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Controlled clinical trial

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https://www.readbyqxmd.com/read/28320142/ventriculo-peritoneal-shunt-surgery-for-tuberculous-meningitis-a-systematic-review
#1
Imran Rizvi, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Eesha Sharma, Chhitij Srivastava, Ravi Uniyal
BACKGROUND: Ventriculo-peritoneal shunt surgery is one of the most commonly performed surgery for the management of tuberculous hydrocephalus. There is decreased clarity on issues regarding the indication as well as timing of cerebrospinal fluid diversion procedures in tuberculous meningitis. We systematically analysed published literature on this subject with an objective to assess the value of cerebrospinal fluid diversion procedures in tuberculous meningitis. METHODS: A systematic search of literature was performed using PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) for articles published till August 2016...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320075/a-cost-utility-analysis-of-high-molecular-weight-hyaluronic-acid-for-knee-osteoarthritis-in-everyday-clinical-care-in-patients-in-the-working-age-an-economic-evaluation-of-a-randomized-clinical-trial
#2
Job Hermans, Max Reijman, Lucas Ma Goossens, Hennie Verburg, Sita Ma Bierma-Zeinstra, Marc A Koopmanschap
Objectives Knee osteoarthritis (OA) is associated with high medical costs and especially with high productivity costs, in particular in patients in their working years. High molecular weight (HMW) hyaluronic acid (HA) is an alternative treatment for non-steroidal anti-inflammatory drugs (NSAIDs), which are known for their serious side-effects. The cost-utility of intra-articular HMW-HA treatment in these patients is unknown though and was assessed in this study. Methods Secondary care patients between 18 and 65 with knee OA were randomized to usual care (UC) + HMW-HA (intervention group) or UC only (control group)...
March 20, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28320042/calcium-channel-modulation-as-a-target-in-chronic-pain-control
#3
REVIEW
Ryan Patel, Carlota Montagut-Bordas, Anthony H Dickenson
Neuropathic pain remains poorly treated for large numbers of patients and little progress has been made in developing novel classes of analgesics. To redress this issue, ziconotide (Prialt(TM) ) was developed and approved as a first in class synthetic version of ω-conotoxin MVIIA, a Cav 2.2 peptide blocker. Unfortunately, the impracticalities of intrathecal delivery, low therapeutic index and severe neurological side effects associated with ziconotide has restricted its use to exceptional circumstances. Ziconotide exhibits no state or use dependent block of Cav 2...
March 20, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28319996/oral-direct-acting-agent-therapy-for-hepatitis-c-virus-infection-a-systematic-review
#4
Oluwaseun Falade-Nwulia, Catalina Suarez-Cuervo, David R Nelson, Michael W Fried, Jodi B Segal, Mark S Sulkowski
Background: Rapid improvements in hepatitis C virus (HCV) therapy have led to the approval of multiple oral direct-acting antiviral (DAA) regimens by the U.S. Food and Drug Administration (FDA) for treatment of chronic HCV infection. Purpose: To summarize published literature on the efficacy and safety of oral DAAs for treatment of persons with chronic HCV infection. Data Sources: MEDLINE and EMBASE from inception through 1 November 2016. Study Selection: 42 English-language studies from controlled and single-group registered clinical trials of adults with HCV infection that evaluated at least 8 weeks of an FDA-approved interferon-free HCV regimen that included at least 2 DAAs...
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28319804/are-diabetes-guidelines-truly-evidence-based
#5
REVIEW
Matthew F Bouchonville, Sara Matani, Jason J DuBroff, Robert J DuBroff
The global epidemic of obesity and diabetes underscores the urgency to develop strategies to prevent cardiovascular (CV) disease in this vulnerable population. Clinical guidelines are intended to help the clinician manage these patients, but guidelines are often discordant among professional organizations and not always evidence based. Clinicians must rely upon the best available evidence, and therefore we critically reviewed the evidence behind the American Diabetes Association (ADA) 2016 guidelines on the prevention of CV disease in diabetes...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319596/medium-term-effects-of-dietary-nitrate-supplementation-on-systolic-and-diastolic-blood-pressure-in-adults-a-systematic-review-and-meta-analysis
#6
Ammar W Ashor, Jose Lara, Mario Siervo
OBJECTIVES: Dietary nitrate supplementation has been shown to lower blood pressure (BP) particularly in short-term clinical trials. Whether these effects are sustained in the long-term remains to be established. The objective was to conduct a meta-analysis of randomized controlled trials that examined whether dietary nitrate supplementation for more than 1 week has beneficial effects on SBP and DBP. METHODS: Electronic databases were searched from inception until May 2016...
