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Transfemoral transcatheter aortic-valve replacement should be preferred over surgery in most intermediate-risk patients
Commentary on: Leon MB, Smith CR, Mack MJ, et al.., PARTNER 2 Investigators. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 2016;374:1609–20 . Context Evidence derived from randomised clinical trials support transcatheter aortic valve replacement (TAVR) as a choice for patients with aortic stenosis with a prohibitive surgical risk and as a valid alternative therapy for those at high-risk of surgical mortality. Owing to increases in operator experience as well as improvements with transcatheter techniques and devices associated with reduction in procedural complications,...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Tamburino, C., Capranzano, P. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research

Psychological therapies help reduce headache and non-headache pain in children and adolescents
Commentary on: Eccleston C, Palermo TM, Williams AC, et al.. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev 2014;5:CD003968. Context Chronic and recurrent pain, especially in the head, abdomen and limbs affects up to 30% of children and adolescents.1 Pain can be severely disabling, disrupting school and social activities and if left untreated, may extend towards adulthood. Increasing evidence shows that psychological factors are pivotal in the transition from acute to chronic disabling pain. As a result, psychological interventions have been ...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Vlaeyen, J. W. S., Gatzounis, R. Tags: Palliative care, Clinical trials (epidemiology), Headache (including migraine), Pain (neurology), Stroke, Child and adolescent psychiatry, Complementary medicine Therapeutics Source Type: research

Modest cancer prevention benefit with long-term multivitamin supplementation: Physicians' Health Study II results warrant cautious interpretation
Commentary on Gaziano JM, Sesso HD, Christen WG, et al.. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomised controlled trial. JAMA 2012;308:1871–80. Context Various vitamins and minerals have been shown to inhibit carcinogenesis or reduce cancer risk in preclinical experiments and observational studies. Such work has given rise to several chemoprevention trials of isolated nutrients, many of which (eg, Alpha-Tocopherol and Beta-Carotene (ATBC) Trial, Carotene and Retinol Efficacy Trial (CARET) and Selenium and Vitamin E Cancer Prevention Trial (SELECT)) have produced d...
Source: Evidence-Based Medicine - November 21, 2013 Category: Internal Medicine Authors: Demark-Wahnefried, W. Tags: Liver disease, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Diet, Prevention, Complementary medicine, Dermatology, Prostate Therapeutics Source Type: research