June 1 – June 9, 2013
In this section, we will highlight the some of the high-impact studies, updates, and analyses published in medicine during the past week.
Controlled Trial of Psychotherapy for Congolese Survivors of Sexual Violence
In this cluster randomized control trial from the Democratic Republic of Congo, women subject to sexual violence were randomized to cognitive behavior therapy vs. social work support alone. 231 women (57%) completed the 3 series of depression and anxiety questionnaires at baseline, after therapy, and 6 months later. The study found 9% of CBT patients met criteria for depression or anxiety vs. 42% of patients without CBT (p < 0.001).
In the internal multicenter unblinded RCT, 120 patients with type 2 diabetes mellitus (Hgb A1c > 8.0%), BMI between 30 and 39.9, and C peptide greater than 1.0 were randomized to intensive medical management with and without Roux-en-Y gastric bypass. At 12 months, patients in surgical arm of the study lost more weight (26.1% vs. 7.9% of initial body weight), had a higher proportion with Hgb A1c < 6.0% (44% vs. 9%) and improved fasting glucose (153 vs. 111). 17.5% of surgery patients had post-operative complications and 43% of surgery patients had iron, B1, B6, or B12 deficiency.
This multicenter randomized control trial enrolled 10,245 children to study the efficicacy of a vaccine for enterovirus 71 (EV71), a RNA virus associated with hand-foot-mouth disease (HFMD), herpangina, and meninigitis. The vaccinated cohort experienced 3 cases of EV71 associated HFMD and 8 cases of other EV71 associated diseases vs. 30 cases of HFMD and 41 cases of other disease in the non-vaccinated cohort. At 14 months, 92.5% of vaccinated patients vs. 31.5% of unvaccinated patients had an antibody titer greater than 1:32 against EV71.
Terminal Complement Inhibitor Eculizumab in Atypical Hemolytic–Uremic Syndrome
Patients with atypical hemolytic uremic syndrome received weekly treatments humanized monoclonal antibody against C5 complement responded with increases in platelet count (mean increase 73), improvement in GFR (35 – 65% of patients improved at least one CKD stage), and resolved LDH elevation (88 – 95%). Earlier intervention was associated with greater functional improvement.
This multicenter randomized control trial examined the efficacy of intermittent pneumatic compression for the prevention of DVTs in immobilized post-CVA patients. 122 of 1267 (9.6%) patients receiving intervention had an ultrasound-confirmed DVT vs. 174 of 1245 (14.0%) of patients without intervention (OR= 0.65, p < 0.001). There was no difference in 30 day mortality (11% vs. 13%, p = 0.057).
By David Ouyang
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