Home About us Contact
|
Home About us Contact | ||
|
|
||
Best Treatment (best + treatment)
Terms modified by Best Treatment Selected AbstractsOn Identification of the Number of Best Treatments Using the Newman-Keuls TestBIOMETRICAL JOURNAL, Issue 5 2008Samuel S. Wu Abstract In this paper, we provide a stochastic ordering of the Studentized range statistics under a balanced one-way ANOVA model. Based on this result we show that, when restricted to the multiple comparisons with the best, the Newman,Keuls (NK) procedure strongly controls experimentwise error rate for a sequence of null hypotheses regarding the number of largest treatment means. In other words, the NK procedure provides an upper confidence bound for the number of best treatments. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Orthodontic treatment of anterior open biteINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2008CHUI SHAN TERESA NG Objective. To review the currently available treatment options of anterior open bite. Methods. Search all major dental journals and literature on treatment and management of anterior open bite. Medline search (1960,2006). Literature and data on treatment and management of anterior open bite with keywords ,open bite', ,anterior open bite', ,orthodontic treatment', ,long face', ,vertical dentoalveolar problem' and ,vertical skeletal problem'. Results. Over 50 articles were found and relevant information and data were reviewed by the authors. It was found that the multifactorial nature of anterior open bite makes its management difficult and various treatment modalities are being used. Clinicians must be able to diagnose the problem and choose the best treatment. Conclusion. Successful treatment of anterior open bite greatly relies on both diagnosis and therapeutics. Although there are many different treatment modalities available, stability after treatment is still a critical issue as evidence on long term stability of various treatment options is lacking. Thus, clinicians should pay more attention during retention phase and long-term studies on post-treatment changes and stability should be encouraged. [source] Impact of anatomical pielocaliceal topography in the treatment of renal lower calyces stones with extracorporeal shock wave lithotripsyINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2005LORENZO RUGGERA Abstract Aim:, There is wide consensus that the lowest success rate of extracorporeal shock wave lithotripsy (ESWL) is in the complete clearance of renal stones located in the lower calyces. We assess the effectiveness of extracorporeal shock wave lithotripsy monotherapy for lower pole renal calculi to determine the relationship between the spatial anatomy of lower pole and the outcome of ESWL. Methods:, We evaluated 107 patients who were treated for solitary lower pole renal stones less than 20 mm in diameter with ESWL. The spatial anatomy of the lower pole, as defined by the lower infundibulopelvic angle, infundibular length and infundibular width, was measured by preoperative intravenous pyelography, while the stone location and size were determined by using abdominal plain X-ray. All patients were followed up at 1 and 3 months with abdominal plain X-ray and ultrasonography. Results:, Only 62 patients (58%) became stone free, while 45 (42%) retained residual fragments. A small lower infundibulopelvic angle, a long infundibular length and a tight infundibular width are unfavorable for stone clearance after ESWL. Conclusions:, ESWL is the treatment of choice for most renal and ureteral stones. However, stone clearance from the lower pole following ESWL is poor and significantly affected by the inferior pole collecting system anatomy. Therefore, we believe it is important to evaluate these anatomical factors when deciding on the best treatment for lower pole renal calculi. [source] Giant Right Atrial Diverticulum in an AdultJOURNAL OF CARDIAC SURGERY, Issue 1 2010Xin Chen M.D. Examination of resected atrial tissue showed extreme wall thinning, central aneurysmal formation, and focal endocardial fibrosis consistent with idiopathic dilatation of the right atrium. It is unclear what the best treatment of right atrial diverticulum are, nor are the risks of thromboembolism, arrhythmia, and rupture of the diverticulum clearly defined, either for patients as a whole or for symptomatic or asymptomatic subgroups. However, to reduce the risk of sudden death we recommend surgical resection of large diverticula.(J Card Surg 2010;25:40-42) [source] Sonographic diagnosis of acute injuries of the ulnar collateral ligament of the metacarpophalangeal joint of the thumbJOURNAL OF CLINICAL ULTRASOUND, Issue 2 2007Takaaki Shinohara Abstract Purpose. To evaluate the significance of the ultrasonographic appearance of the aponeurosis for deciding the best treatment for ulnar collateral ligament (UCL) injuries of the thumb metacarpophalangeal joint. Methods. Fourteen patients (11 men, 3 women; mean age, 41 years; range, 15,66 years) who had an acute UCL tear were included. All patients were examined by ultrasonography (US) with a 7.5-MHz transducer and subsequently underwent surgery. The ultrasonographic findings were compared to the intraoperative findings. Results. UCL injuries were classified into two types by US according to the appearance of aponeurosis and its spatial relationship with the UCL: the intra-aponeurosis type (5 patients) and the extra-aponeurosis type (9 patients). In the 5 patients with intra-aponeurosis, ultrasonographic findings were well consistent with intraoperative findings. In contrast, extra-aponeurosis cases contained two different pathologies: of the 9 patients, 7 had so-called ,Stener lesions', one showed folding of a ruptured capsule, and one showed a ruptured aponeurosis. Conclusions. Because US is highly reliable in differentiating intra-aponeurosis from extra-aponeurosis types of injuries, the aponeurosis is a more reliable reference than Stener lesion for treatment decision by US. