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https://www.readbyqxmd.com/read/28543041/the-added-value-of-cardiac-index-and-pulse-pressure-variation-monitoring-to-mean-arterial-pressure-guided-volume-therapy-in-moderate-risk-abdominal-surgery-coguide-a-pragmatic-multicentre-randomised-controlled-trial
#1
J Stens, J-P Hering, C W P van der Hoeven, A Boom, H S Traast, L E Garmers, S A Loer, C Boer
There is disagreement regarding the benefits of goal-directed therapy in moderate-risk abdominal surgery. Therefore, we tested the hypothesis that the addition of non-invasive cardiac index and pulse pressure variation monitoring to mean arterial pressure-based goal-directed therapy would reduce the incidence of postoperative complications in patients having moderate-risk abdominal surgery. In this pragmatic multicentre randomised controlled trial, we randomly allocated 244 patients by envelope drawing in a 1:1 fashion, stratified per centre...
May 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28540716/single-dose-oral-ketoprofen-or-dexketoprofen-for-acute-postoperative-pain-in-adults
#2
REVIEW
Helen Gaskell, Sheena Derry, Philip J Wiffen, R Andrew Moore
BACKGROUND: This review is an update of "Single dose oral ketoprofen and dexketoprofen for acute postoperative pain in adults" last updated in Issue 4, 2009. Ketoprofen is a non-selective nonsteroidal anti-inflammatory drug (NSAID) used to treat acute and chronic painful conditions. Dexketoprofen is the (S)-enantiomer, which is believed to confer analgesia. Theoretically dexketoprofen is expected to provide equivalent analgesia to ketoprofen at half the dose, with a consequent reduction in gastrointestinal adverse events...
May 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28534382/meta-meta-analysis-a-paradigm-in-the-case-of-surgical-publications
#3
Georgios C Sotiropoulos, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Anastasia Prodromidou, Athanasios Katsargyris
PURPOSE: Meta-analyses are considered to provide level I-II evidence. Based on this premise, several statements have been developed to standardize guidelines and optimize results. The purpose of this study was to investigate the quality of the information delivered by meta-analyses. METHODS: Meta-analyses published in Annals of Surgery during an 11-year period were reviewed whereas individual publications of each meta-analysis were assessed. An Excel database encompassing 29 parameters was constructed based on the Quality of Reporting of Meta-analyses (QUOROM) statement...
March 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28532478/study-protocol-a-double-blind-randomised-control-trial-of-high-volume-image-guided-injections-in-achilles-and-patellar-tendinopathy-in-a-young-active-population
#4
Robert M Barker-Davies, Alastair Nicol, I McCurdie, James Watson, Polly Baker, Patrick Wheeler, Daniel Fong, Mark Lewis, Alexander N Bennett
BACKGROUND: Chronic tendinopathy is a significant problem particularly in active populations limiting sporting and occupational performance. The prevalence of patellar tendinopathy in some sports is near 50% and the incidence of lower limb tendinopathy is 1.4% p.a. in the UK Military. Management includes isometric, eccentric, heavy slow resistance exercises and extracorporeal shockwave therapy (ESWT). Often these treatments are inadequate yet there is no good evidence for injection therapies and success rates from surgery can be as low as 50%...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28522452/arthroscopic-partial-meniscectomy-versus-placebo-surgery-for-a-degenerative-meniscus-tear-a-2-year-follow-up-of-the-randomised-controlled-trial
#5
Raine Sihvonen, Mika Paavola, Antti Malmivaara, Ari Itälä, Antti Joukainen, Heikki Nurmi, Juha Kalske, Anna Ikonen, Timo Järvelä, Tero Ah Järvinen, Kari Kanto, Janne Karhunen, Jani Knifsund, Heikki Kröger, Tommi Kääriäinen, Janne Lehtinen, Jukka Nyrhinen, Juha Paloneva, Outi Päiväniemi, Marko Raivio, Janne Sahlman, Roope Sarvilinna, Sikri Tukiainen, Ville-Valtteri Välimäki, Ville Äärimaa, Pirjo Toivonen, Teppo Ln Järvinen
OBJECTIVE: To assess if arthroscopic partial meniscectomy (APM) is superior to placebo surgery in the treatment of patients with degenerative tear of the medial meniscus. METHODS: In this multicentre, randomised, participant-blinded and outcome assessor-blinded, placebo-surgery controlled trial, 146 adults, aged 35-65 years, with knee symptoms consistent with degenerative medial meniscus tear and no knee osteoarthritis were randomised to APM or placebo surgery. The primary outcome was the between-group difference in the change from baseline in the Western Ontario Meniscal Evaluation Tool (WOMET) and Lysholm knee scores and knee pain after exercise at 24 months after surgery...
