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Monthly Archives: June 2015

How to break away from articles and invent new story forms feedly

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From Stephen Downes’ blog…
http://www.downes.ca/cgi-bin/page.cgi?post=64074

I have talked in the past about how we as a society are developing a new multimedia language (and in the process, reshaping what ‘language of thought’ theories could possibly mean). We are seeing more and more evidence of this, beginning with this lead story. It’s a great set of thought-experiments on how authors could respond to specific audience needs with more useful and informative multimedia responses. Do they work? Yes – as Poynter points out, the most popular features on the New York Times web site were interactives and multimedia, not stories.

JAMA Network | JAMA | Use of Phosphodiesterase Type 5 Inhibitors for Erectile Dysfunction and Risk of Malignant MelanomaPDE5 Inhibitors for Erectile Dysfunction and Malignant Melanoma RiskPDE5 Inhibitors for Erectile Dysfunction and Malignant Melanoma Risk

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Seems like the increased risk of melanoma with sildafenil et al is real, but maybe not causal:
jama.jamanetwork.com/Mobile/article.aspx?articleID=2338254&utm_source=twitter&utm_medium=social_jama&utm_campaign=

article_alert&utm_content=automated

Download the official Twitter app here

Cannabinoids for Medical Use: A systematic review and meta-analysis

Original Investigation|June 23/30, 2015

Cannabinoids for Medical UseA Systematic Review and Meta-analysis

Penny F. Whiting, PhD1,2,3; Robert F. Wolff, MD3; Sohan Deshpande, MSc3; Marcello Di Nisio, PhD4,5; Steven Duffy, PgD3; Adrian V. Hernandez, MD, PhD6,7; J. Christiaan Keurentjes, MD, PhD8; Shona Lang, PhD3; Kate Misso, MSc3; Steve Ryder, MSc3; Simone Schmidlkofer, MSc9; Marie Westwood, PhD3; Jos Kleijnen, MD, PhD3,10

[+] Author Affiliations

JAMA. 2015;313(24):2456-2473. doi:10.1001/jama.2015.6358.

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Article

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ABSTRACT

ABSTRACT | INTRODUCTION | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES

Importance  Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear.

Objective  To conduct a systematic review of the benefits and adverse events (AEs) of cannabinoids.

Data Sources  Twenty-eight databases from inception to April 2015.

Study Selection  Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome.

Data Extraction and Synthesis  Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis.

Main Outcomes and Measures  Patient-relevant/disease-specific outcomes, activities of daily living, quality of life, global impression of change, and AEs.

Results  A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47% vs 20%; odds ratio [OR], 3.82 [95% CI, 1.55-9.42]; 3 trials), reduction in pain (37% vs 31%; OR, 1.41 [95% CI, 0.99-2.00]; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference [WMD], −0.46 [95% CI, −0.80 to −0.11]; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, −0.36 [95% CI, −0.69 to −0.05]; 7 trials). There was an increased risk of short-term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination.

Conclusions and Relevance  There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome. Cannabinoids were associated with an increased risk of short-term AEs.

POEM: Fresh blood does not improve outcomes more than older units of blood

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This is rather reassuring for those smaller hospitals who have less turnover in their blood supply. Another great POEM from CMA.
POEM