Maternal intrahepatic cholestasis of pregnancy and neurodevelopmental conditions in offspring: A population-based cohort study of 2 million Swedish children
ConclusionsIn this study, we observed that exposure to ICP during gestation is associated with an increased likelihood of neurodevelopmental conditions in offspring, particularly in cases of early-onset ICP. Further studies are warranted to better understand the role of early-ICP in offspring neurodevelopment. (Source: PLoS Medicine)
Source: PLoS Medicine - January 16, 2024 Category: Internal Medicine Authors: Shuyun Chen Source Type: research
Mapping clinical interactions in an Australian tertiary hospital emergency department for patients presenting with risk of suicide or self-harm: Network modeling from observational data
ConclusionsThis study demonstrates a data-driven research framework, new to the best of our knowledge, to assess and reinforce important information pathways that guide clinical decision processes and provide complementary insights for improving clinical practice and operational models in emergency medicine for patients at risk of suicide or self-harm. Our findings suggest that PLNs can play a crucial role in clinical communication, but overreliance on PLNs may pose risks to reliable information flow. Operational models that utilize PLNs may be made more robust to these risks by improving interdisciplinary communication be...
Source: PLoS Medicine - January 12, 2024 Category: Internal Medicine Authors: Michael H. McCullough Source Type: research
The forecasted prevalence of comorbidities and multimorbidity in people with HIV in the United States through the year 2030: A modeling study
ConclusionsThe PEARL forecasts suggest a continued rise in comorbidity and multimorbidity prevalence to 2030, marked by heterogeneities across race/ethnicity, gender, and HIV acquisition risk subgroups. HIV clinicians must stay current on the ever-changing comorbidities-specific guidelines to provide guideline-recommended care. HIV clinical directors should ensure linkages to subspecialty care within the clinic or by referral. HIV policy decision-makers must allocate resources and support extended clinical capacity to meet the healthcare needs of people aging with HIV. (Source: PLoS Medicine)
Source: PLoS Medicine - January 12, 2024 Category: Internal Medicine Authors: Keri N. Althoff Source Type: research
Tafenoquine following G6PD screening versus primaquine for the treatment of vivax malaria in Brazil: A cost-effectiveness analysis using a transmission model
ConclusionsIn our modelling study that incorporated impact on transmission, tafenoquine prescribed after a semiquantitative G6PD testing was highly likely to be cost-effective in Brazil. These results demonstrate the potential health and economic importance of ensuring safe and effective radical cure. (Source: PLoS Medicine)
Source: PLoS Medicine - January 9, 2024 Category: Internal Medicine Authors: David J. Price Source Type: research
Costs and cost-effectiveness of influenza illness and vaccination in low- and middle-income countries: A systematic review from 2012 to 2022
ConclusionsThe 54 studies identified in this review suggest an increased momentum to generate economic evidence about influenza illness and vaccination from low- and middle-income countries during 2012 to 2022. However, given that we observed substantial heterogeneity, continued evaluation of the economic burden of influenza illness and costs/cost-effectiveness of influenza vaccination, particularly in LICs and among underrepresented target groups (e.g., healthcare workers and pregnant persons), is needed. Use of standardized methodology could facilitate pooling across settings and knowledge sharing to strengthen global in...
Source: PLoS Medicine - January 5, 2024 Category: Internal Medicine Authors: Radhika Gharpure Source Type: research
Price negotiation and pricing of anticancer drugs in China: An observational study
This study aimed to assess the changes in prices and their relationship with the clinical value of anticancer drugs after the implementation of price negotiations in China. Methods and findingsIn this observational study, anticancer drug indications that were negotiated successfully between 2017 and 2022 were identified through National Reimbursement Drug Lists (NRDL) of China. We excluded extensions of indications for drugs already listed in the NRDL, indications for pediatric use, and indications lacking corresponding clinical trials. We identified pivotal clinical trials for included indications by consulting review rep...
Source: PLoS Medicine - January 2, 2024 Category: Internal Medicine Authors: Jing Zhou Source Type: research
Procedural sedation and analgesia versus general anesthesia for hysteroscopic myomectomy (PROSECCO trial): A multicenter randomized controlled trial
This study aims to investigate whether hysteroscopic myomectomy under procedural sedation and analgesia with propofol is noninferior to hysteroscopic myomectomy under general anesthesia. Methods and findingsThis was a multicenter, randomized controlled noninferiority trial conducted in 14 university and teaching hospitals in the Netherlands between 2016 and 2021. Inclusion criteria were age ≥18 years, maximum number of 3 type 0 or 1 fibroids, maximum fibroid diameter 3.5 cm, American Society of Anesthesiologists class 1 or 2, and having sufficient knowledge of the Dutch or English language. Women with clotting disorders ...
