Why Cochrane is Wrong About Hypertension. Very Wrong.

By SWAPNIL HIREMATH MD Archie Cochrane and the Cochrane Collaboration Archie Cochrane was born in Scotland, educated in London (King’s College, University College and London School of Hygiene and Tropical Medicine) and worked in Cardiff, Wales. His work as a doctor during the Spanish Civil War and World War II, especially in a prisoner of war camp in Salonica, is credited with his push towards generating higher quality evidence. In his description of the clinical trial he conducted, he mentions James Lind as his hero. Ironically, that clinical trial – with weak randomization, open allocation, non-blinding of investigator or participants, and use of surrogate outcomes, would rate poorly in the Cochrane risk of bias tool. But the scientific method of measuring stuck with him, and among many other achievements, he did perform a proper randomized clinical trial (RCT) a few decades later. He continued to be strong supporter of RCTs, and pushed for the Medical Research Council (MRC) to move from purely fundamental research towards applied clinical research. As an aside, the first proper RCT in the modern era was funded by the MRC, and was published in 1950 – on the use of Streptomycin vs para-amino salicylic acid, or a combination, in tuberculosis. Far more influential was his paper (and later book) published as part of the Rock Carling Fellowship, available here freely and worth a read. It’s where he puts forward the vision for RCTs in moving towards ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: EBM Source Type: blogs

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ConclusionsAdjustment of the cfPWV value may be necessary for a more accurate distinction between lower and higher risk group of patients for white matter microstructural injury related to arterial stiffness. Targeting the highest risk group for prevention methods may, in turn, help preserve brain health and cognitive functions.
Source: NeuroImage: Clinical - Category: Radiology Source Type: research
Publication date: Available online 16 September 2019Source: Academic RadiologyAuthor(s): Mohammad Hadi Bagheri, Holger Roth, William Kovacs, Jianhua Yao, Faraz Farhadi, Xiaobai Li, Ronald M. SummersPurposeAccurate pancreas segmentation has application in surgical planning, assessment of diabetes, and detection and analysis of pancreatic tumors. Factors that affect pancreas segmentation accuracy have not been previously reported. The purpose of this study is to identify technical and clinical factors that adversely affect the accuracy of pancreas segmentation on CT.Method and MaterialsIn this IRB and HIPAA compliant study, ...
Source: Academic Radiology - Category: Radiology Source Type: research
This study is a prospective, exploratory, qualitative analysis. Twenty midwives from Grenoble Alpes University Hospital who took care of one of the selected patients participated in this study. Two women had schizophrenia and one bipolar disorder. Interviews realized with a semi-structured guide were fully transcribed, anonymized and thematically analyzed. Topics have been structured according to the number of occurrences to build a thematic tree. RESULTS: Midwives felt insecure and resourceless when the postpartum care was unclear, insufficiently anticipated and in case of a danger for the women or the children. They ...
Source: L Encephale - Category: Psychiatry Tags: Encephale Source Type: research
In this study, we investigated the ability of raspberry fruit extract (RBE) to mitigate adipose tissue dysfunction using hypertrophied 3T3-L1 adipocytes. The obtained results showed that RBE decreased intracellular ROS generation in hypertrophied adipocytes by enhancing expression of antioxidant defense enzymes SOD, catalase, and GPx, and inhibiting an oxidant enzyme NADPH oxidase 4. Moreover, RBE reduced lipid accumulation accompanied by increased lipid mobilization. RBE significantly inhibited LPL, aP2, FAS and PLIN mRNA expression, and enhanced the expression of HSL. Furthermore, RBE exhibited a high anti-inflammatory p...
Source: Journal of Functional Foods - Category: Nutrition Source Type: research
In conclusion, BHF may be a potential natural product candidate for the effective treatment of DN.Graphical abstract
Source: Journal of Functional Foods - Category: Nutrition Source Type: research
Conclusions The 13-item DBII scale is appropriately short and possesses satisfactory validity and reliability for both insulin-naive and insulin-treated patients with T2DM. Healthcare providers may use this scale as a checklist to guide clinical discussions related to insulin therapy with both insulin-naive and insulin-treated patients with T2DM across time.
Source: Journal of Nursing Research - Category: Nursing Tags: ORIGINAL ARTICLES Source Type: research
Conclusions/Implications for Practice: Our findings confirmed a deterioration in pulmonary function in smokers who did not perform moderate or vigorous PA. The level of PA performed was positively related to pulmonary function in smokers, whereas in nonsmokers, improvements were only significant in LA–CA.
Source: Journal of Nursing Research - Category: Nursing Tags: ORIGINAL ARTICLES Source Type: research
Regulatory agencies in three countries, including the United States, all approved lenvatinib in combination with pembrolizumab for the treatment of patients with advanced endometrial carcinoma.FDA Approvals
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Hematology-Oncology News Alert Source Type: news
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
By SWAPNIL HIREMATH, MD Archie Cochrane and the Cochrane Collaboration Archie Cochrane was born in Scotland, educated in London (King’s College, University College and London School of Hygiene and Tropical Medicine) and worked in Cardiff, Wales. His work as a doctor during the Spanish Civil War and World War II, especially in a prisoner of war camp in Salonica, is credited with his push towards generating higher quality evidence. In his description of the clinical trial he conducted, he mentions James Lind as his hero. Ironically, that clinical trial – with weak randomization, open allocation, non-blindin...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: EBM Cochrane patient population risks Source Type: blogs
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