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randomised controlled trial surgery

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https://www.readbyqxmd.com/read/28944752/a-randomised-controlled-study-of-the-effectiveness-of-breathing-retraining-exercises-taught-by-a-physiotherapist-either-by-instructional-dvd-or-in-face-to-face-sessions-in-the-management-of-asthma-in-adults
#1
Mike Thomas, Anne Bruton, Paul Little, Stephen Holgate, Amanda Lee, Lucy Yardley, Steve George, James Raftery, Jennifer Versnel, David Price, Ian Pavord, Ratko Djukanovic, Michael Moore, Sarah Kirby, Guiqing Yao, Shihua Zhu, Emily Arden-Close, Manimekalai Thiruvothiyur, Frances Webley, Mark Stafford-Watson, Elizabeth Dixon, Lynda Taylor
BACKGROUND: Asthma control is suboptimal, resulting in quality of life (QoL) impairment and costs. Breathing retraining exercises have evidence of effectiveness as adjuvant treatment, but are infrequently used. OBJECTIVES: To transfer the contents of a brief (three-session) physiotherapist-delivered breathing retraining programme to a digital versatile disc (DVD) and booklet format; to compare the effectiveness of the self-guided intervention with that of 'face-to-face' physiotherapy and usual care for QoL and other asthma-related outcomes; to perform a health economic assessment of both interventions; and to perform a process evaluation using quantitative and qualitative methods...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28941138/prolapse-surgery-with-or-without-incontinence-procedure-a-systematic-review-and-meta-analysis
#2
REVIEW
J Marinus van der Ploeg, Annemarie van der Steen, Sandra Zwolsman, C Huub van der Vaart, Jan-Paul W R Roovers
BACKGROUND: To reduce the risk of postoperative stress urinary incontinence (POSUI) prolapse repair might be combined with incontinence surgery. OBJECTIVES: Compare efficacy and safety of prolapse surgery with and without incontinence surgery. SEARCH STRATEGY: Including our earlier review a systematic search in PubMed, EMBASE, the Cochrane Library and the Register of Current Controlled Trials was performed from 1995 to 2017. SELECTION CRITERIA: Randomised trials comparing prolapse surgery with a midurethral sling (MUS) or Burch colposuspension...
September 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28940368/cerebral-oximetry-and-postoperative-delirium-after-cardiac-surgery-a-randomised-controlled-trial
#3
L Lei, R Katznelson, L Fedorko, J Carroll, H Poonawala, M Machina, R Styra, V Rao, G Djaiani
Postoperative delirium is associated with increased morbidity and mortality. We hypothesised that restoration of regional cerebral oxygen desaturation would reduce the incidence of postoperative delirium in elderly patients after cardiac surgery. After institutional ethics review board approval and informed consent, a double-blinded, prospective, randomised, controlled trial was conducted in patients ≥ 60 years of age undergoing cardiac surgery with cardiopulmonary bypass. In the intervention group, an algorithm was commenced if regional cerebral oxygen saturation decreased below 75% of baseline value for 1 min or longer...
September 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28939582/a-randomised-controlled-trial-of-an-intervention-delivered-by-app-instant-messaging-to-increase-the-acceptability-of-effective-contraception-among-young-people-in-tajikistan-study-protocol
#4
Ona McCarthy, Baptiste Leurent, Phil Edwards, Ravshan Tokhirov, Caroline Free
INTRODUCTION: Women in lower income countries experience unintended pregnancies at a higher rate compared with women in higher income countries. Unintended pregnancy is associated with numerous poorer health outcomes for both women and their children. In Tajikistan, an estimated 26% of married individuals aged 15-24 years have an unmet need for contraception. The strong cultural value placed on childbearing and oppositional attitudes towards contraception are major barriers to contraceptive uptake in the country...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#5
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935227/physiotherapy-education-and-training-prior-to-upper-abdominal-surgery-is-memorable-and-has-high-treatment-fidelity-a-nested-mixed-methods-randomised-controlled-study
#6
Ianthe Boden, Doa El-Ansary, Nadia Zalucki, Iain K Robertson, Laura Browning, Elizabeth H Skinner, Linda Denehy
OBJECTIVES: To (1) assess memorability and treatment fidelity of pre-operative physiotherapy education prior to elective upper abdominal surgery and, (2) to explore patient opinions on pre-operative education. DESIGN: Mixed-methods analysis of a convenience sample within a larger parallel-group, double-blinded, randomised controlled trial with concealed allocation and intention-to-treat analysis. SETTING: Tertiary Australian hospital. PARTICIPANTS: Twenty-nine patients having upper abdominal surgery attending pre-admission clinic within six-weeks of surgery...
