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https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#1
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28231605/endonasal-versus-external-dacryocystorhinostomy-for-nasolacrimal-duct-obstruction
#2
REVIEW
Lona Jawaheer, Caroline J MacEwen, Deepa Anijeet
BACKGROUND: A dacryocystorhinostomy (DCR) procedure aims to restore drainage of tears by bypassing a blockage in the nasolacrimal duct, through the creation of a bony ostium that allows communication between the lacrimal sac and the nasal cavity. It can be performed using endonasal or external approaches. The comparative success rates of these two approaches have not yet been established and this review aims to evaluate the relevant up-to-date research. OBJECTIVES: The primary aim of this review is to compare the success rates of endonasal DCR with that of external DCR...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230910/adhesives-for-bonded-molar-tubes-during-fixed-brace-treatment
#3
REVIEW
Declan T Millett, Nicky A Mandall, Rye Cr Mattick, Joy Hickman, Anne-Marie Glenny
BACKGROUND: Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. The success of a fixed appliance depends partly on the metal attachments (brackets and bands) being glued to the teeth so that they do not become detached during treatment. Brackets (metal squares) are usually attached to teeth other than molars, where bands (metal rings that go round each tooth) are more commonly used. Orthodontic tubes (stainless steel tubes that allow wires to pass through them), are typically welded to bands but they may also be glued directly (bonded) to molars...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230908/probiotics-for-people-with-hepatic-encephalopathy
#4
REVIEW
Rohan Dalal, Richard G McGee, Stephen M Riordan, Angela C Webster
BACKGROUND: Hepatic encephalopathy is a disorder of brain function as a result of liver failure or portosystemic shunt or both. Both hepatic encephalopathy (clinically overt) and minimal hepatic encephalopathy (not clinically overt) significantly impair patient's quality of life and daily functioning, and represent a significant burden on healthcare resources. Probiotics are live micro-organisms, which when administered in adequate amounts, may confer a health benefit on the host. OBJECTIVES: To determine the beneficial and harmful effects of probiotics in any dosage, compared with placebo or no intervention, or with any other treatment for people with any grade of acute or chronic hepatic encephalopathy...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#5
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230324/effects-of-short-term-energy-restriction-on-liver-lipid-content-and-inflammatory-status-in-severely-obese-adults-results-of-a-randomised-controlled-trial-rct-using-two-dietary-approaches
#6
Emma L Baldry, Guruprasad P Aithal, Philip Kaye, Iskandar R Idris, Andrew Bennett, Paul C Leeder, Ian A Macdonald
Short-term very low energy diets (VLED) are used in clinical practice prior to bariatric surgery, however, regimens vary and outcomes for a short intervention are unclear. We examined the effect of two VLEDs; a food-based diet (FD) and meal replacement plan (MRP) (LighterLife) over two weeks in a randomised controlled trial (RCT). We collected clinical and anthropometric data, fasting blood samples, and dietary evaluation questionnaires. Surgeons took liver biopsies and made a visual assessment of the liver...
February 23, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28230062/triple-combination-therapy-in-the-treatment-of-hypertension-a-review-of-the-evidence
#7
REVIEW
R Düsing, B Waeber, M Destro, C Santos Maia, P Brunel
Hypertension is a serious public health concern with inadequate control of blood pressure (BP) worldwide. Contributing factors include low efficacy of drugs, underuse of combination therapies, irrational combinations, physicians' therapeutic inertia and poor adherence to treatment. Current guidelines recommend the use of initial (dual) combination therapy in high-risk patients for immediate BP response, better short- and long-term BP control, and continued/improved patient adherence. This article aims to review the existing evidence of triple-combination therapies with respect to efficacy, safety and adherence to treatment...
