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https://www.readbyqxmd.com/read/29331966/effectiveness-and-safety-of-oral-sedation-in-adult-patients-undergoing-dental-procedures-protocol-for-a-systematic-review
#1
Jimmy de Oliveira Araújo, Rogério Heládio Lopes Motta, Cristiane de Cássia Bergamaschi, Caio Chaves Guimarães, Juliana Cama Ramacciato, Natalia Karol de Andrade, Mabel Fernandes Fiqueiró, Luciane Cruz Lopes
INTRODUCTION: The management of anxious patients undergoing dental procedures is still a challenge in clinical practice. Despite a wide variety of drugs for oral sedation in adult patients, there are relatively few systematic reviews that compare the effectiveness and safety of different drugs administered via this route. Thus, this study will evaluate the effectiveness and safety of oral sedation with benzodiazepines and other agents to patients undergoing dental surgical procedures...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331262/can-interrogation-of-tumour-characteristics-lead-us-to-safely-omit-adjuvant-radiotherapy-in-patients-with-early-breast-cancer
#2
I S Bhattacharya, A M Kirby, J M Bliss, C E Coles
Adjuvant radiotherapy after breast-conserving surgery has been an important component of the standard of care for early breast cancer. Improvements in breast cancer care have resulted in a substantial reduction in local relapse rates over recent decades. Although the proportional benefits of adjuvant radiotherapy are similar for different prognostic risk groups of patients, the absolute benefits depend on the risk of relapse and therefore vary considerably between prognostic groups. Radiotherapy is not without risk and for some patients at very low risk of relapse the risks of radiotherapy may outweigh the benefit, leading to potential overtreatment...
January 10, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29330853/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-vs-facemask-breathing-pre-oxygenation-for-rapid-sequence-induction-in-adults-a-prospective-randomised-non-blinded-clinical-trial
#3
Å Lodenius, J Piehl, A Östlund, J Ullman, M Jonsson Fagerlund
Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) can prolong apnoea time in adults. Therefore, THRIVE used for pre-oxygenation in rapid sequence induction of anaesthesia could extend safe apnoea time during prolonged laryngoscopy and intubation. In this randomised controlled trial, we compared the lowest peripheral oxygen saturation (SpO2 ) during intubation when pre-oxygenating with either traditional facemask or THRIVE. Eighty adult patients, undergoing rapid sequence induction of anaesthesia for emergency surgery, were randomly allocated to pre-oxygenation with 100% oxygen with facemask or with THRIVE...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29326183/transvaginal-natural-orifice-transluminal-endoscopic-surgery-vnotes-adnexectomy-for-benign-pathology-compared-with-laparoscopic-excision-notable-a-protocol-for-a-randomised-controlled-trial
#4
Jan Filip Baekelandt, Peter A De Mulder, Ilse Le Roy, Chantal Mathieu, Annouschka Laenen, Paul Enzlin, Steven Weyers, Ben W J Mol, Jan J A Bosteels
INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the cavities of the human body to perform surgical interventions. NOTES limits the magnitude of surgical trauma and potentially reduces postoperative pain. Our group published a protocol on a randomised study comparing transvaginal NOTES (vNOTES) versus laparoscopy for hysterectomy (HALON). We simultaneously designed a similar randomised controlled trial (RCT) comparing vNOTES with laparoscopy for adnexectomy...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#5
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29319024/what-to-do-when-heller-s-myotomy-fails-pneumatic-dilatation-laparoscopic-remyotomy-or-peroral-endoscopic-myotomy-a-systematic-review
#6
REVIEW
Sonia Fernández-Ananín, Arnulfo F Fernández, Carmen Balagué, David Sacoto, Eduardo Maria Targarona
BACKGROUND: Surgical treatment of achalasia fails in 10%-20% of patients. The most frequent responsible cause is the performance of an incomplete myotomy at primary surgery. The treatment when the failure happens is not well defined. In this study, we review and evaluate the possible treatments to be carried out when surgical myotomy fails. We define its benefits and results, with the purpose of defining a therapeutic algorithm. MATERIALS AND METHODS: The systematic review was performed following the guidelines established by the Meta-analysis of Observational Studies in Epidemiology statement...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29318985/a-randomised-controlled-trial-and-economic-evaluation-of-intraoperative-cell-salvage-during-caesarean-section-in-women-at-risk-of-haemorrhage-the-salvo-cell-salvage-in-obstetrics-trial
#7
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29318031/para-aortic-lymphadenectomy-in-advanced-stage-cervical-cancer-a-protocol-for-comparing-safety-feasibility-and-diagnostic-accuracy-of-surgical-staging-versus-pet-ct-paldisc-trial
#8
Casper Tax, Karin Abbink, Maroeska M Rovers, Ruud L M Bekkers, Petra L M Zusterzeel
