Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial
by Tracey L. Sletten, Michelle Magee, Jade M. Murray, Christopher J. Gordon, Nicole Lovato, David J. Kennaway, Stella M. Gwini, Delwyn J. Bartlett, Steven W. Lockley, Leon C. Lack, Ronald R. Grunstein, Shantha M. W. Rajaratnam, for the Delayed Sleep on Melatonin (DelSoM) Study Group BackgroundDelayed Sleep-Wake Phase Disorder (DSWPD) is characterised by sleep initiation insomnia when attempting sleep at conventional times and difficulty waking at the required time for daytime commitments. Although there are published therapeutic guidelines for the administration of melatonin for DSWPD, to our knowledge, randomised controll...
Source: PLoS Medicine - June 18, 2018 Category: Internal Medicine Authors: Tracey L. Sletten Source Type: research

The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties
by Jacqueline K. Olive, Peter J. Hotez, Ashish Damania, Melissa S. Nolan In a Policy Forum, Peter Hotez and colleagues discuss vaccination exemptions in US states and possible consequences for infectious disease outbreaks. (Source: PLoS Medicine)
Source: PLoS Medicine - June 12, 2018 Category: Internal Medicine Authors: Jacqueline K. Olive Source Type: research

Artemether-lumefantrine dosing for malaria treatment in young children and pregnant women: A pharmacokinetic-pharmacodynamic meta-analysis
by Frank Kloprogge, Lesley Workman, Steffen Borrmann, Mamadou T ékété, Gilbert Lefèvre, Kamal Hamed, Patrice Piola, Johan Ursing, Poul Erik Kofoed, Andreas Mårtensson, Billy Ngasala, Anders Björkman, Michael Ashton, Sofia Friberg Hietala, Francesca Aweeka, Sunil Parikh, Leah Mwai, Timothy M. E. Davis, Harin Karunajeewa, Sam Salman, Francesco Checchi, Carol e Fogg, Paul N. Newton, Mayfong Mayxay, Philippe Deloron, Jean François Faucher, François Nosten, Elizabeth A. Ashley, Rose McGready, Michele van Vugt, Stephane Proux, Ric N. Price, Juntra Karbwang, Farkad Ezzet, Rajes...
Source: PLoS Medicine - June 12, 2018 Category: Internal Medicine Authors: Frank Kloprogge Source Type: research

Fixed-dose combination antihypertensive medications, adherence, and clinical outcomes: A population-based retrospective cohort study
by Amol A. Verma, Wayne Khuu, Mina Tadrous, Tara Gomes, Muhammad M. Mamdani BackgroundThe majority of people with hypertension require more than one medication to achieve blood pressure control. Many patients are prescribed multipill antihypertensive regimens rather than single-pill fixed-dose combination (FDC) treatment. Although FDC use may improve medication adherence, the impact on patient outcomes is unclear. We compared clinical outcomes and medication adherence with FDC therapy versus multipill combination therapy in a real-world setting using linked clinical and administrative databases. Methods and findingsWe cond...
Source: PLoS Medicine - June 11, 2018 Category: Internal Medicine Authors: Amol A. Verma Source Type: research

Estimating retention in HIV care accounting for patient transfers: A national laboratory cohort study in South Africa
ConclusionsIn this study, HIV care retention was substantially higher when viewed from a national perspective than from a facility perspective. Our results suggest that traditional clinical cohorts underestimate retention. (Source: PLoS Medicine)
Source: PLoS Medicine - June 11, 2018 Category: Internal Medicine Authors: Matthew P. Fox Source Type: research

Academic response to improving value and reducing waste: A comprehensive framework for INcreasing QUality In patient-oriented academic clinical REsearch (INQUIRE)
ConclusionsWe present a framework based on a consensus of different stakeholder groups guiding the practical assessment of clinical research quality at all stages of a research project. Operationalization of this common structure will support the increase of value by guiding academic institutions and researchers in developing quality enhancement initiatives, from posing the right research question to the transparent publication of results. (Source: PLoS Medicine)
Source: PLoS Medicine - June 7, 2018 Category: Internal Medicine Authors: Belinda von Niederh äusern Source Type: research

