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This is the first-time use of montelukast in post-tonsillectomy pain .

Double-blind , controlled-randomized study .

University teaching and research hospital .

A total of 60 children , aged 5 to 15 years , American Society of Anesthesiologist class I-II , scheduled for elective tonsillectomy were enrolled in this clinical trial study .

The patients were randomized into 2 groups : the montelukast group ( group M , n = 30 ) and control group ( group C , n = 30 ) .

Group M recieved an oral montelukast tablet and group C recieved placebo at 2400pm on the morning before surgery .

Post-tonsillectomy pain was evaluated with the Wong-Baker FACES Scale during the 24 hours after surgery .

Patients ' intraoperative hemodynamic parameters and intraoperative and postoperative complications were recorded .

There were statistically significant differences between group C and group M for Wong-Baker FACES pain rating scale scores ( P < .05 ) .

In the 24 hours after surgery , the total number of patients using rescue analgesics was higher in group C than in group M , and the difference was statistically significant ( P < .001 ) .

There was no significant difference in demographic parameters ( P > .05 ) .

There were no significant differences in postoperative nausea and vomiting , otalgia , trismus , fever , or halitosis between the groups ( P > .05 ) .

Preemptive montelukast can be used safely to reduce the serious pain caused by tonsillectomy in children .

Metastatic colon cancer patients are treated with the chemotherapy regimens , FOLFOX and FOLFIRI , in either order .

So far , we can not predict the response of chemotherapeutic agent , so it is necessary to find which regimen is adequate before starting chemotherapy .

Enrolled patients are randomized into either conventional treatment or planned treatment preceded by pretreatment genetic analysis .

Blood samples of patients in planned treatment group ( N = 53 ) were analyzed for the genetic polymorphism before selection of chemotherapeutic agents .

Target genes were XPD-751 , GSTP-1-105 , XRCC1-399 for oxaliplatin , UGT1A1 for irinotecan .

The response was measured by computed tomographic scan after completion of three cycles of chemotherapy .

Overall response rate was significantly higher in planned group ( 67.9 % vs. 46.3 % , P = 0.020 ) .

In FOLFOX group , response rate was significantly improved in the planned patients ( 77.1 % vs. 50 % , P = 0.018 ) .

In FOLFIRI group , the difference did n't reach statistical significance ( 50 % vs. 42.5 % , P = 0.776 ) .

We found significantly improved response rates in the chemotherapy of metastatic colon cancer by pretreatment genetic analysis , especially in FOLFOX group .

Cardiac arrest causes ischaemic brain injury .

Arterial carbon dioxide tension ( PaCO2 ) is a major determinant of cerebral blood flow .

Thus , mild hypercapnia in the 24 h following cardiac arrest may increase cerebral blood flow and attenuate such injury .

We describe the Carbon Control and Cardiac Arrest ( CCC ) trial .

The CCC trial is a pilot multicentre feasibility , safety and biological efficacy randomized controlled trial recruiting adult cardiac arrest patients admitted to the intensive care unit after return of spontaneous circulation .

At admission , using concealed allocation , participants are randomized to 24 h of either normocapnia ( PaCO2 35 to 45 mmHg ) or mild hypercapnia ( PaCO2 50 to 55 mmHg ) .

Key feasibility outcomes are recruitment rate and protocol compliance rate .

The primary biological efficacy and biological safety measures are the between-groups difference in serum neuron-specific enolase and S100b protein levels at 24 h , 48 h and 72 h. Secondary outcome measure include adverse events , in-hospital mortality , and neurological assessment at 6 months .

The trial commenced in December 2012 and , when completed , will provide clinical evidence as to whether targeting mild hypercapnia for 24 h following intensive care unit admission for cardiac arrest patients is feasible and safe and whether it results in decreased concentrations of neurological injury biomarkers compared with normocapnia .

Trial results will also be used to determine whether a phase IIb study powered for survival at 90 days is feasible and justified .