Background: Currently, a PET-CT is used to assess the need for extended field radiotherapy of para-aortic lymph nodes (PALN) in International Federation of Gynaecology and Obstetrics (FIGO) stage IB2, IIA2-IVA (locally advanced stage) cervical cancer. A small study established a sensitivity and specificity estimate for PALN metastases of 50% (95% CI; 7-93%) and 83% (95% CI; 52-98%), respectively. Surgical staging of PALN may lead to a higher diagnostic accuracy. However, surgical staging of para-aortic lymph nodes in locally advanced stage cervical cancer is not common practice...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29316962/hopon-hyperbaric-oxygen-for-the-prevention-of-osteoradionecrosis-a-randomised-controlled-trial-of-hyperbaric-oxygen-to-prevent-osteoradionecrosis-of-the-irradiated-mandible-study-protocol-for-a-randomised-controlled-trial
#9
Richard Shaw, Christopher Butterworth, Binyam Tesfaye, Matthew Bickerstaff, Susanna Dodd, Gary Smerdon, Seema Chauhan, Peter Brennan, Keith Webster, James McCaul, Peter Nixon, Anastasios Kanatas, Paul Silcocks
BACKGROUND: Osteoradionecrosis of the mandible is the most common serious complication of radiotherapy for head and neck malignancy. For decades, hyperbaric oxygen has been employed in efforts to prevent those cases of osteoradionecrosis that are precipitated by dental extractions or implant placement. The evidence for using hyperbaric oxygen remains poor and current clinical practice varies greatly. We describe a protocol for a clinical trial to assess the benefit of hyperbaric oxygen in the prevention of osteoradionecrosis during surgery on the irradiated mandible...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#10
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29314425/ebus-faster-cheaper-and-most-effective-in-lung-cancer-staging
#11
REVIEW
Fotios Sampsonas, Loukas Kakoullis, Dimosthenis Lykouras, Kiriakos Karkoulias, Konstantinos Spiropoulos
The use of endobronchial ultrasound trans-bronchial needle aspiration (EBUS-TBNA) as the initial diagnostic and staging procedure in patients with suspected, non-metastatic lung cancer has gained substantial support, and is now recommended by numerous guidelines. Whereas considerable attention has been pointed to the reductions in costs achieved by EBUS-TBNA, that has not been the case for some of its more significant benefits, namely the reduction of the diagnostic work-up time and its ability to accurately assess and restage lymph nodes, which were previously stated incorrectly by CT or PET scan...
January 3, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29312732/bronchial-suction-does-not-facilitate-lung-collapse-when-using-a-double-lumen-tube-during-video-assisted-thoracoscopic-surgery-a-randomized-controlled-trial
#12
Xiang Quan, Jie Yi, Yuguang Huang, Xiuhua Zhang, Le Shen, Shanqing Li
Background: Bronchial suction through the lumen of a bronchial blocker has been reported to accelerate lung collapse. The aim of the current study was to examine whether bronchial suction could also facilitate lung collapse when using a double-lumen tube (DLT). Methods: Eighty patients scheduled for elective video-assisted thoracoscopic surgery for lung cancer using a DLT for one-lung ventilation (OLV) were randomised into an arm that received bronchial suction and an arm that underwent spontaneous collapse (n=40 per arm)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29312730/cost-effectiveness-analysis-of-sealant-impact-in-management-of-moderate-intraoperative-alveolar-air-leaks-during-video-assisted-thoracoscopic-surgery-lobectomy-a-multicentre-randomised-controlled-trial
#13
Francesco Zaraca, Maurizio Vaccarili, Gino Zaccagna, Pio Maniscalco, Giampiero Dolci, Birgit Feil, Reinhold Perkmann, Luca Bertolaccini, Roberto Crisci
Background: Intraoperative alveolar air leak (IOAAL) is one of most common complications after video-assisted thoracoscopic surgery (VATS) lobectomy. The study aimed to evaluate if, in moderate IOAAL, intraoperative polymeric biodegradable sealant (ProgelTM) reduced postoperative air leak (PAL) and consequently was cost-effective. Methods: Patients with moderate IOAAL were randomised in a multicentre trial to intraoperative use of a sealant (Sealant group) or standard management of air leaks (Control group)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310681/comparison-of-outcome-measures-and-complication-rates-following-three-different-approaches-for-primary-total-hip-arthroplasty-a-pragmatic-randomised-controlled-trial
#14
Adrian J Talia, Cassandra Coetzee, Oren Tirosh, Phong Tran
BACKGROUND: Total hip arthroplasty is one of the most commonly performed surgical procedures worldwide. There are a number of surgical approaches for total hip arthroplasty and no high-level evidence supporting one approach over the other. Each approach has its unique benefits and drawbacks. This trial aims to directly compare the three most common surgical approaches for total hip arthroplasty. METHODS/DESIGN: This is a single-centre study conducted at Western Health, Melbourne, Australia; a large metropolitan centre...
January 8, 2018: Trials
https://www.readbyqxmd.com/read/29309720/radical-multimodality-therapy-for-malignant-pleural-mesothelioma
#15
REVIEW
Omar Abdel-Rahman, Zeinab Elsayed, Hadeer Mohamed, Mostafa Eltobgy
BACKGROUND: Malignant pleural mesothelioma is an almost always fatal tumour, for which palliative platinum-based chemotherapy is currently the standard treatment. Multimodal therapeutic strategies incorporating surgery, radiation therapy or photodynamic therapy and chemotherapy have been recommended for selected patients but there is no consensus about their effectiveness. OBJECTIVES: To assess the benefits and harms of radical multimodal treatment options (including radical surgery ± radical radiotherapy ± photodynamic therapy ± systemic therapy) compared to each other or to palliative treatments, for people with malignant pleural mesothelioma...