A peer-support lifestyle intervention for preventing type 2 diabetes in India: A cluster-randomized controlled trial of the Kerala Diabetes Prevention Program
ConclusionsA low-cost community-based peer-support lifestyle intervention resulted in a nonsignificant reduction in diabetes incidence in this high-risk population at 24 months. However, there were significant improvements in some cardiovascular risk factors and physical functioning score of the HRQoL scale. Trial registrationAustralia and New Zealand Clinical Trials Registry ACTRN12611000262909. (Source: PLoS Medicine)
Source: PLoS Medicine - June 6, 2018 Category: Internal Medicine Authors: Kavumpurathu R. Thankappan Source Type: research

Estimating the real-world effects of expanding antiretroviral treatment eligibility: Evidence from a regression discontinuity analysis in Zambia
ConclusionsIn this study, guidelines raising the CD4 threshold for treatment from 350 to 500 cells/ μL were associated with a rapid rise in ART initiation as well as enhanced retention among newly treatment-eligible patients, without negatively impacting patients with lower CD4 levels. These data suggest that health systems in Zambia and other high-prevalence settings could substantially enhance engagement even among those with high CD4 levels (i.e., above 500 cells/μL) by expanding treatment without undermining existing care standards. (Source: PLoS Medicine)
Source: PLoS Medicine - June 5, 2018 Category: Internal Medicine Authors: Aaloke Mody Source Type: research

Correction: Distributional change of women ’s adult height in low- and middle-income countries over the past half century: An observational study using cross-sectional survey data
by Jewel Gausman, Iv án Mejía-Guevara, S. V. Subramanian, Fahad Razak (Source: PLoS Medicine)
Source: PLoS Medicine - June 4, 2018 Category: Internal Medicine Authors: Jewel Gausman Source Type: research

Establishing a research agenda for early-onset colorectal cancer
by Caitlin C. Murphy, Amit G. Singal In this month's Editorial Caitlin C. Murphy and Amit Singal discuss the increasing incidence of early-onset colorectal cancer in patients under the age of 50. (Source: PLoS Medicine)
Source: PLoS Medicine - June 1, 2018 Category: Internal Medicine Authors: Caitlin C. Murphy Source Type: research

Future cost-effectiveness and equity of the NHS Health Check cardiovascular disease prevention programme: Microsimulation modelling using data from Liverpool, UK
ConclusionsAccording to our analysis of the situation in Liverpool, current NHS Health Check implementation appears neither equitable nor cost-effective. Optimal implementation is likely to be cost-saving but not equitable, while targeted implementation is likely to be both. Adding structural policies targeting cardiovascular risk factors could substantially improve equity and generate cost savings. (Source: PLoS Medicine)
Source: PLoS Medicine - May 29, 2018 Category: Internal Medicine Authors: Chris Kypridemos Source Type: research

Complement-activating donor-specific anti-HLA antibodies and solid organ transplant survival: A systematic review and meta-analysis
ConclusionsIn this study, we found that circulating complement-activating anti-HLA DSAs had a significant deleterious impact on solid organ transplant survival and risk of rejection. The detection of complement-activating anti-HLA DSAs may add value at an individual patient level for noninvasive biomarker-guided risk stratification. Trial registrationNational Clinical Trial protocol ID: NCT03438058. (Source: PLoS Medicine)
Source: PLoS Medicine - May 25, 2018 Category: Internal Medicine Authors: Antoine Bouquegneau Source Type: research

Correction: Multimorbidity in patients with heart failure from 11 Asian regions: A prospective cohort study using the ASIAN-HF registry
by Jasper Tromp, Wan Ting Tay, Wouter Ouwerkerk, Tiew-Hwa Katherine Teng, Jonathan Yap, Michael R. MacDonald, Kirsten Leineweber, John J. V. McMurray, Michael R. Zile, Inder S. Anand, A. Mark Richards, Carolyn S. P. Lam, ASIAN-HF authors (Source: PLoS Medicine)
Source: PLoS Medicine - May 25, 2018 Category: Internal Medicine Authors: Jasper Tromp Source Type: research

Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: A nationwide microsimulation study
ConclusionsThe implementation of fiscal austerity measures in Brazil can be responsible for substantively higher childhood morbidity and mortality than expected under maintenance of social protection —threatening attainment of Sustainable Development Goals for child health and reducing inequality. (Source: PLoS Medicine)
Source: PLoS Medicine - May 22, 2018 Category: Internal Medicine Authors: Davide Rasella Source Type: research

