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Randomized controlled trial, surgery

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https://www.readbyqxmd.com/read/28219918/clinical-outcomes-of-remote-ischemic-preconditioning-prior-to-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#1
REVIEW
Brian Pierce, Indra Bole, Vaiibhav Patel, David L Brown
BACKGROUND: Multiple randomized controlled trials of remote ischemic preconditioning (RIPC) prior to cardiac surgery have failed to demonstrate clinical benefit. The aim of this updated meta-analysis was to evaluate the effect of RIPC on outcomes following cardiac surgery. METHODS AND RESULTS: Searches of PubMed, Cochrane, EMBASE, and Web of Science databases were performed for 1970 to December 13, 2015. Randomized controlled trials comparing RIPC with a sham procedure prior to cardiac surgery performed with cardiopulmonary bypass were assessed...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28219088/single-bundle-versus-double-bundle-anterior-cruciate-ligament-reconstruction-a-prospective-randomized-controlled-trial-with-6-year-follow-up
#2
Paolo Adravanti, Francesco Dini, Laura de Girolamo, Massimo Cattani, Michele Attilio Rosa
Single-bundle (SB) anterior cruciate ligament (ACL) reconstruction is increasingly used in a large number of patients and it allows obtaining very good clinical and subjective results; however, functional tests show a persistent rotational instability. Biomechanical studies seem to indicate that double-bundle (DB) ACL reconstruction allows to obtain increased anterior and rotational stability compared with SB. The aim of this prospective randomized controlled study was to compare the clinical outcome and the possible osteoarthritic evolution of patients treated either with a SB (freehand transtibial femoral tunnel) or with a DB technique (outside-in for posterolateral femoral tunnel/inside-out for anteromedial femoral tunnel) at a final follow-up of 6 years...
February 20, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28217498/usefulness-of-pre-and-post-operative-calcium-and-vitamin-d-supplementation-in-prevention-of-hypocalcemia-after-total-thyroidectomy-a-randomized-controlled-trial
#3
Sumiya Jaan, Ashish Sehgal, Rauf Ahmad Wani, Muneer Ahmad Wani, Khursheed Alam Wani, Bashir Ahmad Laway
BACKGROUND: Total thyroidectomy (TT) is a commonly performed surgery and postoperative hypocalcemia is a major detriment to early discharge. The aim of this randomized controlled trial was to ascertain the usefulness of routine pre- and post-operative calcium and Vitamin D supplementation in prevention of hypocalcemia after TT. MATERIALS AND METHODS: Sixty consecutive patients who underwent total or near TT from February 2013 to August 2014 were included in the study...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217054/role-of-intercostal-nerve-block-in-reducing-postoperative-pain-following-video-assisted-thoracoscopy-a-randomized-controlled-trial
#4
Zulfiqar Ahmed, Khalid Samad, Hameed Ullah
BACKGROUND: The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216699/comparison-of-volume-controlled-ventilation-and-pressure-controlled-ventilation-in-patients-undergoing-robot-assisted-pelvic-surgeries-an-open-label-trial
#5
Rishabh Jaju, Pooja Bihani Jaju, Mamta Dubey, Sadik Mohammad, A K Bhargava
BACKGROUND AND AIMS: Although volume controlled ventilation (VCV) has been the traditional mode of ventilation in robotic surgery, recently pressure controlled ventilation (PCV) has been used more frequently. However, evidence on whether PCV is superior to VCV is still lacking. We intended to compare the effects of VCV and PCV on respiratory mechanics and haemodynamic in patients undergoing robotic surgeries in steep Trendelenburg position. METHODS: This prospective, randomized trial was conducted on sixty patients between 20 and 70 years belonging to the American Society of Anesthesiologist Physical Status I-II...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215494/2d-versus-3d-in-laparoscopic-surgery-by-beginners-and-experts-a-randomized-controlled-trial-on-a-pelvitrainer-in-objectively-graded-surgical-steps
#6
Johannes Spille, Antonia Wenners, Ulrike von Hehn, Nicolai Maass, Ulrich Pecks, Liselotte Mettler, Ibrahim Alkatout
BACKGROUND AND OBJECTIVE: Progress in endoscopic surgery in the past few decades has led to the application of 3-dimensional (3D) procedures in operating rooms. This permits patient- and surgeon-friendly operations and also maximizes the superiority of laparoscopy over laparotomy. In this study, we compare 2-dimensional (2D) and 3D endoscopy techniques with regard to time, efficiency, optics, and handling by users with different degrees of experience at 4 difficulty levels. DESIGN: A randomized controlled trial on a pelvitrainer in objectively graded surgical steps for students and postgraduates...
