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S J Lain, C L Roberts, D M Bond, J Smith, J M Morris
OBJECTIVE: This study is an economic evaluation of immediate birth compared with expectant management in women with preterm prelabour rupture of the membranes near term (PPROMT). DESIGN: A cost-effectiveness analysis alongside the PPROMT randomised controlled trial. SETTING: Obstetric departments in 65 hospitals across 11 countries. POPULATION: Women with a singleton pregnancy with ruptured membranes between 34(+0) and 36(+6) weeks gestation...
October 21, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
T Meng, Z Zhong, L Meng
Lumbar spinal surgery is most commonly performed under general anaesthesia. However, spinal anaesthesia has also been used. We aimed to systematically review the comparative evidence. We only included randomised, controlled trials in this meta-analysis and calculated the risk ratio or standardised mean difference for haemodynamics, blood loss, surgical time, analgesic requirement, nausea and/or vomiting, and length of hospital stay. Eight studies with a total of 625 patients were included. These were considered to be at high risk of bias...
October 22, 2016: Anaesthesia
Benjamin Kearns, Abdullah Pandor, Matt Stevenson, Jean Hamilton, Duncan Chambers, Mark Clowes, John Graham, M Satish Kumar
As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures cabazitaxel (Jevtana(®), Sanofi, UK) to submit evidence for the clinical and cost effectiveness of cabazitaxel for treatment of patients with metastatic hormone-relapsed prostate cancer (mHRPC) previously treated with a docetaxel-containing regimen. The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG)...
October 22, 2016: PharmacoEconomics
Sofoklis Panteleimonitis, Jamil Ahmed, Meghana Ramachandra, Muhammad Farooq, Mick Harper, Amjad Parvaiz
PURPOSE: Urological and sexual dysfunction are recognised risks of rectal cancer surgery; however, there is limited evidence regarding urogenital function comparing robotic to laparoscopic techniques. The aim of this study was to assess the urogenital functional outcomes of patients undergoing laparoscopic and robotic rectal cancer surgery. METHODS: Urological and sexual functions were assessed using gender-specific validated standardised questionnaires. Questionnaires were sent a minimum of 6 months after surgery, and patients were asked to report their urogenital function pre- and post-operatively, allowing changes in urogenital function to be identified...
October 21, 2016: International Journal of Colorectal Disease
Ana S Cravo, Jim Bush, Girish Sharma, Rebecca Savioz, Claire Martin, Simon Craige, Tanvir Walele
A randomised, parallel group clinical study was performed to evaluate the safety profile of an e-vapour product (EVP; 2.0% nicotine) in smokers of conventional cigarettes (CCs) switching to use the EVP for 12 weeks. During the study, no clinically significant product-related findings were observed in terms of vital signs, electrocardiogram, lung function tests and standard clinical laboratory parameters. Adverse events (AEs) reported by EVP subjects were more frequent during the first week after switching to the EVP...
October 18, 2016: Regulatory Toxicology and Pharmacology: RTP
Andrew Bottomley, Madeline Pe, Jeff Sloan, Ethan Basch, Franck Bonnetain, Melanie Calvert, Alicyn Campbell, Charles Cleeland, Kim Cocks, Laurence Collette, Amylou C Dueck, Nancy Devlin, Hans-Henning Flechtner, Carolyn Gotay, Eva Greimel, Ingolf Griebsch, Mogens Groenvold, Jean-Francois Hamel, Madeleine King, Paul G Kluetz, Michael Koller, Daniel C Malone, Francesca Martinelli, Sandra A Mitchell, Carol M Moinpour, Jammbe Musoro, Daniel O'Connor, Kathy Oliver, Elisabeth Piault-Louis, Martine Piccart, Francisco L Pimentel, Chantal Quinten, Jaap C Reijneveld, Christoph Schürmann, Ashley Wilder Smith, Katherine M Soltys, Martin J B Taphoorn, Galina Velikova, Corneel Coens
Measures of health-related quality of life (HRQOL) and other patient-reported outcomes generate important data in cancer randomised trials to assist in assessing the risks and benefits of cancer therapies and fostering patient-centred cancer care. However, the various ways these measures are analysed and interpreted make it difficult to compare results across trials, and hinders the application of research findings to inform publications, product labelling, clinical guidelines, and health policy. To address these problems, the Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative has been established...
October 18, 2016: Lancet Oncology
Yitao Zhang, Weijie Zeng, Shiyao Cheng, Zhichong Chen, Jiaojie Xue, Qing Wang, Maode Ou, Kanglin Cheng
BACKGROUND: Pulmonary hypertension (PH) is a serious disease, and treatment is a continuing challenge. Some in vitro and in vivo studies identified that statins were effective for PH. However, results of some randomised controlled trials (RCTs) have been controversial. The objective of our study was to clarify whether statins are effective and safe for pulmonary hypertension. METHODS: We systematically searched for eligible RCTs from PubMed, EMBASE, Web of Science, and the Cochrane Library during January 2016...
