The burden of illness resulting from NSAID-related CHF may exceed that resulting from gastrointestinal tract damage. NSAIDs should be used with caution in patients with a history of cardiovascular disease.

BG level appears to be a fair diagnostic adjunct for IFD in patients with appropriate pretest probability and a suggestive clinical syndrome, especially when checked serially in patients not receiving factors associated with an elevated BG level in the absence of IFD.

Background: Beginning March 2020, the COVID-19 pandemic has disrupted different aspects of life. The impact on children's rate of weight gain has not been analysed. Methods:In this retrospective cohort study, we used United States (US) Electronic Health Record (EHR) data from Optum® to calculate the age-and sex-adjusted change in BMI ( BMI adj ) in individual 6to-17-year-old children between two well child checks (WCCs). The mean of individual BMI adj during 2017-2020 was calculated by month. For September-December WCCs, the mean of individual BMI adj (overall and by subgroup) was reported for 2020 and 2017-2019, and the impact of 2020 vs 2017-2019 was tested by multivariable linear regression. Findings: The mean [95% Confidence Interval -CI] BMI adj in September-December of 2020 was 0 •62 [0 •59,0 •64] kg/m 2 , compared to 0 •31 [0 •29, 0 •32] kg/m 2 in previous years. The increase was most prominent in children with pre-existing obesity (1 •16 [1 •07,1 •24] kg/m 2 in 2020 versus 0 •56 [0 •52,0 •61] kg/m 2 in previous years), Hispanic children (0 •93 [0 •84,1 •02] kg/m 2 in 2020 versus 0 •41 [0 •36,0 •46] kg/m 2 in previous years), and children who lack commercial insurance (0 •88 [0 •81,0 •95] kg/m 2 in 2020 compared to 0 •43 [0 •39,0 •47] kg/m 2 in previous years). BMI adj accelerated most in ages 8-12 and least in ages 15-17.Interpretation: Children's rate of unhealthy weight gain increased notably during the COVID-19 pandemic across demographic groups, and most prominently in children already vulnerable to unhealthy weight gain. This data can inform policy decisions critical to child development and health as the pandemic continues to unfold.

PurposeThe study aims to assess the relative efficacy of granulocyte colony-stimulating factor (G-CSF) products administered as primary prophylaxis (PP) to patients with cancer receiving myelosuppressive chemotherapy.MethodsA systematic literature review identified publications (January 1990 to September 2013) of randomized controlled trials evaluating PP with filgrastim, pegfilgrastim, lenograstim, or lipegfilgrastim in adults receiving myelosuppressive chemotherapy for solid tumors or non-Hodgkin lymphoma. Direct, indirect, and mixed-treatment comparison (MTC) were used to estimate the odds ratio and 95 % credible interval of febrile neutropenia (FN) during cycle 1 and all cycles of chemotherapy combined without adjusting for differences in relative dose intensity (RDI) between study treatment arms.ResultsTwenty-seven publications representing 30 randomized controlled trials were included. Using MTC over all chemotherapy cycles, PP with filgrastim, pegfilgrastim, lenograstim, and lipegfilgrastim versus no G-CSF PP or placebo were associated with statistically significantly reduced FN risk. FN risk was also significantly reduced with pegfilgrastim PP versus filgrastim PP. Over all chemotherapy cycles, there was a numerical but statistically nonsignificant increase in the FN risk for lipegfilgrastim PP versus pegfilgrastim PP. Using MTC in cycle 1, PP with filgrastim, pegfilgrastim, and lipegfilgrastim versus no G-CSF PP or placebo were associated with statistically significantly reduced FN risk.ConclusionsIn this meta-analysis, using MTC without adjustment for RDI, PP with all G-CSFs evaluated reduced the FN risk in patients receiving myelosuppressive chemotherapy. Future studies are needed to assess the influence of RDI on FN outcomes and to eliminate potential bias between G-CSF arms receiving more intensive chemotherapy than control arms.Electronic supplementary materialThe online version of this article (doi:10.1007/s00520-015-2686-9) contains supplementary material, which is available to authorized users.

Background-A family history of prostate cancer (PCa) or breast cancer (BCa) has been associated with the risk of PCa, but the risks were inconsistent in terms of the affected family members, and data in the PSA era are limited.

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In the presence of time-varying confounders affected by prior treatment, standard statistical methods for failure time analysis may be biased. Methods that correctly adjust for this type of covariate include the parametric g-formula, inverse probability weighted estimation of marginal structural Cox proportional hazards models, and g-estimation of structural nested accelerated failure time models. In this article, we propose a novel method to estimate the causal effect of a time-dependent treatment on failure in the presence of informative right-censoring and time-dependent confounders that may be affected by past treatment: g-estimation of structural nested cumulative failure time models (SNCFTMs). An SNCFTM considers the conditional effect of a final treatment at time m on the outcome at each later time k by modeling the ratio of two counterfactual cumulative risks at time k under treatment regimes that differ only at time m. Inverse probability weights are used to adjust for informative censoring. We also present a procedure that, under certain “no-interaction” conditions, uses the g-estimates of the model parameters to calculate unconditional cumulative risks under nondynamic (static) treatment regimes. The procedure is illustrated with an example using data from a longitudinal cohort study, in which the “treatments” are healthy behaviors and the outcome is coronary heart disease.

Pneumonia is a common terminal event in advanced dementia for which many patients receive parenteral antibiotics. The aggressiveness of treatment is most strongly determined by advance care planning, the patient's cultural background, and clinical features of the suspected pneumonia episode.