May 18, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28516472/nasal-decontamination-for-the-prevention-of-surgical-site-infection-in-staphylococcus-aureus-carriers
#6
REVIEW
Zhenmi Liu, Gill Norman, Zipporah Iheozor-Ejiofor, Jason Kf Wong, Emma J Crosbie, Peter Wilson
BACKGROUND: Surgical site infection rates in the month following surgery vary from 1% to 5%. Due to the large number of surgical procedures conducted annually, the costs of these surgical site infections (SSIs) can be considerable in financial and social terms. Nasal decontamination using antibiotics or antiseptics is performed to reduce the risk of SSIs by preventing organisms from the nasal cavity being transferred to the skin where a surgical incision will be made. Staphylococcus aureus (S aureus) colonises the nasal cavity and skin of carriers and can cause infection in open or unhealed surgical wounds...
May 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28515060/barriers-and-facilitators-experienced-in-collaborative-prospective-research-in-orthopaedic-oncology-a-qualitative-study
#7
J S Rendon, M Swinton, N Bernthal, M Boffano, T Damron, N Evaniew, P Ferguson, M Galli Serra, W Hettwer, P McKay, B Miller, L Nystrom, W Parizzia, P Schneider, A Spiguel, R Vélez, K Weiss, J P Zumárraga, M Ghert
OBJECTIVES: As tumours of bone and soft tissue are rare, multicentre prospective collaboration is essential for meaningful research and evidence-based advances in patient care. The aim of this study was to identify barriers and facilitators encountered in large-scale collaborative research by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. METHODS: All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss their experiences with collaborative research in this area...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28508180/a-study-evaluating-the-effects-of-throat-packs-during-nasal-surgery-a-randomised-controlled-trial
#8
Ali Al-Lami, Kwamena Amonoo-Kuofi, Praneta Kulloo, Raj Lakhani, Navin Prakash, Nazir Bhat
The aims of this study were to identify differences in post-operative nausea and vomiting (PONV) and throat pain between throat packed and non-packed patient groups in nasal surgery. This was a prospective, double blind, randomised controlled trial. A water-soaked throat pack gauze was inserted in the mouth to occlude the oropharynx was used in the throat pack group. The second group received no throat pack. A validated PONV questionnaire was completed 6 h post-operatively. Visual analogue scores (VAS) for throat pain were completed in recovery, 2, and 6 h post-operatively...
May 15, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28506775/supervised-or-unsupervised-rehabilitation-after-total-hip-replacement-provides-similar-improvements-for-patients-a-randomised-controlled-trial
#9
Corinne Coulter, Diana M Perriman, Teresa M Neeman, Paul N Smith, Jennifer M Scarvell
OBJECTIVE: To determine do patients do better with unsupervised home PT or in an outpatient setting Are the outcomes after a supervised (centre-based) and an independent (home-based) physical rehabilitation program delivered in the early post-discharge phase (<8weeks) equivalent in an adult THR population. SETTING: Acute care public hospital in the region, supporting a population of almost 540,000. DESIGN: Single blinded randomised controlled trial...