Clinical, socioeconomic, and behavioural factors at age 50 years and risk of cardiometabolic multimorbidity and mortality: A cohort study
ConclusionsThe importance of specific midlife factors in disease progression, from disease-free state to single disease, multimorbidity, and death, varies depending on the disease stage. While clinical risk factors at age 50 determine the risk of incident cardiometabolic disease in a disease-free population, midlife socioeconomic and behavioural factors are stronger predictors of progression to multimorbidity and mortality in people with cardiometabolic disease. (Source: PLoS Medicine)
Source: PLoS Medicine - May 21, 2018 Category: Internal Medicine Authors: Archana Singh-Manoux Source Type: research

Injury and death during the ISIS occupation of Mosul and its liberation: Results from a 40-cluster household survey
ConclusionsDeath and injuries during the military offensive to liberate Mosul considerably exceeded those during ISIS occupation. Airstrikes were the major reported cause of deaths, with the majority occurring in west Mosul. The extensive use of airstrikes and heavy artillery risks an extensive loss of life in densely populated urban areas. The high probability of survivor bias in this survey suggests that the actual number of injuries, kidnappings, and deaths in the neighborhoods sampled is likely to be higher than we report here. (Source: PLoS Medicine)
Source: PLoS Medicine - May 15, 2018 Category: Internal Medicine Authors: Riyadh Lafta Source Type: research

Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women —A double-blind, randomized non-inferiority trial
ConclusionsIbuprofen was inferior to pivmecillinam for treating uncomplicated UTIs. More than half of the women in the ibuprofen group recovered without antibiotics. However, pyelonephritis occurred in 7 out of 181 women using ibuprofen. Until we can identify those women who will develop complications, we cannot recommend ibuprofen alone as initial treatment to women with uncomplicated UTIs. Trial registrationClinicalTrials.gov NCT01849926EU Clinical Trials Register (EU-CTR), EudraCT Number 2012-002776-14 (Source: PLoS Medicine)
Source: PLoS Medicine - May 15, 2018 Category: Internal Medicine Authors: Ingvild Vik Source Type: research

Distributional change of women ’s adult height in low- and middle-income countries over the past half century: An observational study using cross-sectional survey data
ConclusionsThe findings of this study indicate that the population-level distribution of women ’s height does not stay constant in relation to mean changes. Because using mean height as a summary population measure does not capture broader distributional changes, overreliance on the mean may lead investigators to underestimate disparities in the distribution of environmental and nutritional determinants of health. (Source: PLoS Medicine)
Source: PLoS Medicine - May 11, 2018 Category: Internal Medicine Authors: Jewel Gausman Source Type: research

The next forum for unraveling FDA off-label marketing rules: State and federal legislatures
by Michael S. Sinha, Aaron S. Kesselheim In a Guest Editorial, Aaron S. Kesselheim and Michael S. Sinha show how federal and state legislation to allow promotion of drugs for non-approved uses threatens to undermine the FDA's public health mission. (Source: PLoS Medicine)
Source: PLoS Medicine - May 8, 2018 Category: Internal Medicine Authors: Michael S. Sinha Source Type: research

Access to antiretroviral therapy in HIV-infected children aged 0 –19 years in the International Epidemiology Databases to Evaluate AIDS (IeDEA) Global Cohort Consortium, 2004–2015: A prospective cohort study
We described time to ART initiation and missed opportunities (death or loss to follow-up [LTFU]: last clinical visit>6 months) since baseline (the date of HIV diagnosis or, if unavailable, date of enrollment). Cumulative incidence functions (CIFs) for and determinants of ART initiation were computed, with death and LTFU as competing risks. Among the 135,479 children included, 99,404 (73.4%) initiated ART, 1.9% died, 1.4% were transferred out, and 20.4% were lost to follow-up before ART initiation. The 24-month CIF for ART initiation was 68.2% (95% CI: 67.9% –68.4%); it was lower in sub-Saharan Africa—ranging...
Source: PLoS Medicine - May 4, 2018 Category: Internal Medicine Authors: Sophie Desmonde Source Type: research

All science should inform policy and regulation
by John P. A. Ioannidis In the context of a recent proposal to exclude research from consideration at the Environmental Protection Agency, John Ioannidis points out that “perceived perfection is not a characteristic of science, but of dogma” and envisions how governments can promote a standard of openness in science. (Source: PLoS Medicine)
Source: PLoS Medicine - May 3, 2018 Category: Internal Medicine Authors: John P. A. Ioannidis Source Type: research

