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Patient intervention comparison outcome

Neil E O'Connell, Louise Marston, Sally Spencer, Lorraine H DeSouza, Benedict M Wand
BACKGROUND: This is an updated version of the original Cochrane Review published in 2010, Issue 9, and last updated in 2014, Issue 4. Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES), transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS) and reduced impedance non-invasive cortical electrostimulation (RINCE)...
March 16, 2018: Cochrane Database of Systematic Reviews
Pin Pin Pek, Huili Zheng, Andrew Fu Wah Ho, Win Wah, Huay Cheem Tan, Ling Li Foo, Marcus Eng Hock Ong
BACKGROUND: With an ageing population, there is a need to understand the relative risk/benefit of interventions for elderly ST segment elevation myocardial infarction (STEMI) patients. The primary aim of this study was to compare epidemiology, treatments and outcomes between young and elderly STEMI patients. Our secondary aim was to determine the cut-off age when the benefits of primary percutaneous coronary intervention (PCI) were less pronounced. METHODS: Data were collected by the Singapore Myocardial Infarction Registry...
March 15, 2018: Emergency Medicine Journal: EMJ
A González-Pérez, J Z Al-Sibai, P Álvarez-Fernández, P Martínez-Camblor, M Argüello-Junquera, J M García-Gala, E Martínez-Revuelta, J Silva, C Morís, G M Albaiceta
BACKGROUND: The optimal blood management after cardiac surgery remains controversial. Moreover, blood transfusions may have an impact on long-term outcomes. OBJECTIVE: The aim of this study is to characterize the impact of liberal red blood cell transfusions on Health-Related Quality of life (HRQoL) after cardiac surgery. METHODS: We studied a cohort of 205 consecutive patients after ICU discharge. Baseline characteristics and clinical data were recorded, and HRQoL was assessed using the EuroQoL-5D instrument, applied 6 months after ICU discharge...
March 12, 2018: Medicina Intensiva
Duan Wang, Hui Zhu, Wei-Kun Meng, Hao-Yang Wang, Ze-Yu Luo, Fu-Xing Pei, Qi Li, Zong-Ke Zhou
BACKGROUND: Although randomized controlled trials have confirmed oral tranexamic acid (TXA) can provide similar blood-sparing efficacy compared with intravenous (IV) TXA in total knee arthroplasty (TKA), some concerns do remain about thromboembolic events after such systemic administration. Many studies have confirmed that intra-articular (IA) application of TXA can show similar blood-saving efficacy with minimal levels of systemic absorption compared with IV TXA. However, it remains unclear whether the efficacy and safety of oral TXA administration is equal to or less than that of IA administration in TKA without the use of a tourniquet and drain...
March 15, 2018: BMC Musculoskeletal Disorders
Brett W Plattner, Pauline Chen, Richard Cross, Matthew A Leavitt, Paul D Killen, Michael Heung
INTRODUCTION: Kidney biopsies are an essential tool in the diagnosis and management of kidney diseases, particularly in kidney transplant recipients. Biopsies carry a risk for serious complications and not all biopsies achieve adequate tissue. We examined the impact of kidney biopsy technique on complications and biopsy adequacy. METHODS: The cohort consisted of consecutive kidney transplant patients undergoing biopsy by one of three techniques: ultrasound localization, real-time ultrasound guidance, and ultrasound-guided trocar placement...
March 1, 2018: Journal of Vascular Access
Carol Kelly, James D Chalmers, Iain Crossingham, Nicola Relph, Lambert M Felix, David J Evans, Stephen J Milan, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life...
March 15, 2018: Cochrane Database of Systematic Reviews
Cherian K Kandathil, Emily A Spataro, Katri Laimi, Sami P Moubayed, Sam P Most, Mikhail Saltychev
Importance: While functional rhinoplasty has been broadly studied, to our knowledge no systematic review and meta-analysis of lateral wall repair has been done previously. Objective: To evaluate the effectiveness of repair of the lateral nasal wall in adult patients with nasal airway obstruction. Data Sources: Medline, Embase, Cinahl, Central, Scopus, and Web of Science databases and reference lists were searched for clinical and observational studies...
March 15, 2018: JAMA Facial Plastic Surgery
Lone Baandrup, Bjørn H Ebdrup, Jesper Ø Rasmussen, Jane Lindschou, Christian Gluud, Birte Y Glenthøj
BACKGROUND: Prolonged treatment with benzodiazepines is common practice despite clinical recommendations of short-term use. Benzodiazepines are used by approximately 4% of the general population, with increased prevalence in psychiatric populations and the elderly. After long-term use it is often difficult to discontinue benzodiazepines due to psychological and physiological dependence. This review investigated if pharmacological interventions can facilitate benzodiazepine tapering. OBJECTIVES: To assess the benefits and harms of pharmacological interventions to facilitate discontinuation of chronic benzodiazepine use...