Source: PLoS Medicine - December 28, 2023 Category: Internal Medicine Authors: Julia F. van der Meulen Source Type: research
Menopausal hormone therapy and central nervous system tumors: Danish nested case-control study
ConclusionsUse of continuous, but not cyclic estrogen-progestin was associated with increased meningioma risk. There was no evidence of increased glioma risk with estrogen-progestin use. Use of progestin-only was associated with increased risk of meningioma and potentially glioma. Further studies are warranted to evaluate our findings and investigate the influence of long-term progestin-only regimens on CNS tumor risk. (Source: PLoS Medicine)
Source: PLoS Medicine - December 19, 2023 Category: Internal Medicine Authors: Nelsan Pourhadi Source Type: research
Overweight or obesity in children born after assisted reproductive technologies in Denmark: A population-based cohort study
ConclusionsWe found no association with BMI at age 5 to 8 years when comparing ART versus OI/IUI or when comparing ICSI versus conventional IVF. However, use of frozen-thawed embryo transfer was associated with a 1.5-fold increased risk of obesity compared to fresh embryo transfer. Despite an elevated relative risk, the absolute risk difference was low. (Source: PLoS Medicine)
Source: PLoS Medicine - December 19, 2023 Category: Internal Medicine Authors: Kristina Laugesen Source Type: research
Use of suboptimal control arms in randomized clinical trials of investigational cancer drugs in China, 2016 –2021: An observational study
ConclusionsIn this study, over one-eighth of randomized trials of cancer drugs registered to apply for regulatory approval in China used a suboptimal comparator. Our results highlight the necessity to refine the design of randomized trials to generate optimal clinical evidence for new cancer therapies. (Source: PLoS Medicine)
Source: PLoS Medicine - December 12, 2023 Category: Internal Medicine Authors: Yichen Zhang Source Type: research
Intensified screening for SARS-CoV-2 in 18 emergency departments in the Paris metropolitan area, France (DEPIST-COVID): A cluster-randomized, two-period, crossover trial
ConclusionsThe results of this study showed that intensified screening for SARS-CoV-2 in EDs was unlikely to identify a higher proportion of newly diagnosed patients. Trial registrationTrial registration number: ClinicalTrials.gov NCT04756609. (Source: PLoS Medicine)
Source: PLoS Medicine - December 7, 2023 Category: Internal Medicine Authors: Judith Leblanc Source Type: research
Maternal B-vitamin and vitamin D status before, during, and after pregnancy and the influence of supplementation preconception and during pregnancy: Prespecified secondary analysis of the NiPPeR double-blind randomized controlled trial
This study presents one prespecified outcome from the randomized controlled NiPPeR trial, aiming to identify longitudinal patterns of maternal vitamin status from preconception, through early and late pregnancy, to 6 months postdelivery, and determine the influence of vitamin supplementation. Methods and findingsIn the NiPPeR trial, 1,729 women (from the United Kingdom, Singapore, and New Zealand) aged 18 to 38 years and planning conception were randomized to receive a standard vitamin supplement (control;n = 859) or an enhanced vitamin supplement (intervention;n = 870) starting in preconception and continued throughout pr...
Source: PLoS Medicine - December 5, 2023 Category: Internal Medicine Authors: Keith M. Godfrey Source Type: research
Successful elimination of falciparum malaria following the introduction of community-based health workers in Eastern Myanmar: A retrospective analysis
by Aye Sandar Zaw, Ei Shwe Sin Win, Soe Wai Yan, Kyaw Sithu Thein, Vasundhara Verma, Alistair R. D. McLean, Thar Tun Kyaw, Nicholas J. White, Frank M. Smithuis
BackgroundMyanmar has a large majority of all malaria in the Greater Mekong Subregion. In the past decade, substantial progress was made in malaria control. The residual burden of malaria is in remote areas where currently recommended malaria elimination approaches are generally not feasible. In such hard-to-reach communities in Mon state, East Myanmar, Medical Action Myanmar introduced community health workers (CHWs) to deliver early diagnosis and treatment for mal...
Source: PLoS Medicine - November 30, 2023 Category: Internal Medicine Authors: Aye Sandar Zaw Source Type: research
Long-term vaccination strategies to mitigate the impact of SARS-CoV-2 transmission: A modelling study
ConclusionsOur modelling suggests that regular boosting of the high-risk population remains an important tool to reduce morbidity and mortality from current and future SARS-CoV-2 variants. Our results suggest that focusing vaccination in the highest-risk cohorts will be the most efficient (and hence cost-effective) strategy to reduce morbidity and mortality. (Source: PLoS Medicine)
Source: PLoS Medicine - November 28, 2023 Category: Internal Medicine Authors: Alexandra B. Hogan Source Type: research
Surgery with locking plate or hemiarthroplasty versus nonoperative treatment of 3 –4-part proximal humerus fractures in older patients (NITEP): An open-label randomized trial
ConclusionsIn this study, no benefit was observed between operative treatment with LP or HA and nonoperative treatment in displaced 3- and 4-part PHFs in patients aged 60 years and older. Further, we observed a high rate of complications related to operative treatments. Trial RegistrationClinicalTrials.gov NCT01246167. (Source: PLoS Medicine)
Source: PLoS Medicine - November 28, 2023 Category: Internal Medicine Authors: Antti P. Launonen Source Type: research
