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Controlled Study (controlled + study)
Kinds of Controlled Study Selected AbstractsAdd-on Phenytoin Fails to Prevent Early Seizures after Surgery for Supratentorial Brain Tumors: A Randomized Controlled StudyEPILEPSIA, Issue 2 2002Antonio De Santis Summary: ,Purpose: To determine the potential effectiveness of phenytoin (PHT) in preventing early postoperative seizures in patients undergoing craniotomy for supratentorial brain tumors. Methods: Two hundred patients requiring elective craniotomy for supratentorial brain tumors were randomized to two groups of equal size, with a prospective, open-label, controlled design. One group received PHT (18 mg/kg as an intravenous intraoperative load, followed by additional daily doses aimed at maintaining serum PHT concentrations within the 10- to 20-æg/ml range) for 7 consecutive days. In the other group, PHT was not administered. More than 90% of patients in both groups continued to take preexisting anticonvulsant medication (AEDs) with carbamazepine or phenobarbital throughout the study. The primary efficacy end point was the number of patients remaining free from seizures during the 7-day period after the operation. Results: Of 100 patients allocated to PHT, 13 experienced seizures during the 7-day observation period, compared with 11 of 100 patients in the placebo group (p > 0.05). Most seizures occurred in the first day after surgery in both groups. There were no differences between groups in the proportion of patients experiencing more than one seizure, but there was a trend for generalized seizures to be more common in PHT-treated patients than in controls (11 vs. five patients, respectively). Status epilepticus occurred in one patient in the PHT group and in two patients in the control group. Of the 13 PHT-treated seizure patients, 11 had serum PHT concentrations within the target range, and only two had concentrations below range on the days their seizures occurred. Conclusions: PHT, given at dosages producing serum concentrations within the target range, failed to prevent early postoperative seizures in patients treated with concomitant AEDs. Prophylactic administration of PHT cannot be recommended in these patients. [source] Effect of 8-Month Vertical Whole Body Vibration on Bone, Muscle Performance, and Body Balance: A Randomized Controlled Study,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2003Saila Torvinen MD Abstract Recent animal studies have given evidence that vibration loading may be an efficient and safe way to improve mass and mechanical competence of bone, thus providing great potential for preventing and treating osteoporosis. Randomized controlled trials on the safety and efficacy of the vibration on human skeleton are, however, lacking. This randomized controlled intervention trial was designed to assess the effects of an 8-month whole body vibration intervention on bone, muscular performance, and body balance in young and healthy adults. Fifty-six volunteers (21 men and 35 women; age, 19-38 years) were randomly assigned to the vibration group or control group. The vibration intervention consisted of an 8-month whole body vibration (4 min/day, 3-5 times per week). During the 4-minute vibration program, the platform oscillated in an ascending order from 25 to 45 Hz, corresponding to estimated maximum vertical accelerations from 2g to 8g. Mass, structure, and estimated strength of bone at the distal tibia and tibial shaft were assessed by peripheral quantitative computed tomography (pQCT) at baseline and at 8 months. Bone mineral content was measured at the lumbar spine, femoral neck, trochanter, calcaneus, and distal radius using DXA at baseline and after the 8-month intervention. Serum markers of bone turnover were determined at baseline and 3, 6, and 8 months. Five performance tests (vertical jump, isometric extension strength of the lower extremities, grip strength, shuttle run, and postural sway) were performed at baseline and after the 8-month intervention. The 8-month vibration intervention succeeded well and was safe to perform but had no effect on mass, structure, or estimated strength of bone at any skeletal site. Serum markers of bone turnover did not change during the vibration intervention. However, at 8 months, a 7.8% net benefit in the vertical jump height was observed in the vibration group (95% CI, 2.8-13.1%; p = 0.003). On the other performance and balance tests, the vibration intervention had no effect. In conclusion, the studied whole body vibration program had no effect on bones of young, healthy adults, but instead, increased vertical jump height. Future human studies are needed before clinical recommendations for vibration exercise. [source] Drinking to Cope in Socially Anxious Individuals: A Controlled StudyALCOHOLISM, Issue 12 2003Suzanne E. Thomas Background: Several hypotheses exist to account for the higher than normal rate of alcoholism in individuals with high trait anxiety (or anxiety disorders). Most of these suggest that the practice of drinking alcohol to reduce anxiety leads to an increased risk of alcoholism in vulnerable individuals. The first assumption of the hypothesis is that anxious individuals use alcohol to cope with their anxiety. Few studies have examined this issue systematically, and none have used a nonanxious matched control group. Methods: Twenty-three individuals with high social anxiety and 23 nonsocially anxious matched controls were included in the study. Groups were similar on demographic variables and alcohol use. All participants were queried regarding the use of alcohol to cope, the practice of avoiding social situations if alcohol was not available, and the degree of relief attained by alcohol. Participants also were asked about using alcohol in 11 specific situations. Results: The socially anxious group was significantly more likely than controls to report using alcohol to feel more comfortable in social situations and to avoid social situations if alcohol was unavailable. They also reported a