March 17, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28319552/evaluation-of-lung-function-and-clinical-features-of-the-ultrasound-guided-stellate-ganglion-block-with-2-different-concentrations-of-a-local-anesthetic-a-randomized-controlled-trial
#7
Won-Joong Kim, Hahck Soo Park, Myung Sub Yi, Gill-Hoi Koo, Hwa-Yong Shin
BACKGROUND: One possible complication of stellate ganglion block (SGB) is respiratory compromise. No study has yet addressed the comparison of its effect on lung function and clinical features, including Horner's syndrome, changes in temperature, sensory and motor functions, and adverse events of lower versus higher concentrations (LC and HC, respectively) of local anesthetics in an ultrasound-guided SGB. METHODS: Fifty patients were randomized into 1 of 2 groups: the LC group (5 mL of 0...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319489/autogenic-drainage-in-children-with-cystic-fibrosis
#8
Lieselotte Corten, Brenda M Morrow
PURPOSE: Airway clearance is an essential part of the management of cystic fibrosis (CF) as it facilitates clearance of viscous pulmonary secretions. This review aimed to determine the effect of autogenic drainage (AD) and assisted autogenic drainage (AAD) compared with no, sham, or other types of airway clearance in children with CF. SUMMARY OF KEY POINTS: Two pediatric randomized cross-over trials were identified on the use of AD in children with CF; no studies were available on the use of AAD...
March 17, 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28319467/effects-of-iv-acetaminophen-on-core-body-temperature-and-hemodynamic-responses-in-febrile-critically-ill-adults-a-randomized-controlled-trial
#9
Hildy M Schell-Chaple, Kathleen D Liu, Michael A Matthay, Daniel I Sessler, Kathleen A Puntillo
OBJECTIVE: To determine the effects of IV acetaminophen on core body temperature, blood pressure, and heart rate in febrile critically ill patients. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: Three adult ICUs at a large, urban, academic medical center. PATIENTS: Forty critically ill adults with fever (core temperature, ≥ 38.3°C). INTERVENTION: An infusion of acetaminophen 1 g or saline placebo over 15 minutes...
March 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28319269/withdrawn-trimetazidine-for-stable-angina
#10
REVIEW
Agustín Ciapponi, Rudolf Pizarro, Jeff Harrison
BACKGROUND: Patients with stable angina not controlled by monotherapy with nitrates, beta blockers, or calcium channel blockers are often treated with combinations of these drugs. There may be adverse effects from, or contraindications to, the use of combinations. In low risk groups, medical treatment appears to be as good an option as percutaneous transluminal coronary angioplasty in terms of averting myocardial infarction, death, or subsequent revascularization. Revascularization procedures are too costly or inaccessible for many patients in developing countries therefore effective and safe medical treatment is needed...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319266/benzodiazepines-for-restless-legs-syndrome
#11
REVIEW
Karla Carlos, Gilmar F Prado, Camila Dm Teixeira, Cristiane Conti, Marcio M de Oliveira, Lucila Bf Prado, Luciane Bc Carvalho
BACKGROUND: Restless legs syndrome (RLS) is a common disease affecting about 5% to 15% of the population. Symptoms of RLS can be severe in a minority of and can have a major impact on sleep, mostly sleep initiation, and quality of life. Benzodiazepines are drugs that can induce and maintain sleep and, hence, intuitively are thought to be beneficial to people with RLS. Altough benzodiazepines, particularly clonazepam, are used to treat RLS symptoms, a systematic review done by the American Academy of Sleep Medicine stated that benzodiazepines should not be used as a first-line treatment, although could be used as a coadjuvant therapy...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319049/resisting-fatal-attraction-a-glioma-oncometabolite-prevents-cd8-t-cell-recruitment
#12
Liliana E Lucca, David A Hafler
Immunotherapy has emerged as a potent approach for treating aggressive cancers, such as non-small-cell lung tumors and metastatic melanoma. Clinical trials are now in progress for patients with malignant gliomas; however, a better understanding of how these tumors escape immune surveillance is required to enhance antitumor immune responses. With gliomas, the recruitment of CD8+ T cells to the tumor is impaired, in part preventing containment or elimination of the tumor. In this issue of the JCI, Kohanbash and colleagues present an elegant dissection of how gliomas exploit an enzymatic activity acquired through a common mutation to abrogate the migration of CD8+ T cells to the tumor...
March 20, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28319018/the-effect-of-elevated-progesterone-levels-before-hcg-triggering-in-modified-natural-cycle-frozen-thawed-embryo-transfer-cycles
#13
Eva R Groenewoud, Nick S Macklon, Ben J Cohlen
Recent studies suggest that elevated late follicular phase progesterone concentrations after ovarian stimulation for IVF may result in embryo-endometrial asynchrony, reducing the chance of successful implantation after fresh embryo transfer. It remains unclear to what extent elevated late follicular phase progesterone levels may occur in unstimulated cycles before frozen-thawed embryo transfer, or what affect they may have on outcomes. In this cohort study, 271 patients randomized to the modified natural cycle arm of a randomized controlled trial comparing two endometrial preparation regimens underwent late follicular phase progesterone and LH testing...
