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Randomized controlled trial in general 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/28934786/long-term-cost-utility-of-spinal-cord-stimulation-in-patients-with-failed-back-surgery-syndrome
#2
S Harrison Farber, Jing L Han, Aladine A Elsamadicy, Qasim Hussaini, Siyun Yang, Promila Pagadala, Beth Parente, Jichun Xie, Shivanand P Lad
BACKGROUND: Failed back surgery syndrome (FBSS) is a cause of significant morbidity for up to 40% of patients following spine surgery, and is estimated to cost almost $20 billion. Treatment options for these patients currently include conventional medical management (CMM), repeat operation, or spinal cord stimulation (SCS). Much of the published data regarding cost effectiveness of SCS comprise smaller scale randomized controlled trials (RCTs) rather than large databases capturing practices throughout the US...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28928585/postoperative-analgesic-efficacy-of-bilateral-transversus-abdominis-plane-block-in-patients-undergoing-midline-colorectal-surgeries-using-ropivacaine-a-randomized-double-blind-placebo-controlled-trial
#3
Nahida Qazi, Wasim Mohammad Bhat, Malik Zaffar Iqbal, Anisur Rehman Wani, Showkat A Gurcoo, Sahir Rasool
BACKGROUND: Ultrasound-guided transversus abdominis plane (TAP) block is done as a part of multimodal analgesia for pain relief after abdominal surgeries. This prospective randomized, double-blind, placebo-controlled trial was conducted to evaluate the postoperative analgesic efficacy of bilateral TAP block in patients undergoing midline colorectal surgeries using ropivacaine. MATERIALS AND METHODS: Eighty patients scheduled for elective colorectal surgeries involving midline abdominal wall incision under general anesthesia were enrolled in this prospective randomized controlled trial...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#4
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
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
#5
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/28894821/the-role-of-infection-and-antibiotics-in-chronic-rhinosinusitis
#6
REVIEW
Miriam Baron Barshak, Marlene L Durand
OBJECTIVE: To review the current understanding of the role of infection and antibiotics in chronic rhinosinusitis. REVIEW METHODS: PubMed literature search. RESULTS: Chronic rhinosinusitis (CRS) in adults is an inflammatory condition and the role of infection is unclear. Biofilms are present in both CRS and normal patients so their role in CRS is unknown. Sinus cultures in CRS demonstrate a mixture of aerobic and anaerobic bacteria but may be hard to interpret due to contaminating nasal flora...
February 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28893727/development-of-a-virtual-reality-exposure-tool-as-psychological-preparation-for-elective-pediatric-day-care-surgery-methodological-approach-for-a-randomized-controlled-trial
#7
Robin Eijlers, Jeroen S Legerstee, Bram Dierckx, Lonneke M Staals, Johan Berghmans, Marc P van der Schroeff, Rene Mh Wijnen, Elisabeth Mwj Utens
BACKGROUND: Preoperative anxiety in children is highly prevalent and is associated with adverse outcomes. Existing psychosocial interventions to reduce preoperative anxiety are often aimed at distraction and are of limited efficacy. Gradual exposure is a far more effective way to reduce anxiety. Virtual reality (VR) provides a unique opportunity to gradually expose children to all aspects of the operating theater. OBJECTIVE: The aims of our study are (1) to develop a virtual reality exposure (VRE) tool to prepare children psychologically for surgery; and (2) to examine the efficacy of the VRE tool in a randomized controlled trial (RCT), in which VRE will be compared to care as usual (CAU)...
September 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28893633/enhanced-recovery-open-versus-laparoscopic-left-donor-nephrectomy-a-randomized-controlled-trial
#8
Ahmed M Mansour, Ahmed R El-Nahas, Bedeir Ali-El-Dein, Ahmed Abdelfattah, Ahmed Hamed, Ahmed Abdel-Rahman, Ibrahim Eraky, Ahmed A Shokeir
OBJECTIVE: To compare recovery outcomes between laparoscopic donor nephrectomy (LDN) and open donor nephrectomy (ODN) within a specified Enhanced Recovery Program (ERP) for left kidney donations. MATERIALS AND METHODS: A phase III randomized trial was conducted between January 2013 and June 2015, eligible left side donors were randomized to laparoscopic or open donor nephrectomy in a 1:1 ratio with recovery optimized within a standardized ERP. The primary outcome was patient-reported measure of physical fatigue, as measured by the physical fatigue domain of the translated Multidimensional Fatigue Inventory 20 (MFI-20)...