September 15, 2016: Heart, Lung & Circulation
Simon Tarp, Daniel E Furst, Anna Dossing, Mikkel Østergaard, Tove Lorenzen, Michael S Hansen, Jasvinder A Singh, Ernest H Choy, Maarten Boers, Maria E Suarez-Almazor, Lars E Kristensen, Henning Bliddal, Robin Christensen
OBJECTIVES: To summarize and compare the benefits and harms of biological agents used as monotherapy for rheumatoid arthritis (RA) in order to inform decisions for patients who are intolerant to conventional DMARD therapy. METHODS: We searched MEDLINE, EMBASE, CENTRAL, and other sources for randomised trials that compared biological monotherapy with methotrexate, placebo, or other biological monotherapies. Primary outcomes were ACR50 and the number of patients who discontinued due to adverse events...
September 14, 2016: Seminars in Arthritis and Rheumatism
Jyh-Ming Liou, Yu-Jen Fang, Chieh-Chang Chen, Ming-Jong Bair, Chi-Yang Chang, Yi-Chia Lee, Mei-Jyh Chen, Chien-Chuan Chen, Cheng-Hao Tseng, Yao-Chun Hsu, Ji-Yuh Lee, Tsung-Hua Yang, Jiing-Chyuan Luo, Chun-Chao Chang, Chi-Yi Chen, Po-Yueh Chen, Chia-Tung Shun, Wen-Feng Hsu, Wen-Hao Hu, Yen-Nien Chen, Bor-Shyang Sheu, Jaw-Town Lin, Jeng-Yih Wu, Emad M El-Omar, Ming-Shiang Wu
BACKGROUND: Whether concomitant therapy is superior to bismuth quadruple therapy or 14-day triple therapy for the first-line treatment of Helicobacter pylori infection remains poorly understood. We aimed to compare the efficacy and safety of 10-day concomitant therapy, 10-day bismuth quadruple therapy, and 14-day triple therapy in the first-line treatment of H pylori. METHODS: In this multicentre, open-label, randomised trial, we recruited adult patients (aged >20 years) with H pylori infection from nine medical centres in Taiwan...
October 18, 2016: Lancet
Sarah A Moore, Ruth Da Silva, Madelaine Balaam, Lianne Brkic, Dan Jackson, Dan Jamieson, Thomas Ploetz, Helen Rodgers, Lisa Shaw, Frederike van Wijck, Christopher Price
BACKGROUND: Loss of upper limb function affects up to 85 % of acute stroke patients. Recovery of upper limb function requires regular intensive practise of specific upper limb tasks. To enhance intensity of practice interventions are being developed to encourage patients to undertake self-directed exercise practice. Most interventions do not translate well into everyday activities and stroke patients continue to find it difficult remembering integration of upper limb movements into daily activities...
October 21, 2016: Trials
Allan Riis, Cathrine Elgaard Jensen, Flemming Bro, Helle Terkildsen Maindal, Karin Dam Petersen, Mette Dahl Bendtsen, Martin Bach Jensen
BACKGROUND: Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from primary care to secondary care. The primary aim of this project was to reduce secondary care referral within 12 weeks by a multifaceted implementation strategy (MuIS). METHODS: In a cluster randomised design, 189 general practices from the North Denmark Region were invited to participate...
October 21, 2016: Implementation Science: IS
Chantal Arditi, Bernard Burnand, Isabelle Peytremann-Bridevaux
BACKGROUND: To reduce the burden of asthma, chronic disease management (CDM) programmes have been widely implemented and evaluated. Reviews including randomised controlled trials (RCTs) suggest that CDM programmes for asthma are effective. Other study designs are however often used for pragmatic reasons, but excluded from these reviews because of their design. We aimed to examine what complementary information could be retrieved from the addition of non-randomised studies to the studies included in a published Cochrane review on asthma CDM programmes, for healthcare stakeholders involved in the development, implementation, conduct or long-term sustainability of such programmes...
October 21, 2016: BMC Health Services Research
Bushra Farah Nasir, Leanne Hides, Steve Kisely, Geetha Ranmuthugala, Geoffrey C Nicholson, Emma Black, Neeraj Gill, Srinivas Kondalsamy-Chennakesavan, Maree Toombs
BACKGROUND: Suicide is a leading cause of death among Indigenous youth worldwide. The aim of this literature review was to determine the cultural appropriateness and identify evidence for the effectiveness of current gatekeeper suicide prevention training programs within the international Indigenous community. METHOD: Using a systematic strategy, relevant databases and targeted resources were searched using the following terms: 'suicide', 'gatekeeper', 'training', 'suicide prevention training', 'suicide intervention training' and 'Indigenous'...
