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Least Equivalent (least + equivalent)
Selected AbstractsComputer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: a randomized controlled trial of clinical efficacyADDICTION, Issue 3 2009Frances J. Kay-Lambkin ABSTRACT Aims To evaluate computer- versus therapist-delivered psychological treatment for people with comorbid depression and alcohol/cannabis use problems. Design Randomized controlled trial. Setting Community-based participants in the Hunter Region of New South Wales, Australia. Participants Ninety-seven people with comorbid major depression and alcohol/cannabis misuse. Intervention All participants received a brief intervention (BI) for depressive symptoms and substance misuse, followed by random assignment to: no further treatment (BI alone); or nine sessions of motivational interviewing and cognitive behaviour therapy (intensive MI/CBT). Participants allocated to the intensive MI/CBT condition were selected at random to receive their treatment ,live' (i.e. delivered by a psychologist) or via a computer-based program (with brief weekly input from a psychologist). Measurements Depression, alcohol/cannabis use and hazardous substance use index scores measured at baseline, and 3, 6 and 12 months post-baseline assessment. Findings (i) Depression responded better to intensive MI/CBT compared to BI alone, with ,live' treatment demonstrating a strong short-term beneficial effect which was matched by computer-based treatment at 12-month follow-up; (ii) problematic alcohol use responded well to BI alone and even better to the intensive MI/CBT intervention; (iii) intensive MI/CBT was significantly better than BI alone in reducing cannabis use and hazardous substance use, with computer-based therapy showing the largest treatment effect. Conclusions Computer-based treatment, targeting both depression and substance use simultaneously, results in at least equivalent 12-month outcomes relative to a ,live' intervention. For clinicians treating people with comorbid depression and alcohol problems, BIs addressing both issues appear to be an appropriate and efficacious treatment option. Primary care of those with comorbid depression and cannabis use problems could involve computer-based integrated interventions for depression and cannabis use, with brief regular contact with the clinician to check on progress. [source] Application of laser scanning cytometry followed by epifluorescent and differential interference contrast microscopy for the detection and enumeration of Cryptosporidium and Giardia in raw and potable watersJOURNAL OF APPLIED MICROBIOLOGY, Issue 4 2002M.-R. De Roubin Aims: The main goal of this study was to validate a new laser scanning cytometry method (ChemScanRDI) that couples immunofluorescence detection with differential interference contrast (DIC) confirmation, against manual microscopic enumeration of Giardia and Cryptosporidium (oo)cysts. This study also assessed the basic performance of the new Association Française de Normalisation (AFNOR) NF T 90-455 method for Giardia and Cryptosporidium (oo)cyst enumeration with respect to (oo)cyst yield, linearity, repeatability, influence of turbidity and detection limit in raw and potable waters. Methods and Results: The new standard method relies on cartridge (Envirocheck) filtration, immunomagnetic separation purification, immunofluorescence staining and detection followed by DIC confirmation. The recovery was 30,50% for both parasites at seeding levels from 30 to 230 (oo)cysts. The method is linear from 0 to around 400 seeded (oo)cysts and the yield does not significantly vary for turbidity levels from 10 to 40 Formazin Nephelometric Units (FNU). The results were obtained using manual microscopic enumeration of the (oo)cysts. The ChemScanRDI yielded counts that were at least equivalent to those obtained using manual microscopy for both parasites in raw and potable water concentrates, for seeding levels of 10,300 or 10,100, respectively. The purification and labelling method proposed by the supplier of theChemScanRDI (Chemunex) reached very similar recoveries to the AFNOR protocol (70,86% in both cases). Conclusions: Laser scanning cytometry can be used as a more standardized alternative to manual enumeration as part of the new AFNOR standard method. Significance and Impact of the Study: By using laser scanning cytometry instead of manual microscopy, laboratories could circumvent the limitations of manual microscopy, namely: low sample throughput, operator subjectivity and operator fatigue. The study further supports the drive to incorporate laser scanning cytometry in the standard methods for Giardia and Cryptosporidium enumeration. [source] A randomized, prospective, pharmacoeconomic trial of neoral 2-hour postdose concentration monitoring versus tacrolimus trough concentration monitoring in de novo liver transplant recipientsLIVER TRANSPLANTATION, Issue 2 2008Surendra Shenoy Two-hour postdose cyclosporine (C2) monitoring is becoming an accepted method of therapeutic drug monitoring, although it is not known whether C2 monitoring is superior to tacrolimus (FK)-based immunosuppression. The purpose of this trial was to compare the safety, efficacy, and