Association of vitamin D with risk of type 2 diabetes: A Mendelian randomisation study in European and Chinese adults
ConclusionsThe concordant risks of diabetes for biochemically measured and genetically instrumented differences in 25(OH)D using synthesis SNPs provide evidence for a causal effect of higher 25(OH)D for prevention of diabetes. (Source: PLoS Medicine)
Source: PLoS Medicine - May 2, 2018 Category: Internal Medicine Authors: Ling Lu Source Type: research

Health insurance coverage with or without a nurse-led task shifting strategy for hypertension control: A pragmatic cluster randomized trial in Ghana
ConclusionsProvision of health insurance coverage plus a nurse-led task shifting strategy was associated with a greater reduction in SBP than provision of health insurance coverage alone, among patients with uncontrolled hypertension in Ghana. Future scale-up of these systems-level strategies for hypertension control in sub-Saharan Africa requires a cost –benefit analysis. Trial registrationClinicalTrials.gov NCT01802372 (Source: PLoS Medicine)
Source: PLoS Medicine - May 1, 2018 Category: Internal Medicine Authors: Gbenga Ogedegbe Source Type: research

Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents
ConclusionsPhilip Morris ’s research suggests that tobacco industry activity influences addiction treatment outcomes. Beyond nicotine’s pharmacology, the industry’s continued aggressive advertising, lobbying, and litigation against effective tobacco control policies promotes various nonpharmacological determinants of addiction. To help tobacco users quit, policy makers should increase attention on the social and environmental dimensions of addiction alongside traditional cessation efforts. (Source: PLoS Medicine)
Source: PLoS Medicine - May 1, 2018 Category: Internal Medicine Authors: Jesse Elias Source Type: research

Two-year impact of community-based health screening and parenting groups on child development in Zambia: Follow-up to a cluster-randomized controlled trial
ConclusionsThe results of this trial suggest that parenting groups hold promise for improving child development, particularly physical growth, in low-resource settings like Zambia. Trial registrationClinicalTrials.gov NCT02234726 (Source: PLoS Medicine)
Source: PLoS Medicine - April 24, 2018 Category: Internal Medicine Authors: Peter C. Rockers Source Type: research

Impacts 2 years after a scalable early childhood development intervention to increase psychosocial stimulation in the home: A follow-up of a cluster randomised controlled trial in Colombia
ConclusionsWe found no evidence that a scalable PS intervention benefited children ’s development 2 years after it ended. It is possible that the initial effects on child development were too small to be sustained or that the lack of continued impact on home stimulation contributed to fade out. Both are likely related to compromises in implementation when going to scale and sugg est one should not extrapolate from medium-term effects of small efficacy trials to scalable interventions. Understanding the salient differences between small efficacy trials and scaled-up versions will be key to making ECD interventions eff...
Source: PLoS Medicine - April 24, 2018 Category: Internal Medicine Authors: Alison Andrew Source Type: research

From surviving to thriving: What evidence is needed to move early child-development interventions to scale?
by Mark Tomlinson In a Perspective, Mark Tomlinson discusses research on early interventions to support child development in developing countries. (Source: PLoS Medicine)
Source: PLoS Medicine - April 24, 2018 Category: Internal Medicine Authors: Mark Tomlinson Source Type: research

Maternal age and offspring developmental vulnerability at age five: A population-based cohort study of Australian children
The objective of this study is to quantify a child ’s risk of developmental vulnerability at age five, according to their mother’s age at childbirth. Methods and findingsLinkage of population-level perinatal, hospital, and birth registration datasets to data from the Australian Early Development Census (AEDC) and school enrolments in Australia ’s most populous state, New South Wales (NSW), enabled us to follow a cohort of 99,530 children from birth to their first year of school in 2009 or 2012. The study outcome was teacher-reported child development on five domains measured by the AEDC, including physica...
Source: PLoS Medicine - April 24, 2018 Category: Internal Medicine Authors: Kathleen Falster Source Type: research

Determining the scope of attacks on health in four governorates of Syria in 2016: Results of a field surveillance program
ConclusionsThe use of field data collectors and use of consistent definitions can play an important role in the tracking incidents of attacks on health services. A mobile systematic data collection tool can complement other methods for tracking incidents of attacks on healthcare and ensure the collection of detailed information about each attack that may assist in better advocacy, programs, and accountability but can be practically challenging. Comparing attacks between SAMS and PHR suggests that there may have been significantly more attacks than previously captured by any one methodology. This scale of attacks suggests t...
Source: PLoS Medicine - April 24, 2018 Category: Internal Medicine Authors: Rohini J. Haar Source Type: research