May 12, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28505954/manipulative-rehabilitation-applied-soon-after-lumbar-disc-surgery-improves-late-post-operative-functional-disability-a-preliminary-2-year-follow-up-study
#10
Byungho J Kim, Taeyeong Kim, Junghoon Ahn, Heecheol Cho, Dongyun Kim, Bumchul Yoon
BACKGROUND: Studies have shown late post-operative physical disability and residual pain in patients following lumbar disc surgery despite growing evidence of its beneficial effects. Therefore, rehabilitation is required to minimise the late post-operative complications. OBJECTIVE: To assess the feasibility of manipulative rehabilitation to improve late post-operative outcomes. METHODS: Twenty-one patients aged 25-65 years undergoing lumbar microdiscectomy were randomly assigned to the rehabilitation group (n = 14) or active control group (n = 7) by simple randomisation...
May 5, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28501287/femoral-nerve-block-in-a-representative-sample-of-elderly-people-with-hip-fracture-a-randomised-controlled-trial
#11
Anna Unneby, Olle Svensson, Yngve Gustafson, Birgitta Olofsson
INTRODUCTION: The number of elderly people with hip fracture and dementia is increasing, and many of these patients suffer from pain. Opioids are difficult to adjust and side effects are common, especially with increased age and among patients with dementia. Preoperative femoral nerve block is an alternative pain treatment. AIM: To investigate whether preoperative femoral nerve block reduced acute pain and opioid use after hip fracture among elderly patients, including those with dementia...
April 24, 2017: Injury
https://www.readbyqxmd.com/read/28498374/ranibizumab-pretreatment-in-diabetic-vitrectomy-a-pilot-randomised-controlled-trial-the-radivit-study
#12
O Comyn, L Wickham, D G Charteris, P M Sullivan, E Ezra, Z Gregor, G W Aylward, L da Cruz, D Fabinyi, T Peto, M Restori, W Xing, C Bunce, P G Hykin, J W Bainbridge
PurposeOur aim was to evaluate the impact of intravitreal ranibizumab pretreatment on the outcome of vitrectomy surgery for advanced proliferative diabetic retinopathy. The objective was to determine the feasibility of a subsequent definitive trial and estimate the effect size and variability of the outcome measure.Patients and methodsWe performed a pilot randomised double-masked single-centre clinical trial in 30 participants with tractional retinal detachment associated with proliferative diabetic retinopathy...
May 12, 2017: Eye
https://www.readbyqxmd.com/read/28495819/knee-arthroscopy-versus-conservative-management-in-patients-with-degenerative-knee-disease-a-systematic-review
#13
Romina Brignardello-Petersen, Gordon H Guyatt, Rachelle Buchbinder, Rudolf W Poolman, Stefan Schandelmaier, Yaping Chang, Behnam Sadeghirad, Nathan Evaniew, Per O Vandvik
OBJECTIVE: To determine the effects and complications of arthroscopic surgery compared with conservative management strategies in patients with degenerative knee disease. DESIGN: Systematic review. MAIN OUTCOME MEASURES: Pain, function, adverse events. DATA SOURCES: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and Open Grey up to August 2016. ELIGIBILITY CRITERIA: For effects, randomised clinical trials (RCTs) comparing arthroscopic surgery with a conservative management strategy (including sham surgery) in patients with degenerative knee disease...
May 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28495818/application-of-minimal-important-differences-in-degenerative-knee-disease-outcomes-a-systematic-review-and-case-study-to-inform-bmj-rapid-recommendations
#14
Tahira Devji, Gordon H Guyatt, Lyubov Lytvyn, Romina Brignardello-Petersen, Farid Foroutan, Behnam Sadeghirad, Rachelle Buchbinder, Rudolf W Poolman, Ian A Harris, Alonso Carrasco-Labra, Reed A C Siemieniuk, Per O Vandvik
OBJECTIVES: To identify the most credible anchor-based minimal important differences (MIDs) for patient important outcomes in patients with degenerative knee disease, and to inform BMJ Rapid Recommendations for arthroscopic surgery versus conservative management DESIGN: Systematic review. OUTCOME MEASURES: Estimates of anchor-based MIDs, and their credibility, for knee symptoms and health-related quality of life (HRQoL). DATA SOURCES: MEDLINE, EMBASE and PsycINFO...
