Response

We thank Raimondi et al for their attention and insightful comments in response to our recent publication1 describing how ultrasound is used to diagnose transient tachypnea of newborns (TTN). Raimondi et al have conducted a large amount of research in this field, and reviewing their publications has increased our knowledge.

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Efficacy of EGFR Tyrosine Kinase Inhibitors in the Adjuvant Treatment for Operable Non-small Cell Lung Cancer by a Meta-Analysis

Background

The role of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in the adjuvant treatment of non-small cell lung cancer (NSCLC) has not been well-established. Our meta-analysis aimed to determine whether the administration of EGFR-TKIs could improve the outcomes of patients with NSCLC undergoing complete resection.

Methods

We comprehensively searched databases and extracted data from eligible studies. Disease-free survival (DFS) and overall survival (OS) with hazard ratios (HRs) as well as disease relapse with odds ratios (OR) were calculated using random and/or fixed-effects models. Meta-regression analysis and test for interaction between subgroups were also carried out.

Results

A total of 1,960 patients in five studies were included. Adjuvant EGFR-TKI treatment was associated with a significant benefit on DFS (HR, 0.63; 95% CI, 0.41-0.99), corresponding to an absolute benefit of 3.1% at 3 years, yet with significant heterogeneity (I2 = 83.4%, P Conclusions

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When Patients and Surrogates Disagree About Advance Directives

In a recent issue of CHEST (February 2016), Bruce et al1 describe decision-making when surrogates disagree with an advance directive and then lay out four considerations for overriding an advance directive. The authors may be comforted to know that there is empiric evidence showing that most patients would welcome having their advance directive ignored. In a study of 300 terminally ill patients who were asked whether they would want their advance directive followed should a loved one object, 54% said they would want their advance directive ignored.2 Reasons given were that surrogates made better decisions, or the patients were concerned that the surrogates' best interest be paramount.

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Pseudohyperkalemia due to severe leukocytosis: case presentation

Journal Name: Clinical Chemistry and Laboratory Medicine (CCLM)
Issue: Ahead of print


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June Issue of NIH News in Health Now Available

The June issue of NIH News in Health is now available.

Featured stories include "Can You Lengthen Your Life?: Researchers Explore How To Stay Healthy Longer" and "Seeking Allergy Relief: When Breathing Becomes Bothersome". Also, check out the health capsules and the featured Web site.

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Right Ventricular Myocardial Ischemia with Arrhythmia in an Asphyxiated Newborn

AJP Rep 2016; 06: e203-e205
DOI: 10.1055/s-0036-1584279

Background Infant and neonatal myocardial infarction (MI) has been described in association with congenital heart disease, coronary artery abnormalities, myocarditis, and tumors. MI in the perinatal period in a structurally normal heart and with ventricular arrhythmia as a presenting feature has not been thoroughly described. Published case reports describe treatment methods extrapolated from adult MI. However, due to the rare occurrence, the most appropriate acute treatment for both MI and ventricular arrhythmia in newborn infants remains unknown. Case A male term infant with perinatal asphyxia and need for extensive cardiopulmonary resuscitation at birth had ventricular tachyarrhythmia and ST-elevations on electrocardiogram. Four hours after birth, he died from cardiogenic failure. A thrombus at the right coronary artery was found on autopsy. Conclusion MI in the perinatal period in a structurally normal heart is very rare and mortality is high. Although acute treatments extrapolated from adult MI has been described to result in favorable outcomes in newborn infants, guidelines are lacking on how to manage acute MI and associated ventricular arrhythmia.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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The Effect of a Universal Cervical Length Screening Program on Antepartum Management and Birth Outcomes

AJP Rep 2016; 06: e206-e211
DOI: 10.1055/s-0036-1584240

Objective The objective of this study was to evaluate the effect of a universal cervical length screening program on the incidence of antepartum interventions. Study Design This retrospective cohort study included women delivering ≥ 20 weeks of gestation with singleton pregnancies before and after implementing universal cervical length screening. Antepartum interventions included admission for threatened preterm birth, ≥ 2 cervical length measurements, cervical cerclage, neonatology consultation, betamethasone, antibiotic administration for preterm premature rupture of membranes, and tocolysis. Results There were 1,131 women—506 before the screening program (unexposed) and 625 afterward (exposed). The screening program resulted in significantly more women screened (3.0 vs. 69.9%, p < 0.0001). The exposed group was more likely to undergo ≥ 1 intervention (20.0 vs. 9.5%, p < 0.0001); specifically, admission for threatened preterm birth (3.8 vs. 1.8%, p = 0.04) and ≥ 2 cervical measurements (11.2 vs. 2.0%, p < 0.001). Other interventions were similar between groups (all p ≥ 0.06). Median gestation length was significantly longer in the exposed (39.6 weeks [interquartile, IQR: 38.6–40.4] vs. 39.0 weeks [IQR: 38.0–40.0, p < 0.001]); however, preterm delivery incidence was unaffected (9.4 vs. 10.9%, p = 0.43). Remaining neonatal outcomes were similar (all p ≥ 0.14). Conclusion Implementing universal cervical length screening significantly increased the proportion of women undergoing ≥ 1 antepartum intervention. With the exception of a modestly prolonged gestation, other outcomes were unaffected.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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