September 8, 2017: Urology
https://www.readbyqxmd.com/read/28886351/does-dexamethasone-facilitate-neurosensory-function-regeneration-after-zygomatic-fracture-a-randomized-controlled-trial
#9
Aleksi Haapanen, Hanna Thorén, Satu Apajalahti, Anna Liisa Suominen, Johanna Snäll
PURPOSE: This study sought to clarify the rate of neurosensory disturbance (NSD) after zygomatic complex fractures in general, as well as the effect of perioperatively administered dexamethasone on neurosensory recovery. PATIENTS AND METHODS: This was a single-blinded randomized study aiming to clarify the benefits of perioperative dexamethasone after surgery. The patients were randomly assigned either to receive dexamethasone (up to a total dose of 10 or 30 mg) or to act as control patients (no glucocorticoid treatment)...
August 12, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28882161/general-anesthesia-versus-local-anesthesia-in-stereotaxy-galaxy-for-parkinson-s-disease-study-protocol-for-a-randomized-controlled-trial
#10
R A Holewijn, D Verbaan, R M A de Bie, P R Schuurman
BACKGROUND: The aim of the study is to investigate if deep brain stimulation (DBS) in the subthalamic nucleus (STN) for Parkinson's disease (PD) under general anesthesia further improves outcome by lessening postoperative cognitive, mood, and behavioral adverse effects; shorten surgical time and hospital admittance; and produce comparable symptomatic and functional improvement to surgery under local anesthesia. METHODS/DESIGN: The study will be a single-center, prospective, randomized, open-label, blinded endpoint trial comparing DBS under general anesthesia with DBS under local anesthesia...
September 7, 2017: Trials
https://www.readbyqxmd.com/read/28874986/neuropathic-pain-related-with-spinal-disorders-a-systematic-review
#11
REVIEW
Kwang-Sup Song, Jae Hwan Cho, Jae-Young Hong, Jae Hyup Lee, Hyun Kang, Dae-Woong Ham, Hyun-Jun Ryu
Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28874985/an-updated-overview-of-low-back-pain-management-in-primary-care
#12
REVIEW
Jae-Young Hong, Kwang-Sup Song, Jae Hwan Cho, Jae Hyup Lee
Currently, guidelines for lower back pain (LBP) treatment are needed. We reviewed the current guidelines and high-quality articles to confirm the LBP guidelines for the Korean Society of Spine Surgery. We searched available databases for high-quality articles in English on LBP published from 2000 to the present year. Literature searches using these guidelines included studies from MEDLINE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Embase. We analyzed a total of 132 randomized clinical trials, 116 systematic reviews, 9 meta-analyses, and 4 clinical guideline reviews...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28873062/a-prospective-randomized-controlled-clinical-trial-to-assess-use-of-2-lidocaine-irrigation-to-prevent-abdominal-surgical-site-infection
#13
Alejandro Quiroga-Garza, Juan Manuel Valdivia-Balderas, Miguel Ángel Trejo-Sánchez, Abraham Guadalupe Espinosa-Uribe, Cynthia Guadalupe Reyes-Hernández, Rodrigo Enrique Elizondo-Omaña
Surgical site infections (SSI) are the third most common nosocomial infection, increasing morbidity and mortality rates of patients as well as their costs of care, but longer-term follow up studies and data are limited. Lidocaine, in addition to being a readily available and accessible local anesthetic, is known to have bacteriostatic properties. A prospective, descriptive, controlled, randomized clinical trial was conducted among patients scheduled to undergo abdominal sur- gery in the general surgical unit of a Mexican hospital...