greater degree of relief of anxiety from alcohol. Exploratory analyses revealed that socially anxious individuals reported using alcohol more to cope with social interactions than with social performance situations. Conclusions: Individuals high in social anxiety deliberately drink alcohol to cope with their social fears. They report that alcohol is moderately effective at reducing their anxiety, which is seemingly sufficient to allow them to endure social situations. The data support the first assumption of the self-medication hypothesis,that alcohol is used to reduce social discomfort in socially anxious individuals; however, the study was not designed to address the veracity of the self-medication hypothesis as a whole. Results can help guide future studies that examine the relationship between social anxiety and alcohol. [source] A Prospective Controlled Study in the Prevalence of Posttraumatic Headache Following Mild Traumatic Brain InjuryPAIN MEDICINE, Issue 8 2008S. Faux FAFRM (RACP) FFPMANZCA ABSTRACT Objective., To establish the prevalence of post traumatic headache, persisting at 3 months following minor traumatic brain injury. Design., A prospective controlled study of patients admitted with a diagnosis of mild traumatic brain injury and matched orthopedic controls over 12 months during 2004. Setting., A level two inner city Emergency Department in Sydney, Australia. Patients., One hundred eligible sequential admissions with mild traumatic brain injury as defined by American Congress of Rehabilitation Medicine, 1993, and 100 matched minor injury controls with nondeceleration injuries. Interventions., Subjects were part of a study on prediction of postconcussive syndrome and had neuropsychological tests, balance test and pain recordings taken at the time of injury, at 1 month and at 3 months post injury. Outcome Measures., Main measures were the reporting of headache "worse than prior to the injury" and concordant with the definition of Posttraumatic Headache according to International Headache Society Classification of Headache Disorders 2003. Results., 15.34% of those with minor head injury continued to complain of perisistant posttraumatic headache at 3 months compared to 2.2% of the minor injury controls. Conclusions., To the authors' knowledge this is the first controlled prospective study in the prevalence of posttraumatic headache following mild traumatic brain injury. [source] Use of in vitro release of interferon-, in the diagnosis of contact allergy to potassium dichromate , a controlled studyCONTACT DERMATITIS, Issue 4 2003A. Trattner The use of in vitro release of interferon-, (IFN-,) in the diagnosis of contact allergy to potassium dichromate was studied in 20 patients who had positive patch tests to chromate and in 30 control subjects (10 patients with contact dermatitis, allergic to other allergens, 10 patients with other dermatologic diseases and 10 healthy subjects). The release of IFN-, in the supernatants of the peripheral blood lymphocytes was significantly higher in the patients with proven allergy to chromate (P = 0·001). Further studies are needed to determine if IFN-, release may serve as an additional diagnostic tool in contact dermatitis. [source] DOES CRIME JUST MOVE AROUND THE CORNER?CRIMINOLOGY, Issue 3 2006A CONTROLLED STUDY OF SPATIAL DISPLACEMENT AND DIFFUSION OF CRIME CONTROL BENEFITS Recent studies point to the potential theoretical and practical benefits of focusing police resources on crime hot spots. However, many scholars have noted that such approaches risk displacing crime or disorder to other places where programs are not in place. Although much attention has been paid to the idea of displacement, methodological problems associated with measuring it have often been overlooked. We try to fill these gaps in measurement and understanding of displacement and the related phenomenon of diffusion of crime control benefits. Our main focus is on immediate spatial displacement or diffusion of crime to areas near the targeted sites of an intervention. Do focused crime prevention efforts at places simply result in a movement of offenders to areas nearby targeted sites,"do they simply move crime around the corner"? Or, conversely, will a crime prevention effort focusing on specific places lead to improvement in areas nearby,what has come to be termed a diffusion of crime control benefits? Our data are drawn from a controlled study of displacement and diffusion in Jersey City, New Jersey. Two sites with substantial street-level crime and disorder were targeted and carefully monitored during an experimental period. Two neighboring areas were selected as "catchment areas" from which to assess immediate spatial displacement or diffusion. Intensive police interventions were applied to each target site but not to the catchment areas. More than 6,000 20-minute social observations were conducted in the target and catchment areas. They were supplemented by interviews and ethnographic field observations. Our findings indicate that, at least for crime markets involving drugs and prostitution, crime does not simply move around the corner. Indeed, this study supports the position that the most likely outcome of such focused crime prevention efforts is a diffusion of crime control benefits to nearby areas. [source] A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010G.