February 16, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28215195/tetanus-a-potential-public-health-threat-in-times-of-disaster
#7
Paige Finkelstein, Laura Teisch, Casey J Allen, Gabriel Ruiz
BACKGROUND: Tetanus is a potentially fatal condition that is rare in urban environments but is seen in developing countries and post-natural-disaster. Therefore, the purpose of this report was to review the epidemiology, pathogenesis, and management of tetanus in the trauma patient. METHODS: A thorough literature review was conducted to look for the most current and thorough guidelines on the prophylaxis and treatment of tetanus. PUBMED (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), MEDLINE (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), and Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom) databases were searched for articles in English, published from 2005 to 2015, using the keywords "Tetanus," "Trauma/Surgery," and "Disaster...
February 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28213669/aspirin-use-prior-to-coronary-artery-bypass-grafting-surgery-a-systematic-review
#8
REVIEW
Ayman Elbadawi, Marwan Saad, Ramez Nairooz
PURPOSE OF REVIEW: Aspirin use before coronary artery bypass graft (CABG) surgery has been a puzzling question for years. Controversy existed regarding the overall benefits vs. risk of pre-operative aspirin use and was translated to conflicting guidelines from major societies. RECENT FINDINGS: Observational studies have suggested a reduced mortality with pre-operative aspirin use. A meta-analysis of randomized controlled trials showed increased risk of post-operative bleeding with aspirin, with no associated increased mortality risk...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28213593/randomised-double-blind-parallel-group-placebo-controlled-study-to-evaluate-the-analgesic-efficacy-and-safety-of-vvz-149-injections-for-postoperative-pain-following-laparoscopic-colorectal-surgery
#9
Srdjan S Nedeljkovic, Darin J Correll, Xiaodong Bao, Natacha Zamor, Jose L Zeballos, Yi Zhang, Mark J Young, Johanna Ledley, Jessica Sorace, Kristen Eng, Carlyle P Hamsher, Rajivan Maniam, Jonathan W Chin, Becky Tsui, Sunyoung Cho, Doo H Lee
INTRODUCTION: In spite of advances in understanding and technology, postoperative pain remains poorly treated for a significant number of patients. In colorectal surgery, the need for developing novel analgesics is especially important. Patients after bowel surgery are assessed for rapid return of bowel function and opioids worsen ileus, nausea and constipation. We describe a prospective, double-blind, parallel group, placebo-controlled randomised controlled trial testing the hypothesis that a novel analgesic drug, VVZ -149, is safe and effective in improving pain compared with providing opioid analgesia alone among adults undergoing laparoscopic colorectal surgery...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#10
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28210935/the-effect-of-fluid-resuscitation-on-the-effective-circulating-volume-in-patients-undergoing-liver-surgery-a-post-hoc-analysis-of-a-randomized-controlled-trial
#11
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28209488/postoperative-maintenance-levonorgestrel-releasing-intrauterine-system-and-endometrioma-recurrence-a-randomized-controlled-study
#12
Yi-Jen Chen, Teh-Fu Hsu, Ben-Shian Huang, Hsiao-Wen Tsai, Yen-Hou Chang, Peng-Hui Wang
BACKGROUND: According to three randomized trials, levonorgestrel-releasing intrauterine system significantly reduced recurrent endometriosis- related pelvic pain at postoperative year 1. Only a few studies have evaluated the long-term effectiveness of the devicefor preventing endometrioma recurrence, and the effects of a levonorgestrel-releasing intrauterine system as a maintenance therapy remain unclear. OBJECTIVES: To evaluate whether a maintenance levonorgestrel-releasing intrauterine system is effective for preventing postoperative endometrioma recurrence...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28209296/best-time-to-assess-complete-clinical-response-after-chemoradiotherapy-in-squamous-cell-carcinoma-of-the-anus-act-ii-a-post-hoc-analysis-of-randomised-controlled-phase-3-trial
#13
Robert Glynne-Jones, David Sebag-Montefiore, Helen M Meadows, David Cunningham, Rubina Begum, Fawzi Adab, Kim Benstead, Robert J Harte, Jill Stewart, Sandy Beare, Allan Hackshaw, Latha Kadalayil
BACKGROUND: Guidelines for anal cancer recommend assessment of response at 6-12 weeks after starting treatment. Using data from the ACT II trial, we determined the optimum timepoint to assess clinical tumour response after chemoradiotherapy. METHODS: The previously reported ACT II trial was a phase 3 randomised trial of patients of any age with newly diagnosed, histologically confirmed, squamous cell carcinoma of the anus without metastatic disease from 59 centres in the UK...