Australian New Zealand Clinical Trials Registry ACTRN12612000690853 .

For decades thiopental has been considered as the hypnotic drug of choice for intracranial surgery .

However , total intravenous anesthesia performed with thiopental is associated with delayed recovery , whereas early post-operative neurological evaluation is critical .

For this reason , target controlled infusion ( TCI ) of propofol is increasingly used for maintenance of anesthesia .

However , a thiopental TCI has never been assessed for this purpose .

We tested the hypothesis that a thiopental TCI provides an acceptable way to achieve early recovery compared to a propofol TCI during supratentorial surgery .

Eighty patients undergoing elective craniotomy for a supratentorial tumor were randomized to receive either a propofol TCI ( group P ) or a thiopental TCI ( group T ) .

Both groups received a sufentanil TCI and the bispectral index was monitored .

The primary end-point was time to tracheal extubation .

Secondary end-points were per - and post-operative hemodynamics as well as respiratory and recovery parameters .

Assessment of study end-points was performed by an intensive care specialist blinded ( like the patient ) to the received hypnotic .

Time to extubation was significantly ( P < 0.0001 ) shorter in group P ( median 149 minutes ; interquartile range 72-250 minutes ) than in group T ( median 453 minutes ; interquartile range 286-813 minutes ) .

Similarly , the recovery parameters were significantly better in group P than in group T.

There was no difference between groups in terms of patient characteristics and hemodynamic parameters .

Even with TCI and bispectral index monitoring , thiopental is associated with an inappropriate delayed recovery from supratentorial surgery compared to propofol TCI .

To investigate the effects of conservative therapy applied before arthroscopic subacromial decompression on the clinical outcome in patients with stage 2 shoulder impingement syndrome .

Sixty-eight patients having stage 2 shoulder impingement syndrome and treated with arthroscopic subacromial decompression were included in the study .

We divided these patients into 2 groups , whereby 32 ( 47 % ) patients received conservative therapy before arthroscopic subacromial decompression and 36 ( 53 % ) patients did not receive conservative therapy .

We compared both groups in terms of the the Constant , UCLA , and VAS scores for shoulder pain before and after arthroscopic subacromial decompression .

Constant , UCLA , and VAS scores were statistically significantly improved in both groups after arthroscopic subacromial decompression ( P < 0.001 ) .

Constant , UCLA , and VAS scores before arthroscopic subacromial decompression were statistically better in Group 1 than in Group 2 ( P < 0.001 ) .

No statistically significant difference was found between the groups in terms of Constant , UCLA , and VAS scores after arthroscopic subacromial decompression ( P > 0.05 ) .

Conservative therapy applied in patients with stage 2 shoulder impingement syndrome before arthroscopic subacromial decompression does not have a positive contribution on the clinical outcome after arthroscopic subacromial decompression .

Obstructive sleep apnea is associated with considerable health risks .

Although continuous positive airway pressure ( CPAP ) can mitigate these risks , effectiveness can be reduced by inadequate adherence to treatment .

We evaluated the clinical safety and effectiveness of upper-airway stimulation at 12 months for the treatment of moderate-to-severe obstructive sleep apnea .

Using a multicenter , prospective , single-group , cohort design , we surgically implanted an upper-airway stimulation device in patients with obstructive sleep apnea who had difficulty either accepting or adhering to CPAP therapy .

The primary outcome measures were the apnea-hypopnea index ( AHI ; the number of apnea or hypopnea events per hour , with a score of 15 indicating moderate-to-severe apnea ) and the oxygen desaturation index ( ODI ; the number of times per hour of sleep that the blood oxygen level drops by 4 percentage points from baseline ) .

Secondary outcome measures were the Epworth Sleepiness Scale , the Functional Outcomes of Sleep Questionnaire ( FOSQ ) , and the percentage of sleep time with the oxygen saturation less than 90 % .

Consecutive participants with a response were included in a randomized , controlled therapy-withdrawal trial .