pharmacoeconomics of cyclosporine A (CsA) monitored by C2 levels versus FK monitored by trough levels in de novo liver transplant recipients. After informed consent, 60 de novo liver transplant recipients were randomized in a 1:1 fashion to receive either FK (trough, 6-10 ng/mL) or CsA (C2, 600-1200 ng/mL) and corticosteroids. The 2 groups were similar for gender, race, indication for liver disease, and age. At 1 year, patient survival was similar (93% for FK versus 90% for C2). One patient in the FK arm was retransplanted because of recurrent hepatitis C virus (HCV). Early acute rejection occurred in 27% of FK-treated patients and 23% of CsA-treated recipients [P = not significant (NS)]. Recurrent HCV occurred in 21% of FK-treated patients and 61% of CsA-treated patient (P = 0.04). The incidence of other infections, new onset diabetes mellitus, requirement for antihypertensives, and requirement for cholesterol medications were similar between the groups. Annual calcineurin inhibitor costs were lower in the C2 arm ($5432 ± 2091 for C2 versus $8291 ± 3948 for FK, P = 0.001). Annual pretransplant drug costs ($2292 ± 2331 for C2 versus $2831 ± 2358 for FK, P = NS) and 1-year posttransplant drug costs ($17,214 ± 16,600 for C2 versus $15,151 ± 11,699 for FK, P = NS) were similar. In conclusion, immunosuppression with CsA, monitored by C2 levels, is safe, effective, and economical in liver transplant recipients and provides immunosuppression at least equivalent to that of FK. Liver Transpl 14:173,180, 2008. © 2008 AASLD. [source] Salvage robotic-assisted radical prostatectomy: initial results and early report of outcomesBJU INTERNATIONAL, Issue 7 2009Ronald S. Boris OBJECTIVE To evaluate the initial results of salvage robotic-assisted radical prostatectomy (SRARP) after recurrence following primary radiotherapy (RT) for localized prostate cancer. PATIENTS AND METHODS Between December 2002 and January 2008, 11 patients had SRARP with pelvic lymph node dissection by one surgeon from one institution. Six patients had brachytherapy, three had external beam RT (EBRT), one intensity-modulated RT, and one received brachytherapy with an EBRT boost. All patients had prostate cancer on biopsy after RT, with negative computed tomography and bone scan. The mean (range) follow-up was 20.5 (1,77) months. RESULTS The mean interval from RT to SRARP was 53.2 months; the mean preoperative prostate-specific antigen (PSA) level was 5.2 ng/mL, the operative duration 183 min and the estimated blood loss 113 mL. One patient had prolonged lymphatic drainage, one had an anastomotic leak, and one had an anastomotic stricture requiring direct vision internal urethrotomy at 3 months. The mean duration of catheterization was 10.4 days and the hospital stay 1.4 days. Three patients had a biochemical recurrence, at 1, 2 and 43 months. In one of two patients with node-positive carcinoma of the prostate the PSA level failed to reach a nadir of zero after surgery. In patients with a minimum follow-up of 2 months, eight of 10 are continent (defined as zero to one pad per day) and two have erections adequate for intercourse with the use of phosphodiesterase-5 inhibitors. CONCLUSION SRARP after RT-resistant disease recurrence is feasible with minimal perioperative morbidity. Early functional outcomes appear to be at least equivalent with historical salvage RP series. Robotic extended pelvic lymph node dissection is safe and can improve the accuracy of surgical staging. A longer follow-up is necessary to better assess the functional and oncological outcomes. [source] Digital X-ray radiogrammetry: a new appendicular bone densitometric method with high precisionCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 5 2000J. T. Jørgensen The precision of any given method for measurement of bone mineral density (BMD) is important in relation to the interpretation of repeated measurements over time, e.g. to monitor the course of suspected osteoporosis or follow the effect of therapy. In the present study a new bone densitometer using the digital X-ray radiogrammetry (DXR) method (Pronosco X-posure SystemÔ) is investigated with respect to its short-term precision. The study was carried out on two groups of females, one consisting of 20 women between the ages of 30 and 40, and the other of 20 post-menopausal women above the age of 64. The mean age of the premenopausal women was 35·2 years and the mean DXR BMD was 0·578 g cm,2. The mean age of the post-menopausal women was 68·2 years and the mean DXR BMD was 0·489 g cm,2. The short-term precision of the two groups was evaluated using the coefficient of variation (CV%) and corresponding 90% confidence intervals. The coefficient of variation in the premenopausal group was 0·68% with a 90% confidence interval of 0·57%,0·83%. The coefficient of variation in the postmenopausal group was 0·61% with a 90% confidence interval of 0·52,0·75%. It can be concluded from the present study that the short-term in vivo precision error of the DXR method is low in both pre- and post-menopausal women. When the results of the study are compared to data reported in the literature, the performance of the DXR method seems to be at least equivalent with peripheral DXA. [source] | ||||||||||