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https://www.readbyqxmd.com/read/28448754/clinical-evaluation-of-cost-efficacy-of-drugs-for-treatment-of-osteoporosis-a-meta-analysis
#1
Stewart G Albert, Supraja Reddy
OBJECTIVE: To assess the cost efficacy of available regimens for therapy of osteoporosis as defined as the cost time's number need to treat to prevent one fracture. PATIENTS AND METHODS: Existing meta-analyses were supplemented through electronic databases SCOPUS and PubMED between 2013 (a date overlapping the latest meta-analyses) and March 2016. Primary references included all randomized controlled trials of anti-osteoporotic drugs versus comparators using search terms "osteoporosis", "random" and "trial"...
April 27, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437598/the-potential-implications-of-using-disability-free-survival-and-number-needed-to-suffer-as-outcome-measures-for-neonatal-intensive-care
#2
Per-Arne Lönnqvist
The use of mortality and surrogate makers to determine outcomes after advanced medical treatment has been questioned, because often these dimensions do not agree with what both many medical staff and laypeople judge as adequate outcome measures. That is why Myles et al introduced the more adequate dimension of disability free survival (1-3). Furthermore, the suffering of other patients that is associated with one single individual having a good outcome has been discussed and the suggested term for this is the number needed to suffer (4), which reflects the similar terms of number needed to treat and number needed to harm...
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28436019/antibiotic-therapy-for-pelvic-inflammatory-disease
#3
REVIEW
Ricardo F Savaris, Daniele G Fuhrich, Rui V Duarte, Sebastian Franik, Jonathan Ross
BACKGROUND: Pelvic inflammatory disease (PID) is an infection that affects 4% to 12% of young women, and is one of the most common causes of morbidity in this age group. The main intervention for acute PID is the use of broad-spectrum antibiotics which cover Chlamydia trachomatis, Neisseria gonorrhoeae, and anaerobic bacteria, administered intravenously, intramuscularly, or orally. In this review, we assessed the optimal treatment regimen for PID. OBJECTIVES: To assess the effectiveness and safety of antibiotic regimens used to treat pelvic inflammatory disease...
April 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28435487/randomized-trial-of-adding-parenteral-acetaminophen-to-prochlorperazine-and-diphenhydramine-to-treat-headache-in-the-emergency-department
#4
Stefan H Meyering, Ryan W Stringer, Matthew K Hysell
INTRODUCTION: Headaches represent over three million emergency department (ED) visits per year, comprising 2.4% of all ED visits. There are many proposed methods and clinical guidelines of treating acute headache presentations. However, data on intravenous acetaminophen usage in these settings are lacking. In this study, we sought to determine the efficacy of intravenous (IV) acetaminophen as an adjunct to a standard therapy for the treatment of patients who present to the ED with a chief complaint of "headache...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28423145/brief-behavioral-therapy-for-pediatric-anxiety-and-depression-in-primary-care-a-randomized-clinical-trial
#5
V Robin Weersing, David A Brent, Michelle S Rozenman, Araceli Gonzalez, Megan Jeffreys, John F Dickerson, Frances L Lynch, Giovanna Porta, Satish Iyengar
Importance: Anxiety and depression affect 30% of youth but are markedly undertreated compared with other mental disorders, especially in Hispanic populations. Objective: To examine whether a pediatrics-based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care. Design, Setting, and Participants: This 2-center randomized clinical trial with masked outcome assessment conducted between brief behavioral therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8...
April 19, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28420629/dexamethasone-versus-standard-treatment-for-postoperative-nausea-and-vomiting-in-gastrointestinal-surgery-randomised-controlled-trial-dreams-trial
#6
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objectives To determine whether preoperative dexamethasone reduces postoperative vomiting in patients undergoing elective bowel surgery and whether it is associated with other measurable benefits during recovery from surgery, including quicker return to oral diet and reduced length of stay.Design Pragmatic two arm parallel group randomised trial with blinded postoperative care and outcome assessment.Setting 45 UK hospitals.Participants 1350 patients aged 18 or over undergoing elective open or laparoscopic bowel surgery for malignant or benign pathology...
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28412467/magnitude-and-direction-of-missing-confounders-had-different-consequences-on-treatment-effect-estimation-in-propensity-score-analysis
#7
Tri-Long Nguyen, Gary S Collins, Jessica Spence, Charles Fontaine, Jean-Pierre Daurès, P J Devereaux, Paul Landais, Yannick Le Manach
OBJECTIVE: Propensity score (PS) analysis allows an unbiased estimate of treatment effects, but assumes that all confounders are measured. We assessed the impact of omitting confounders from a PS analysis on clinical decision-making. STUDY DESIGN AND SETTING: We conducted Monte Carlo simulations on hypothetical observational studies based on virtual populations and on the population from a large randomized trial (CRASH-2). In both series of simulations, PS analysis was conducted with all confounders and with omitted confounders, which were defined to have different strengths of association with the outcome and treatment exposure...