The study included 126 participants ; 83 % were men .

The mean age was 54.5 years , and the mean body-mass index ( the weight in kilograms divided by the square of the height in meters ) was 28.4 .

The median AHI score at 12 months decreased 68 % , from 29.3 events per hour to 9.0 events per hour ( P < 0.001 ) ; the ODI score decreased 70 % , from 25.4 events per hour to 7.4 events per hour ( P < 0.001 ) .

Secondary outcome measures showed a reduction in the effects of sleep apnea and improved quality of life .

In the randomized phase , the mean AHI score did not differ significantly from the 12-month score in the nonrandomized phase among the 23 participants in the therapy-maintenance group ( 8.9 and 7.2 events per hour , respectively ) ; the AHI score was significantly higher ( indicating more severe apnea ) among the 23 participants in the therapy-withdrawal group ( 25.8 vs. 7.6 events per hour , P < 0.001 ) .

The ODI results followed a similar pattern .

The rate of procedure-related serious adverse events was less than 2 % .

In this uncontrolled cohort study , upper-airway stimulation led to significant improvements in objective and subjective measurements of the severity of obstructive sleep apnea .

( Funded by Inspire Medical Systems ; STAR ClinicalTrials.gov number , NCT01161420 . )

To identify facilitators and barriers to clinical trial implementation in Aboriginal health services .

Indepth interview study with thematic analysis .

Six Aboriginal community-controlled health services and one government-run service involved in the Kanyini Guidelines Adherence with the Polypill ( KGAP ) study , a pragmatic randomised controlled trial that aimed to improve adherence to indicated drug treatments for people at high risk of cardiovascular disease .

32 health care providers and 21 Aboriginal and Torres Strait Islander patients .

A fundamental enabler was that participants considered the research to be governed and endorsed by the local health service .

That the research was perceived to address a health priority for communities was also highly motivating for both providers and patients .

Enlisting the support of Aboriginal and Torres Strait Islander staff champions who were visible to the community as the main source of information about the trial was particularly important .

The major implementation barrier for staff was balancing their service delivery roles with adherence to often highly demanding trial-related procedures .

This was partially alleviated by the research team 's provision of onsite support and attempts to make trial processes more streamlined .

Although more intensive support was highly desired , there were usually insufficient resources to provide this .

Despite strong community and health service support , major investments in time and resources are needed to ensure successful implementation and minimal disruption to already overstretched , routine services .

Trial budgets will necessarily be inflated as a result .

Funding agencies need to consider these additional resource demands when supporting trials of a similar nature .

To compare the effect of incomplete caries removal ( ICR ) and indirect pulp capping ( IPC ) with calcium hydroxide ( CH ) or an inert material ( wax ) on color , consistency and contamination of the remaining dentin of primary molars .

This double-blind , parallel-design , randomized controlled trial included 30 children presenting one primary molar with deep caries lesion .

Children were randomly assigned after ICR to receive IPC with CH or wax .

All teeth were then restored with resin composite .

Baseline dentin color and consistency were evaluated after ICR , and dentin samples were collected for contamination analyses using scanning electron microscopy .

After 3 months , restorations were removed and the three parameters were re-evaluated .

In both groups , dentin became significantly darker after 3 months .

No cases of yellow dentin were observed after 3 months with CH compared to 33.3 % of the wax cases ( P < 0.05 ) .

A statistically significant difference over time was observed only for CH regarding consistency .

CH stimulated a dentin hardening process in a statistically higher number of cases than wax ( 86.7 % vs. 33.3 % ; P = 0.008 ) .

Contamination changed significantly over time in CH and wax without significant difference between groups .

It was concluded that CH and wax arrested the carious process of the remaining carious dentin after indirect pulp capping , but CH showed superior dentin color and consistency after 3 months .

In literature there is a general consensus that the use of the mirror improves proprioception .

During rehabilitation the mirror is an important instrument to improve stability .

In some sports , such as dancing , mirrors are widely used during training .