Read by QxMD icon Read

Clinical trialls

Gin S Malhi, Tim Outhred, Grace Morris, Philip M Boyce, Richard Bryant, Paul B Fitzgerald, Malcolm J Hopwood, Bill Lyndon, Roger Mulder, Greg Murray, Richard J Porter, Ajeet B Singh, Kristina Fritz
In December 2015, the Royal Australian and New Zealand College of Psychiatrists published a comprehensive set of mood disorder clinical practice guidelines for psychiatrists, psychologists and mental health professionals. This guideline summary, directed broadly at primary care physicians, is an abridged version that focuses on bipolar disorder. It is intended as an aid to the management of this complex disorder for primary care physicians working in collaboration with psychiatrists to implement successful long term management...
March 19, 2018: Medical Journal of Australia
Vindya Abeysinghe, Siva Sundararajan, Luc Delriviere, Jonathan Tibballs
Unresectableintrahepaticcholangiocarcinoma has a very poor prognosis despite various treatment options. The case presented describes the diagnostic challenges of a young pregnant woman with unresectable cholangiocarcinoma. The current treatment options for cholangiocarcinoma have limited evidence and high recurrence rate. Given the young age of this patient, selective internal radiotherapy was trialled with traditional chemotherapy with a clinically significant result. This case highlights the delays when diagnosing cholangiocarcinoma in younger patients and the possibility of selective internal radiation therapy in combination with chemotherapy as a potential first-line treatment for a complete response in unresectable disease...
March 9, 2018: BMJ Case Reports
Philippa Fibert, Clare Relton, Tessa Peasgood, David Daley
Background: Attention deficit hyperactivity disorder (ADHD) is a common and growing problem and a leading cause of child referrals to Child and Adult Mental Health Services (CAMHS). It is a drain on resources across nationally funded support agencies and associated with negative outcomes such as early criminality, school disruption and antisocial behaviour. Mainstream interventions (pharmacological and behavioural) demonstrate effectiveness whilst implemented, but are costly, often have unwanted side effects and do not appear to be affecting long-term outcomes...
2018: Pilot and Feasibility Studies
Vincent Deary, Elaine McColl, Paul Carding, Tracy Miller, Janet Wilson
Background: Medically unexplained loss or alteration of voice-functional dysphonia-is the commonest presentation to speech and language therapists (SLTs). Besides the impact on personal and work life, functional dysphonia is also associated with increased levels of anxiety and depression and poor general health. Voice therapy delivered by SLTs improves voice but not these associated symptoms. The aims of this research were the systematic development of a complex intervention to improve the treatment of functional dysphonia, and the trialling of this intervention for feasibility and acceptability to SLTs and patients in a randomised pilot study...
2018: Pilot and Feasibility Studies
Katharine S Baker, Nellie Georgiou-Karistianis, Amit Lampit, Michael Valenzuela, Stephen J Gibson, Melita J Giummarra
Chronic pain is associated with reduced efficiency of cognitive performance, and few studies have investigated methods of remediation. We trialled a computerised cognitive training protocol to determine whether it could attenuate cognitive difficulties in a chronic pain sample. Thirty-nine adults with chronic pain (mean age = 43.3, 61.5% females) were randomised to an 8-week online course (3 sessions/week from home) of game-like cognitive training exercises, or an active control involving watching documentary videos...
January 11, 2018: Pain
Claire Gregory
The colorectal services at The Royal Bournemouth Hospital needed to adapt to meet the extra demand on fast-track patient referrals to the outpatient department, as a consequence of the changes in the National Institute for Health and Care Excellence (NICE) guidance on cancer referrals in June 2015. Learning from other units, a telephone assessment clinic (TAC) triaging patients straight to colonoscopy was trialled. A Plan-Do-Study-Act (PDSA) methodology was used. A baseline study showed that fast-track colorectal patients referred from their general practitioner (GP) were taking on average 30 days until they received their colonoscopy...
