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Patient intervention comparison outcome

Vahideh Lajevardi, Afsaneh Ghayoumi, Robabeh Abedini, Hamed Hosseini, Azadeh Goodarzi, Zahra Akbari, Kosar Hedayat
BACKGROUND: Melasma's high prevalence and profound psychological impact on patients necessitate efficacious, economical, and safe therapeutic interventions. Adjunctive therapies such as tranexamic acid (TA) can enhance the therapeutic effect of standard treatments like hydroquinone 4% cream (HQ). OBJECTIVE: To conduct an assessor- and analyst-blinded, parallel, superiority, randomized controlled trial to compare the clinical efficacy and safety of oral TA plus HQ vs...
October 20, 2016: Journal of Cosmetic Dermatology
Ahmad S Azhar
OBJECTIVES: To assess the safety and effectiveness of transthoracic echocardiography (TTE) in monitoring transcatheter closure of atrial septal defect (ASD), in comparison with conventional technique using transesophageal echocardiography (TEE).  Methods: A retrospective review of all cases of transcatheter closure of isolated ostium secundum ASDs operated from 2005 to 2015, at the Pediatric Interventional Cardiology Department, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia...
November 2016: Saudi Medical Journal
Suguru Kimoto, Yasuhiko Kawai, Atsuko Gunji, Hisatomo Kondo, Taro Nomura, Tomohiko Murakami, Akito Tsuboi, Guang Hong, Shunsuke Minakuchi, Yusuke Sato, Gaku Ohwada, Tetsuya Suzuki, Katsuhiko Kimoto, Noriyuki Hoshi, Makiko Saita, Yoshikazu Yoneyama, Yohei Sato, Masakazu Morokuma, Joji Okazaki, Takeshi Maeda, Kenichiro Nakai, Tetsuo Ichikawa, Kan Nagao, Keiko Fujimoto, Hiroshi Murata, Tadafumi Kurogi, Kazuhiro Yoshida, Masahiro Nishimura, Yasuhiro Nishi, Mamoru Murakami, Toshio Hosoi, Taizo Hamada
BACKGROUND: Denture adhesives, characterized as medical products in 1935 by the American Dental Association, have been considered useful adjuncts for improving denture retention and stability. However, many dentists in Japan are hesitant to acknowledge denture adhesives in daily practice because of the stereotype that dentures should be inherently stable, without the aid of adhesives. The aim of this study is to verify the efficacy of denture adhesives to establish guidelines for Japanese users...
October 18, 2016: Trials
Meri Kankaanpää, Maria Raitakari, Leila Muukkonen, Siv Gustafsson, Merja Heitto, Ari Palomäki, Kimmo Suojanen, Veli-Pekka Harjola
BACKGROUND: To assess whether the use of point-of-care testing (POCT) and early assessment team (EAT) model shortens emergency department (ED) length of stay (LOS). METHODS: This prospective, observational study with comparison between three study periods was performed in three phases in a metropolitan ED with 57,000 annual visits. Data were collected from adult ambulatory patients who were discharged home. Phase 1 served as a control (n = 1559 in one month)...
October 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Anthony G Messina, Michael Wang, Marshall J Ward, Chase C Wilker, Brett B Smith, Daniel P Vezina, Nathan Leon Pace
BACKGROUND: General anaesthesia is usually associated with unconsciousness. 'Awareness' is when patients have postoperative recall of events or experiences during surgery. 'Wakefulness' is when patients become conscious during surgery, but have no postoperative recollection of the period of consciousness. OBJECTIVES: To evaluate the efficacy of two types of anaesthetic interventions in reducing clinically significant awareness:- anaesthetic drug regimens; and- intraoperative anaesthetic depth monitors...
October 18, 2016: Cochrane Database of Systematic Reviews
Kirsi Kautiainen, Heikki Ekroos, Mikko Puhakka, Helena Liira, Juha Laine, Kari Linden, Jarmo Hahl
OBJECTIVE: One quit attempt with varenicline has been found to be a cost-effective smoking cessation intervention. The purpose of this study was to analyze varenicline's cost-effectiveness in patients who relapse during or after the first treatment. A comparison was made between retreatment schema with varenicline and retreatment schema with bupropion, NRT and unaided cessation, and treatment once with varenicline in a Finnish context. METHODS: The two-quit version of BENESCO Markov model was used to follow a cohort of smokers making up to two quit attempts over a lifetime...