October 21, 2016: BMC Psychiatry
Wouter van Ballegooijen, Jeroen Ruwaard, Eirini Karyotaki, David D Ebert, Johannes H Smit, Heleen Riper
BACKGROUND: Ecological momentary assessment (EMA) of mental health symptoms may influence the symptoms that it measures, i.e. assessment reactivity. In the field of depression, EMA reactivity has received little attention. We aim to investigate whether EMA of depressive symptoms induces assessment reactivity. Reactivity will be operationalised as an effect of EMA on depressive symptoms measured by a retrospective questionnaire, and, secondly, as a change in response rate and variance of the EMA ratings...
October 21, 2016: BMC Psychiatry
Naomi M Saville, Bhim P Shrestha, Sarah Style, Helen Harris-Fry, B James Beard, Aman Sengupta, Sonali Jha, Anjana Rai, Vikas Paudel, Anni-Maria Pulkki-Brannstrom, Andrew Copas, Jolene Skordis-Worrall, Bishnu Bhandari, Rishi Neupane, Joanna Morrison, Lu Gram, Raghbendra Sah, Machhindra Basnet, Jayne Harthan, Dharma S Manandhar, David Osrin, Anthony Costello
BACKGROUND: Low birth weight (LBW, < 2500 g) affects one third of newborn infants in rural south Asia and compromises child survival, infant growth, educational performance and economic prospects. We aimed to assess the impact on birth weight and weight-for-age Z-score in children aged 0-16 months of a nutrition Participatory Learning and Action behaviour change strategy (PLA) for pregnant women through women's groups, with or without unconditional transfers of food or cash to pregnant women in two districts of southern Nepal...
October 21, 2016: BMC Pregnancy and Childbirth
M Aurich, D Albrecht, P Angele, C Becher, S Fickert, J Fritz, P E Müller, P Niemeyer, M Pietschmann, G Spahn, M Walther
Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques, in particular magnetic resonance imaging (MRI), have improved the possibilities for the diagnosis of OCLs of the ankle. Moreover, these technologies aim at developing new classification systems and modern treatment strategies...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Daniel J Peart, Andy Hensby, Matthew P Shaw
The purpose of this study was to compare markers of hydration during sub-maximal exercise and subsequent time trial performance when consuming water (PW) or coconut water (CW). There was also a secondary aim to assess the palatability of CW during exercise and voluntary intake during intense exercise. 10 males (age 27.9 + 4.9 years, body mass 78.1 + 10.1kg, average max minute power 300.2 + 28.2W) completed 60-min of sub-maximal cycling followed by a 10-km time trial on two occasions. During these trials participants consumed either PW or CW in a randomised manner, drinking a 250 ml of the assigned drink between 10-15 min, 25-30 min and 40-45 min, and then drinking ad libitum from 55-min until the end of the time trial...
October 21, 2016: International Journal of Sport Nutrition and Exercise Metabolism
Marie Congiusta, Analia Veitz-Keenan
Data sourcesCochrane Oral Health group Trials Register, the Cochrane Central Register of Controlled Trials, Medline, US National Institutes of Health Trials Register, WHO-Clinical Trials Registry Platform for ongoing trials.Study selectionOnly randomised and quasi-randomised studies were pursued. No restrictions were placed on language or date of publication. The primary outcome sought was treatment success (complete healing or incomplete healing), uncertain healing and failure after one year of treatment, between one and four years and more than four years after treatment...
September 2016: Evidence-based Dentistry
Richard D Holmes
Data sourcesAMED, CINAHL, Cochrane Library, Embase, Medline, PsycINFO, PsycARTICLES, ScienceDirect, SocINDEX, ASSIA, Social Policy and Practice, HMIC (Health Management Information Consortium), The Knowledge Network, Intute, MedNar, Copac, EPPI-Centre, EThOS, OpenGrey and TRIP databases. Searches were limited to publications in the English language published after 1994.Study selectionStudies set in general practice that investigated promoting good oral health in adult or child patients were considered. Study quality was assessed using NICE public health guidance checklists...
September 2016: Evidence-based Dentistry
Eileen Hoskin, Analia Veitz-Keenan
Data sourcesCochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Clinical and the WHO International Clinical Trials Registry Platform. There were no language restrictions.Study selectionRandomised controlled trials which compared the relief of pain with systemic antibiotics and analgesics against placebo and analgesics in the preoperative phase of irreversible pulpitis. The primary interest was pain control with an antibiotic or without one in the presence of analgesics...
September 2016: Evidence-based Dentistry
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