifically treatment de-escalation in individuals with any angiographically-defined CAD.

Comparison of 8 versus 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults

2018 ◽  
pp. 257-262
Author(s):  
Laurie O. Mark ◽  
Jean Kwo
Keyword(s):  
Antibiotic Therapy ◽  
Randomized Trial ◽  
Study Design ◽  
Clinical Case ◽  
Pulmonary Infection ◽  
Ventilator Associated Pneumonia ◽  
Icu Patients ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of the landmark study “Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” In adult patients with ventilator-associated pneumonia (VAP), is treatment with an 8-day course of antimicrobials as effective as a 15-day course? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. In ICU patients who develop microbiologically proven VAP, an 8-day antimicrobial course is not inferior to a 15-day course with respect to all-cause mortality or recurrence of pulmonary infection. However, these findings may not apply to patients who are immunocompromised, and shorter or longer duration of antibiotics may sometimes be indicated.

Cognitive Therapy versus Medication in the Treatment of Moderate to Severe Depression

2018 ◽  
Author(s):  
Daniel Barron ◽  
Robert Ostroff
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Study Design ◽  
Clinical Case ◽  
Severe Depression ◽  
Major Depressive ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study on major depressive disorder. Is paroxetine or cognitive therapy more effective in treating patients with moderate to severe major depressive disorder? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Behavioral and/or Pharmacotherapy for Older Patients with Insomnia

2018 ◽  
Author(s):  
Robert Ross ◽  
Rajesh R. Tampi
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Older Patients ◽  
Clinical Case ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Healthy Elderly ◽  
Longterm Treatment ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study on short and longterm treatment of insomnia. Should older patients with insomnia be managed with cognitive behavioral therapy, benzodiazepines, or both? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The study shows that bensodiazepines and cognitive behavioral therapy are equally effective for shorterm treatment of insomnia in otherwise healthy elderly participants but cognitive behavioral therapy is far more effective for longterm treatment of insomnia.

Prevalence and Severity of Psychiatric Comorbidities

2018 ◽  
Author(s):  
Stephanie Yarnell ◽  
Ellen Edens
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Impulse Control ◽  
Clinical Case ◽  
Psychiatric Comorbidities ◽  
National Comorbidity Survey Replication ◽  
Psychiatric Conditions ◽  
Study Intervention ◽  
Landmark Study

Chapter 20—The Prevalence and Severity of Psychiatric Comorbidities provides a summary of a landmark study in epidemiology, the The National Comorbidity Survey Replication (NCS-R). This chapter study sought to answer some fundamental questions. How common are comorbid psychiatric conditions? What are the prevalence and severity rates for comorbid anxiety, mood, impulse control, and substance use disorders? Starting with these questions, this chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Global Burden of Mental and Substance Use Disorders

2018 ◽  
Author(s):  
Stephanie Yarnell ◽  
Ellen Edens
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Study Design ◽  
Burden Of Disease ◽  
Clinical Case ◽  
Global Burden ◽  
Disease Study ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in epidemiology. The Global Burden of Disease Study was a ground breaking venture in answering the question regarding the prevalence of various diseases. By analyzing this database, the current study was sought to determine the burden of disease attributable to mental and substance use disorders. With this in mind, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety

2018 ◽  
Author(s):  
David Saunders ◽  
Andres Martin ◽  
Jerome H. Taylor
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Anxiety Disorders ◽  
Clinical Case ◽  
Behavioral Therapy ◽  
Childhood Anxiety ◽  
Child And Adolescent Psychiatry ◽  
Cognitive Behavioral ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study evaluating the treatment of anxiety disorders in child and adolescent psychiatry. Is sertraline in combination with cognitive behavioral therapy more effective than monotherapy with either treatment alone in children with anxiety disorders? Also, how do these treatments compare with placebo therapy? Starting with these questions, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Levomethadyl Acetate versus Buprenorphine versus Methadone for Opioid Dependence

2018 ◽  
Author(s):  
Robert Ross ◽  
Brian Fuehrlein
Keyword(s):  
Substance Use ◽  
Opioid Dependence ◽  
Clinical Case ◽  
Low Dose ◽  
High Dose ◽  
Opiate Use ◽  
Opiate Use Disorder ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study on substance use disorders. Which of the following is most effective for treatment of opioid dependence: levomethadyl acetate, buprenorphine, high-dose methadone, or low-dose methadone? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The study demonstrates that buprenorphine, high-dose methadone, and levomethadyl acetate are equally effective in the treatment of opiate use disorder. All three treatments are significantly more effective than low-dose methadone.

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