February 28, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28319001/impact-on-psychosocial-outcomes-of-a-nationally-available-weight-management-program-tailored-for-individuals-with-type-2-diabetes-results-of-a-randomized-controlled-trial
#14
Lauren Holland-Carter, Peter W Tuerk, Thomas A Wadden, Ken N Fujioka, Lynne E Becker, Karen Miller-Kovach, Priscilla L Hollander, W Timothy Garvey, Daniel Weiss, Domenica M Rubino, Robert F Kushner, Robert J Malcolm, William J Raum, Kathie L Hermayer, Jan L Veliko, Stephanie L Rost, Nicoleta D Sora, Jonny L Salyer, Patrick M O'Neil
AIMS: Type 2 diabetes mellitus (T2DM) can substantially decrease quality of life (QOL). This study examined the effects on QOL-relevant psychosocial measures of a widely available commercial weight loss program enhanced for individuals with T2DM. METHODS: A year-long multi-site randomized clinical trial compared the Weight Watchers (WW) approach, supplemented with phone and email counseling with a certified diabetes educator (CDE), to brief standard diabetes nutrition counseling and education (Standard Care; SC)...
February 16, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28318984/safety-and-efficacy-of-thrombectomy-in-acute-ischaemic-stroke-revascat-1-year-follow-up-of-a-randomised-open-label-trial
#15
Antoni Dávalos, Erik Cobo, Carlos A Molina, Angel Chamorro, M Angeles de Miquel, Luis San Román, Joaquín Serena, Elena López-Cancio, Marc Ribó, Mónica Millán, Xabier Urra, Pere Cardona, Alejandro Tomasello, Carlos Castaño, Jordi Blasco, Lucía Aja, Marta Rubiera, Meritxell Gomis, Arturo Renú, Blanca Lara, Joan Martí-Fàbregas, Brian Jankowitz, Neus Cerdà, Tudor G Jovin
BACKGROUND: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. METHODS: Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone...
March 16, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28318926/effectiveness-of-tranexamic-acid-for-reducing-intraoperative-bleeding-in-palatoplasties-a-randomized-clinical-trial
#16
Guilherme C Arantes, Rui Manoel R Pereira, Daniela B de Melo, Nivaldo Alonso, Maria do Carmo M B Duarte
BACKGROUND: Few data are available regarding blood loss during cleft palate surgery. This study assessed the effect of using tranexamic acid in the reduction of intraoperative bleeding. METHODS: A double-blind, randomized clinical trial compared intraoperative bleeding and the incidence of oronasal fistulas after palatoplasties in a control group that was given placebo and an intervention group that was given 10 mg/kg tranexamic acid followed by a continuous infusion of 1 mg/kg/h of the same until the end of surgery...
December 30, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28318897/efficacy-of-off-label-augmentation-in-unipolar-depression-a-systematic-review-of-the-evidence
#17
REVIEW
Julia Kleeblatt, Felix Betzler, Laura L Kilarski, Tom Bschor, Stephan Köhler
Treatment of unipolar depression with currently available antidepressants is still unsatisfactory. Augmentation with lithium or second generation antipsychotics is an established practice in non-responders to antidepressant monotherapy, but is also associated with a substantial non-response rate and with non-tolerance. Based on a systematic review of the literature, including meta-analyses, randomized controlled trials (RCTs), non-randomized comparative studies and case studies, off-label augmentation agents (administered in addition to an antidepressant, without FDA approval for treatment of MDD) were identified and evaluated regarding their efficacy using levels of evidence...
March 16, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28318860/a-prospective-randomized-trial-comparing-liposomal-bupivacaine-vs-fascia-iliaca-compartment-block-for-postoperative-pain-control-in-total-hip-arthroplasty
#18
Molly A McGraw-Tatum, Michael T Groover, Nicole E George, John S Urse, Victor Heh
BACKGROUND: Increasing demand for total hip arthroplasty (THA) in a climate of increasing focus on clinical outcomes, patient satisfaction, and cost has created a need for better acute postoperative pain control for patients. An ideal pain control method would have few side effects, decreased opioid consumption, improved pain control, early ambulation, and decreased hospital length of stay (LOS). METHODS: We performed a prospective randomized, controlled study involving 79 patients undergoing elective THA between June 2015 and February 2016...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318850/safety-and-efficacy-of-hyperosmolar-irrigation-solution-in-shoulder-arthroscopy
#19
Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J Smith
BACKGROUND: A hyperosmolar irrigation solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar solution were compared with a standard isotonic solution when used for shoulder arthroscopy. METHODS: A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) irrigation solutions used for arthroscopic rotator cuff repair...
March 15, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28318848/randomized-controlled-trial-of-supervised-physiotherapy-versus-a-home-exercise-program-after-hydrodilatation-for-the-management-of-primary-frozen-shoulder
#20
Paul M Robinson, Jennie Norris, Christopher P Roberts
HYPOTHESIS AND BACKGROUND: Hydrodilatation and physiotherapy are commonly used treatments for primary frozen shoulder. Little is known about the optimal form of physiotherapy. This study reports a randomized controlled trial comparing 2 forms of physiotherapy after hydrodilatation. The null hypothesis was that there would be no difference between the 2 groups at 1 year as measured by the Oxford Shoulder Score (OSS). METHODS: We randomized 41 patients undergoing hydrodilatation for primary frozen shoulder into 2 treatment groups: group 1 (n = 20) underwent supervised physiotherapy in addition to a home exercise program, and group 2 (n = 21) followed a self-directed home exercise program in isolation...
March 15, 2017: Journal of Shoulder and Elbow Surgery
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