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound, 2007. [source] Modified Atmosphere Packaging of PomegranateJOURNAL OF FOOD SCIENCE, Issue 7 2000F. Artés ABSTRACT: Spanish ,Mollar de Elche' sweet pomegranates (Punica granatum L.) were stored at 2 or 5 °C for 12 wk in unperforated polypropylene (UPP) film of 25 ,m thickness in modified atmosphere packaging (MAP). Perforated polypropylene (PPP) film of 20 ,m thickness and conventional cold storage were applied as control treatments. Quality was evaluated after storage and after shelf life of 6 d at 15 °C and 75% RH. PPP at 5 °C was the best treatment for maintaining red skin-color of the arils at the end of storage. All treatments suffered a decrease in total anthocyanins content at the end of shelf life. After shelf life, UPP fruits had higher values of absorbance at 510 and 446 nm. MAP strongly reduced water loss and chilling injuries without incidence of decay. [source] Recommendations for the topical treatment of psoriasisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2005PCM Van De Kerkhof ABSTRACT Several topical treatments are available for patients with psoriasis. Although individualization of the treatment remains important, there is a need for treatment recommendations to identify the best treatment out of the available treatments and to help with improvement in treatment compliance. In this communication we give our views on the assessment of severity of psoriasis. We provide recommendations for selection of treatments, reconciling the clearance phase and the long-term management. Finally, we provide recommendations for the treatment of particular localizations: the scalp and psoriasis at sensitive sites. [source] Finding the best treatment under heavy censoring and hidden biasJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2007Myoung-jae Lee Summary., We analyse male survival duration after hospitalization following an acute myocardial infarction with a large (N=11024) Finnish data set to find the best performing hospital district (and to disseminate its treatment protocol). This is a multiple-treatment problem with 21 treatments (i.e. 21 hospital districts). The task of choosing the best treatment is difficult owing to heavy right censoring (73%), which makes the usual location measures (the mean and median) unidentified; instead, only lower quantiles are identified. There is also a sample selection issue that only those who made it to a hospital alive are observed (54%); this becomes a problem if we wish to know their potential survival duration after hospitalization, if they had survived to a hospital contrary to the fact. The data set is limited in its covariates,only age is available,but includes the distance to the hospital, which plays an interesting role. Given that only age and distance are observed, it is likely that there are unobserved confounders. To account for them, a sensitivity analysis is conducted following pair matching. All estimators employed point to a clear winner and the sensitivity analysis indicates that the finding is fairly robust. [source] Cost-effectiveness analysis at the development phase of a potential health technology: examples based on tissue engineering of bladder and urethraJOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE, Issue 5 2007Helen McAteer Abstract Objectives: We demonstrate the use of health economics to guide investment decisions in regenerative medicine. Our examples are based on proposed tissue engineering applications in the urinary tract. We show that health economics have a role in strengthening the supply side, not just the demand side of the health economy. Methods: We reviewed the epidemiology and treatment of the clinical conditions where TE of urothelium may be considered using literature identified from a range of sources including electronic databases, article bibliographies and references, online articles and expert opinion in the field. Results: Careful analysis of current best treatment suggested that urethral defects and bladder resection for cancer offered the most propitious applications of TE. The headroom for engineered urethral tissue was estimated at £186. This is unlikely to be large enough to support the launch of a TE product populated with viable cells. The headroom for TE bladder, on the other hand, was estimated at around £16 268. However, the market size is limited reducing potential profitability. Conclusions: The Headroom Method can help inform instrumental decisions concerning new treatments without having to build a complex model with very wide parameter uncertainty. Copyright © 2007 John Wiley & Sons, Ltd. [source] Isolated fetal hydrothorax with hydrops: a systematic review of prenatal treatment optionsPRENATAL DIAGNOSIS, Issue 10 2007K. L. Deurloo Abstract Objective To evaluate the