Screening and Intervention to Prevent Falls and Fractures in Older People

“We assessed the clinical effectiveness and cost-effectiveness of a brief falls-risk screening questionnaire, sent by mail, followed by an exercise program or a multifactorial intervention targeted to persons at increased risk for falls, as compared with no screening in community-dwelling older people. All participants received advice by mail. [Methods] [..] This was a three-group, pragmatic, cluster-randomized, controlled trial with parallel economic evaluation that included 63 general practices in seven rural and urban regions in England. Drawing from their patient registries, general practices contacted community-dwelling persons 70 years of age or older who were living in their own homes. Residents of … Read More

World Health Organization Guidelines on Treatment of Hepatitis C Virus Infection: Best Practice Advice From the American College of Physicians

“The World Health Organization (WHO) updated its evidence-based guideline on chronic HCV infection in July 2018. [..] We discuss implications of the WHO recommendations for clinicians and patients in the United States. The WHO recommends offering treatment to all persons older than 12 years who have chronic HCV infection, and it notes 3 major considerations for this “treat all” strategy: the effectiveness and safety of direct-acting antiviral agents (DAAs), the emergence of pangenotypic drug regimens, and reduction in the cost of treatment. In current treatment regimens, combination therapy with oral DAAs has replaced interferon and ribavirin. The WHO recommends pangenotypic … Read More

Effect of Outpatient Rehabilitation on Functional Mobility After Single Total Knee Arthroplasty: A Randomized Clinical Trial

“Numerous studies have shown that rehabilitation is associated with improved post-TKA [total knee arthroplasty] outcomes, whether comparing rehabilitation received at different settings or examining different physical therapy (PT) protocols. This typically requires active patient engagement by incorporating weight bearing exercise, active range of motion, and gait training. However, patients’ fear of falling and postsurgical pain accompanying weight bearing and range of motion exercises often limit patient’s ability to fully participate in PT and thus prolong a patient’s recovery. [..] This randomized clinical trial used a Food and Drug Administration–cleared treadmill using patented National Aeronautics and Space Administration technology to unload … Read More

Adjuvant or early salvage radiotherapy for the treatment of localised and locally advanced prostate cancer: a prospectively planned systematic review and meta-analysis of aggregate data

“It is unclear whether adjuvant or early salvage radiotherapy following radical prostatectomy is more appropriate for men who present with localised or locally advanced prostate cancer. We aimed to prospectively plan a systematic review of randomised controlled trials (RCTs) comparing these radiotherapy approaches. [..] We identified three eligible trials and were able to obtain updated results for event-free survival for 2153 patients recruited between November, 2007, and December, 2016. Median follow-up ranged from 60 months to 78 months, with a maximum follow-up of 132 months. 1075 patients were randomly assigned to receive adjuvant radiotherapy and 1078 to a policy of … Read More

Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity: The TREAT Randomized Clinical Trial

“Intermittent fasting (IF) has gained attention as a simple weight loss method. Intermittent fasting refers to eating windows separated by defined periods of fasting (>12 hours and up to 48 hours, or more). Most of the reported benefits of IF are either untested or undertested in humans. Time-restricted eating (TRE) is a specific IF protocol involving consistent fasting and eating periods within a 24-hour cycle. [..] We conducted a randomized clinical trial (RCT) designed to determine the effect of TRE on weight and comprehensive metabolic outcomes in overweight and obese patients. We hypothesized that 8-hour TRE prescribed to individuals with … Read More