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One Arm (one + arm)
Selected AbstractsAcceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized-controlled trialACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2009C. CLAUDIUS Background: Acceleromyography (AMG) is increasingly being used in neuromuscular research, including in studies establishing the potency of neuromuscular blocking and reversal agents. However, AMG is insufficiently validated for use interchangeably with the gold standard, mechanomyography (MMG) for this purpose. The aim of this study was to compare AMG and MMG for establishing dose,response relationship and potency, using rocuronium as an example. Methods: We included 40 adult patients in this randomized-controlled single-dose response study. Anaesthesia was induced and maintained with propofol and opioid. Neuromuscular blockade was induced with rocuronium 100, 150, 200 or 250 ,g/kg. Neuromuscular monitoring was performed with AMG (TOF-Watch® SX) with pre-load (Hand Adapter) at one arm and MMG (modified TOF-Watch® SX) on the other, using 0.1 Hz single twitch stimulation. Dose,response relationships were determined for both recording methods using log (dose) against probit (maximum block). The obtained slopes of the regression lines, ED50, ED95 and the maximum block were compared. Results: The ED50 and ED95 [95% confidence interval (CI)] for AMG were 185 ,g/kg (167,205 ,g/kg) and 368 ,g/kg (288,470 ,g/kg), compared with 174 ,g/kg (159,191 ,g/kg) and 338 ,g/kg (273,418 ,g/kg) for MMG. There were no statistically significant biases in maximum block, ED50, ED95 or slopes obtained with the two methods. Conclusion: Our results indicate that any possible difference between AMG and MMG is so small that it justifies AMG to be used for establishing the potency of neuromuscular blocking agents. However, the wide CIs show that we cannot rule out a 13% higher ED50 and a 26% higher ED95 for AMG. [source] Action of a silk fabric treated with AEGISTM in children with atopic dermatitis: A 3-month trialPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 4 2007D. Y. Koller Irritation of the skin of patients with atopic dermatitis by contact with rough fibres of synthetic or woollen clothes is well known. Therefore, it has been recommended that patients should wear cotton clothes. However, cotton also consists of rough fibres able to irritate the skin, whereas silk is characterized by smooth fibres without irritating potential. The aim of our study was to evaluate the clinical effect of Dermasilk®, a special silk fabric (sericin-free silk treated with AEGIS AEM5772/5 which has antibacterial properties) , in children with atopic dermatitis. A total of 22 children with mild-to-moderate atopic dermatitis were recruited for a study period of 3 months. All of them received three different tube-fabrics , Dermasilk, sericin-free silk fabric without AEGIS AEM 5772/5 and cotton, covering the cubital region. Patients were advised to wear the Dermasilk fabric all day long during the whole study period on one arm, whereas the sericin-free AEGIS-free silk tube had to be used during the first 2 wk only on the other arm followed by the use of the cotton tube for the rest of the study period. Evaluation of the local SCORAD score was carried out at the beginning of the study, after 2, 4, 8 and 12 wk. A significant reduction of the local SCORAD index of the Dermasilk covered arm was observed after 4, 8 and 12 wk in comparison with the cotton-covered arm score [median (quartile 1,quartile 3)] 6.5 (5,8) vs. 8 (7,9), p < 0.002; 6 (5.25,7.75) vs. 8 (7,9), p < 0.0001; and 6 (5,6) vs. 8 (7.25,10), p < 0.0001. The use of Dermasilk has a significant beneficial effect in atopic dermatitis because of the non-irritating properties of silk as well as the antibacterial capacity of AEGIS AEM 5772/5. [source] GRAPHICAL SENSITIVITY ANALYSIS WITH DIFFERENT METHODS OF IMPUTATION FOR A TRIAL WITH PROBABLE NON-IGNORABLE MISSING DATAAUSTRALIAN & NEW ZEALAND JOURNAL OF STATISTICS, Issue 4 2009M. Weatherall Summary Graphical sensitivity analyses have recently been recommended for clinical trials with non-ignorable missing outcome. We demonstrate an adaptation of this methodology for a continuous outcome of a trial of three cognitive-behavioural therapies for mild depression in primary care, in which one arm had unexpectedly high levels of missing data. Fixed-value and multiple imputations from a normal distribution (assuming either varying mean and fixed standard deviation, or fixed mean and varying standard deviation) were used to obtain contour plots of the contrast estimates with their,P -values superimposed, their confidence intervals, and the root mean square errors. Imputation was based either on the outcome value alone, or on change from baseline. The plots showed fixed-value imputation to be more sensitive than imputing from a normal distribution, but the normally distributed imputations were subject to sampling noise. The contours of the sensitivity plots were close to linear in appearance, with the slope approximately equal to the ratio of the proportions of subjects with missing data in each trial arm. [source] Recent concerns surrounding HRTCLINICAL ENDOCRINOLOGY, Issue 2 2003Mary Armitage Summary Millions of women are treated with hormone replacement therapy (HRT) for relief of menopausal symptoms, including vasomotor flushes and sweats for which oestrogen is uniquely and highly effective. Others may continue longer-term treatment in the hope that HRT will help to prevent chronic disease. The preservation of bone mass with continuing oestrogen therapy and reduction of subsequent risk of fracture is well established. Observational studies of the metabolic and vascular effects of oestrogens have suggested a potential benefit in reducing the risk of vascular disease, but recently published randomized controlled trials demonstrate no evidence of benefit in women with established vascular disease or in apparently healthy women. The increased risks of breast cancer and thromboembolic disease have been confirmed in these trials, with evidence of increased risk of stroke. Observational data suggest there may be a small increased risk of ovarian cancer associated with longer-term use of HRT. The premature termination of one arm of the Women's Health Initiative randomized controlled trial caused concern among patients, doctors and pharmaceutical companies. There are difficulties in extrapolating the results from trials using a specific HRT product to advise women on the wide range of other hormone products, doses, combinations and routes of administration. However, in the absence of evidence that other products are safer, the data suggest that for many women the risks associated with long-term use of HRT outweigh the benefits. There are nonhormonal strategies for the prevention and treatment of osteoporosis. HRT is not, and has never been, licensed in the UK for the prevention or treatment of vascular disease, and the data suggesting potential benefit should now be regarded as biased. The absolute incidence of an adverse event is low, and the risk in an individual woman in a single year is very small, but the risks are cumulative over time with long-term use. The risk,benefit balance of each woman needs regular reappraisal with continued use. [source] Infant carrying: The role of increased locomotory costs in early tool developmentAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2007C.M. Wall-Scheffler Abstract Among the costs of reproduction, carrying one's infant incurs one of the greatest drains on maternal energy, simply because of the added mass alone. Because of the dearth of archaeological evidence, however, how early bipeds dealt with the additional cost of having to carry infants who were less able to support their body weight against gravity is not particularly well understood. This article presents evidence on the caloric drain of carrying an infant in one's arms versus having a tool with which to sling the infant and carry her passively. The burden of carrying an infant in one's arms is on average 16% greater than having a tool to support the baby's mass and seems to have the potential to be a greater energetic burden even than lactation. In addition, carrying a baby in one's arms shortens and quickens the stride. An anthropometric trait that seems to offset some of the increased cost of carrying a baby in the arms is a wider bi-trochanteric width. Am J Phys Anthropol, 2007. © 2007 Wiley-Liss, Inc. [source] | ||||||||||