October 18, 2016: Journal of Medical Economics
Yuko M Komesu, Rebecca G Rogers, Robert E Sapien, Ronald M Schrader, Timothy Simmerman-Sierra, Andrew R Mayer, Loren H Ketai
INTRODUCTION AND HYPOTHESIS: We describe the rationale and methodology for a study comparing mind-body treatment and pharmacotherapy in women with urgency urinary incontinence (UUI). To explore brain associations in UUI, a subset of patients will also undergo functional magnetic resonance imaging (fMRI). We hypothesize that hypnotherapy, a mind-body intervention, will be at least as effective as pharmacotherapy in treating UUI. We also hypothesize that fMRI findings will change following treatment, with changes potentially differing between groups...
October 17, 2016: International Urogynecology Journal
J E Dietrich, D L Yee, X M Santos, J L Bercaw-Pratt, J Kurkowski, H Soni, Y J Lee-Kim, M D Shah, D Mahoney, L V Srivaths
BACKGROUND: Bleeding disorders (BD) occur in up to 50% of adolescents with heavy menstrual bleeding (HMB). This presents unique challenges to healthcare providers given the complexity of treating the condition and such complexity can result in difficulty with patients understanding basic information about their condition, limit communication with medical providers, and patient compliance. SPECIFIC AIMS: To use an electronic approach to enhance patient compliance with medications used to treat their HMB...
October 14, 2016: Journal of Pediatric and Adolescent Gynecology
Steven L Clark, Emily Hamilton, Thomas J Garite, Audra Timmins, Philip A Warrick, Samuel Smith
BACKGROUND: Despite intensive efforts directed at initial training in fetal heart rate interpretation, continuing medical education, board certification/recertification, team training and the development of specific protocols for the management of abnormal fetal heart rate patterns, the goals of consistently preventing hypoxia-induced fetal metabolic acidemia and neurologic injury remain elusive. OBJECTIVE: To validate a recently published algorithm for the management of category II fetal heart rate tracings , examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring and critically examine the limits of EFHRM in the prevention of neonatal metabolic acidemia...
October 14, 2016: American Journal of Obstetrics and Gynecology
Mariam F Eskander, Lindsay A Bliss, Ellen P McCarthy, Susanna W L de Geus, Sing Chau Ng, Deborah Nagle, James R Rodrigue, Jennifer F Tseng
BACKGROUND: Insurance impacts access to therapeutic options, yet little is known about how healthcare reform might change the pattern of surgical admissions. OBJECTIVE: We compared rates of emergent admissions and outcomes after colectomy before and after reform in Massachusetts with a nationwide control group. DESIGN: This study is a retrospective cohort analysis in a natural experiment. Prereform was defined as hospital discharge from 2002 through the second quarter of 2006 and postreform from the third quarter of 2006 through 2012...
November 2016: Diseases of the Colon and Rectum
Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
October 3, 2016: Anesthesia and Analgesia
Alfreda Holloway-Beth, Linda Forst, Julia Lippert, Sherry Brandt-Rauf, Sally Freels, Lee Friedman
BACKGROUND: Current research regarding injuries caused during interactions between police officers and civilians is conducted intermittently or on a very narrow sample frame which provides very little clinical information about the injuries suffered or the adverse outcomes. The aim of this study is to identify comorbid risk factors and describe acute outcomes of medically treated traumatic injuries occurring as a result of contact with law enforcement personnel. METHODS: For this retrospective study, patients injured as a result of contact with law enforcement personnel were identified using ICD-9 external cause of injury codes from medical record databases of patients treated in all hospitals and trauma units in Illinois between 2000 and 2009...
December 2016: Injury Epidemiology
Michelle K Haas, Kristen Dalton, Bryan C Knepper, Sarah A Stella, Lilia Cervantes, Connie S Price, William J Burman, Philip S Mehler, Timothy C Jenkins
Background.  Syndrome-specific interventions are a recommended approach to antibiotic stewardship, but additional data are needed to understand their potential impact. We implemented an intervention to improve the management of inpatient community-acquired pneumonia (CAP) and evaluated its effects on antibiotic and resource utilization. Methods.  A stakeholder group developed and implemented a clinical practice guideline and order set for inpatient, non-intensive care unit CAP recommending a short course (5 days) of a fluoroquinolone-sparing antibiotic regimen in uncomplicated cases...
October 2016: Open Forum Infectious Diseases
Akihito Tanaka, Azeem Latib, Hiroyoshi Kawamoto, Richard J Jabbour, Katsumasa Sato, Tadashi Miyazaki, Toru Naganuma, Antonio Mangieri, Matteo Pagnesi, Claudio Montalto, Alaide Chieffo, Mauro Carlino, Matteo Montorfano, Antonio Colombo
AIMS: It has become clearly apparent that in comparison to metallic stents, bioresorbable vascular scaffold (BVS) require specific implantation techniques. The aim of this study was to investigate outcomes following BVS implantation using a dedicated strategy for optimal deployment. METHODS AND RESULTS: 400 consecutive lesions (264 patients) treated with Absorb BVS were analyzed. All procedures were performed based on the following principles: 1) aggressive lesion preparation; 2) high-pressure post-dilation; and 3) a low threshold for intravascular imaging...
