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general surgery randomised controlled trial

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https://www.readbyqxmd.com/read/29776444/mediastinal-staging-of-non-small-cell-lung-cancer-by-endobronchial-and-endoscopic-ultrasonography-with-or-without-additional-surgical-mediastinoscopy-mediastrial-study-protocol-of-a-multicenter-randomised-controlled-trial
#1
Jelle E Bousema, Marcel G W Dijkgraaf, Nicole E Papen-Botterhuis, Hermien W Schreurs, Jos G Maessen, Erik H van der Heijden, Willem H Steup, Jerry Braun, Valentin J J M Noyez, Fieke Hoeijmakers, Naomi Beck, Martijn van Dorp, Niels J M Claessens, Birgitta I Hiddinga, Johannes M A Daniels, David J Heineman, Harmen R Zandbergen, Ad F T M Verhagen, Paul E van Schil, Jouke T Annema, Frank J C van den Broek
BACKGROUND: In case of suspicious lymph nodes on computed tomography (CT) or fluorodeoxyglucose positron emission tomography (FDG-PET), advanced tumour size or central tumour location in patients with suspected non-small cell lung cancer (NSCLC), Dutch and European guidelines recommend mediastinal staging by endosonography (endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS)) with sampling of mediastinal lymph nodes. If biopsy results from endosonography turn out negative, additional surgical staging of the mediastinum by mediastinoscopy is advised to prevent unnecessary lung resection due to false negative endosonography findings...
May 18, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29746373/incidence-of-akathisia-after-postoperative-nausea-and-vomiting-prophylaxis-with-droperidol-and-ondansetron-in-outpatient-surgery-a-multicentre-controlled-randomised-trial
#2
Antoine Charton, Nicolas Greib, Aude Ruimy, Valentina Faitot, Yves Noudem, Girish P Joshi, Nicolas Meyer, Pierre Diemunsch
BACKGROUND: Akathisia, a distressing movement disorder induced by butyrophenones, has been described with low doses of droperidol used for postoperative nausea and vomiting (PONV) prophylaxis, but the incidence remains unclear. OBJECTIVES: To determine the incidence of akathisia after PONV prophylaxis with two doses of droperidol in comparison with ondansetron, in patients undergoing ambulatory surgery. We hypothesised that the incidence of akathisia is higher with droperidol than that with ondansetron...
May 8, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29741289/grommets-ventilation-tubes-for-recurrent-acute-otitis-media-in-children
#3
REVIEW
Roderick P Venekamp, Paul Mick, Anne Gm Schilder, Desmond A Nunez
BACKGROUND: Acute otitis media (AOM) is one of the most common childhood illnesses. While many children experience sporadic AOM episodes, an important group suffer from recurrent AOM (rAOM), defined as three or more episodes in six months, or four or more in one year. In this subset of children AOM poses a true burden through frequent episodes of ear pain, general illness, sleepless nights and time lost from nursery or school. Grommets, also called ventilation or tympanostomy tubes, can be offered for rAOM...
May 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29683196/hypogonadism-and-male-obesity-focus-on-unresolved-questions
#4
Mathis Grossmann
Obesity, increasing in prevalence globally, is the clinical condition most strongly associated with lowered testosterone concentrations in men, and presents as one of the strongest predictors of receiving testosterone treatment. While low circulating total testosterone concentrations in modest obesity primarily reflect reduced concentrations of sex hormone binding globulin, more marked obesity can lead to genuine hypothalamic-pituitary-testicular axis (HPT) suppression. HPT axis suppression is likely mediated via pro-inflammatory cytokine and dysregulated leptin signalling and aggravated by associated comorbidities...