September 1, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28931203/scalpel-versus-electrosurgery-for-major-abdominal-incisions
#7
REVIEW
Kittipat Charoenkwan, Zipporah Iheozor-Ejiofor, Kittipan Rerkasem, Elizabeth Matovinovic
BACKGROUND: Scalpels or electrosurgery can be used to make abdominal incisions. The potential benefits of electrosurgery may include reduced blood loss, dry and rapid separation of tissue, and reduced risk of cutting injury to surgeons. Postsurgery risks possibly associated with electrosurgery may include poor wound healing and complications such as surgical site infection. OBJECTIVES: To assess the effects of electrosurgery compared with scalpel for major abdominal incisions...
June 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28923395/percutaneous-coronary-intervention-versus-surgery-in-left-main-stenosis-a-meta-analysis-and-systematic-review-of-randomised-controlled-trials
#8
REVIEW
Safi U Khan, Hammad Rahman, Adeel Arshad, Muhammad U Khan, Manidhar Lekkala, Tsujung Yang, Abhishek Mishra, Edo Kaluski
OBJECTIVE: To investigate the safety and efficacy of percutaneous coronary interventions (PCI) versus coronary artery bypass graft (CABG) surgery for left main coronary artery (LMCA) disease. METHODS: Six randomised controlled trials (RCTs) were reviewed by searching PubMed/Medline, Embase and the Cochrane Library. Estimates were pooled according to random effects model. Binary outcomes were reported as risk ratio (RR) and continuous outcomes were reported as mean difference (MD) with 95% confidence interval (CI)...
August 25, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28919087/outcomes-of-restrictive-versus-liberal-transfusion-strategies-in-older-adults-from-nine-randomised-controlled-trials-a-systematic-review-and-meta-analysis
#9
Geoff I Simon, Alison Craswell, Ogilvie Thom, Yoke Lin Fung
BACKGROUND: Guidelines for patient blood management recommend restrictive transfusion practice for most adult patients. These guidelines are supported by evidence from randomised controlled trials (RCTs); however, one of the patient groups not explicitly examined in these studies is the geriatric population. We examined RCTs relevant to transfusion outcomes in older patients. Our aim was to determine whether special guidelines are warranted for geriatric patients, recognising the different pathophysiological characteristics of this group...
September 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28914440/olaratumab-in-combination-with-doxorubicin-for-the-treatment-of-advanced-soft-tissue-sarcoma-an-evidence-review-group-perspective-of-a-national-institute-for-health-and-care-excellence-single-technology-appraisal
#10
REVIEW
Irina A Tikhonova, Tracey Jones-Hughes, James Dunham, Fiona C Warren, Sophie Robinson, Peter Stephens, Martin Hoyle
The manufacturer of olaratumab (Lartruvo(®)), Eli Lilly & Company Limited, submitted evidence for the clinical and cost effectiveness of this drug, in combination with doxorubicin, for untreated advanced soft tissue sarcoma (STS) not amenable to surgery or radiotherapy, as part of the National Institute for Health and Care Excellence (NICE) Single Technology Appraisal process. The Peninsula Technology Assessment Group, commissioned to act as the Evidence Review Group (ERG), critically reviewed the company's submission...