February 23, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28229895/impulse-control-disorders-and-levodopa-induced-dyskinesias-in-parkinson-s-disease-an-update
#8
REVIEW
Valerie Voon, T Celeste Napier, Michael J Frank, Veronique Sgambato-Faure, Anthony A Grace, Maria Rodriguez-Oroz, Jose Obeso, Erwan Bezard, Pierre-Olivier Fernagut
Dopaminergic medications used in the treatment of patients with Parkinson's disease are associated with motor and non-motor behavioural side-effects, such as dyskinesias and impulse control disorders also known as behavioural addictions. Levodopa-induced dyskinesias occur in up to 80% of patients with Parkinson's after a few years of chronic treatment. Impulse control disorders, including gambling disorder, binge eating disorder, compulsive sexual behaviour, and compulsive shopping occur in about 17% of patients with Parkinson's disease on dopamine agonists...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28229893/safety-and-efficacy-of-natalizumab-in-patients-with-acute-ischaemic-stroke-action-a-randomised-placebo-controlled-double-blind-phase-2-trial
#9
Jacob Elkins, Roland Veltkamp, Joan Montaner, S Claiborne Johnston, Aneesh B Singhal, Kyra Becker, Maarten G Lansberg, Weihua Tang, Ih Chang, Kumar Muralidharan, Sarah Gheuens, Lahar Mehta, Mitchell S V Elkind
BACKGROUND: In animal models of acute ischaemic stroke, blocking of the leukocyte-endothelium adhesion by antagonism of α4 integrin reduces infarct volumes and improves outcomes. We assessed the effect of one dose of natalizumab, an antibody against the leukocyte adhesion molecule α4 integrin, in patients with acute ischaemic stroke. METHODS: In this double-blind, phase 2 study, patients with acute ischaemic stroke (aged 18-85 years) from 30 US and European clinical sites were randomly assigned (1:1) to 300 mg intravenous natalizumab or placebo with stratification by treatment window and baseline infarct size...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28229892/safety-and-efficacy-of-opicinumab-in-acute-optic-neuritis-renew-a-randomised-placebo-controlled-phase-2-trial
#10
Diego Cadavid, Laura Balcer, Steven Galetta, Orhan Aktas, Tjalf Ziemssen, Ludo Vanopdenbosch, Jette Frederiksen, Mark Skeen, Glenn J Jaffe, Helmut Butzkueven, Focke Ziemssen, Luca Massacesi, Yi Chai, Lei Xu, Stefanie Freeman
BACKGROUND: The human monoclonal antibody opicinumab (BIIB033, anti-LINGO-1) has shown remyelinating activity in preclinical studies. We therefore assessed the safety and tolerability, and efficacy of opicinumab given soon after a first acute optic neuritis episode. METHODS: This randomised, double-blind, placebo-controlled, phase 2 study (RENEW) was done at 33 sites in Australia, Canada, and Europe in participants (aged 18-55 years) with a first unilateral acute optic neuritis episode within 28 days from study baseline...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28229054/effectiveness-of-vitamin-d-supplementation-for-cardiovascular-health-outcomes
#11
REVIEW
Panagiota Veloudi, Graeme Jones, James E Sharman
There is a plausible physiological theory, supported by many observational studies, that vitamin D supplementation should be effective for improving cardiovascular end points, such as blood pressure (BP), large artery stiffness, atherosclerosis, endothelial function and clinical events. However, results from randomised controlled trials (RCTs) have been inconsistent. In this review, we evaluated the evidence regarding the effectiveness of vitamin D supplementation for cardiovascular surrogate and hard clinical end points...
January 2017: Pulse (Basel, Switzerland)
https://www.readbyqxmd.com/read/28228942/effects-of-renal-denervation-on-vascular-remodelling-in-patients-with-heart-failure-and-preserved-ejection-fraction-a-randomised-control-trial
#12
Hitesh C Patel, Carl Hayward, Jennifer Keegan, Peter D Gatehouse, Ronak Rajani, Rajdeep S Khattar, Raad H Mohiaddin, Stuart D Rosen, Alexander R Lyon, Carlo di Mario
OBJECTIVE: To assess the effect of renal denervation (RDT) on micro- and macro-vascular function in patients with heart failure with preserved ejection fraction (HFpEF). DESIGN: A prospective, randomised, open-controlled trial with blinded end-point analysis. SETTING: A single-centre London teaching hospital. PARTICIPANTS: Twenty-five patients with HFpEF who were recruited into the RDT-PEF trial. MAIN OUTCOME MEASURES: Macro-vascular: 24-h ambulatory pulse pressure, aorta distensibilty (from cardiac magnetic resonance imaging (CMR), aorta pulse wave velocity (CMR), augmentation index (peripheral tonometry) and renal artery blood flow indices (renal MR)...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28228571/who-cares-the-lost-legacy-of-archie-cochrane
#13
Clemet Askheim, Tony Sandset, Eivind Engebretsen
Over the last 20 years, the evidence-based medicine (EBM) movement has sought to develop standardised approaches to patient treatment by drawing on research results from randomised controlled trials (RCTs). The Cochrane Collaboration and its eponym, Archie Cochrane, have become symbols of this development, and Cochrane's book Effectiveness and Efficiency from 1972 is often referred to as the first sketch of what was to become EBM. In this article, we claim that this construction of EBM's historical roots is based on a selective reading of Cochrane's text...
March 2017: Medical Humanities
https://www.readbyqxmd.com/read/28228151/unravelling-effectiveness-of-a-nurse-led-behaviour-change-intervention-to-enhance-physical-activity-in-patients-at-risk-for-cardiovascular-disease-in-primary-care-study-protocol-for-a-cluster-randomised-controlled-trial
#14
Heleen Westland, Irene D Bos-Touwen, Jaap C A Trappenburg, Carin D Schröder, Niek J de Wit, Marieke J Schuurmans
BACKGROUND: Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focus on behaviour change in both patients and nurses. The intervention aims for change in a single self-management behaviour, namely physical activity, in primary care patients at risk for cardiovascular disease...