-J. Hendriks Hendriks G-J, Keijsers GPJ, Kampman M, Oude Voshaar RC, Verbraak MJPM, Broekman TG, Hoogduin CAL. A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder. Objective:, To examine the effectiveness of paroxetine and cognitive-behavioural therapy (CBT) in elderly patients suffering from panic disorder with or without agoraphobia (PD(A)). Method:, Forty-nine patients aged 60+ years with confirmed PD(A) were randomly assigned to 40 mg paroxetine, individual CBT, or to a 14-week waiting list. Outcomes, with avoidance behaviour and agoraphobic cognitions being the primary measures, were assessed at baseline and at weeks 8, 14 (conclusion CBT/waiting list), and at week 26 (treated patients only) and analysed using mixed models. Results:, All outcome measures showed that the patients having received CBT and those treated with paroxetine had significantly better improvement compared with those in the waiting-list condition. With one patient (1/20, 5%) in the CBT and three (3/14, 17.6%) in the paroxetine condition dropping out, attrition rates were low. Conclusion:, Patients with late-life panic disorder respond well to both paroxetine and CBT. Although promising, the outcomes warrant replication in larger study groups. [source] The effect of spironolactone, cilazapril and their combination on albuminuria in patients with hypertension and diabetic nephropathy is independent of blood pressure reduction: a randomized controlled studyDIABETIC MEDICINE, Issue 5 2004R. Rachmani Abstract Objective The effect of spironolactone, cilazapril and their combination on albuminuria was examined in a randomized prospective study in female patients with diabetes and hypertension. Patients and methods Sixty female diabetic patients aged 45,70 years with blood pressure (BP) 140,180/90,110 mmHg, serum creatinine (sCr) , 160 µmol/l, HbA1c , 10%, and albuminuria were treated by atenolol 12.5,75 mg/d and hydrochlorothiazide 6.25,25 mg/d. Titration-to-target helped to reach BP values , 135/85 mmHg in 46 patients after 12 weeks. These patients were randomized to spironolactone 100 mg/d or cilazapril 5 mg/d for 24 weeks. Then both groups received spironolactone 50 mg/d and cilazapril 2.5 mg/d for 24 weeks. BP was stabilized by tapering the dose of the initial agents. Urinary albumin/creatinine ratio (ACR), BP, K+. sCr and HbA1c were assessed at baseline and at weeks 12, 16, 36 and 60. Results The average BP at week 12 was 128 ± 4/81 ± 3 mmHg and remained constant, in both groups, throughout the study. ACR declined on spironolactone from a median value (range) of 452 (124,1571) to 216 (64,875) mg/g (P = 0.001), and on cilazapril to 302 (90,975) mg/g (P = 0.001). The difference between spironolactone and cilazapril was significant (P = 0.002). Combined treatment resulted in a further modest decline in ACR. Serum creatinine was unaltered by spironolactone and rose slightly (121 to 126 µmol/l, P = 0.02) on cilazapril. Conclusion At the doses tested, spironolactone was superior to cilazapril in reducing albuminuria. Combined administration was more effective than either drug alone. These effects were independent of BP values. Hyperkalaemia was the main side-effect. [source] Gaining time: early treatment of severe pediatric malaria in TanzaniaDRUG DEVELOPMENT RESEARCH, Issue 1 2010M.F. Gomes Abstract Early effective treatment prevents death or disability from malaria. In malaria-endemic rural areas, pediatric patients who cannot take drugs orally and require injectable treatment have to be transported to the nearest facility that can give injectable malaria drugs. If time to reach the hospital is long, pre-referral treatment and effective referral can play a major positive role. We compare the clinical course of illness and time taken to reach hospital in patients from Study 13, a randomized controlled study of pre-referral rectal artesunate in which rapid referral was emphasized, with a comparator group of pediatric patients admitted at the same hospital in Tanzania whose parents' actions prior to admission at the hospital reflected routine behavior. The key difference was that parents of sick children from the intervention study rapidly transferred their children to the hospital following the advice they were given. Time gained by the referral study was 48,h and this difference was reflected in less severe symptoms at admission. Efforts to improve referral advice in the community can be a powerful complement to other malaria case management strategies. Drug Dev Res 71: 92,98, 2010. © 2009 Wiley-Liss, Inc. [source] High Risk of Reading Disability and Speech Sound Disorder in Rolandic Epilepsy Families: Case,Control StudyEPILEPSIA, Issue 12 2007Tara Clarke Summary Purpose: Associations between rolandic epilepsy (RE) with reading disability (RD) and speech sound disorder (SSD) have not been tested in a controlled study. We conducted a case,control study to determine whether (1) RD and SSD odds are higher in RE probands than controls and (2) an RE proband predicts a family member with RD or SSD, hence suggesting a shared genetic etiology for RE, RD, and SSD. Methods: Unmatched case,control study with 55 stringently defined RE cases, 150 controls in the same age range lacking a primary brain disorder diagnosis, and their siblings and parents. Odds ratios (OR) were calculated by multiple logistic regression, adjusted for sex and age, and for relatives, also adjusted for comorbidity of RD and SSD in the proband. Results: RD was strongly associated with RE after adjustment for sex and age: OR 5.78 (95% CI: 2.86,11.69). An RE proband predicts RD in family members: OR 2.84 (95% CI: 1.38,5.84), but not independently of the RE proband's RD status: OR 1.30 (95% CI: 0.55,12.79). SSD was also comorbid with RE: adjusted OR 2.47 (95%CI: 1.22,4.97). An RE proband predicts SSD in relatives, even after controlling for sex, age and proband SSD comorbidity: OR 4.44 (95% CI: 1.93,10.22). Conclusions: RE is strongly comorbid with RD and SSD. Both RD and SSD are likely to be genetically influenced and may contribute to the complex genetic etiology of the RE syndrome. Siblings of RE patients are at high risk of RD and SSD and both RE patients and their younger siblings should be screened early. [source] Iron Status: A Possible Risk Factor for the First Febrile SeizureEPILEPSIA, Issue 7 2002Azhar S. Daoud Summary: ,Purpose: We conducted a controlled study to investigate the relation of iron status and first febrile seizure (FFS). Methods: Measures of iron sufficiency including hemoglobin concentration (HB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and plasma ferritin (PF) were prospectively measured in 75 children with FFS and compared with 75 controls matched for age and sex with febrile illnesses without