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randomised controlled trial surgery

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https://www.readbyqxmd.com/read/28738443/urethral-injection-therapy-for-urinary-incontinence-in-women
#1
REVIEW
Vivienne Kirchin, Tobias Page, Phil E Keegan, Kofi Om Atiemo, June D Cody, Samuel McClinton, Patricia Aluko
BACKGROUND: Urinary incontinence imposes a significant health and economic burden to society. Periurethral or transurethral injection of bulking agents is a minimally invasive surgical procedure used as one the surgical treatments of stress urinary incontinence (SUI) in adult women. OBJECTIVES: To assess the effects of periurethral or transurethral injection therapy on the cure or improvement of urinary incontinence in women. SEARCH METHODS: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 8 November 2010) and the reference lists of relevant articles...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28734705/a-proficiency-based-stepwise-endovascular-curricular-training-prospect-program-enhances-operative-performance-in-real-life-a-randomised-controlled-trial
#2
H Maertens, R Aggarwal, N Moreels, F Vermassen, I Van Herzeele
OBJECTIVES: Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. DESIGN: A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions...
July 19, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28733366/the-available-evidence-on-demineralised-bone-matrix-in-trauma-and-orthopaedic-surgery-a-systematic-review
#3
J van der Stok, K A Hartholt, D A L Schoenmakers, J J C Arts
OBJECTIVES: The aim of this systematic literature review was to assess the clinical level of evidence of commercially available demineralised bone matrix (DBM) products for their use in trauma and orthopaedic related surgery. METHODS: A total of 17 DBM products were used as search terms in two available databases: Embase and PubMed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement. All articles that reported the clinical use of a DBM-product in trauma and orthopaedic related surgery were included...
July 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28733301/a-3d-navigation-template-for-guiding-a-unilateral-lumbar-pedicle-screw-with-contralateral-translaminar-facet-screw-fixation-a-study-protocol-for-multicentre-randomised-controlled-trials
#4
Zhen-Xuan Shao, Wei He, Shao-Qi He, Sheng-Lei Lin, Zhe-Yu Huang, Hong-Chao Tang, Wen-Fei Ni, Xiang-Yang Wang, Ai-Min Wu
INTRODUCTION: The incidence of lumbar disc degeneration disease has increased in recent years. Lumbar interbody fusion using two unilateral pedicle screws and a translaminar facet screw fixation has advantages of minimal invasiveness and lower costs compared with the traditional methods. Moreover, a method guided by a three-dimensional (3D) navigation template may help us improve the surgical accuracy and the success rate. This is the first randomised study using a 3D navigation template to guide a unilateral lumbar pedicle screw with contralateral translaminar facet screw fixation...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#5
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28729319/accelerated-enhanced-recovery-following-minimally-invasive-colorectal-cancer-surgery-recovermi-a-study-protocol-for-a-novel-randomised-controlled-trial
#6
Brandee A Price, Brian K Bednarski, Y Nancy You, Meryna Manandhar, E Michelle Dean, Zeinab M Alawadi, B Bryce Speer, Vijaya Gottumukkala, Marla Weldon, Robert L Massey, Xuemei Wang, Wei Qiao, George J Chang
INTRODUCTION: Definitive treatment of localised colorectal cancer involves surgical resection of the primary tumour. Short-stay colectomies (eg, 23-hours) would have important implications for optimising the efficiency of inpatient care with reduced resource utilisation while improving the overall recovery experience with earlier return to normalcy. It could permit surgical treatment of colorectal cancer in a wider variety of settings, including hospital-based ambulatory surgery environments...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728984/operative-versus-non-operative-management-of-adhesive-small-bowel-obstruction-a-systematic-review-and-meta-analysis
#7
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, Nilanjan Panda, Asaf Khan, Samik Kumar Bandyopadhyay, Sanjay Dalmia, Sohail Malik, Zahirul Huq, Moustafa Mansour
OBJECTIVES: To investigate outcomes of operative and non-operative management of adhesive small bowel obstruction (SBO). METHODS: We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. We conducted a search of electronic information sources to identify all randomised controlled trials (RCTs) and observational studies investigating outcomes of operative versus non-operative management of patients with adhesive SBO...
July 17, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28728580/lumbar-microdiscectomy-and-post-operative-activity-restrictions-a-protocol-for-a-single-blinded-randomised-controlled-trial
#8
Chris D Daly, Kai Zheong Lim, Jennifer Lewis, Kelly Saber, Mohammed Molla, Naor Bar-Zeev, Tony Goldschlager
BACKGROUND: Lumbar microdiscectomy is the most commonly performed spinal surgery procedure, with over 300,000 cases performed annually in the United States alone. Traditionally, patients were advised to restrict post-operative activity as this was believed to reduce the risk of disc reherniation and progressive instability. However, this practice would often delay patients return to work. In contemporary practice many surgeons do not restrict patient post-operative activity due to the perception this practice is unnecessary...