Attacks on medical workers in Syria: Implications for conflict research
by Michael Spagat In a Perspective linked to the Research Article by Haar and colleagues, Michael Spagat discusses the challenges and importance of conducting research on mortality in regions affected by violent conflicts. (Source: PLoS Medicine)
Source: PLoS Medicine - April 24, 2018 Category: Internal Medicine Authors: Michael Spagat Source Type: research

Breastfeeding during infancy and neurocognitive function in adolescence: 16-year follow-up of the PROBIT cluster-randomized trial
by Seungmi Yang, Richard M. Martin, Emily Oken, Mikhail Hameza, Glen Doniger, Shimon Amit, Rita Patel, Jennifer Thompson, Sheryl L. Rifas-Shiman, Konstantin Vilchuck, Natalia Bogdanovich, Michael S. Kramer BackgroundEvidence on the long-term effect of breastfeeding on neurocognitive development is based almost exclusively on observational studies. In the 16-year follow-up study of a large, cluster-randomized trial of a breastfeeding promotion intervention, we evaluated the long-term persistence of the neurocognitive benefits of the breastfeeding promotion intervention previously observed at early school age. Methods and fi...
Source: PLoS Medicine - April 20, 2018 Category: Internal Medicine Authors: Seungmi Yang Source Type: research

Universal versus conditional day 3 follow-up for children with non-severe unclassified fever at the community level in the Democratic Republic of the Congo: A cluster-randomized, community-based non-inferiority trial
ConclusionsWe found that advising caregivers to return only if children worsened or remained ill on day 3 resulted in similar rates of caregiver-reported fever and other clinical outcomes on day 8, compared to advising all caregivers to return on day 3. Policy-makers could consider revising guidelines for management of uncomplicated fever within the iCCM framework. Trial registrationClinicalTrials.gov NCT02595827 (Source: PLoS Medicine)
Source: PLoS Medicine - April 17, 2018 Category: Internal Medicine Authors: Luke C. Mullany Source Type: research

Universal versus conditional day 3 follow-up for children with non-severe unclassified fever at the community level in Ethiopia: A cluster-randomised non-inferiority trial
by Karin K ällander, Tobias Alfvén, Tjede Funk, Ayalkibet Abebe, Abreham Hailemariam, Dawit Getachew, Max Petzold, Laura C. Steinhardt, Julie R. Gutman BackgroundWith declining malaria prevalence and improved use of malaria diagnostic tests, an increasing proportion of children seen by community health workers (CHWs) have unclassified fever. Current community management guidelines by WHO advise that children seen with non-severe unclassified fever (on day 1) should return to CHWs on day 3 for reassessment. We compared the safety of conditional follow-up reassessment only in cases where symptoms do not resolve w...
Source: PLoS Medicine - April 17, 2018 Category: Internal Medicine Authors: Karin K ällander Source Type: research

Preprints in medical research: Progress and principles
by Larry Peiperl, on behalf of the PLOS Medicine Editors In this month’s editorial, the PLOS Medicine Editors discuss the role of preprints in human health research and propose a 3-part framework for ensuring benefit. (Source: PLoS Medicine)
Source: PLoS Medicine - April 16, 2018 Category: Internal Medicine Authors: Larry Peiperl Source Type: research

Estimating the health and economic effects of the proposed US Food and Drug Administration voluntary sodium reformulation: Microsimulation cost-effectiveness analysis
by Jonathan Pearson-Stuttard, Chris Kypridemos, Brendan Collins, Dariush Mozaffarian, Yue Huang, Piotr Bandosz, Simon Capewell, Laurie Whitsel, Parke Wilde, Martin O ’Flaherty, Renata Micha BackgroundSodium consumption is a modifiable risk factor for higher blood pressure (BP) and cardiovascular disease (CVD). The US Food and Drug Administration (FDA) has proposed voluntary sodium reduction goals targeting processed and commercially prepared foods. We aimed to quantify the potential health and economic impact of this policy. Methods and findingsWe used a microsimulation approach of a close-to-reality synthetic popula...
Source: PLoS Medicine - April 10, 2018 Category: Internal Medicine Authors: Jonathan Pearson-Stuttard Source Type: research