April 12, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28408193/imipramine-versus-placebo-for-multiple-functional-somatic-syndromes-stress-3-a-double-blind-randomised-study
#8
Johanne L Agger, Andreas Schröder, Lise K Gormsen, Jens S Jensen, Troels S Jensen, Per K Fink
BACKGROUND: Functional somatic syndromes, including chronic fatigue syndrome or irritable bowel syndrome, often co-exist. Treatment guidelines supported by high quality evidence exist for most functional somatic syndromes, but are lacking for multiple comorbid functional somatic syndromes. We aimed to assess the effect of the tricyclic antidepressant, imipramine, in patients with multiple functional somatic syndromes defined by the criteria for multiorgan bodily distress syndrome, a unifying diagnosis that encompasses most functional somatic syndromes and somatoform disorders...
April 10, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28405705/-cost-effectiveness-of-gnrh-antagonists-in-patients-with-prostate-cancer-and-cardiovascular-risk-comparative-analysis-against-leuprorelin-by-the-number-needed-to-treat
#9
D Anderson, J Lehmann, T Ecker, S Vosgerau, V Donatz
BACKGROUND: Recent studies suggest that androgen deprivation therapy (ADT) is associated with increased cardiovascular (CV) risk for patients with hormone-sensitive prostate cancer (PCa) and pre-existing CV disease. This risk seems to be different for the gonadotropin-releasing hormone (GnRH) agonists leuprolide and goserelin and GnRH antagonists, whereas the slightly more expensive GnRH antagonist shows a beneficial risk profile. The present study assesses the cost effectiveness of degarelix compared to leuprolide for PCa patients with increased CV risk...
April 12, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28402756/effectiveness-of-manual-therapy-and-stretching-for-baseball-players-with-shoulder-range-of-motion-deficits
#10
Lane B Bailey, Charles A Thigpen, Richard J Hawkins, Paul F Beattie, Ellen Shanley
BACKGROUND: Baseball players displaying deficits in shoulder range of motion (ROM) are at increased risk of arm injury. Currently, there is a lack of consensus regarding the best available treatment options to restore shoulder ROM. HYPOTHESIS: Instrumented manual therapy with self-stretching will result in clinically significant deficit reductions when compared with self-stretching alone. STUDY DESIGN: Controlled laboratory study. METHODS: Shoulder ROM and humeral torsion were assessed in 60 active baseball players (mean age, 19 ± 2 years) with ROM deficits (nondominant - dominant, ≥15°)...
April 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28402497/systematic-review-of-safety-and-cost-effectiveness-of-venous-thromboembolism-prophylaxis-strategies-in-patients-undergoing-craniotomy-for-brain-tumor
#11
Hanna Algattas, Dushyant Damania, Ian DeAndrea-Lazarus, Kristopher T Kimmell, Nicholas F Marko, Kevin A Walter, G Edward Vates, Babak S Jahromi
BACKGROUND: Studies have evaluated various strategies to prevent venous thromboembolism (VTE) in neuro-oncology patients, without consensus. OBJECTIVE: To perform a systematic review with cost-effectiveness analysis (CEA) of various prophylaxis strategies in tumor patients undergoing craniotomy to determine the safest and most cost-effective prophylaxis regimen. METHODS: A literature search was conducted for VTE prophylaxis in brain tumor patients...
April 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28400629/biostatistics-series-module-8-assessing-risk
#12
Avijit Hazra, Nithya Gogtay
In observational studies, as well as in interventional ones, it is frequently necessary to estimate risk that is the association between an observed outcome or event and exposure to one or more factors that may be contributing to the event. Understanding incidence and prevalence are the starting point in any discussion of risk assessment. Incidence rate uses person-time as the denominator rather than a simple count. Ideally, rates and ratios estimated from samples should be presented with their corresponding 95% confidence intervals (CIs)...
March 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28399330/arginine-supplementation-for-prevention-of-necrotising-enterocolitis-in-preterm-infants
#13
REVIEW
Prakeshkumar S Shah, Vibhuti S Shah, Lauren E Kelly
BACKGROUND: Decreased concentration of nitric oxide has been proposed as one of the possible cellular mechanisms of necrotising enterocolitis (NEC). Arginine can act as a substrate for production of nitric oxide in the tissues, and arginine supplementation may help to prevent NEC. OBJECTIVES: To examine the effect of arginine supplementation (administered by any route) on the incidence of NEC in preterm neonates. To conduct subgroup analyses based on the dose of arginine and the gestational age of participants (≤ 32 weeks, > 32 weeks)...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28398671/transcatheter-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-evidence-from-a-meta-analysis
#14
Partha Sardar, Amartya Kundu, Saurav Chatterjee, Dmitriy N Feldman, Theophilus Owan, Nikolaos Kakouros, Ramez Nairooz, Linda A Pape, Ted Feldman, J Dawn Abbott, Sammy Elmariah
OBJECTIVES: We performed a meta-analysis to evaluate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR) in intermediate-risk patients. BACKGROUND: TAVR is an established treatment option in high-risk patients with severe aortic valve stenosis (AS). There are fewer data regarding efficacy of TAVR in intermediate-risk patients. METHODS: Databases were searched through April 30, 2016 for studies that compared TAVR with SAVR for the treatment of intermediate-risk patients with severe AS...