July 20, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28723374/urodynamics-before-surgery-for-stress-urinary-incontinence
#9
Suneetha Rachaneni, Pallavi Latthe
Following three noninferiority randomised controlled trials from different countries showing exactly the same results, it is time to translate this evidence into practice. In women undergoing primary surgery for pure stress urinary incontinence or stress-predominant mixed urinary incontinence without voiding difficulties, careful office evaluation including uroflowmetry and postvoid residual urine can replace invasive investigations such as cystometry, saving patients from embarrassment and a risk of urinary infection...
August 2016: European Urology Focus
https://www.readbyqxmd.com/read/28716796/clinical-and-cost-effectiveness-of-progressive-exercise-compared-with-best-practice-advice-with-or-without-corticosteroid-injection-for-the-treatment-of-rotator-cuff-disorders-protocol-for-a-2x2-factorial-randomised-controlled-trial-the-grasp-trial
#10
Sally Hopewell, David J Keene, Michael Maia Schlüssel, Melina Dritsaki, Susan Dutton, Andrew Carr, William Hamilton, Zara Hansen, Anju Jaggi, Chris Littlewood, Hessam Soutakbar, Peter Heine, Lucy Cureton, Karen Barker, Sarah E Lamb
INTRODUCTION: Shoulder pain is very common, with around 70% of cases due to disorders of the rotator cuff. Despite widespread provision of physiotherapy, there is uncertainty about which type of exercise and delivery mechanisms are associated with best outcomes. There is also uncertainty around the long-term benefits and harms of corticosteroid injection therapy, which is often used in addition to physiotherapy. The Getting it Right: Addressing Shoulder Pain trial will assess the clinical and cost-effectiveness of individually tailored, progressive exercise compared with best practice advice, with or without corticosteroid injection, in adults with a rotator cuff disorder...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716313/telemedicine-for-management-of-inflammatory-bowel-disease-myibdcoach-a-pragmatic-multicentre-randomised-controlled-trial
#11
Marin J de Jong, Andrea E van der Meulen-de Jong, Mariëlle J Romberg-Camps, Marco C Becx, Jeroen P Maljaars, Mia Cilissen, Ad A van Bodegraven, Nofel Mahmmod, Tineke Markus, Wim M Hameeteman, Gerard Dijkstra, Ad A Masclee, Annelies Boonen, Bjorn Winkens, Astrid van Tubergen, Daisy M Jonkers, Marie J Pierik
BACKGROUND: Tight and personalised control of inflammatory bowel disease in a traditional setting is challenging because of the disease complexity, high pressure on outpatient clinics, and rising incidence. We compared the effects of self-management with a telemedicine system, which was developed for all subtypes of inflammatory bowel disease, on health-care utilisation and patient-reported quality of care versus standard care. METHODS: We did this pragmatic, randomised trial in two academic and two non-academic hospitals in the Netherlands...
July 14, 2017: Lancet
https://www.readbyqxmd.com/read/28716147/stop-smoking-and-alcohol-drinking-before-operation-for-bladder-cancer-%C3%AF-the-stop-op-study-%C3%AF-perioperative-smoking-and-alcohol-cessation-intervention-in-relation-to-radical-cystectomy-study-protocol-for-a-randomised-controlled-trial
#12
Susanne Vahr Lauridsen, Thordis Thomsen, Peter Thind, Hanne Tønnesen
BACKGROUND: To evaluate the effect of a smoking-, alcohol- or combined-cessation intervention starting shortly before surgery and lasting 6 weeks on overall complications after radical cystectomy. Secondary objectives are to examine the effect on types and grades of complications, smoking cessation and alcohol cessation, length of hospital stay, health-related quality of life and return to work or habitual level of activity up to 12 months postoperatively. METHODS/DESIGN: The study is a multi-institutional randomised clinical trial involving 110 patients with a risky alcohol intake and daily smoking who are scheduled for radical cystectomy...
July 17, 2017: Trials
https://www.readbyqxmd.com/read/28712537/efficacy-and-safety-of-voretigene-neparvovec-aav2-hrpe65v2-in-patients-with-rpe65-mediated-inherited-retinal-dystrophy-a-randomised-controlled-open-label-phase-3-trial
#13
Stephen Russell, Jean Bennett, Jennifer A Wellman, Daniel C Chung, Zi-Fan Yu, Amy Tillman, Janet Wittes, Julie Pappas, Okan Elci, Sarah McCague, Dominique Cross, Kathleen A Marshall, Jean Walshire, Taylor L Kehoe, Hannah Reichert, Maria Davis, Leslie Raffini, Lindsey A George, F Parker Hudson, Laura Dingfield, Xiaosong Zhu, Julia A Haller, Elliott H Sohn, Vinit B Mahajan, Wanda Pfeifer, Michelle Weckmann, Chris Johnson, Dina Gewaily, Arlene Drack, Edwin Stone, Katie Wachtel, Francesca Simonelli, Bart P Leroy, J Fraser Wright, Katherine A High, Albert M Maguire
BACKGROUND: Phase 1 studies have shown potential benefit of gene replacement in RPE65-mediated inherited retinal dystrophy. This phase 3 study assessed the efficacy and safety of voretigene neparvovec in participants whose inherited retinal dystrophy would otherwise progress to complete blindness. METHODS: In this open-label, randomised, controlled phase 3 trial done at two sites in the USA, individuals aged 3 years or older with, in each eye, best corrected visual acuity of 20/60 or worse, or visual field less than 20 degrees in any meridian, or both, with confirmed genetic diagnosis of biallelic RPE65 mutations, sufficient viable retina, and ability to perform standardised multi-luminance mobility testing (MLMT) within the luminance range evaluated, were eligible...