convulsions. Results: Mean ferritin level was significantly lower in cases with FFS (29.5 ± 21.3 ,g/L) than in controls (53.3 ± 37.6 ,g/L) with p = 0.0001. The proportion of subjects with a PF level ,30 ,g/L was significantly higher among children with FFS (49 of 75 vs. 24 of 75) than in controls (p = 0.000). Mean levels of HB, MCV, and MCH also were lower among FFS cases, but differences failed to attain statistical significance. A higher proportion of cases with FFS had an HB <110 g/L, MCV <72 fL, and MCH <24 pg than did the controls, but the differences were not statistically significant. There were no statistically significant differences between the cases and the controls in the mean peak temperature on admission, types of underlying illness, or family history of epilepsy and of febrile convulsion. Conclusions: PF level was significantly lower in children with FFS than in the reference group, suggesting a possible role for iron insufficiency in FFS. [source] Primary prevention of eating disorders: characteristics of effective programmes and how to bring them to broader disseminationEUROPEAN EATING DISORDERS REVIEW, Issue 3 2008Uwe Berger Abstract Objective Based upon the observation of advances in the primary prevention of eating disorders (ED), it is summarized that school-based programmes, focusing on risk factors for females with interactive elements, dissonance induction and booster sessions yield significant effects even under strong methodological conditions. However, beyond the presented research findings it remains often unclear, if and how programmes can be brought to a broader dissemination within a community, region or country. Method Introducing the programme PriMa (German school-based programme for the primary prevention of anorexia nervosa (AN) for girls up to the age of 12), we describe the process of programme evaluation (including 1.006 girls from 42 schools in Thuringia, Germany, who participated in a controlled study using a pre-post-design and a 3 months follow-up), programme implementation and development of follow-up programmes, including an intervention for boys and flanking secondary preventive actions (such as a telephone hotline). Results Using standardized measures, the girls in the intervention group of PriMa reported significant improvements in body self esteem, figure dissatisfaction, knowledge and eating attitudes. The teachers, who conducted the programme, felt well qualified and were evaluated significantly positive by their students. Based upon the PriMa evaluation, we established a comprehensive health promotion programme at 60 Thuringian schools within the last 3 years, which could function as a model of a fruitful cooperation between a governmental institution (Thuringian Ministry of Culture) and a research institution (University Hospital Jena). Conclusions Existing programmes have the potential for effective prevention of ED. To confirm these effects under ,real world conditions' within a given community will still be a great challenge that often requires methodological and organizational concessions and compromises. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source] The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2010G. KAPUR frcr KAPUR G., WINDSOR P.M. & Mc COWAN C. (2010) European Journal of Cancer Care19, 643,647 The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancer We retrospectively analysed acute radiation toxicity data for patients who had participated in a randomised controlled study in our centre in order to assess the impact of aerobic exercise on acute rectal and bladder morbidity during treatment. Data from 65 of 66 patients were analysed: 33 allocated into a control group (standard advice) and 33 into an exercise group (aerobic walking for 30 min at least three times per week) during 4 weeks of external beam radiotherapy; one patient in the exercise group withdrew after randomisation before starting radiotherapy. There was a trend towards less severe acute rectal toxicity in the exercise group with a statistically significant difference in mean toxicity scores over the 4 weeks of radiotherapy (P = 0.004), with no significant difference in bladder toxicity scores between the two groups (P = 0.123). The lack of an association for severity of bladder toxicity could be attributed to the confounding effect of lower urinary tract symptoms from their prostate cancer. Keeping active and being asked to adhere to a well-defined exercise schedule appears to reduce the severity of rectal toxicity during radiotherapy to the prostate. [source] Effects of peer-assisted training during the neurology clerkship: a randomized controlled studyEUROPEAN JOURNAL OF NEUROLOGY, Issue 12 2008J. G. Heckmann Objective:, To determine the efficacy of peer-assisted clinical skills training for students during their neurology clerkship. Methods:, Students (n = 122) were randomized to get clinical skills training from either student (peer) instructors (experimental group) or from experienced clinical staff (control group). The remaining schedule during the clerkship did not differ between both groups. Primary endpoint was students' practical skills and knowledge tested at the end of the course by a written test and objective structured clinical examination (OSCE). Secondary endpoints were evaluation of the practical training and self-estimated gain in theoretical and practical competence. Results:, In the written test, the peer-trained group (n = 66) scored 69.5 ± 10.2 (95% CI 67,72) points of 100 and the postgraduates-trained group (n = 56) 66.7 ± 11.4 (95% CI 63.6,69.8) (P = 0.15). In the OSCE the peer-trained group scored 93.7 ± 6.3 (95% CI 92.1 to 95.2) points of 100 and the postgraduates-trained group 92 ± 5.1 (95% CI 90.6 to 93.4) (P = 0.11). In the evaluation and self-assessment items, there was no significant difference between the two groups except for the postgraduates' higher competence (P = 0.004). Conclusion:, Peer-trained students pass written exam and OSCE as efficient as postgraduates-trained students. Self-assessed