2018: BMJ Open Quality
Joanna Macdonald, Justin Henri, Kislay Roy, Emma Hays, Michelle Bauer, Rakesh Naduvile Veedu, Normand Pouliot, Sarah Shigdar
The epithelial cell adhesion molecule (EpCAM), or CD326, was one of the first cancer associated biomarkers to be discovered. In the last forty years, this biomarker has been investigated for use in personalized cancer therapy, with the first monoclonal antibody, edrecolomab, being trialled in humans more than thirty years ago. Since then, several other monoclonal antibodies have been raised to EpCAM and tested in clinical trials. However, while monoclonal antibody therapy has been investigated against EpCAM for almost 40 years as primary or adjuvant therapy, it has not shown as much promise as initially heralded...
January 12, 2018: Cancers
Kate Bryson, Chris Wilkinson, Sabrina Kuah, Geoff Matthews, Deborah Turnbull
BACKGROUND: Women's views are critical for informing the planning and delivery of maternity care services. ST segment analysis (STan) is a promising method to more accurately detect when unborn babies are at risk of brain damage or death during labour that is being trialled for the first time in Australia. This is the first study to examine women's views about STan monitoring in this context. METHODS: Semi-structured interviews were conducted with pregnant women recruited across a range of clinical locations at the study hospital...
December 29, 2017: BMC Pregnancy and Childbirth
David Reeves, Kelly Howells, Mark Sidaway, Amy Blakemore, Mark Hann, Maria Panagioti, Peter Bower
OBJECTIVE: The 'cohort multiple randomized controlled trial' (cmRCT) is a recent innovation by which novel interventions are trialled within large longitudinal cohorts of patients to take gain efficiencies and align trials more closely to standard clinical practice. The use of cmRCTs is outpacing methodological understanding of them and more appropriate methods for designing and analysing such trials are urgently needed. STUDY DESIGN AND SETTING: We established the UK CLASSIC cohort of 4,377 patients with long-term conditions within which we are conducting a cmRCT ("PROTECTS") of telephone-based health coaching...
December 19, 2017: Journal of Clinical Epidemiology
Jamie A Mawhinney, Craig A Mounsey, David P Taggart
Despite the apparent superiority of arterial conduits for coronary artery bypass grafting (CABG), the long saphenous vein remains the most commonly used graft. The high failure rate of long saphenous vein grafts (SVGs) over time is therefore an important limiting factor for the long-term outcomes of CABG. Various methods to improve SVG patency have been proposed, although few have had a significant impact on clinical practice. External SVG supports have been a focus of research over the past 50 years, with their use intended to minimize well-documented pathophysiological changes that occur in the SVG following implantation into the coronary circulation...
December 8, 2017: European Journal of Cardio-thoracic Surgery
Christopher Atkins, Richard Fordham, Allan B Clark, Andrea Stockl, Andrew P Jones, Andrew M Wilson
INTRODUCTION: Fatigue is a frequent and troublesome manifestation of chronic sarcoidosis. This symptom can be debilitating and difficult to treat, with poor response to the treatment. Symptomatic management with neurostimulants, such as methylphenidate, is a possible treatment option. The use of such treatment strategies is not without precedent and has been trialled in cancer-related fatigue. Their use in sarcoidosis requires further evaluation before it can be recommended for clinical practice...
December 4, 2017: BMJ Open
Alice Lee, Mustafa B A Djamgoz
Triple negative breast cancer (TNBC) is a complex and aggressive subtype of breast cancer which lacks oestrogen receptors, progesterone receptors and HER2 amplification, thereby making it difficult to target therapeutically. In addition, TNBC has the highest rates of metastatic disease and the poorest overall survival of all breast cancer subtypes. Resultantly, development of targeted therapies for TNBC is urgently needed. Recent efforts aimed at molecular characterisation of TNBCs have revealed various emerging therapeutic targets including PARP1, receptor and non-receptor tyrosine kinases, immune-checkpoints, androgen receptor and epigenetic proteins...
January 2018: Cancer Treatment Reviews
Stephen Parker, Frances Dark, Ellie Newman, Dominic Hanley, William McKinlay, Carla Meurk
AIMS: Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers' expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them...