July 13, 2017: Lancet
https://www.readbyqxmd.com/read/28711318/procalcitonin-guided-decision-making-for-duration-of-antibiotic-therapy-in-neonates-with-suspected-early-onset-sepsis-a-multicentre-randomised-controlled-trial-neopins
#14
Martin Stocker, Wendy van Herk, Salhab El Helou, Sourabh Dutta, Matteo S Fontana, Frank A B A Schuerman, Rita K van den Tooren-de Groot, Jantien W Wieringa, Jan Janota, Laura H van der Meer-Kappelle, Rob Moonen, Sintha D Sie, Esther de Vries, Albertine E Donker, Urs Zimmerman, Luregn J Schlapbach, Amerik C de Mol, Angelique Hoffman-Haringsma, Madan Roy, Maren Tomaske, René F Kornelisse, Juliette van Gijsel, Eline G Visser, Sten P Willemsen, Annemarie M C van Rossum
BACKGROUND: Up to 7% of term and late-preterm neonates in high-income countries receive antibiotics during the first 3 days of life because of suspected early-onset sepsis. The prevalence of culture-proven early-onset sepsis is 0·1% or less in high-income countries, suggesting substantial overtreatment. We assess whether procalcitonin-guided decision making for suspected early-onset sepsis can safely reduce the duration of antibiotic treatment. METHODS: We did this randomised controlled intervention trial in Dutch (n=11), Swiss (n=4), Canadian (n=2), and Czech (n=1) hospitals...
July 12, 2017: Lancet
https://www.readbyqxmd.com/read/28701028/psychological-interventions-for-acute-pain-after-open-heart-surgery
#15
REVIEW
Susanne Ziehm, Jenny Rosendahl, Jürgen Barth, Bernhard M Strauss, Anja Mehnert, Susan Koranyi
BACKGROUND: This is an update of a Cochrane review previously published in 2014. Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES: To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention control in adults undergoing open heart surgery for pain, pain medication, psychological distress, mobility, and time to extubation...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28698347/carbon-dioxide-surgical-field-flooding-and-aortic-no-touch-off-pump-coronary-artery-bypass-grafting-to-reduce-neurological-injuries-after-surgical-coronary-revascularisation-canon-protocol-for-a-randomised-controlled-investigator-and-patient-blinded-single
#16
Szwed Krzysztof, Pawliszak Wojciech, Serafin Zbigniew, Kowalewski Mariusz, Tomczyk Remigiusz, Perlinski Damian, Szwed Magdalena, Tomaszewska Marta, Anisimowicz Lech, Borkowska Alina
INTRODUCTION: Neurological injuries remain a major concern following coronary artery bypass grafting (CABG) that offsets survival benefit of CABG over percutaneous coronary interventions. Among numerous efforts to combat this issue is the development of off-pump CABG (OPCABG) that obviates the need for extracorporeal circulation and is associated with improved neurological outcomes. The objective of this study is to examine whether the neuroprotective effect of OPCABG can be further pronounced by the use of two state-of-the-art operating techniques...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#17
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#18
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28693599/determining-the-impact-of-24-7-phone-support-on-hospital-readmissions-after-aortic-valve-replacement-surgery-the-avrre-study-study-protocol-for-a-randomised-controlled-trial
#19
Irene Lie, Stein Ove Danielsen, Theis Tønnessen, Svein Solheim, Marit Leegaard, Leiv Sandvik, Torbjørn Wisløff, Jonny Vangen, Tor Henning Røsstad, Philip Moons
BACKGROUND: Patients undergoing surgical aortic valve replacement (sAVR) have high rates of 30-day readmissions. They also report a low health-related quality of life (HRQOL) and elevated anxiety and depression. The aim of the AVRre study is to determine the efficacy and cost of a 24/7 phone-support intervention in reducing post-discharge readmissions after sAVR. The nature of the support is to help patients better understand and self-manage non-urgent symptoms at home. METHODS/DESIGN: AVRre is a prospective, randomised controlled study comprising 30 days of continuous phone-support intervention and then intermittent follow-up for the first 12 months...
May 30, 2017: Trials
https://www.readbyqxmd.com/read/28691229/desmopressin-use-for-minimising-perioperative-blood-transfusion
#20
REVIEW
Michael J Desborough, Kathryn Oakland, Charlotte Brierley, Sean Bennett, Carolyn Doree, Marialena Trivella, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. OBJECTIVES: To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders...
July 10, 2017: Cochrane Database of Systematic Reviews
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