effect of prenatal therapeutic interventions on perinatal outcome in pregnancies complicated by isolated fetal hydrothorax with hydrops. Methods A systematic review of the literature from January 1982 to January 2006 of perinatal outcome in pregnancies with isolated fetal hydrothorax with hydrops with any form of prenatal treatment was conducted. Results Forty-four articles met our selection criteria, reporting a total of 172 fetuses treated prenatally. Reported treatment options were single (n = 13) or serial thoracocentesis (n = 18), thoraco-amniotic shunt placement (n = 100) or a combination of thoracocentesis and shunting (n = 36). Four case-reports described pleurodesis with OK-432, (n = 3) and intrapleural injection of autologous blood (n = 2). Overall survival rate was 63%, ranging from 54% for single thoracocentesis to 80% in the 5 cases treated with pleurodesis, without statistically significant differences between the treatment modalities. Shunt-placement with or without prior thoracocentesis was most often described, with survival rates of 67 and 61% respectively. Discussion The available literature consists exclusively of case reports and case series. This systematic review suggests that with prenatal intervention, perinatal survival rates around 63% are possible. There is a need for prospective, adequately controlled studies with long-term follow-up to determine the best treatment and more reliable outcome data in pregnancies complicated by fetal hydrothorax with hydrops. Copyright © 2007 John Wiley & Sons, Ltd. [source] What Ever Happened to N-of-1 Trials?THE MILBANK QUARTERLY, Issue 4 2008Insiders' Perspectives, a Look to the Future Context: When feasible, randomized, blinded single-patient (n-of-1) trials are uniquely capable of establishing the best treatment in an individual patient. Despite early enthusiasm, by the turn of the twenty-first century, few academic centers were conducting n-of-1 trials on a regular basis. Methods: The authors reviewed the literature and conducted in-depth telephone interviews with leaders in the n-of-1 trial movement. Findings: N-of-1 trials can improve care by increasing therapeutic precision. However, they have not been widely adopted, in part because physicians do not sufficiently value the reduction in uncertainty they yield weighed against the inconvenience they impose. Limited evidence suggests that patients may be receptive to n-of-1 trials once they understand the benefits. Conclusions: N-of-1 trials offer a unique opportunity to individualize clinical care and enrich clinical research. While ongoing changes in drug discovery, manufacture, and marketing may ultimately spur pharmaceutical makers and health care payers to support n-of-1 trials, at present the most promising resuscitation strategy is stripping n-of-1 trials to their essentials and marketing them directly to patients. In order to optimize statistical inference from these trials, empirical Bayes methods can be used to combine individual patient data with aggregate data from comparable patients. [source] GASTRIC ANTRAL PATCH OESOPHAGOPLASTY FOR IATROGENIC TRACHEO-OESOPHAGEAL FISTULAANZ JOURNAL OF SURGERY, Issue 4 2007Michael L. Talbot Acquired tracheo-oesophageal fistula is a devastating condition, usually occurring as a late manifestation of oesophageal or other thoracic malignancies. In these cases palliation by placement of an oesophageal stent is the preferred option, but management of a large non-malignant fistula is more complex. In many patients in whom primary repair of the defects is not possible oesophagectomy may be seen as the best treatment. We present a case of a large tracheo-oesophageal fistula repaired with a gastric antral patch oesophagoplasty and intercostal muscle flap. [source] Ingestion of Artemia nauplii by Chinese mitten crab Eriocheir sinensis zoea larvaeAQUACULTURE RESEARCH, Issue 8 2009Li-ying Sui Abstract A series of ingestion trials were conducted to determine the ingestion rate of Artemia nauplii by Eriocheir sinensis zoea larvae with increasing densities of Artemia and with or without rotifers as a co-feed. At each zoeal stage, 10 groups of 10 larvae were reared individually in glass beakers and fed with increasing densities of newly hatched Artemia nauplii (0.5, 2.5, 5, 10 and 20 individual (ind.) mL,1) with or without rotifers (15,25 ind. mL,1) as a co-feed. The average number of ingested Artemia was measured over 24 h. In addition, the average larval development rate (Larval Stage Index, LSI) over a longer period (time needed for the best treatment to reach 100% moult or metamorphosis to the next larval stage) was compared. The results showed that Artemia ingestion rate of E. sinensis larvae increased with increasing prey densities and larval development, and had a significantly negative correlation with rotifer consumption for all zoeal stages. Rotifers as an alternative prey significantly affected the intake of Artemia at early larval stages (Z1 and Z2) and promoted LSI at a lower Artemia density. Further experiments are needed to clarify the effect of prey density on survival and larval development when larvae are reared communally. [source] A Generalized Estimator of the Attributable Benefit of an Optimal Treatment RegimeBIOMETRICS, Issue 2 2010Jason Brinkley Summary For many diseases where there are several treatment options often there is no consensus on the best treatment to give