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https://www.readbyqxmd.com/read/28435487/randomized-trial-of-adding-parenteral-acetaminophen-to-prochlorperazine-and-diphenhydramine-to-treat-headache-in-the-emergency-department
#1
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/28420629/dexamethasone-versus-standard-treatment-for-postoperative-nausea-and-vomiting-in-gastrointestinal-surgery-randomised-controlled-trial-dreams-trial
#2
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/28415667/effect-of-radiotherapy-after-breast-conserving-surgery-in-older-patients-with-early-breast-cancer-and-breast-ductal-carcinoma-in-situ-a-meta-analysis
#3
Xuan-Zhang Huang, You Chen, Wen-Jun Chen, Xi Zhang, Cong-Cong Wu, Chao-Ying Zhang, Shuang-Shuang Sun, Jian Wu
BACKGROUND: There are no consistent agreements on whether radiotherapy after breast-conserving surgery (BCS) could provide local control and survival benefit for older patients with early breast cancer or breast ductal carcinoma in situ (DCIS). The present study aimed to evaluate the efficacy of radiotherapy after BCS in older patients with early breast cancer or DCIS. RESULTS: Radiotherapy could reduce the risk of local relapse in older patients with early breast cancer...
March 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28412467/magnitude-and-direction-of-missing-confounders-had-different-consequences-on-treatment-effect-estimation-in-propensity-score-analysis
#4
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/28406132/role-of-tolterodine-in-the-management-of-postoperative-catheter-related-bladder-discomfort-findings-in-a-nigerian-teaching-hospital
#5
K H Tijani, N O Akanmu, J O Olatosi, R W Ojewola
BACKGROUND: Patient discomfort secondary to an indwelling urethral catheter in the post operative period can be very distressing. These symptoms resemble the overactive bladder (OAB) syndrome. Muscarinic receptor blockers have been successful in the management of OAB. However, information on the use of these drugs in the management of the postoperative catheter-related bladder discomfort (CRBD) in sub-Saharan Africa is still relatively sparse. OBJECTIVE: To assess the efficacy of preoperative oral tolterodine in the management of CRBD in surgical patients in the immediate postoperative period...
April 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28403508/impact-of-transitional-care-services-for-chronically-ill-older-patients-a-systematic-evidence-review
#6
Mélanie Le Berre, Geva Maimon, Nadia Sourial, Muriel Guériton, Isabelle Vedel
Transitions in care from hospital to primary care for older patients with chronic diseases (CD) are complex and lead to increased mortality and service use. In response to these challenges, transitional care (TC) interventions are being widely implemented. They encompass education on self-management, discharge planning, structured follow-up and coordination among the different healthcare professionals. We conducted a systematic review to determine the effectiveness of interventions targeting transitions from hospital to the primary care setting for chronically ill older patients...
April 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28403075/gabapentin-can-decrease-acute-pain-and-morphine-consumption-in-spinal-surgery-patients-a-meta-analysis-of-randomized-controlled-trials
#7
Chuangang Peng, Chen Li, Ji Qu, Dankai Wu
BACKGROUND: Approximately 80% of patients who underwent spinal surgeries experience moderate to extreme postoperative pain. Gabapentin was used as an adjunct for the management of acute pain in approximately half of enhanced recovery programs. This meta-analysis aimed to illustrate the efficacy and safety of gabapentin for pain management following spinal surgery. METHODS: In January 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28402756/effectiveness-of-manual-therapy-and-stretching-for-baseball-players-with-shoulder-range-of-motion-deficits
#8
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/28400887/antibiotic-prophylaxis-in-orbital-fractures
#9
Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz
PURPOSE: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics. MAIN OUTCOME MEASURES: Development of orbital infection. RESULTS: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28400629/biostatistics-series-module-8-assessing-risk
#10
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/28398671/transcatheter-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-evidence-from-a-meta-analysis
#11
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
#12
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/28359980/number-needed-to-treat-for-stroke-thrombectomy-based-on-a-systematic-review-and-meta-analysis
#13
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
#14
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
https://www.readbyqxmd.com/read/28351408/application-of-short-message-service-to-control-blood-cholesterol-a-field-trial
#15
Saeed Sadeghian, Mohsen Shams, Zahra Alipour, Soheil Saadat, Reza Hamidian, Maryam Shahrzad
BACKGROUND: Despite recommendations, many middle-age adults neglect to check their blood cholesterol levels. Short message service (SMS, also known as texting) has been seldom studied for preventive education. We estimated how SMS can be a cost-effective method in encouraging people to check their blood cholesterol levels. METHODS: In a field trial, 3600 cell phone users (age > 30) were randomly assigned to the intervention (N: 1200) and the control groups (N: 2400)...