September 15, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28911287/effect-of-sugammadex-versus-neostigmine-atropine-combination-on-postoperative-cognitive-dysfunction-after-elective-surgery
#11
C Batistaki, M Riga, F Zafeiropoulou, G Lyrakos, G Kostopanagiotou, P Matsota
This study aimed to assess the effects of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. A randomised, double-blind controlled trial was carried out on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years. The Mini-Mental State Evaluation, clock-drawing test and the Isaacs Set test were used to assess cognitive function at three timepoints: 1) preoperatively, 2) one hour postoperatively, and 3) at discharge...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28911065/development-of-an-integrated-electronic-platform-for-patient-self-report-and-management-of-adverse-events-during-cancer-treatment
#12
P Holch, L Warrington, L C A Bamforth, A Keding, L E Ziegler, K Absolom, C Hector, C Harley, O Johnson, G Hall, C Morris, G Velikova
Background: Significant adverse events (AE) during cancer therapy disrupt treatment and escalate to emergency admissions. Approaches to improve the timeliness and accuracy of AE reporting may improve safety and reduce health service costs. Reporting AE via patient reported outcomes (PROs), can improve clinician-patient communication and making data available to clinicians in 'real-time' using electronic PROs (ePROs) could potentially transform clinical practice by providing easily accessible records to guide treatment decisions...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28901935/partial-pancreatoduodenectomy-versus-duodenum-preserving-pancreatic-head-resection-in-chronic-pancreatitis-the-multicentre-randomised-controlled-double-blind-chropac-trial
#13
Markus K Diener, Felix J Hüttner, Meinhard Kieser, Phillip Knebel, Colette Dörr-Harim, Marius Distler, Robert Grützmann, Uwe A Wittel, Rebekka Schirren, Hans-Michael Hau, Axel Kleespies, Claus-Dieter Heidecke, Ales Tomazic, Christopher M Halloran, Torsten J Wilhelm, Marcus Bahra, Tobias Beckurts, Thomas Börner, Matthias Glanemann, Ulrich Steger, Frank Treitschke, Ludger Staib, Karsten Thelen, Thomas Bruckner, André L Mihaljevic, Jens Werner, Alexis Ulrich, Thilo Hackert, Markus W Büchler
BACKGROUND: There is substantial uncertainty regarding the optimal surgical treatment for chronic pancreatitis. Short-term outcomes have been found to be better after duodenum-preserving pancreatic head resection (DPPHR) than after partial pancreatoduodenectomy. Therefore, we designed the multicentre ChroPac trial to investigate the long-term outcomes of patients with chronic pancreatitis within 24 months after surgery. METHODS: This randomised, controlled, double-blind, parallel-group, superiority trial was done in 18 hospitals across Europe...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28900822/an-international-review-and-meta-analysis-of-prehabilitation-compared-to-usual-care-for-cancer-patients
#14
REVIEW
C Treanor, T Kyaw, M Donnelly
PURPOSE: The purpose of the study is to systematically review and synthesise randomised controlled trials investigating the effectiveness of prehabilitation compared to usual care for newly diagnosed, adult-onset cancer patients. METHODS: MEDLINE, EMBASE, PsycINFO, CINAHL and SSCI were searched up to April 2017. Studies were included if disease-related, treatment-related, patient-reported and health service utilisation outcomes were assessed. Two reviewers independently reviewed and appraised the risk of bias of each study...