February 22, 2017: Trials
https://www.readbyqxmd.com/read/28225210/prophylactic-drug-management-for-febrile-seizures-in-children
#15
REVIEW
Martin Offringa, Richard Newton, Martinus A Cozijnsen, Sarah J Nevitt
BACKGROUND: Febrile seizures occurring in a child older than one month during an episode of fever affect 2% to 4% of children in Great Britain and the United States and recur in 30%. Rapid-acting antiepileptics and antipyretics given during subsequent fever episodes have been used to avoid the adverse effects of continuous antiepileptic drugs. OBJECTIVES: To evaluate primarily the effectiveness and safety of antiepileptic and antipyretic drugs used prophylactically to treat children with febrile seizures; but also to evaluate any other drug intervention where there was a sound biological rationale for its use...
February 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28225186/randomised-clinical-trial-the-efficacy-and-safety-of-oltipraz-a-liver-x-receptor-alpha-inhibitory-dithiolethione-in-patients-with-non-alcoholic-fatty-liver-disease
#16
W Kim, B G Kim, J S Lee, C K Lee, J E Yeon, M S Chang, J H Kim, H Kim, S Yi, J Lee, J-Y Cho, S G Kim, J-H Lee, Y J Kim
BACKGROUND: Oltipraz is a synthetic dithiolethione with an antisteatotic effect by inhibiting the activity of liver X receptor alpha (LXR-α). Recent studies demonstrated the disruptive role of oltipraz on LXR-α-dependent lipogenesis in hepatocytes and a high-fat diet mouse model. AIM: To evaluate the efficacy and safety of oltipraz for reducing liver fat in subjects with non-alcoholic fatty liver disease (NAFLD). METHODS: We performed a multicentre, double-blind, placebo-controlled, phase II study...
February 22, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28225050/impact-of-baseline-vitamin-b12-status-on-the-effect-of-vitamin-b12-supplementation-on-neurologic-function-in-older-people-secondary-analysis-of-data-from-the-open-randomised-controlled-trial
#17
L M Miles, E Allen, R Clarke, K Mills, R Uauy, A D Dangour
BACKGROUND/OBJECTIVES: The available evidence from randomised controlled trials suggests that vitamin B12 supplementation does not improve neurologic function in older people with marginal but not deficient Vitamin B12 status. This secondary analysis used data from the Older People and Enhanced Neurological function (OPEN) randomised controlled trial to assess whether baseline vitamin B12 status or change in vitamin B12 status over 12 months altered the effectiveness of dietary vitamin B12 supplementation on neurologic function in asymptomatic older people with depleted vitamin B12 status at study entry...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28224745/the-effect-of-maternal-low-flow-oxygen-administration-during-the-second-stage-of-labour-on-umbilical-cord-artery-ph-a-randomised-controlled-trial
#18
G Qian, X Xu, L Chen, S Xia, A Wang, Y Chuai, W Jiang
OBJECTIVE: To assess the effect of maternal low flow oxygen administration during the second stage of labour on umbilical cord artery pH. DESIGN: A randomised controlled trial. SETTING: A tertiary teaching hospital in China. POPULATION: Women in the second stage of labour with no complications. METHODS: About 443 women were randomly allocated to receive either supplemental oxygen at a flow rate of 2 l/min or a sham supplementation by nasal cannula...
March 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28223259/use-of-an-antiepileptic-drug-to-control-epileptic-seizures-associated-with-cranioplasty-a-randomised-controlled-trial
#19
Fei Chen, Yaqi Duan, Yongqin Li, Wenjie Han, Weilei Shi, Weiwei Zhang, Yonghua Huang
BACKGROUND: Epilepsy is a common complication of cranioplasty. The present study was designed to explore the clinical effect of prophylactic anti-epilepsy drugs (AED) to control epileptic seizures associated with cranioplasty. METHODS: and design: This trial was a prospective, randomized, open-label, single-centre, active controlled study designed to investigate the use of antiepileptic drug to control epileptic seizures associated with cranioplasty. We tested the necessity and methods of drug use...
February 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28222778/sample-size-considerations-for-trials-using-cerebral-white-matter-hyperintensity-progression-as-an-intermediate-outcome-at-1%C3%A2-year-after-mild-stroke-results-of-a-prospective-cohort-study
#20
Francesca M Chappell, Maria Del Carmen Valdés Hernández, Stephen D Makin, Kirsten Shuler, Eleni Sakka, Martin S Dennis, Paul A Armitage, Susana Muñoz Maniega, Joanna M Wardlaw
BACKGROUND: White matter hyperintensities (WMHs) are commonly seen on in brain imaging and are associated with stroke and cognitive decline. Therefore, they may provide a relevant intermediate outcome in clinical trials. WMH can be measured as a volume or visually on the Fazekas scale. We investigated predictors of WMH progression and design of efficient studies using WMH volume and Fazekas score as an intermediate outcome. METHODS: We prospectively recruited 264 patients with mild ischaemic stroke and measured WMH volume, Fazekas score, age and cardiovascular risk factors at baseline and 1 year...
February 21, 2017: Trials
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