April 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28396999/dutasteride-is-associated-with-reduced-risk-of-transrectal-prostate-biopsy-associated-urinary-tract-infection-and-related-hospitalizations
#15
Daniel M Moreira, Gerald L Andriole, J Curtis Nickel, Claus G Roehrborn, Ramiro Castro-Santamaria, Stephen J Freedland
OBJECTIVES: To evaluate whether the use of dutasteride is associated with a lower risk of transrectal prostate biopsy-associated urinary tract infection (TPBA-UTI) among men in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study. METHODS: Retrospective analysis of 6045 men undergoing 2-year repeat prostate biopsy in REDUCE. Participants were randomized to receive dutasteride 0.5 mg or placebo daily. TPBA-UTI was defined as the presence of urinary symptoms and the prescription of antibiotics by the treating physician within 30 days after biopsy...
April 10, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#16
Kathryn Martinello, Anthony R Hart, Sufin Yap, Subhabrata Mitra, Nicola J Robertson
This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10)...
April 6, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28385410/comparative-efficacy-of-endovascular-revascularization-versus-supervised-exercise-training-in-patients-with-intermittent-claudication-meta-analysis-of-randomized-controlled-trials
#17
Ambarish Pandey, Subhash Banerjee, Christian Ngo, Purav Mody, Steven P Marso, Emmanouil S Brilakis, Ehrin J Armstrong, Jay Giri, Marc P Bonaca, Aruna Pradhan, Anthony A Bavry, Dharam J Kumbhani
OBJECTIVES: The authors performed a meta-analysis of randomized controlled trials to compare the efficacy of initial endovascular treatment with or without supervised exercise training (SET) versus SET alone in patients with intermittent claudication. BACKGROUND: Current guidelines recommend SET as the initial treatment modality for patients with intermittent claudication, in addition to optimal medical therapy. The role of endovascular therapy as primary treatment for claudication has been controversial...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28360514/laba-lama-combinations-versus-lama-monotherapy-or-laba-ics-in-copd-a-systematic-review-and-meta-analysis
#18
Gustavo J Rodrigo, David Price, Antonio Anzueto, Dave Singh, Pablo Altman, Giovanni Bader, Francesco Patalano, Robert Fogel, Konstantinos Kostikas
BACKGROUND: Randomized controlled trials (RCTs) indicate that long-acting bronchodilator combinations, such as β2-agonist (LABA)/muscarinic antagonist (LAMA), have favorable efficacy compared with commonly used COPD treatments. The objective of this analysis was to compare the efficacy and safety of LABA/LAMA with LAMA or LABA/inhaled corticosteroid (ICS) in adults with stable moderate-to-very-severe COPD. METHODS: This systematic review and meta-analysis (PubMed/MEDLINE, Embase, Cochrane Library and clinical trial/manufacturer databases) included RCTs comparing ≥12 weeks' LABA/LAMA treatment with LAMA and/or LABA/ICS (approved doses only)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28359980/number-needed-to-treat-for-stroke-thrombectomy-based-on-a-systematic-review-and-meta-analysis
#19
Ephraim W Church, Alexandra Gundersen, Michael J Glantz, Scott D Simon
The positive results of recent clinical trials examining endovascular treatment of acute stroke were the culmination of nearly two decades of studies of endovascular stroke treatment. We systematically reviewed this body of work, evaluated the strength of evidence, and performed a meta-analysis to define the clinical impact of these investigations. Terms were entered into search engines in a systematic fashion. Articles were reviewed independently by study authors, graded for level of evidence, and combined in a meta-analysis...
March 10, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28359010/a-systematic-review-and-meta-analysis-of-treatments-for-acrophobia
#20
REVIEW
Bruce Arroll, Henry B Wallace, Vicki Mount, Stephen P Humm, Douglas W Kingsford
OBJECTIVE: To review the literature on the comparative efficacy of psychological, behavioural and medical therapies for acrophobia (fear of heights). DATA SOURCES: Multiple databases were searched through the Cochrane Common Mental Disorders review group on 1 December 2015. DATA SYNTHESIS: The data were extracted independently and were pooled using RevMan version 5.3.5. The main outcome measures were changes from baseline on questionnaires for measurement of fear of heights, such as the Acrophobia Questionnaire (AQ), Attitude Towards Height Questionnaire (ATHQ), and behavioural avoidance tests...
April 3, 2017: Medical Journal of Australia
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