learning success is equally rated in both groups. [source] TENS and optokinetic stimulation in neglect therapy after cerebrovascular accident: a randomized controlled studyEUROPEAN JOURNAL OF NEUROLOGY, Issue 9 2008A. Schröder Background:, In a randomized controlled type Ib study, the effectiveness of three different forms of therapy for the treatment of visual neglect was assessed by comparing therapy outcomes in three groups of patients after cerebrovascular accidents. Methods:, A control group received only standard exploration training, whilst the second and third group received exploration training combined with either contralateral transcutaneous electrical nerve stimulation (TENS) or optokinetic stimulation (OKS) respectively. Results:, It was found that exploration training alone resulted in no improvement on both standard neglect tests (NTs) and everyday-relevant measures of reading and writing performance. In contrast, the groups receiving TENS or OKS showed significant improvements in both sets of measures with the difference that for the TENS group the improvement in NT scores at the end of therapy had disappeared 1-week later. However, both treatments resulted in significant improvements in reading and writing which were still present upon retesting 1-week after the end of therapy. Conclusion:, Both methods can be recommended for neglect therapy and are superior to exploration therapy alone. [source] Capsicum cream in soft tissue rheumatic musculoskeletal diseases , a randomised controlled studyFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 4 2003SUM Schmidt [source] Marigold therapy for bunion , a randomised controlled studyFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 1 2001M T Khan [source] Peripheral Neurostimulation for the Treatment of Chronic, Disabling Transformed MigraineHEADACHE, Issue 4 2003Charles A. Popeney DO Background.,Up to 5% of the general population suffers from transformed migraine. This study analyzes clinical responses of transformed migraine to cervical peripheral nerve stimulation. Methods.,Headache frequency, severity, and disability (Migraine Disability Assessment [MIDAS] scores) were independently measured in an uncontrolled consecutive case series of 25 patients with transformed migraine implanted with C1 through C3 peripheral nerve stimulation. All patients met International Headache Society (IHS) criteria for episodic migraine, as well as suggested criteria for transformed migraine, and had been refractory to conventional treatment for at least 6 months. Responses to C1 through C3 peripheral nerve stimulation were recorded. Results.,Prior to stimulation, all patients experienced severe disability (grade IV on the MIDAS) with 75.56 headache days (average severity, 9.32; average MIDAS score, 121) over a 3-month period. Following stimulation, 15 patients reported little or no disability (grade I), 1 reported mild disability (grade II), 4 reported moderate disability (grade III), and 5 continued with severe disability (grade IV), with 37.45 headache days (average severity, 5.72; average MIDAS score, 15). The average improvement in the MIDAS score was 88.7%, with all patients reporting their headaches well controlled after stimulation. Conclusions.,These results raise the possibility that C1 through C3 peripheral nerve stimulation can help improve transformed migraine symptoms and disability. A controlled study is required to confirm these results. [source] Methodology and Transport Medium for Collection of Helicobacter pylori on a String Test in Remote LocationsHELICOBACTER, Issue 6 2005Helen M. Windsor ABSTRACT Background.,Helicobacter pylori can be isolated from patients using the string test but contaminating oral and nasopharyngeal microflora need to be suppressed by rapid plating out onto selective culture media. Recently, use of this diagnostic method was enhanced by using a novel transport medium to collect specimens from subjects in a remote Australian clinic over 1300 km from the laboratory. Methods., Retrieved string tests were transported to the laboratory in chilled polystyrene boxes in 5 ml screw-cap bottles with 3 ml of a brain heart infusion broth plus antibiotics. These were 20 g/ml vancomycin, 10 g/ml trimethoprim, 10 g/ml cefsulodin, and 10 g/ml amphotericin B. A comparison was made between subjects who gargled with a chlorhexidine mouthwash before swallowing the string test and those who did not. Results., Forty-five urea breath test-positive subjects were tested and H. pylori was isolated from 34 of them. Successful culture was achieved from string tests that were in transit for up to 29 hours and where the maximum temperature in the transport box was 14 °C. The additional use of a mouthwash had a marked effect on the isolation rate. H. pylori was cultured from 75% of subjects who gargled but only from 39% who did not. Conclusions., This methodology and transport medium can broaden the use of the string test to more remote geographic areas where endoscopy is not feasible so that H. pylori isolates may still be obtained for diagnostic and epidemiologic studies. The value of this promising methodology of collection and transport should be assessed in a controlled study. [source] Fluvoxamine in obsessive-compulsive disorder: similar efficacy but superior tolerability in comparison with clomipramineHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2001Emanuela Mundo Abstract Some meta-analyses have suggested that the selective serotonin reuptake inhibitors (SSRIs) are less effective than clomipramine in the treatment of obsessive-compulsive disorder (OCD). The aim of this double-blind, randomised, multicentre study was to directly compare the efficacy and safety of fluvoxamine and clomipramine in patients with OCD. A total of 227 patients were randomised to flexible doses of fluvoxamine or clomipramine (both 150,300,mg/day) for 10 weeks. Fluvoxamine and clomipramine were both clinically effective and there were no statistically significant differences between the two treatment groups, at any visit, on