Genetic scores to stratify risk of developing multiple islet autoantibodies and type 1 diabetes: A prospective study in children
ConclusionsA type 1 diabetes genetic score identified infants without family history of type 1 diabetes who had a greater than 10% risk for pre-symptomatic type 1 diabetes, and a nearly 2-fold higher risk than children identified by high-risk HLA genotypes alone. This finding extends the possibilities for enrolling children into type 1 diabetes primary prevention trials. (Source: PLoS Medicine)
Source: PLoS Medicine - April 3, 2018 Category: Internal Medicine Authors: Ezio Bonifacio Source Type: research

Preprints: An underutilized mechanism to accelerate outbreak science
by Michael A. Johansson, Nicholas G. Reich, Lauren Ancel Meyers, Marc Lipsitch In an Essay, Michael Johansson and colleagues advocate the posting of research studies addressing infectious disease outbreaks as preprints. (Source: PLoS Medicine)
Source: PLoS Medicine - April 3, 2018 Category: Internal Medicine Authors: Michael A. Johansson Source Type: research

Cardiovascular disease: The rise of the genetic risk score
by Joshua W. Knowles, Euan A. Ashley In a Perspective, Joshua Knowles and Euan Ashley discuss the potential for use of genetic risk scores in clinical practice (Source: PLoS Medicine)
Source: PLoS Medicine - March 30, 2018 Category: Internal Medicine Authors: Joshua W. Knowles Source Type: research

Integration of postpartum healthcare services for HIV-infected women and their infants in South Africa: A randomised controlled trial
We examined the impact of integrating postpartum ART for HIV+ mothers alongside infant follow-up within maternal and child health (MCH) services in Cape Town, South Africa. Methods and findingsWe conducted a randomised trial among HIV+ postpartum women aged ≥18 years who initiated ART during pregnancy in the local antenatal care clinic and were breastfeeding when screened before 6 weeks postpartum. We compared an integrated postnatal service among mothers and their infants (the MCH-ART intervention) to the local standard of care (control)—immediate postnatal referral of HIV+ women on ART to general adult ART servi...
Source: PLoS Medicine - March 30, 2018 Category: Internal Medicine Authors: Landon Myer Source Type: research

Polycystic ovary syndrome, androgen excess, and the risk of nonalcoholic fatty liver disease in women: A longitudinal study based on a United Kingdom primary care database
by Balachandran Kumarendran, Michael W. O ’Reilly, Konstantinos N. Manolopoulos, Konstantinos A. Toulis, Krishna M. Gokhale, Alice J. Sitch, Chandrika N. Wijeyaratne, Arri Coomarasamy, Wiebke Arlt, Krishnarajah Nirantharakumar BackgroundAndrogen excess is a defining feature of polycystic ovary syndrome (PCOS), which affects 10% of women and represents a lifelong metabolic disorder, with increased risk of type 2 diabetes, hypertension, and cardiovascular events. Previous studies have suggested an increased risk of nonalcoholic fatty liver disease (NAFLD) in individuals with PCOS and implicated androgen excess as a pot...
Source: PLoS Medicine - March 28, 2018 Category: Internal Medicine Authors: Balachandran Kumarendran Source Type: research

Cost-effectiveness of multidisciplinary care in mild to moderate chronic kidney disease in the United States: A modeling study
ConclusionsOur model estimates that a Medicare-funded MDC program could reduce the need for dialysis, prolong life expectancy, and meet conventional cost-effectiveness thresholds in middle-aged to elderly patients with mild to moderate CKD. (Source: PLoS Medicine)
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: Eugene Lin Source Type: research

What is the value of multidisciplinary care for chronic kidney disease?
by Richard J. Fluck, Maarten W. Taal In a Persepctive, Richard Fluck and Maarten Taal discuss the potential value of implementing multidisciplinary care programs for chronic kidney disease. (Source: PLoS Medicine)
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: Richard J. Fluck Source Type: research