January 8, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29307904/randomised-controlled-trial-of-central-venous-catheterisation-through-external-jugular-vein-a-comparison-of-success-with-or-without-body-manoeuvres
#16
Rohan Magoon, Surender Kumar Malhotra, Vikas Saini, Ridhima Sharma, Jasleen Kaur
Background and Aims: The external jugular vein (EJV), often used for resuscitation, has been underutilised for central venous catheterisation (CVC) in view of an unpredictable success rate. There is an encouraging literature on the improved success rate of CVC through EJV with the inclusion of certain body manoeuvres. This prospective randomised controlled study was conducted with the aim of evaluating the efficacy of body manoeuvres in improving the success rate of CVC through EJV. Methods: One hundred patients aged 18-50 years, scheduled for elective surgery requiring CVC, were randomly assigned to either undergo CVC using Seldinger technique with body manoeuvres or a control group undergoing CVC without body manoeuvres...
December 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29305324/real-world-outcomes-in-patients-with-neovascular-age-related-macular-degeneration-treated-with-intravitreal-vascular-endothelial-growth-factor-inhibitors
#17
REVIEW
Hemal Mehta, Adnan Tufail, Vincent Daien, Aaron Lee, Vuong Nguyen, Mehmet Ozturk, Daniel Barthelmes, Mark C Gillies
Clinical trials identified intravitreal vascular endothelial growth factor inhibitors (anti-VEGF agents) have the potential to stabilise or even improve visual acuity outcomes in neovascular age-related macular degeneration (AMD), a sight-threatening disease. Real-world evidence allows us to assess whether results from randomised controlled trials can be applied to the general population. We describe the development of global registries, in particular the Fight Retinal Blindness! registry that originated in Australia, the United Kingdom AMD Electronic Medical Records User Group and the IRIS registry in the USA...
January 2, 2018: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/29304735/effect-of-single-dose-dexmedetomidine-on-postoperative-recovery-after-ambulatory-ureteroscopy-and-ureteric-stenting-a-double-blind-randomized-controlled-study
#18
I I Shariffuddin, W H Teoh, S Wahab, C Y Wang
BACKGROUND: Ambulatory surgery has recently gain popularity, as it is a good method of optimizinghospital resources utilization. To support ambulatory surgery, anaesthetic goals nowrevolve around patients' early recovery with minimal pain and nausea, expedientdischarge home and prompt resumption of activities of daily living. In this study, weevaluated the effect of a single pre-induction dose of dexmedetomidine on anaestheticrequirements, postoperative pain and clinical recovery after ambulatory ureteroscopy andureteric stenting under general anaesthesia...
January 5, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29288561/the-effect-of-flurbiprofen-oral-spray-and-ibuprofen-versus-ibuprofen-alone-on-postoperative-tonsillectomy-pain-an-open-randomised-controlled-trial
#19
Bilge Türk, Meltem Akpınar, Zeynep Nur Erol, Kerem Sami Kaya, Özlem Ünsal, Berna Uslu Coşkun
OBJECTIVE: This prospective clinical study was carried out to evaluate the analgesic efficacy and safety of oral spray form of flurpiprofen in the treatment of postoperative pain in tonsillectomy patients. STUDY DESIGN: Open randomised controlled clinical study. SETTING: Tertiary care training and research hospital. PARTICIPANTS: One hundred (53 males, 47 females) with an age range of 18-53 years old (mean 27.4 ± 9...
December 30, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29288190/can-we-save-the-rectum-by-watchful-waiting-or-transanal-microsurgery-following-chemo-radiotherapy-versus-total-mesorectal-excision-for-early-rectal-cancer-star-trec-study-protocol-for-a-multicentre-randomised-feasibility-study
#20
Anouk J M Rombouts, Issam Al-Najami, Natalie L Abbott, Ane Appelt, Gunnar Baatrup, Simon Bach, Aneel Bhangu, Karen-Lise Garm Spindler, Richard Gray, Kelly Handley, Manjinder Kaur, Ellen Kerkhof, Camilla Jensenius Kronborg, Laura Magill, Corrie A M Marijnen, Iris D Nagtegaal, Lars Nyvang, Femke P Peters, Per Pfeiffer, Cornelis Punt, Philip Quirke, David Sebag-Montefiore, Mark Teo, Nick West, Johannes H W de Wilt
INTRODUCTION: Total mesorectal excision (TME) is the highly effective standard treatment for rectal cancer but is associated with significant morbidity and may be overtreatment for low-risk cancers. This study is designed to determine the feasibility of international recruitment in a study comparing organ-saving approaches versus standard TME surgery. METHODS AND ANALYSIS: STAR-TREC trial is a multicentre international randomised, three-arm parallel, phase II feasibility study in patients with biopsy-proven adenocarcinoma of the rectum...
December 28, 2017: BMJ Open
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