the National Institute of Mental Health Obsessive-Compulsive global rating scale, the Yale-Brown Obsessive-Compulsive scale (total score and obsession and compulsion subscores), the Clinical Global Impression severity of illness and global improvement subscales, the Clinical Anxiety Scale and the 17-item Hamilton Depression Rating Scale. However, there were differences in safety between the two treatments. Compared with fluvoxamine-treated patients, those treated with clomipramine had more anticholinergic side effects (dry mouth, constipation and tremor) and premature withdrawals due to adverse events (18 versus 9). The results from this controlled study indicate that fluvoxamine is as effective as clomipramine in the treatment of OCD but has a better tolerability profile. Copyright © 2001 John Wiley & Sons, Ltd. [source] High levels of anxiety and depression have a negative effect on quality of life of women with chronic pelvic painINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2009A. P. M. S. Romão Summary Background:, Chronic pelvic pain (CPP) is a common and complex disease whose cause is often clinically inexplicable, with consequent difficulty in diagnosis and treatment. Patients with CPP have high levels of anxiety and depression, with a consequent impairment of their quality of life. Aims:, The objective of this study was to determine the prevalence of anxiety and depression and their impact on the quality of life of women with CPP. Materials and methods:, A cross-sectional controlled study was conducted on 52 patients with CPP and 54 women without pain. Depression and anxiety were evaluated by the Hospital Anxiety and Depression Scale, and quality of life was evaluated by the World Health Organization Quality of life Whoqol-bref questionnaire. Data were analysed statistically by the Mann-Whitney U -test, the Fisher exact test, chi-square test and Spearman correlation test. Results:, The prevalence of anxiety was 73% and 37% in the CPP and control groups, respectively, and the prevalence of depression was 40% and 30% respectively. Significant differences between groups were observed in the physical, psychological and social domains. Patients with higher anxiety and depression scores present lower quality of life scores. Discussion:, The fact that DPC is a syndromic complex, many patients enter a chronic cycle of search for improvement of medical symptoms. The constant presence of pain may be responsible for affective changes in dynamics, family, social and sexual. Initially the person is facing the loss of a healthy body and active, to a state of dependence and limitations. In this study, patients with higher scores of anxiety and depression scores had lower quality of life and patients with lower scores of anxiety and depression had scores of quality of life. These results show that perhaps the depression and anxiety may be related to the negative impact on quality of life of these patients. Conclusion:, In view of this association, we emphasise the importance of a specific approach to the treatment of anxiety and depression together with clinical treatment to improve the quality of life of these patients. [source] Males with anorexia nervosa: A controlled study of eating disorders in first-degree relativesINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2001Michael Strober Abstract Objective To compare lifetime rates of full and partial anorexia nervosa and bulimia nervosa in first-degree relatives of males with anorexia nervosa and in relatives of never-ill comparison subjects. Methods Rates of eating disorders were obtained for 747 relatives of 210 probands from personal structured clinical interviews and family history. Best-estimate diagnoses were determined blind to proband diagnosis and pedigree status. Results Full and partial syndromes of anorexia nervosa aggregated in female relatives of ill probands. For the full syndrome of anorexia nervosa, the crude relative risk was 20.3 among female relatives and for partial syndrome anorexia nervosa, the crude relative risk was 3.3. In contrast, bulimia nervosa was relatively uncommon among relatives of ill probands. Conclusion Although anorexia nervosa in males is exceedingly rare, there is a pattern of familial aggregation that is highly similar to that observed in recent family studies of affected females. On the basis of these findings, there is no evidence that familial-genetic factors distinguish the occurrence of anorexia nervosa in the two sexes. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 29: 263,269, 2001. [source] Evidence-based practice-focused interactive teaching strategy: a controlled studyJOURNAL OF ADVANCED NURSING, Issue 6 2009Son C. Kim Abstract Title.,Evidence-based practice-focused interactive teaching strategy: a controlled study. Aim., This paper is a report of a study to evaluate the effectiveness of the evidence-based practice (EBP)-focused interactive teaching (E-FIT) strategy. Background., Although EBP is a mandatory competency for all healthcare professionals, little is known about the effectiveness of E-FIT in nursing. Methods., A quasi-experimental, controlled, pre- and post-test study involving senior, 4th-year nursing students (N = 208) at two nursing schools in the USA was carried out from August 2007 to May 2008. The experimental group (n = 88) received the E-FIT strategy intervention and the control group (n = 120) received standard teaching. A Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice was used to assess the effectiveness of the E-FIT strategy. Results., Independent t -tests showed that the experimental group had statistically significant higher post-test Evidence-Based Practice Knowledge (mean difference = 0·25; P = 0·001) and Evidence-Based Practice Use (mean difference = 0·26; P = 0·015) subscale scores compared to the control group, but showed no statistically significant differences in Attitudes toward Evidence-Based Practice and Future Use of Evidence-Based Practice (mean difference = ,0·12; P = 0·398 and mean difference = 0·13; P = 0·255 