April 23, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29680809/impact-of-dexmedetomidine-infusion-during-general-anaesthesia-on-incidence-of-postoperative-delirium-in-elderly-patients-after-major-non-cardiac-surgery-study-protocol-of-a-randomised-double-blinded-and-placebo-controlled-trial
#5
Bo-Jie Wang, Chun-Jing Li, Jian Hu, Huai-Jin Li, Chao Guo, Zhen-Han Wang, Qiao-Chu Zhang, Dong-Liang Mu, Dong-Xin Wang
INTRODUCTION: Delirium is a common complication in the elderly after surgery and is associated with worse outcomes. Multiple risk factors are related with postoperative delirium, such as exposure to general anaesthetics, pain and postoperative inflammatory response. Preclinical and clinical studies have shown that dexmedetomidine attenuated neurotoxicity induced by general anaesthetics, improved postoperative analgesia and inhibited inflammatory response after surgery. Several studies found that intraoperative use of dexmedetomidine can prevent postoperative delirium, but data were inconsistent...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29666130/does-dexmedetomidine-given-as-a-premedication-or-intraoperatively-reduce-post-hospitalisation-behaviour-change-in-children-a-study-protocol-for-a-randomised-controlled-trial-in-a-tertiary-paediatric-hospital
#6
Paul Lee-Archer, Craig McBride, Rebecca Paterson, Michael Reade, Britta Regli-von Ungern-Sternberg, Deborah Long
INTRODUCTION: It has been reported that post-hospitalisation behaviour change (PHBC) occurs in over 50% of children undergoing a general anaesthetic and manifests as behaviours such as sleep and eating disorders, defiance of authority, nightmares, enuresis and temper tantrums. The effect is usually short-lived (2-4 weeks); however, in 5-10% of children, these behaviours can last up to 12 months. The risk factors for developing PHBC include underlying anxiety in the child or parent, a previous bad hospital experience, emergence delirium and preschool age...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29656301/septoplasty-for-nasal-obstruction-due-to-a-deviated-nasal-septum-in-adults-a-systematic-review
#7
M M H T van Egmond, M M Rovers, A H J Tillema, N van Heerbeek
BACKGROUND: The status of current evidence for the effectiveness of septoplasty is unclear. This systematic review evaluates the effectiveness of a) septoplasty (with or without concurrent turbinate surgery) versus non-surgical management, and b) septoplasty with concurrent turbinate surgery versus septoplasty alone, for nasal obstruction due to a deviated nasal septum in adults. METHODOLOGY: Eligible for inclusion were randomised controlled trials and non-randomised designs comparing treatment strategies...
April 15, 2018: Rhinology
https://www.readbyqxmd.com/read/29643163/effect-of-intratracheal-dexmedetomidine-administration-on-recovery-from-general-anaesthesia-after-gynaecological-laparoscopic-surgery-a-randomised-double-blinded-study
#8
Fei Wang, Haoxiang Zhong, Xiaoyan Xie, Weiping Sha, Caili Li, Zhenping Li, Zhuomei Huang, Chaojin Chen
OBJECTIVES: To examine the efficacy of intratracheal dexmedetomidine (Dex) injection for the prevention of the laryngeal response on emergence from general anaesthesia following gynaecological laparoscopic surgery. DESIGN: Prospective, randomised, double-blinded, controlled trial. SETTING: A general hospital, Guangdong Province, China. PARTICIPANTS: All patients who underwent elective laparoscopic gynaecological surgery, aged 18-60 years old, 40-80 kg in weight, American Society of Anesthesiologists class I-II were eligible...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29622512/cost-effectiveness-evaluation-of-heparin-coated-versus-standard-graft-for-bypass-surgery-in-peripheral-artery-disease-alongside-a-randomised-controlled-trial
#9
Marie K Villemoes, Jes S Lindholt, Kim C Houlind, Bo Gottschalksen, Christian N Petersen, Martin Rasmussen, Charlotte Wedel, Morten B Bramsen, Rikke Søgaard
OBJECTIVE/BACKGROUND: Heparin coating has recently been shown to reduce the risk of graft failure in arterial revascularisation, at least transiently. The aim of this study was to assess the cost-effectiveness of heparin coated versus standard polytetrafluoroethylene grafts for bypass surgery in peripheral artery disease from a long-term healthcare system perspective. METHODS: Cost-effectiveness evaluation was conducted alongside the Danish part of the Scandinavian Propaten trial in which 431 patients planned for femoro-femoral or femoro-popliteal bypass surgery were randomised to either type of graft and followed for 5 years...
April 2, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29574683/topical-application-of-corticosteroids-to-tracheal-tubes-to-prevent-postoperative-sore-throat-in-adults-undergoing-tracheal-intubation-a-systematic-review-and-meta-analysis
#10
REVIEW
A Kuriyama, H Maeda, R Sun, M Aga
Postoperative sore throat negatively affects patient satisfaction and recovery. Numerous randomised trials have tested the efficacy of corticosteroids applied to tracheal tubes to prevent postoperative sore throat. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Wanfang Database, and the China Academic Journal Network Publishing Database from inception to 7 December 2017. We included randomised controlled trials that assessed the efficacy and safety of corticosteroids applied to tracheal tubes, compared either with non-analgesic controls and analgesic agents, in adults undergoing elective surgery under general anaesthesia...