Antiviral efficacy of favipiravir against Ebola virus: A translational study in cynomolgus macaques
by J érémie Guedj, Géraldine Piorkowski, Frédéric Jacquot, Vincent Madelain, Thi Huyen Tram Nguyen, Anne Rodallec, Stephan Gunther, Caroline Carbonnelle, France Mentré, Hervé Raoul, Xavier de Lamballerie BackgroundDespite repeated outbreaks, in particular the devastating 2014 –2016 epidemic, there is no effective treatment validated for patients with Ebola virus disease (EVD). Among the drug candidates is the broad-spectrum polymerase inhibitor favipiravir, which showed a good tolerance profile in patients with EVD (JIKI trial) but did not demonstrate a strong antivira...
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: J érémie Guedj Source Type: research

Transmission of HIV-1 drug resistance mutations within partner-pairs: A cross-sectional study of a primary HIV infection cohort
ConclusionsDrug-resistant majority variants appeared to be commonly transmitted by ARV-na ïve participants in our analysis and may contribute significantly to transmitted drug resistance on a population level. When present at low frequency, no major mutation was observed to be shared between partner-pairs; identification of accessory mutations shared within a pair could be due to transm ission, laboratory artifact, or apolipoprotein B mRNA-editing enzyme, catalytic polypeptides (APOBECs), and warrants further study. (Source: PLoS Medicine)
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: Joanne D. Stekler Source Type: research

Comorbidity health pathways in heart failure patients: A sequences-of-regressions analysis using cross-sectional data from 10,575 patients in the Swedish Heart Failure Registry
ConclusionsIdentification of distinct comorbidity health pathways in HF could provide the evidence for individualised person-centred care that targets specific comorbidities and associated symptoms. (Source: PLoS Medicine)
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: Claire A. Lawson Source Type: research

Multimorbidity in patients with heart failure from 11 Asian regions: A prospective cohort study using the ASIAN-HF registry
by Jasper Tromp, Wan Ting Tay, Wouter Ouwerkerk, Tiew-Hwa Katherine Teng, Jonathan Yap, Michael R. MacDonald, Kirsten Leineweber, John J. V. McMurray, Michael R. Zile, Inder S. Anand, Carolyn S. P. Lam, ASIAN-HF authors BackgroundComorbidities are common in patients with heart failure (HF) and complicate treatment and outcomes. We identified patterns of multimorbidity in Asian patients with HF and their association with patients ’ quality of life (QoL) and health outcomes. Methods and findingsWe used data on 6,480 patients with chronic HF (1,204 with preserved ejection fraction) enrolled between 1 October 2012 and 6 ...
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: Jasper Tromp Source Type: research

Comparative analysis of the association between 35 frailty scores and cardiovascular events, cancer, and total mortality in an elderly general population in England: An observational study
ConclusionThere is high variability in the strength of the association between frailty scores and 7-year all-cause mortality, incident CVD, and cancer. With regard to all-cause mortality, some scores give a modest improvement to the predictive ability. Our results show that certain scores clearly outperform others with regard to three important health outcomes in later life. Finally, we think that despite their limitations, the use of frailty scores to identify the elderly population at risk is still a useful measure, and the choice of a frailty score should balance feasibility with performance. (Source: PLoS Medicine)
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: Gloria A. Aguayo Source Type: research

Cardiovascular disease and multimorbidity: A call for interdisciplinary research and personalized cardiovascular care
by Kazem Rahimi, Carolyn S. P. Lam, Steven Steinhubl In a Guest Editorial, Kazem Rahimi, Carolyn Lam, and Steven Steinhubl call for interdisciplinary research and personalized cardiovascular care to better manage patients with cardiovascular disease and multimorbidity. (Source: PLoS Medicine)
Source: PLoS Medicine - March 27, 2018 Category: Internal Medicine Authors: Kazem Rahimi Source Type: research

HIV treatment eligibility expansion and timely antiretroviral treatment initiation following enrollment in HIV care: A metaregression analysis of programmatic data from 22 countries
ConclusionsThese findings underscore the potential of ART eligibility expansion to improve the timeliness of ART initiation globally, particularly for young adults. (Source: PLoS Medicine)
Source: PLoS Medicine - March 23, 2018 Category: Internal Medicine Authors: Olga Tymejczyk Source Type: research

Time for high-burden countries to lead the tuberculosis research agenda
by Madhukar Pai In a Guest Editorial, Madhukar Pai discusses the need for high-burden burden, middle-income countries to take a leading role in tuberculosis research. (Source: PLoS Medicine)
Source: PLoS Medicine - March 23, 2018 Category: Internal Medicine Authors: Madhukar Pai Source Type: research