respectively). Hierarchical multiple regression analyses of the post-test data indicated that the intervention explained 7·6% and 5·1% of variance in Evidence-Based Practice Knowledge and Evidence-Based Practice Use respectively. Conclusion., The EBP-focused interactive teaching strategy was effective in improving the knowledge and use of EBP among nursing students but not attitudes toward or future use of EBP. [source] Training programme in techniques of self-control and communication skills to improve nurses' relationships with relatives of seriously ill patients: a randomized controlled studyJOURNAL OF ADVANCED NURSING, Issue 2 2000Luisa García De Lucio RN Training programme in techniques of self-control and communication skills to improve nurses' relationships with relatives of seriously ill patients: a randomized controlled study The interpersonal relationships with relatives of seriously ill patients may cause anxiety on the part of nurses and the need for adequate communication and self-control skills. To assess the efficacy of training nurses in self-control techniques and communication skills when they interact with relatives of seriously ill patients we planned a randomized, controlled trial in two parallel groups: an experimental group, with immediate training, and a control group, with training delayed for 6 months. We recruited 61 nurses from the nursing staff of a university hospital of 500 beds. The intervention consisted of training in relaxation, cognitive restructuring and some communication skills. The outcome variables were communication skills measured under simulated conditions using an observation instrument of our own, administered by observers masked with respect to the study groups, and the levels of state-anxiety measured with the self-assessment questionnaire the State-Trait Anxiety Inventory, under imaginary conditions. The two groups initially had similar scores in the scales of communication skills, and state and trait-anxiety. After intervention, compared with the control group, the experimental group showed significant improvements in the skills of listening, emphasizing, interrupting and coping with emotions (P < 0·05). State-anxiety levels did not show any changes. In conclusion, the joint training in self-control and communication improves some communication skills in nurses when they interact with relatives of seriously ill patients under simulated conditions. [source] Immunoglobulin A deficiency and oral health status: a case,control studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2010Gudmundur H. Jorgensen Abstract Introduction: Immunoglobulin A (IgA) is important for mucosal health. Selective IgA deficiency (IgAD) is the most common primary immunodeficiency but its effect on oral health is unclear. The aim of this study was to investigate dental, periodontal and oral mucosal health in IgAD individuals. Material and methods: In total, 32 adult IgAD subjects were compared with 63 randomly selected individuals. Participants answered questionnaires regarding general and oral health and underwent oral examination, including examination using the periodontal screening and recording (PSR) system and dental examination using the DMF system. Results: The IgAD individuals had significantly more often undergone tonsillectomy (44%versus 24%, p=0.046) and adenoidectomy (31%versus 8%, p=0.003) compared with the controls. Furthermore, the IgAD subjects reported having pharyngitis, stomatitis and herpes labialis significantly more often. There was no significant difference in periodontal health (mean PSR index; 1.87 versus 1.77) or dental health (mean DMFS; 51.3 versus 53.7) between the two cohorts. A positive correlation between Helicobacter pylori infection and severity of periodontitis was found (p=0.036). Conclusion: IgAD predisposes to oral mucosal infections but does not influence periodontal or dental health. This is the first controlled study to include detailed clinical history and investigations, together with full oral and dental examination, in adults with IgAD. [source] Facilitating police,minority youth attitude change: The effects of cooperation within a competitive context and exposure to typical exemplarsJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2002Dana Rabois Previous community programs have been unsuccessful in changing youths' attitudes toward police, and have thus far not addressed police attitudes toward youth. In this pilot study, police (n = 26) competed together with minority youths (n = 51) on heterogeneous basketball teams. Pre- and postintervention attitudes toward youths/officers and posttest attitudes toward team members were examined. Police reported positive ratings of out-group team members, and demonstrated a positive shift in attitude toward minority youth in general. Generalization of positive attitude was more likely when officers perceived their team members as typical exemplars of minority youth. Minority youths did not show a significant improvement in attitude toward police but reported favorable attitudes toward team members. Results suggest that a short-term competitive tournament exposing individuals to typical exemplars may be effective for addressing hostile police attitudes toward minority youths. A controlled study is recommended to replicate and expand on our findings. © 2002 John Wiley & Sons, Inc. [source] Effect of concurrent elemental diet on infliximab treatment for Crohn's diseaseJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7 2006Torao Tanaka Abstract Background:, Infliximab and elemental diet (ED) have been shown to be effective in the management of Crohn's disease. However, few experiences have been reported regarding their combination therapy. The aim of the present study was to investigate the efficacy and safety of infliximab in Japanese patients, the first such study in Asia, as well as the effect of concomitant ED. Methods:, One hundred and ten consecutive patients receiving infliximab were followed up to week 16 after the last infusion, and clinical response and