October 18, 2016: EuroIntervention
Tatsuya Morita, Kengo Imai, Naosuke Yokomichi, Masanori Mori, Yoshiyuki Kizawa, Satoru Tsuneto
Continuous deep sedation until death (CDS) is a type of palliative sedation therapy, and it has recently become a focus of intense debate. Marked inconsistencies in intervention procedures (i.e., what is CDS?) and unstandardized descriptions of patient backgrounds lead to difficulty in comparing the results in the literature. The primary aim of this paper was to propose a conceptual framework to perform empirical studies on CDS. We propose the definition of CDS using the intervention protocol. As there are two types of CDS proposed in world-wide literature, we recommend to prepare two types of intervention protocol for CDS: "continuous deep sedation as a result of proportional sedation" (gradual CDS), and "continuous deep sedation to rapidly induce unconsciousness" (rapid CDS)...
October 13, 2016: Journal of Pain and Symptom Management
Rui Quintas, Milda Cerniauskaite, Ambra Mara Giovannetti, Silvia Schiavolin, Alberto Raggi, Venusia Covelli, Flavio Villani, Giuseppe Didato, Francesco Deleo, Silvana Franceschetti, Simona Binelli, Laura Canafoglia, Marina Casazza, Matilde Leonardi
AIM: The aim of this observational study was to test the effectiveness of the PARADISE 24 instrument in describing the psychosocial difficulties (PSDs) reported by people with epilepsy, their relation with disability, and quality-of-life (QoL) levels and, overall, to explore a horizontal epidemiology methodology applied to a sample of patients with epilepsy. METHODS: A convenience sample of 80 adult patients with epilepsy was included in this cross-sectional study...
October 12, 2016: Epilepsy & Behavior: E&B
Karin Meissner, Annemarie Schweizer-Arau, Anna Limmer, Christine Preibisch, Roxana M Popovici, Isabel Lange, Barbara de Oriol, Florian Beissner
OBJECTIVE: To evaluate whether psychotherapy with somatosensory stimulation is effective for the treatment of pain and quality of life in patients with endometriosis-related pain. METHODS: Patients with a history of endometriosis and chronic pelvic pain were randomized to either psychotherapy with somatosensory stimulation (ie, different techniques of acupuncture point stimulation) or wait-list control for 3 months, after which all patients were treated. The primary outcome was brain connectivity assessed by functional magnetic resonance imaging...
October 6, 2016: Obstetrics and Gynecology
Karen L Barker, David Beard, Andrew Price, Francine Toye, Martin Underwood, Avril Drummond, Gary Collins, Susan Dutton, Helen Campbell, Nicola Kenealy, Jon Room, Sarah E Lamb
BACKGROUND: The number of knee arthroplasties performed each year is steadily increasing. Although the outcome is generally favourable, up to 15 % fail to achieve a satisfactory clinical outcome which may indicate that the existing model of rehabilitation after surgery may not be the most efficacious. Given the increasing number of knee arthroplasties, the relative limited physiotherapy resources available and the increasing age and frailty of patients receiving arthroplasty surgery, it is important that we concentrate our rehabilitation resources on those patients who most need help to achieve a good outcome...
October 13, 2016: Trials
Sarah D Corathers, Jessica C Kichler, Nora F Fino, Wei Lang, Jean M Lawrence, Jennifer K Raymond, Joyce P Yi-Frazier, Dana Dabelea, Angela D Liese, Sharon H Saydah, Michael Seid, Lawrence M Dolan
Objective: This study was conducted to identify factors contributing to health satisfaction outcomes among emerging adults (ages 18-25) with diabetes. Method: SEARCH for Diabetes in Youth study participants whose diabetes was prevalent in 2001 and were ≥18 years of age when they completed a 2008-2009 follow-up survey (n = 340) were included. We developed a health resilience model (HRM) to identify potentially modifiable factors (anticipatory guidance, social support, physical activity, quality of life) associated with health outcomes (satisfaction with health care, overall personal health, self-report of hemoglobin A1c [HbA1c])...
October 13, 2016: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
Bradley C Johnston, Gordon H Guyatt
Among clinical trials of adequate size, randomization balances both known and unknown prognostic factors between trial arms, thus allowing an unbiased comparison of intervention and control. To preserve this benefit, all randomly assigned participants should be followed to study termination and analyzed in the arm to which they were allocated. There are 2 potential limitations in study implementation: 1) patients are nonadherent and continue with follow-up visits, or 2) patients are lost to follow-up and their outcome data are missing...
October 12, 2016: American Journal of Clinical Nutrition
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