August 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28859943/population-screening-and-intervention-for-vascular-disease-in-danish-men-viva-a-randomised-controlled-trial
#14
Jes S Lindholt, Rikke Søgaard
BACKGROUND: Abdominal aortic aneurysm is the only cardiovascular disease targeted by population screening. In this study, we test the effect of screening and subsequent intervention for abdominal aortic aneurysm, peripheral arterial disease, and hypertension combined. METHODS: In this randomised controlled trial, we randomly allocated (1:1) all men aged 65-74 years living in the Central Denmark Region to screening for abdominal aortic aneurysm, peripheral arterial disease, and hypertension, or to no screening...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28842086/comparison-of-time-to-operation-and-efficacies-of-ultrasound-guided-nerve-block-and-general-anesthesia-in-emergency-external-fixation-of%C3%A2-lower-leg-fractures-ao-42-43-44
#15
Chan Kang, Sang-Bum Kim, Youn-Moo Heo, You-Gun Won, Byung-Hak Oh, June-Bum Jun, Gi-Soo Lee
The present randomized controlled trial evaluated the usefulness of ultrasound (US)-guided nerve block (NB) for emergency external fixation of lower leg fractures, by investigating the time required before surgery and the clinical results stratified by the anesthesia method (US-guided NB or general anesthesia [GA]). From June 2014 to April 2016, 40 patients who had undergone emergency surgery for external fixator application were enrolled in the present study. We measured the lead time before the start of surgery after the decision to perform emergency surgery in both groups...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28838644/laparoscopic-ileocaecal-resection-versus-infliximab-for-terminal-ileitis-in-crohn-s-disease-a-randomised-controlled-open-label-multicentre-trial
#16
Cyriel Y Ponsioen, E Joline de Groof, Emma J Eshuis, Tjibbe J Gardenbroek, Patrick M M Bossuyt, Ailsa Hart, Janindra Warusavitarne, Christianne J Buskens, Ad A van Bodegraven, Menno A Brink, Esther C J Consten, Bart A van Wagensveld, Marno C M Rijk, Rogier M P H Crolla, Casper G Noomen, Alexander P J Houdijk, Rosalie C Mallant, Maarten Boom, Willem A Marsman, Hein B Stockmann, Bregje Mol, A Jeroen de Groof, Pieter C Stokkers, Geert R D'Haens, Willem A Bemelman
BACKGROUND: Treatment of patients with ileocaecal Crohn's disease who have not responded to conventional therapy is commonly scaled up to biological agents, but surgery can also offer excellent short-term and long-term results. We compared laparoscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life. METHODS: In this randomised controlled, open-label trial, in 29 teaching hospitals and tertiary care centres in the Netherlands and the UK, adults with non-stricturing, ileocaecal Crohn's disease, in whom conventional therapy has failed were randomly allocated (1:1) by an internet randomisation module with biased-coin minimisation for participating centres and perianal fistula to receive laparoscopic ileocaecal resection or infliximab...
August 21, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28836009/contralateral-cerebral-hemoglobin-oxygen-saturation-changes-in-patients-undergoing-thoracotomy-with-general-anesthesia-with-or-without-paravertebral-block-a-randomized-controlled-trial
#17
Keika Mukaihara, Maiko Hasegawa-Moriyama, Yuichi Kanmura
PURPOSE: Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. We used NIRS to measure changes in cerebral blood flow provoked by thoracotomy incision made under GA and determine how these changes were influenced by supplementation of GA with PVB. METHODS: Thirty-four patients undergoing elective thoracotomy were enrolled...
August 23, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28829911/chemoradiotherapy-versus-chemoradiotherapy-plus-surgery-for-esophageal-cancer
#18
REVIEW
Balamurugan A Vellayappan, Yu Yang Soon, Geoffrey Y Ku, Cheng Nang Leong, Jiade J Lu, Jeremy Cs Tey
BACKGROUND: Please see Appendix 4 for a glossary of terms.The outcome of patients with esophageal cancer is generally poor. Although multimodal therapy is standard, there is conflicting evidence regarding the addition of esophagectomy to chemoradiotherapy. OBJECTIVES: To compare the effectiveness and safety of chemoradiotherapy plus surgery with that of chemoradiotherapy alone in people with nonmetastatic esophageal carcinoma. SEARCH METHODS: We performed a computerized search for relevant studies, up to Feburary 2017, on the CENTRAL, MEDLINE, and Embase databases using MeSH headings and keywords...
August 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#19
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28810091/preoperative-chest-radiography-in-elective-surgery-review-and-update
#20
Ethan M Young, Joel D Farmer
INTRODUCTION: The preoperative evaluation is designed to identify factors that may predispose a patient to perioperative complications in an effort to ensure patient safety. The use of chest radiography in the preoperative evaluation has progressed from routine testing to a more selective approach based on evidence that routine testing is low yield. However, preoperative chest radiography (POCR) may still be utilized more frequently than necessary as guidelines provide varying recommendations and providers continue to order the test by convention...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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