The evidence suggests patency is feasible with both solutions but if longer duration of use (arterial line) is advocated, heparin is superior in the long term. Furthermore, heparin flush effects are dose dependent and require fewer numbers of flushes. In addition, no adverse effects were found with heparin flush solution.
Efficacy, tolerability, and acceptability of bupropion for major depressive disorder: a meta-analysis of randomized-controlled trials comparison with venlafaxine
According to the limited data obtained from three RCTs, bupropion XL is as effective and tolerable as venlafaxine XR for adult patients with MDD. Further studies in this area should be conducted to confirm these findings. Maneeton N, Maneeton B, Eurviriyanukul K, Srisurapanont M. Drug Des Devel Ther. 2013 Sep 27;7:1053-1062. Review. PMID: 24101861
Gastroesophageal Reflux Disease Relief in Patients Treated with Rabeprazole 20 mg versus Omeprazole 20 mg: A Meta-Analysis
These data suggest that rabeprazole demonstrates a clinical advantage over omeprazole in symptomatic relief but no significant difference in endoscopic relief of erosive GERD for up to 8 weeks of treatment. Rabeprazole and omeprazole were both tolerated by GERD patients. Xia XM, Wang H. Gastroenterol Res Pract. 2013;2013:327571. Epub 2013 Sep 9. Review. PMID: 24106498
Systematic review of clinical studies related to pork intake and metabolic syndrome or its components.
These findings suggest possible mechanisms for the association between processed meat and the development of diabetes. Nonprocessed pork meats were not compared with eggs or whey. The three longer interventions (11 days to 6 months) did not show a significant impact of pork on the components of the metabolic syndrome, with the exception of a possible benefit on waist circumference and high-density lipoprotein cholesterol (one study each with significant limitations). Most of the findings are weak and there is a lack of solid evidence. The literature on the topic is limited and important research gaps are identified. Considering recent trends and projections for diabetes and pork intake, this is an important global public health question that requires more attention in order to provide improved evidence-based dietary recommendations. Stettler N, Murphy MM, Barraj LM, Smith KM, Ahima RS. Diabetes Metab Syndr Obes. 2013 Sep 25;6:347-357. Review. PMID: 24106428
Neuraxial opioid-induced pruritus: An update
Pruritus is a troublesome side-effect of neuraxial (epidural and intrathecal) opioids. Sometimes it may be more unpleasant than pain itself. The prevention and treatment still remains a challenge. A variety of medications with different mechanisms of action have been used for the prevention and treatment of opioid-induced pruritus, with mixed results. The aim of this article is to review the current body of literature and summarize the current understanding of the mechanisms and the pharmacological therapies available to manage opioid-induced pruritus. Kumar K, Singh SI. J Anaesthesiol Clin Pharmacol. 2013 Jul;29(3):303-307. Review. PMID: 24106351
Efficacy of Anti-inflammatory Agents to Improve Symptoms in Patients With Schizophrenia: An Update
The results of aspirin addition to antipsychotic treatment seem promising, as does the addition of NAC and estrogens. These 3 agents are all very broadly active substances, and it has to be investigated if the beneficial effects on symptom severity are indeed mediated by their anti-inflammatory aspects. Sommer IE, van Westrhenen R, Begemann MJ, de Witte LD, Leucht S, Kahn RS. Schizophr Bull. 2013 Oct 8. [Epub ahead of print] PMID: 24106335
A systematic review of thyroid dysfunction in preterm neonates exposed to topical iodine
There is evidence that neonatal exposure to iodine-containing disinfectants causes thyroid dysfunction in infants born < 32 weeks. None of the studies evaluated neurodevelopment. Larger scale studies are needed to determine definitively the nature of the relationship and the impact of exposure on neurodevelopment. In the meantime, it would seem prudent to restrict exposure of iodine-containing skin disinfectants in preterm infants; chlorhexidine might be a credible alternative. Aitken J, Williams FL. Arch Dis Child Fetal Neonatal Ed. 2013 Oct 8. [Epub ahead of print] PMID: 241056
Oral versus intravenous antibiotic treatment for febrile neutropenia in cancer patients
Based on the present data, oral treatment is an acceptable alternative to intravenous antibiotic treatment in febrile neutropenic cancer patients (excluding patients with acute leukaemia) who are haemodynamically stable, without organ failure, and do not have pneumonia, infection of a central line or a severe soft-tissue infection. The wide CI for mortality allows the present use of oral treatment in groups of patients with an expected low risk for mortality, and further research should be aimed at clarifying the definition of low risk patients. Vidal L, Ben Dor I, Paul M, Eliakim-Raz N, Pokroy E, Soares-Weiser K, Leibovici L. Cochrane Database Syst Rev. 2013 Oct 9;10:CD003992. [Epub ahead of print] PMID: 24105485
Maternal positions and mobility during first stage labour
There is clear and important evidence that walking and upright positions in the first stage of labour reduces the duration of labour, the risk of caesarean birth, the need for epidural, and does not seem to be associated with increased intervention or negative effects on mothers' and babies' well being. Given the great heterogeneity and high performance bias of study situations, better quality trials are still required to confirm with any confidence the true risks and benefits of upright and mobile positions compared with recumbent positions for all women. Based on the current findings, we recommend that women in low-risk labour should be informed of the benefits of upright positions, and encouraged and assisted to assume whatever positions they choose. Lawrence A, Lewis L, Hofmeyr GJ, Styles C. Cochrane Database Syst Rev. 2013 Oct 9;10:CD003934. [Epub ahead of print] PMID: 24105444
Performance of risk assessment instruments for predicting osteoporotic fracture risk: a systematic review
Few studies have evaluated the performance or calibration of osteoporosis fracture risk assessment instruments in populations separate from their development cohorts. Findings are mixed, and many studies had methodological limitations making susceptibility to bias a possibility, raising concerns about use of these tools outside of the original derivation cohorts. Further studies are needed to assess the calibration of instruments in different populations prior to widespread use. Nayak S, Edwards DL, Saleh AA, Greenspan SL. Osteoporos Int. 2013 Oct 9. [Epub ahead of print] PMID: 24105431
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