May 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#15
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28495804/sham-surgery-versus-labral-repair-or-biceps-tenodesis-for-type-ii-slap-lesions-of-the-shoulder-a-three-armed-randomised-clinical-trial
#16
Cecilie Piene Schrøder, Øystein Skare, Olav Reikerås, Petter Mowinckel, Jens Ivar Brox
BACKGROUND: Labral repair and biceps tenodesis are routine operations for superior labrum anterior posterior (SLAP) lesion of the shoulder, but evidence of their efficacy is lacking. We evaluated the effect of labral repair, biceps tenodesis and sham surgery on SLAP lesions. METHODS: A double-blind, sham-controlled trial was conducted with 118 surgical candidates (mean age 40 years), with patient history, clinical symptoms and MRI arthrography indicating an isolated type II SLAP lesion...
May 11, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28494405/radical-treatment-of-oligometastatic-non-small-cell-lung-cancer-ready-for-prime-time
#17
Matteo Brighenti, Fausto Petrelli, Sandro Barni, Barbara Conti, Enrico Sarti, Margherita Ratti, Stefano Panni, Rodolfo Passalacqua, Melissa Bersanelli
Oligometastatic non-small cell lung cancer (NSCLC), defined as a disease with low metastatic burden and limited organ involvement, is conceived as an intermediate condition between a truly localised disease and a widely metastatic tumour. Traditionally, local ablative therapies (LATs), such as surgery and radiotherapy, have been limited to symptoms' palliation in advanced NSCLC. Several retrospective studies suggest that using local ablative therapy for oligometastatic disease could offer good local control of the disease and improvement in terms of progression-free survival...
May 8, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28493219/a-critical-appraisal-of-the-cost-effectiveness-of-laparoscopic-colorectal-surgery-for-oncological-and-non-oncological-resections
#18
Muhammad Shafique Sajid, Munir Ahmad Rathore, Mirza Khurrum Baig, Parv Sains
The aim of this study was to critically appraise the cost effectiveness of the laparoscopic colorectal (LCRS) surgery using published randomised, control trials (RCTs). Published RCTs comparing the cost effectiveness of LCRS with conventional open surgery were selected from the search of standard electronic databases and the extracted data were analysed using the statistical software RevMan 5.3. Seven RCTs on 2197 patients reported the cost effectiveness of the LCRS. There was significant heterogeneity (τ (2) = 161,772...
May 10, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28488557/-added-value-of-observational-studies-in-surgery-the-hierarchical-structure-of-study-designs-requires-a-more-refined-approach
#19
R B Beks, R M Houwert, R H H Groenwold
The randomised placebo-controlled trial (RCT) is the gold standard for the evaluation of medical interventions. Observational studies, on the other hand, usually do not get much credit. For studies investigating surgical interventions this does not always seem entirely justified. A more refined approach might be needed for the often-used hierarchical structure of research designs. Instead of a strict separation of results from RCTs and other designs, results of the different designs should rather be regarded as complementary to each other when evaluating surgical interventions in traumatology...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28485814/partial-nephrectomy-versus-radical-nephrectomy-for-clinical-localised-renal-masses
#20
REVIEW
Frank Kunath, Stefanie Schmidt, Laura-Maria Krabbe, Arkadiusz Miernik, Philipp Dahm, Anne Cleves, Mario Walther, Nils Kroeger
BACKGROUND: Partial nephrectomy and radical nephrectomy are the relevant surgical therapy options for localised renal cell carcinoma. However, debate regarding the effects of these surgical approaches continues and it is important to identify and summarise high-quality studies to make surgical treatment recommendations. OBJECTIVES: To assess the effects of partial nephrectomy compared with radical nephrectomy for clinically localised renal cell carcinoma. SEARCH METHODS: We searched CENTRAL, MEDLINE, PubMed, Embase, Web of Science, BIOSIS, LILACS, Scopus, two trial registries and abstracts from three major conferences to 24 February 2017, together with reference lists; and contacted selected experts in the field...
May 9, 2017: Cochrane Database of Systematic Reviews
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