March 15, 2018: Cochrane Database of Systematic Reviews
Irene Bighelli, Georgia Salanti, Cornelia Reitmeir, Sofia Wallis, Corrado Barbui, Toshi A Furukawa, Stefan Leucht
INTRODUCTION: There is rising awareness that we need multidisciplinary approaches integrating psychological treatments for schizophrenia, but a comprehensive evidence based on their relative efficacy is lacking. We will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomised controlled trials (RCTs) to rank psychological treatments for schizophrenia according to their efficacy, acceptability and tolerability. METHODS AND ANALYSIS: We will include all RCTs comparing a psychological treatment aimed at positive symptoms of schizophrenia with another psychological intervention or with a no treatment condition (waiting-list and treatment as usual)...
March 14, 2018: BMJ Open
Ahmed T Ahmed, Omar Abdel-Rahman, Mohamed Morsi, Karim Mustafa, Paola Testini, Ilyas S Aleem, M Hassan Murad, Ahmad Nassr
STUDY DESIGN: Systematic review and meta-analysis of observational studies. OBJECTIVE: The aim of the study is to evaluate different treatment modalities in the management of sacrococcygeal chordoma. SUMMARY OF BACKGROUND DATA: Chordomas are primary malignant bone tumors associated with considerable morbidity and mortality. METHODS: We searched MEDLINE, EMBASE, Cochrane Central-Register of Controlled Trials, and Scopus from inception to July 2015...
March 13, 2018: Spine
Gianfranco Sanson, Rosaria Alvaro, Antonello Cocchieri, Ercole Vellone, John Welton, Massimo Maurici, Maurizio Zega, Fabio D'Agostino
BACKGROUND: Oncological diseases affect the biopsychosocial aspects of a person's health, resulting in the need for complex multidisciplinary care. The quality and outcomes of healthcare cannot be adequately assessed without considering the contribution of nursing care, whose essential elements such as the nursing diagnoses (NDs), nursing interventions (NIs), and nursing activities (NAs) can be recorded in the Nursing Minimum Data Set (NMDS). There has been little research using the NMDS in oncology setting...
March 13, 2018: Cancer Nursing
Kevin McGarry, Duncan Redmill, Mark Edwards, Aoife Byrne, Aaron Brady, Mark Taylor
Northern Ireland (NI) has been in a post-conflict state for over twenty years. However, injuries sustained during paramilitary Punishment Attacks (PA) remain a common hospital presentation. The aim of this study was to compare the current province-wide frequency and cost with data collected from the same unit in 1994, the end of the so called, "Troubles". A ten month retrospective emergency chart analysis from all assault and gunshot wound (GSW) attendances to the Emergency Department, Royal Victoria Hospital Belfast (RVH) in 2012 was carried out...
May 2017: Ulster Medical Journal
Han-Gil Jeong, Beom Joon Kim, Jay Chol Choi, Keun-Sik Hong, Mi Hwa Yang, Cheolkyu Jung, Moon-Ku Han, Hee-Joon Bae
BACKGROUND AND PURPOSE: The majority of ischemic stroke patients receiving endovascular recanalization therapy (EVT) experience variable changes of neurological severities during the hyperacute period. We hypothesized that the National Institutes of Health Stroke Scale (NIHSS) score after EVT is a better prognostic factor compared with the initial NIHSS score or revascularization status. METHODS: We identified 566 stroke patients who received EVT at Seoul National University Bundang Hospital between April 2008 and December 2015...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Valthierre Nunes de Lima, Leonardo Perez Faverani, Joel Ferreira Santiago, Celso Palmieri, Osvaldo Magro Filho, Eduardo Piza Pellizzer
The purpose of this study was to perform a systematic review of morphological alterations in the condyles after orthographic surgery involving a sagittal split ramus osteotomy (SSRO), with or without surgery on the maxilla. Searches were performed on three databases and registered in the PROSPERO. The selected studies fulfilled the criteria established by the following PICO model: (1) population: individuals with skeletal dentofacial deformities (class II or III facial patterns), without asymmetry; (2) intervention: orthognathic surgery for mandibular setback using an SSRO, with or without a Le Fort I osteotomy, and fixed with bicortical screws or plates and screws; (3) comparison: orthognathic surgery for mandibular advancement using an SSRO, with or without a Le Fort I osteotomy, and fixed with plates and screws or bicortical screws; and (4) outcome: condylar resorption rate and relapse...
