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Effect of Inhaled Xenon on Cerebral White Matter Damage
Preclinical studies suggest inhalation of xenon gas can prevent cerebral damage after hypoxic-ischemic brain injury. In a randomized phase 2 clinical trial involving 110 comatose patients who had experienced out-of-hospital cardiac arrest, Laitio and colleagues found that inhaled xenon combined with hypothermia for 24 hours vs hypothermia treatment alone resulted in less magnetic resonance imaging–measured white matter damage, without a significant difference in neurological outcome or mortality at 6 months.
Continuing Medical Education
Genetics of Maternal Obesity-Related Traits and Birth Weight
To explore potentially causal associations of maternal obesity-related genetic traits with offspring birth weight, Tyrrell and colleagues analyzed maternal genotype data from 30 487 women with singleton offspring. Among the authors’ findings were that genetically elevated maternal body mass index and blood glucose levels were potentially causally associated with higher offspring birth weight, whereas genetically elevated maternal systolic blood pressure was potentially causally related to lower birth weight.
Reporting of P Values in the Biomedical Literature, 1990-2015
The use and misuse of P values in the biomedical literature is a topic of debate. Chavalarias and colleagues assessed the reporting of P values in the biomedical literature from 1990 through 2015 in an automated text-mining analysis of 12 821 790 abstracts in MEDLINE and 843 884 abstracts and full-text articles in PubMed Central. The authors found that use of P values in the reporting of study findings increased over the 25-year period, particularly in the presentation of statistically significant results. Analysis of a random subset of abstracts and articles reporting empirical data found that few reported effect sizes or uncertainty metrics for the significant results. In an Editorial, Kyriacou discusses use and interpretations of P values.
Clinical Review & Education
Vaccine Refusal and Vaccine-Preventable Diseases
Phadke and colleagues reviewed the literature through November 2015 to evaluate the association between vaccine delay, refusal, or exemption and the epidemiology of measles (18 studies; 1416 cases) and pertussis (32 reports; 10 609 cases with vaccine status) in the United States. The authors found a substantial proportion of US measles cases in the postelimination era (after January 1, 2000) were intentionally unvaccinated. Although pertussis resurgence has been attributed to waning immunity and other factors, vaccine refusal is associated with increased risk of pertussis in some populations. In an Editorial, Davis discusses opportunities to increase population-level immunity to vaccine-preventable illnesses.
Author Audio and Video Interviews and Continuing Medical Education
Neck Pain, Stiffness, Periorbital Edema in Man With Diabetes
A man with type 2 diabetes was evaluated for a 4-year history of neck pain and stiffness, and a thickening of the skin at the nape of his neck. On examination he had facial swelling and brawny periorbital edema. A nonpitting woody induration extending from the nape of his neck to his upper back, shoulders, and arms limited his range of motion. Results of laboratory evaluation suggested suboptimal diabetes control. What would you do next?
From The Medical Letter: Liraglutide for Weight Loss
Liraglutide, an injectable glucagonlike peptide receptor agonist previously approved for treatment of type 2 diabetes, has been approved as an adjunct to diet and exercise for chronic weight management in adults with a BMI of 30 or higher or with a BMI of 27 or higher and a weight-related comorbidity. This Medical Letter on Drugs and Therapeutics article summarizes results of 3 randomized, placebo-controlled clinical trials of liraglutide for weight loss and compares liraglutide efficacy and cost with other approved pharmacotherapies for obesity.
Highlights. JAMA. 2016;315(11):1077–1079. doi:10.1001/jama.2015.14162
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