In this section, we will highlight the some of the high-impact studies, updates, and analyses published in medicine during the past week.
Urinary-Cell mRNA Profile and Acute Cellular Rejection in Kidney Allografts
4300 urine samples from 485 kidney-graft recipients were collected to quantify RNA levels of CD3ε mRNA, IP-10 mRNA, and 18S rRNA levels to prognosticate allograft rejection risk. Patients with biopsy proven rejection was more likely to have elevated levels compared to patients with stable allograft function. A logistic model had an area under the curve (AUC) of 0.74 for the receiver operating characteristic (ROC) curve.
Natriuretic Peptide–Based Screening and Collaborative Care for Heart Failure
In this study, patients with newly diagnosed heart failure were randomized to screening brain-type natruiretic peptide (BNP) with echocardiogram and management if BNP > 50 pg/mL or standard care. In the intervention group, 41.6% had at least one BNP > 50, received more cardiovascular follow-up (RR: 1.71, p < 0.001) and more aggressive medical management. Acute decompensation of heart failure occurred in 1.0% of intervention patients vs. 2.1% of control patients (p = 0.12). There was a statistically significant decrease in the incidence of emergent hospitalization for cardiovascular events (22.3 per 1000 patient-years in the intervention arm vs. 40.4 per 1000-patient years in the control arm, p =0.002).
Targeting BTK with Ibrutinib in Relapsed Chronic Lymphocytic Leukemia
This study was a phase 1b-2 trial of Ibrutinib, an oral Bruton’s tyrosine kinase inhibitor, in patients with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic leukemia. 71% patients had at least a partial response, with a 25-month progression free survival of 75% and overall survival of 83%.
Effect of Home Blood Pressure Telemonitoring and Pharmacist Management on Blood Pressure Control
A cluster-randomized, unblinded trial compared telemonitoring with active titration of blood pressure medications to standard care in patients with uncontrolled hypertension. At 12 months, there was a statistically significant improved rate of controlled blood pressure (<130/90) in the intervention arm with 57.2% vs. 30.0% (p = 0.001). At 18 months (6 months after the end of the intervention), there was a sustained improvement (71.8% vs. 57.1% with controlled blood pressure, p = 0.003).
Autism and Mental Retardation Among Offspring Born After In Vitro Fertilization
A retrospective analysis of Swedish national health registries between 1987 and 2007 suggest that for offspring born after in vitro fertilization (IVF), there was an increased but not statistically significant risk of autism (RR 1.14, CI 0.94 – 1.39) and a statistically significant increased risk of mental retardation (RR 1.16, CI 1.01-1.36). Intracytoplasmic sperm injection (ICSI) was associated with increased risk of autism and mental retardation compared to IVF without ISCI.
By David Ouyang
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