February 21, 2018: Journal of Cranio-maxillo-facial Surgery
Douglas Zatzick, Joan Russo, Peter Thomas, Doyanne Darnell, Harry Teter, Leah Ingraham, Lauren K Whiteside, Jin Wang, Roxanne Guiney, Lea Parker, Kirsten Sandgren, Margot Kelly Hedrick, Erik G Van Eaton, Gregory Jurkovich
OBJECTIVE: The investigation aimed to compare two approaches to the delivery of care for hospitalized injury survivors, a patient-centered care transition intervention versus enhanced usual care. METHOD: This pragmatic comparative effectiveness trial randomized 171 acutely injured trauma survivors with three or more early postinjury concerns and high levels of emotional distress to intervention (I; n = 85) and enhanced usual care control (C; n = 86) conditions...
March 13, 2018: Psychiatry
Muhammet Furkan Korkmaz, Ahmet Güzel, Mehmet Açıkgöz, Ali Okuyucu, Hasan Alaçam
OBJECTIVES: Community-acquired pneumonia (CAP) in children is one of the most important causes of mortality and morbidity in developing countries. Therefore, it is very important for clinicians to detect the presence and severity of pneumonia. Proadrenomedullin (Pro-ADM) and Interleukin-1β (IL-1β) are thought to have potential for CAP evaluation in children. We sought to investigate the value of Pro-ADM and IL-1β levels for severity assessment and outcome prediction in children with CAP...
January 2018: Annals of Clinical and Laboratory Science
David Yuen Chung Chan, Danny Tat Ming Chan, Cannon Xian Lun Zhu, Patricia Kwok Yee Kan, Amelia Yikjin Ng, Yi-Pin Sonia Hsieh, Jill Abrigo, Wai Sang Poon, George Kwok Chu Wong
Treatment of arteriovenous malformations (AVM) located at the eloquent area has been a challenge. Awake brain mapping allows identification of a non-eloquent gyrus for intervention and can potentially facilitate resection with preservation of functions. An alternative treatment option is stereotactic radiosurgery (SRS). The objective of this study was to perform a qualitative comparison of the treatment outcome of awake AVM excision versus SRS. We conducted a 13-year retrospective review of AVM excision under awake craniotomy performed at Prince of Wales Hospital, Hong Kong, from 2003 to 2016...
March 9, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Siddharth A Mahure, Joseph A Bosco, James D Slover, Jonathan Vigdorchik, Richard Iorio, Ran Schwarzkopf
BACKGROUND: Individuals coinfected with both hepatitis C virus (HCV) and HIV represent a unique and growing population of patients undergoing orthopaedic surgical procedures. Data regarding complications for HCV monoinfection or HIV monoinfection are robust, but there are no data available, to our knowledge, on patients who have both HCV and HIV infections. QUESTIONS/PURPOSES: We sought to determine whether patients with coinfection differed in terms of baseline demographics and comorbidity burden as compared with patients without coinfection and whether these potential differences were translated into varying levels of postoperative complications, mortality, and hospital readmission risk...
February 2018: Clinical Orthopaedics and related Research
Sharon E Culliton, Dianne M Bryant, Steven J MacDonald, Kathryn M Hibbert, Bert M Chesworth
BACKGROUND: In 2012, a new Knee Society Knee Scoring System (KSS) was developed and validated to address the needs for a scoring system that better encompasses the expectations, satisfaction, and physical involvement of a younger, more active population of patients undergoing TKA. Revalidating this tool in a separate population by individuals other than the developers of the scoring system seems important, because such replication would tend to confirm the generalizability of this tool...
January 2018: Clinical Orthopaedics and related Research
Diego Castini, Marco Centola, Giulia Ferrante, Sara Cazzaniga, Simone Persampieri, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: Compare the discriminative performance of two validated bleeding risk models for in-hospital bleeding events in a non-selected cohort of acute coronary syndrome (ACS) patients. METHODS: CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) and ACUITY-HORIZONS (Acute Catheterization and Urgent Intervention Triage strategY-Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) scores were calculated in 501 consecutive patients (median age 68 years (IQR 57-77), 31% female) admitted for ACS to the coronary care unit (CCU) of San Paolo Hospital in Milan (Italy)...
March 2, 2018: Heart, Lung & Circulation
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