March 25, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29574439/randomised-controlled-trial-of-exercise-to-prevent-shoulder-problems-in-women-undergoing-breast-cancer-treatment-study-protocol-for-the-prevention-of-shoulder-problems-trial-uk-prosper
#11
Julie Bruce, Esther Williamson, Clare Lait, Helen Richmond, Lauren Betteley, Ranjit Lall, Stavros Petrou, Sophie Rees, Emma J Withers, Sarah E Lamb, Alastair M Thompson
Musculoskeletal shoulder problems are common after breast cancer treatment. Early postoperative exercises targeting the upper limb may improve shoulder function. This protocol describes a National Institute for Health Research-funded randomised controlled trial (RCT) to evaluate the clinical and cost-effectiveness of an early supervised structured exercise programme compared with usual care, for women at high risk of developing shoulder problems after breast cancer surgery. METHODS: This pragmatic two-armed, multicentre RCT is underway within secondary care in the UK...
March 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29571946/nilotinib-in-locally-advanced-pigmented-villonodular-synovitis-a-multicentre-open-label-single-arm-phase-2-trial
#12
Hans Gelderblom, Claire Cropet, Christine Chevreau, Richard Boyle, Martin Tattersall, Silvia Stacchiotti, Antoine Italiano, Sophie Piperno-Neumann, Axel Le Cesne, Virginia Ferraresi, Nicolas Penel, Florence Duffaud, Philippe Cassier, Maud Toulmonde, Paolo Casali, Sophie Taieb, Séverine Guillemaut, Séverine Metzger, David Pérol, Jean-Yves Blay
BACKGROUND: Pigmented villonodular synovitis (alternatively known as diffuse-type giant cell tumour) is a rare, locally aggressive tumour driven by a specific translocation resulting in the overexpression of colony-stimulating factor 1 (CSF1). CSF1 receptor (CSF1R) inhibitors (ie, tyrosine kinase inhibitors and antibodies) induce a response in patients with pigmented villonodular synovitis. We investigated the safety and efficacy of a CSF1R tyrosine kinase inhibitor, nilotinib, in patients with locally advanced non-resectable pigmented villonodular synovitis...
March 20, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29570108/intra-operative-lidocaine-in-the-prevention-of-vomiting-after-elective-tonsillectomy-in-children-a-randomised-controlled-trial
#13
Ghislaine C Echevarría, Fernando R Altermatt, Sebastian Paredes, Valentina Puga, Hernán Auad, Ana M Veloso, María F Elgueta
BACKGROUND: Postoperative vomiting (POV) is a frequent complication of tonsillectomy in children. In adult patients undergoing abdominal surgeries, the use of intravenous lidocaine infusion can prevent POV. OBJECTIVE: To evaluate the anti-emetic effect of an intravenous lidocaine infusion used as an adjuvant to general anaesthesia, in children undergoing elective ear, nose and throat surgery. DESIGN: Double-blind, randomised, controlled study...
May 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29530664/vulvar-field-resection-based-on-ontogenetic-cancer-field-theory-for-surgical-treatment-of-vulvar-carcinoma-a-single-centre-single-group-prospective-trial
#14
Michael Höckel, Sophia Trott, Nadja Dornhöfer, Lars-Christian Horn, Bettina Hentschel, Benjamin Wolf
BACKGROUND: The incidence of vulvar cancer is increasing, but surgical treatment-the current standard of care-often leads to unsatisfactory outcomes, especially in patients with node-positive disease. Preliminary results at our centre showed that locoregional spread of vulvar carcinoma occurs within tissue domains defined by stepwise embryonic and fetal development (ontogenetic cancer fields and associated lymph node regions). We propose that clinical translation of these insights into practice could improve outcomes of surgical treatment of vulvar cancer...
April 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29521661/spinal-anaesthesia-with-chloroprocaine-1-versus-total-intravenous-anaesthesia-for-outpatient-knee-arthroscopy-a-randomised-controlled-trial
#15
Volker Gebhardt, Vera Zawierucha, Oliver Schöffski, Anke Schwarz, Christel Weiss, Marc D Schmittner
BACKGROUND: Both general and spinal anaesthesia with short-acting local anaesthetics are suitable and reliable for knee arthroscopy as an ambulatory procedure. Chloroprocaine (CP) 1% seems to be the ideal spinal local anaesthetic for this indication. OBJECTIVE: The aim of this study was to compare spinal anaesthesia using CP 1% with general for outpatient knee arthroscopy with regard to procedure times, occurrence of pain, patient satisfaction and recovery, and also costs...