December 4, 2017: Epidemiology and Psychiatric Sciences
Rachel Schembri, Jo Spong, Allison Peters, Peter Rochford, Philip Wilksch, Fergal J O'Donoghue, Kenneth M Greenwood, Maree Barnes, Gerard A Kennedy, David J Berlowitz
Ambulatory polysomnography (PSG) does not commonly include an objective measure of light to determine the time of lights off (Loff), and thus cannot be used to calculate important indices such as sleep onset latency and sleep efficiency. This study examined the technical specifications and appropriateness of a prototype light sensor (LS) for use in ambulatory Compumedics Somte PSG.Two studies were conducted. The first examined the light measurement characteristics of the LS when used with a portable PSG device, specifically recording trace range, linearity, sensitivity, and stability...
2017: PloS One
Matthew P Hamilton, Sarah E Hetrick, Cathrine Mihalopoulos, David Baker, Vivienne Browne, Andrew M Chanen, Kerryn Pennell, Rosemary Purcell, Heather Stavely, Patrick D McGorry
OBJECTIVES: To explore the potential utility of clinical stage and mental disorder categories as a basis for determining which attributes of youth mental health care should be offered to which groups of young people. METHODS: In June 2017, we conducted an online survey of youth mental health clinicians that collected information on the participants' background and areas of expertise, then presented vignettes describing young people with different stages of six mental disorders (disorder-based vignettes were matched to participants' area of expertise)...
November 20, 2017: Medical Journal of Australia
Sheree A McCormick, Kathryn R McDonald, Sabina Vatter, Vasiliki Orgeta, Ellen Poliakoff, Sarah J Smith, Iracema Leroi
Background: Group-based psychosocial therapy, such as group Cognitive Stimulation Therapy, improves cognition and quality of life in people living with dementia. Neuropsychiatric symptoms and restricted mobility are common complications for people with Parkinson's-related dementia (PRD) and may limit access to, and participation in, group activities. This study describes the development of a condition-specific, home-based psychosocial therapy for people with PRD ready to be trialled in a clinical population...
2017: Clinical Interventions in Aging
Kim N Nguyen, Samantha Bobba, Alexander Richardson, Mijeong Park, Stephanie L Watson, Denis Wakefield, Nick Di Girolamo
Limbal stem cell deficiency (LSCD) is a complex blinding disease of the cornea, which cannot be treated with conventional corneal transplants. Instead, a stem cell (SC) graft is required to replenish the limbal epithelial stem cell (LESC) reservoir, which is ultimately responsible for regenerating the corneal epithelium. Current therapies utilize limbal tissue biopsies that harbor LESCs as well as tissue culture expanded cells. Typically, this tissue is placed on a scaffold that supports the formation of corneal epithelial cell sheets, which are then transferred to diseased eyes...
January 2018: Acta Biomaterialia
Thomas Richards, Thomas Tudor Hughes, Jake Moss, Tessa Lomax
An 80-year-old woman was admitted to hospital with acute anarthria and severe dysphagia, characterised by loss of voluntary control of the muscles of facial expression, mastication, bolus manipulation (tongue) and pharyngeal constriction, with relative preservation of involuntary movements. Brain imaging revealed an acute infarct in the left frontal operculum and an area of gliosis consistent with an old infarct in the right frontal operculum. A clinical and radiological diagnosis of bilateral anterior frontal opercular syndrome (Foix-Chavany-Marie-syndrome) was made...
October 24, 2017: BMJ Case Reports
P Zaratin, G Comi, D Leppert
This article outlines the principal challenges to establish a standard phase-2 approach for progressive multiple sclerosis (PMS) and presents referring strategies to accelerate the registration process via a guidance approved by regulatory agencies. Accordingly, the contribution of 'big datasets' for a better understanding of the natural history of primary-progressive multiple sclerosis (PPMS) and secondary-progressive multiple sclerosis (SPMS) and of their prognostic factors and the value of novel biomarkers are discussed...
October 2017: Multiple Sclerosis: Clinical and Laboratory Research
Roanne Hurley, Liana Machado
Transcranial direct current stimulation (tDCS) has been trialled by many researchers attempting to improve brain function. Outcomes have been quite variable with seemingly similar protocols yielding either inconsistent or insufficiently robust improvements for clinical translation. A potentially fruitful avenue for increasing benefits conferred by tDCS stems from findings from motor and visual cortex studies that indicate tDCS priming prior to a subsequent period of stimulation (tDCS or transcranial magnetic stimulation) can in some cases boost outcomes compared to protocols without priming...
December 2017: Neuroscience and Biobehavioral Reviews
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"