primary outcome were collected. A response was defined as a reduction in Harvey,Bradshaw Index for inflammatory disease and closure of fistula in fistulizing disease. Results:, Out of 75 inflammatory and 35 fistulizing disease patients, 68 (90.7%) and 25 (71.4%) responded at week 4, and 38 (50.7%) and 14 (40.0%) continued to respond until week 16, respectively. Interestingly, inflammatory disease patients with concurrent ED had a significantly higher response rate at week 16 (68.4%) than those without ED (32.4%, P = 0.0026). The effects of ED were independent of the usage of azathioprine and smoking habit. Conclusions:, Infliximab was clinically useful in the treatment of Crohn's disease in Japanese patients as well as in those in Western countries. The efficacy of concurrent ED was suggestive and should be confirmed in a randomized controlled study. [source] Gastric electrical activity in patients with cholelithiasis undergoing laparoscopic cholecystectomy: A prospective controlled studyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 6 2004SPIROS N SGOUROS Abstract Background:, The aim of the present study was to evaluate the effect of gallstone disease (GD) and laparoscopic cholecystectomy on gastric electrical activity of slow waves, which was recorded via transcutaneous electrogastrography (EGG). Methods:, Twenty-one consecutive patients (M/F: 12/9, 52.7 ± 15 years old) with GD and no previous history of abdominal operations or known disease affecting gastrointestinal motility were studied. The EGG was performed for 30 min prior to and 90 min after a standard meal, during a 4,6 month period prior to and after laparoscopic cholecystectomy. The percentile proportion of the three spectra of gastric slow waves frequency was studied, defined as follows: bradygastria, 1,2.1 cycles per min (c.p.m.); normogastria, 2.2,3.9 c.p.m.; and tachygastria, 4,9 c.p.m. The findings were compared to those of nine healthy subjects (M/F: 5/4, 49.5 ± 14.8 years old). Results:, No statistically significant difference was found in percentile distribution of bradygastria, normogastria and tachygastria, pre- or post-prandially, neither before or after laparoscopic cholecystectomy, nor between patients and controls. Conclusions:, Patients with GD do not exhibit differences in gastric electrical activity of slow waves in comparison to normal subjects and laparoscopic cholecystectomy does not alter gastric electrical activity. These findings suggest that cholelithiasis does not seem to cause dyspeptic symptoms due to gastric dysrythmias. [source] Treatment of chronic liver diseases with traditional Chinese medicineJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2000Bao-En Wang Traditional Chinese medicine is still being extensively used for treatment of liver disease in China. The anti-viral herbs, Phyllanthus amarus, P. niruri and P. urninaria, and Oxymatrine extracted from Sophora flavecientis and S. subprostratae, have been shown to have a remarkable HBV suppressing effect with a serum conversion rate for HBeAg and HBV DNA around 45%, similar to that of IFN-,. The anti-inflammatory compound, Stronger NeoMinophagen C (SNMC), is a Japanese preparation of glycerrhizin, extracted from Glyceriza glabra, which has shown an effective rate of ALT and AST normalization and reduction to < 60 U/L in 65.6% and 73.5% of patients. Compound 861, made of 10 herbs with Salvia miltiorrhiza as its chief component, has been shown experimentally to be effective in suppressing fibrogenesis, enhancing collagen degradation, and inhibiting TIMP expression. Clinically, an open trial of 2000 patients showed improvement of symptoms in 83% and normalization of serum ALT in 82%. In a controlled study of 107 patients with HBV-related diseases, double liver biopsies showed that the fibrosis reversal rate after 6 months treatment with Cpd 861 was 78% in S2, 82% in S3 (precirrhotic stage) and 75% in S4 (early cirrhosis), as assessed by Scheuer's and Chevallier's criterion. In conclusion, traditional Chinese medicine has great potential in the treatment of chronic hepatitis B. [source] Randomized controlled trial of oral versus intravenous fluid supplementation on serum bilirubin level during phototherapy of term infants with severe hyperbilirubinaemiaJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 2 2002N-Y Boo Objective: To compare the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy. Methods: A randomized controlled study was carried out in the neonatal intensive care unit (NICU) of Hospital Universiti Kebangsaan Malaysia over a 12-month period. Fifty-four healthy term infants with severe hyperbilirubinemia were randomized to receive either solely enteral feeds (n = 27) or both enteral and intravenous (n = 27) fluid during phototherapy. Results: There were no significant differences in the mean birthweight, mean gestational age, ethnic distribution, gender distribution, modes of delivery and types of feeding between the two groups. Similarly, there was no significant difference in the mean indirect serum bilirubin (iSB) level at the time of admission to the NICU between the enteral (359 ± 69 ,mol/L [mean ± SD]) and intravenous group (372 ± 59 ,mol/L; P = 0.4). The mean rates of decrease in iSB during the first 4 h of phototherapy were also not significantly different between the enteral group (10.4 ± 4.9 ,mol/L per h) and intravenous group (11.2 ± 7.4 ,mol/L per h; P = 0.6). There was no significant difference in the proportion of infants requiring exchange transfusion (P = 0.3) nor in the median duration of hospitalization (P = 0.7) between the two groups. No infant developed vomiting or abdominal distension during the study period. Conclusion: Severely jaundiced healthy term infants had similar rates of decrease in iSB levels during the first 4 h of intensive phototherapy, irrespective of whether they received oral or intravenous fluid supplementation. However, using the oral route avoided the need for intravenous cannulae and their attendant complications. [source] | |||||||||||||||||||||||||||||||||||||||||||