September 12, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/28899891/effect-of-anesthesia-depth-on-postoperative-clinical-outcome-in-patients-with-supratentorial-tumor-depth-study-protocol-for-a-randomized-controlled-trial
#15
Qianyu Cui, Yuming Peng, Xiaoyuan Liu, Bo Jia, Jia Dong, Ruquan Han
INTRODUCTION: Recent studies have shown that deep anaesthesia is associated with poor outcomes. However, no randomised controlled trials have been conducted to test the causality in patients undergoing brain tumour resection. METHODS AND ANALYSIS: DEPTH is a multicenter, randomised, parallel-group, blind trial. The depth of general anaesthesia will be monitored using the bispectral index (BIS). Patients elected for supratentorial tumour resection will be randomly allocated to the deep or the light anaesthesia group in which the target BIS value is 35 or 50, respectively...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28895658/laparoscopic-and-robotic-assisted-versus-open-radical-prostatectomy-for-the-treatment-of-localised-prostate-cancer
#16
REVIEW
Dragan Ilic, Sue M Evans, Christie Ann Allan, Jae Hung Jung, Declan Murphy, Mark Frydenberg
BACKGROUND: Prostate cancer is commonly diagnosed in men worldwide. Surgery, in the form of radical prostatectomy, is one of the main forms of treatment for men with localised prostate cancer. Prostatectomy has traditionally been performed as open surgery, typically via a retropubic approach. The advent of laparoscopic approaches, including robotic-assisted, provides a minimally invasive alternative to open radical prostatectomy (ORP). OBJECTIVES: To assess the effects of laparoscopic radical prostatectomy or robotic-assisted radical prostatectomy compared to open radical prostatectomy in men with localised prostate cancer...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28894407/fluorescence-guided-versus-conventional-surgical-resection-of-high-grade-glioma-a-single-centre-7-year-comparative-effectiveness-study
#17
Wei Ping Ng, Boon Seng Liew, Zamzuri Idris, Azmin Kass Rosman
BACKGROUND: High grade gliomas (HGGs) are locally invasive brain tumours that carry a dismal prognosis. Although complete resection increases median survival, the difficulty in reliably demonstrating the tumour border intraoperatively is a norm. The Department of Neurosurgery, Hospital Sungai Buloh is the first public hospital in Malaysia to overcome this problem by adopting fluorescence-guided (FG) surgery using 5-aminolevulinic acid (5-ALA). METHODS: A total of 74 patients with histologically proven HGGs treated between January 2008 and December 2014, who fulfilled the inclusion criteria, were enrolled...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28893234/study-comparing-3%C3%A2-hour-and-24%C3%A2-hour-post-operative-removal-of-bladder-catheter-and-vaginal-pack-following-vaginal-surgery-a-randomised-controlled-trial
#18
Priya Rajan, S Soundara Raghavan, Deepak Sharma
BACKGROUND: Traditional practice after vaginal hysterectomy was to keep the vaginal pack and urinary catheter for 24 hours post operatively. But there were studies that prolonged cathterisation was associated with urinary infection. So this study was conducted to compare the post operative outcome when the urinary catheter and vaginal pack were removed after 3 hours and after 24 hours after surgery. METHODS: The study was done in the Department of Obstetrics and Gynecology, in a tertiary teaching institute of South India from September 2008 to March 2010...
September 11, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28891203/effects-of-epidural-volume-extension-by-saline-injection-on-the-efficacy-and-safety-of-intrathecal-local-anaesthetics-systematic-review-with-meta-analysis-meta-regression-and-trial-sequential-analysis
#19
REVIEW
M Heesen, S Weibel, M Klimek, R Rossaint, L R Arends, P Kranke
Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery...
September 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28890409/the-strocss-statement-strengthening-the-reporting-of-cohort-studies-in-surgery
#20
Riaz Ahmed Agha, Mimi R Borrelli, Martinique Vella-Baldacchino, Rachel Thavayogan, Dennis P Orgill
INTRODUCTION: The development of reporting guidelines over the past 20 years represents a major advance in scholarly publishing with recent evidence showing positive impacts. Whilst over 350 reporting guidelines exist, there are few that are specific to surgery. Here we describe the development of the STROCSS guideline (Strengthening the Reporting of Cohort Studies in Surgery). METHODS AND ANALYSIS: We published our protocol apriori. Current guidelines for case series (PROCESS), cohort studies (STROBE) and randomised controlled trials (CONSORT) were analysed to compile a list of items which were used as baseline material for developing a suitable checklist for surgical cohort guidelines...
September 7, 2017: International Journal of Surgery
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