March 28, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28349517/oral-nonsteroidal-anti-inflammatory-drugs-for-fibromyalgia-in-adults
#16
REVIEW
Sheena Derry, Philip J Wiffen, Winfried Häuser, Martin Mücke, Thomas Rudolf Tölle, Rae F Bell, R Andrew Moore
BACKGROUND: Oral nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in the treatment of pain in fibromyalgia, despite being considered not to be effective. OBJECTIVES: To assess the analgesic efficacy, tolerability (drop-out due to adverse events), and safety (serious adverse events) of oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase for randomised controlled trials from inception to January 2017...
March 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28340011/evaluation-of-the-impact-of-physical-exercise-in-reducing-pain-in-women-undergoing-mammography-a-randomized-clinical-trial
#17
Tadeu Cardoso de Almeida, Luane Marques de Mello, Jacó Saraiva de Castro Mattos, Anderson Soares da Silva, Altacílio Aparecido Nunes
Objective. : To evaluate the efficacy of exercise prior to mammography in reducing perceived postexamination pain. Methods. : An open, randomized, and controlled clinical trial was conducted. The interventions consisted of warm-up and stretching exercises of the upper or lower limbs of women who consulted at Barretos Cancer Hospital, São Paulo State, Brazil. The women were divided into three groups based on the intervention and its location: upper limbs (group 1), lower limbs (group 2), and no intervention (group 0)...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28334435/withdrawn-radioisotopes-for-metastatic-bone-pain
#18
REVIEW
Marta Roqué I Figuls, Maria José Martinez-Zapata, Martin Scott-Brown, Pablo Alonso-Coello
BACKGROUND: This is an update of the review published in Issue 4, 2003. Bone metastasis cause severe pain as well as pathological fractures, hypercalcaemia and spinal cord compression. Treatment strategies currently available to relieve pain from bone metastases include analgesia, radiotherapy, surgery, chemotherapy, hormone therapy, radioisotopes and bisphosphonates. OBJECTIVES: To determine efficacy and safety of radioisotopes in patients with bone metastases to improve metastatic pain, decrease number of complications due to bone metastases and improve patient survival...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28331332/clinical-role-of-brexpiprazole-in-depression-and-schizophrenia
#19
REVIEW
Nishant B Parikh, Diana M Robinson, Anita H Clayton
Brexpiprazole, a serotonin-dopamine activity modulator, is the second D2 partial agonist to come to market and has been approved for the treatment of schizophrenia and as an adjunctive treatment in major depressive disorder. With less intrinsic activity than aripiprazole at the D2 receptor and higher potency at 5-HT2A, 5-HT1A, and α1B receptors, the pharmacological properties of brexpiprazole suggest a more tolerable side effect profile with regard to akathisia, extrapyramidal dysfunction, and sedation. While no head-to-head data are currently available, double-blind placebo-controlled studies show favorable results, with the number needed to treat (NNT) vs placebo of 6-15 for response in acute schizophrenia treatment and 4 for maintenance...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28318619/effect-on-the-lipid-parameters-of-an-intervention-to-reduce-weight-in-overweight-and-obese-patients
#20
M Loreto Tárraga Marcos, Josefa María Panisello Royo, Julio A Carbayo Herencia, Nuria Rosich Domenech, Josep Alins Presas, Pedro J Tárraga López
OBJECTIVE: To assess the effect on lipid parameters most associated with excess weight (triglycerides [TG], cholesterol, and high density lipoprotein [HDL-C]) of an intervention to reduce weight in overweight and obese patients. METHODS: A randomised, controlled, double blind clinical trial, with three groups, and a follow-up of 12 months. Patients included in the study were randomised into three intervention groups: Obesity motivational intervention group with previously trained nurse (G1), lower intensity consultation, non-motivational group, with digital platform support (G2), and a third group that received a recommendation to lose weight and usual follow-up (G3)...
March 16, 2017: Clínica e Investigación en Arteriosclerosis
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