March 7, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29514697/cardiac-output-optimisation-following-liver-transplant-colt-trial-study-protocol-for-a-feasibility-randomised-controlled-trial
#16
Farid Froghi, Rahul Koti, Kurinchi Gurusamy, Susan Mallett, Douglas Thorburn, Linda Selves, Sarah James, Jeshika Singh, Manuel Pinto, Christine Eastgate, Margaret McNeil, Helder Filipe, Fatima Jichi, Nick Schofield, Daniel Martin, Brian Davidson
BACKGROUND: Patients with liver cirrhosis undergoing liver transplantation have a hyperdynamic circulation which persists into the early postoperative period making accurate assessment of fluid requirements challenging. Goal-directed fluid therapy (GDFT) has been shown to reduce morbidity and mortality in a number of surgery settings. The impact of GDFT in patients undergoing liver transplantation is unknown. A feasibility trial was designed to determine patient and clinician support for recruitment into a randomised controlled trial of GDFT following liver transplantation, adherence to a GDFT protocol, participant withdrawal, and to determine appropriate endpoints for a subsequent larger trial to evaluate the efficacy of GDFT in patients undergoing liver transplantation...
March 7, 2018: Trials
https://www.readbyqxmd.com/read/29482596/baden-prevention-and-reduction-of-incidence-of-postoperative-delirium-trial-pride-a-phase-iv-multicenter-randomized-placebo-controlled-double-blind-clinical-trial-of-ketamine-versus-haloperidol-for-prevention-of-postoperative-delirium
#17
Harriet Riegger, Alexa Hollinger, Burkhardt Seifert, Katharina Toft, Andrea Blum, Tatjana Zehnder, Martin Siegemund
BACKGROUND: Delirium is a neurobehavioural syndrome that frequently develops in the postoperative setting. The incidence of elderly patients who develop delirium during hospital stay ranges from 10 to 80% (Schonauer et al., J Pept Sci. 2017). Delirium was first described more than half a century ago in the cardiac surgery population (Blachy and Starr, Am J Psychiatry 121:371-5, 1964), where it was already discovered as a state that might be accompanied by serious complications such as prolonged ICU and hospital stay, reduced quality of life and increased mortality...
February 26, 2018: Trials
https://www.readbyqxmd.com/read/29472259/feasibility-of-a-multicentre-randomised-controlled-trial-of-laparoscopic-versus-open-colorectal-surgery-in-the-acute-setting-the-laces-feasibility-trial-protocol
#18
Deena Harji, Helen Marshall, Katie Gordon, Hannah Crow, Victoria Hiley, Dermot Burke, Ben Griffiths, Catherine Moriarty, Maureen Twiddy, John L O'Dwyer, Azmina Verjee, Julia Brown, Peter Sagar
INTRODUCTION: Acute colorectal surgery forms a significant proportion of emergency admissions within the National Health Service. There is limited evidence to suggest minimally invasive surgery may be associated with improved clinical outcomes in this cohort of patients. Consequently, there is a need to assess the clinical effectiveness and cost-effectiveness of laparoscopic surgery in the acute colorectal setting. However,emergency colorectal surgical trials have previously been difficult to conduct due to issues surrounding recruitment and equipoise...
February 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29460275/community-screening-for-visual-impairment-in-older-people
#19
REVIEW
Emily L Clarke, Jennifer R Evans, Liam Smeeth
BACKGROUND: Visual problems in older people are common and frequently under-reported. The effects of poor vision in older people are wide reaching and include falls, confusion and reduced quality of life. Much of the visual impairment in older ages can be treated (e.g. cataract surgery, correction of refractive error). Vision screening may therefore reduce the number of older people living with sight loss. OBJECTIVES: The objective of this review was to assess the effects on vision of community vision screening of older people for visual impairment...
February 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29458392/recruitment-of-older-adults-to-three-preventative-lifestyle-improvement-studies
#20
Robin Chatters, Louise Newbould, Kirsty Sprange, Daniel Hind, Gail Mountain, Katy Shortland, Lauren Powell, Rebecca Gossage-Worrall, Tim Chater, Anju Keetharuth, Ellen Lee, Bob Woods
BACKGROUND: Recruiting isolated older adults to clinical trials is complex, time-consuming and difficult. Previous studies have suggested querying existing databases to identify appropriate potential participants. We aim to compare recruitment techniques (general practitioner (GP) mail-outs, community engagement and clinician referrals) used in three randomised controlled trial (RCT) studies assessing the feasibility or effectiveness of two preventative interventions in isolated older adults (the Lifestyle Matters and Putting Life In Years interventions)...
February 20, 2018: Trials
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