February 10, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28209169/vascular-impulse-technology-versus-elevation-in-the-treatment-of-posttraumatic-swelling-of-extremity-fractures-study-protocol-for-a-randomized-controlled-trial
#14
Marc Schnetzke, Benedict Swartman, Isabel Bonnen, Holger Keil, Svenja Schüler, Paul A Grützner, Jochen Franke
BACKGROUND: Fractures of the extremities are often complicated by a variable degree of swelling secondary to hemorrhage and soft tissue injury. Patients typically require up to 7 days of inpatient bed rest and elevation to reduce swelling to an acceptable level for operative treatment with internal fixation. Alternatively, an intermittent pneumatic compression device, such as the Vascular Impulse Technology (VIT) system, can be used at the injured extremity to reduce the posttraumatic swelling...
February 16, 2017: Trials
https://www.readbyqxmd.com/read/28208200/massive-pulmonary-embolism-extracorporeal-membrane-oxygenation-and-surgical-pulmonary-embolectomy
#15
Aaron Weinberg, Victor F Tapson, Danny Ramzy
Massive pulmonary embolism (PE) refers to large emboli that cause hemodynamic instability, right ventricular failure, and circulatory collapse. According to the 2016 ACCP Antithrombotic Guidelines, therapy for massive PE should include systemic thrombolytic therapy in conjunction with anticoagulation and supportive care. However, in patients with a contraindication to systemic thrombolytics or in those who fail the above interventions, extracorporeal membrane oxygenation (ECMO) and/or surgical embolectomy may be used to improve oxygenation, achieve hemodynamic stability, and successfully treat massive PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28207669/is-intraoperative-local-vancomycin-powder-the-answer-to-surgical-site-infections-in-spine-surgery
#16
Hwee Weng Dennis Hey, Desmond Wei Thiam, Zhi Seng Darren Koh, Joseph Shantakumar Thambiah, Naresh Kumar, Leok-Lim Lau, Ka-Po Gabriel Liu, Hee-Kit Wong
STUDY DESIGN: This is a retrospective cohort comparative study of all patients who underwent instrumented spine surgery at a single institution. OBJECTIVE: To compare the rate of surgical site infection (SSI) between the treatment (vancomycin) and the control group (no vancomycin) in patients undergoing instrumented spine surgery. SUMMARY OF BACKGROUND DATA: SSI after spine surgery is a dreaded complication associated with increased morbidity and mortality...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28207608/effects-of-internal-limiting-membrane-peeling-combined-with-removal-of-idiopathic-epiretinal-membrane-a-systematic-review-of-literature-and-meta-analysis
#17
Kunihiro Azuma, Takashi Ueta, Shuichiro Eguchi, Makoto Aihara
PURPOSE: To evaluate the effects on postoperative prognosis of internal limiting membrane (ILM) peeling in conjunction with removal of idiopathic epiretinal membranes (ERMs). METHODS: MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE were systematically searched for studies that compared ILM peeling with no ILM peeling in surgery to remove idiopathic ERM. Outcome measures were best-corrected visual acuity, central macular thickness, and ERM recurrence...
February 15, 2017: Retina
https://www.readbyqxmd.com/read/28207529/comparison-of-the-pro-postoperative-analgesia-of-intraoperative-dexmedetomidine-with-and-without-loading-dose-following-general-anesthesia-a-prospective-randomized-controlled-clinical-trial
#18
Wei Fan, Haikou Yang, Yong Sun, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Intraoperative dexemdetomidine (DEX) with or without loading dose is well-established to improve postoperative pain control in patient-controlled analgesia (PCA). This study was designed to compare the pro-analgesia effect between the 2 in patients received general anesthesia.Seventy patients shceduced abdominal surgery under general anesthesia were randomly assigned into 3 groups which were maintained using propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/dexmedetomidine with (PRDw) or without (PRDo) a loading dose of dexmedetomidine before induction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28207503/clamping-drainage-is-unnecessary-after-minimally-invasive-total-knee-arthroplasty-in-patients-with-tranexamic-acid-a-randomized-controlled-trial
#19
Yuangang Wu, Timin Yang, Yi Zeng, Canfeng Li, Bin Shen, Fuxing Pei
BACKGROUND: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. METHODS: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28206671/surgery-for-cataracts-in-people-with-age-related-macular-degeneration
#20
REVIEW
Heather Casparis, Kristina Lindsley, Irene C Kuo, Shameema Sikder, Neil M Bressler
BACKGROUND: Cataract and age-related macular degeneration (AMD) are common causes of decreased vision that often occur simultaneously in people over age 50. Although cataract surgery is an effective treatment for cataract-induced visual loss, some clinicians suspect that such an intervention may increase the risk of worsening of underlying AMD and thus have deleterious effects on vision. OBJECTIVES: The objective of this review was to evaluate the effectiveness and safety of cataract surgery compared with no surgery in eyes with AMD...
February 16, 2017: Cochrane Database of Systematic Reviews
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