individual patients. In such cases, it may be necessary to define a strategy for treatment assignment; that is, an algorithm that dictates the treatment an individual should receive based on their measured characteristics. Such a strategy or algorithm is also referred to as a treatment regime. The optimal treatment regime is the strategy that would provide the most public health benefit by minimizing as many poor outcomes as possible. Using a measure that is a generalization of attributable risk (AR) and notions of potential outcomes, we derive an estimator for the proportion of events that could have been prevented had the optimal treatment regime been implemented. Traditional AR studies look at the added risk that can be attributed to exposure of some contaminant; here we will instead study the benefit that can be attributed to using the optimal treatment strategy. We will show how regression models can be used to estimate the optimal treatment strategy and the attributable benefit of that strategy. We also derive the large sample properties of this estimator. As a motivating example, we will apply our methods to an observational study of 3856 patients treated at the Duke University Medical Center with prior coronary artery bypass graft surgery and further heart-related problems requiring a catheterization. The patients may be treated with either medical therapy alone or a combination of medical therapy and percutaneous coronary intervention without a general consensus on which is the best treatment for individual patients. [source] Use of polytetrafluoroethylene-covered stent for treatment of coronary artery aneurysmCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2005Auryan Szalat MD Abstract Coronary artery aneurysm is an uncommon occurrence, yet it is described more often today than in the past as coronary angiography is now routinely used for diagnosis and treatment of ischemic heart disease. However, there is no therapeutic consensus regarding this finding. We present a case of giant coronary artery aneurysm and review the literature on the use of polytetrafluoroethylene-covered stents as a therapeutic option for this condition. Combined antiaggregant therapy is needed after the procedure. Randomized controlled trials of surgery versus covered stents are necessary to define the best treatment for large coronary artery aneurysms. © 2005 Wiley-Liss, Inc. [source] Evidence for a need to mandate kidney transplant living donor registriesCLINICAL TRANSPLANTATION, Issue 5 2008Mahmoud Emara Abstract:, Kidney disease is a global public health problem of growing proportions. Currently the best treatment for end-stage renal failure is transplantation. Living organ donation remains a complex ethical, moral and medical issue. It is based on a premise that kidney donation is associated with short-term minimal risks to harm the donor, and is outweighed by the definite advantages to the recipient. A growing number of patients with end-stage renal disease and shortage of kidney donors poses a pressing need to expand the criteria needed to accept kidney donors. The current donor registries are structured and are driven to expand donor pool. As living kidney donation is not without risks, more attention should be given to protect the donor health. After kidney donation, mild to moderate renal insufficiency may occur. Renal insufficiency, even mild, is associated with increased risks of hypertension, proteinuria and cardiovascular morbidity. We, therefore, foresee a need to mandate the establishment of renal transplant donor registries at all transplanting programs as a prerequisite to protect the long-term well being of kidney donors. These registries can collect the database necessary to develop standards of practice and guidelines for future kidney donation. [source] Renal transplantation outcomes: a comparative analysis between elderly and younger recipientsCLINICAL TRANSPLANTATION, Issue 6 2007Helena Moisés Mendonça Abstract:, Renal transplantation is presently the best treatment for end-stage renal disease, although considered contraindicated for elderly patients. However, more investigation is needed due to higher life expectancy rates of the general population and the increasing number of over 60-yr-old patients with chronic renal failure dependant upon dialysis. This study aims to determine graft and patient survival rates of renal transplant patients 60 yr and older compared to a younger group (50,59 yr old). Relevant pre- and post-transplant clinical data related to graft and patient survival in both groups were also investigated. Three-hundred and twenty consecutive renal transplant patients were enrolled in this study and grouped based on age at the time of the transplantation: one-hundred and ten patients at or over 60 yr old (elderly group) and 210 patients ranging from 50 to 59 yr old (younger group). There were no statistical differences in either group regarding clinical characteristics and immunological risk factors. The incidence of acute rejection was higher in the younger group (37.6%) than in the elderly (22.7%) (p = 0.01). Censored to death graft survivals at five yr were respectively 86.7% for patients , 60 yr and 82.1% for patients 50,59 yr old (p = 0.49). Patient survival rates at five yr were respectively 76.2% for patients , 60 yr and 81.6% for patients 50,59 yr old (p = 0.33). Our data show that renal transplantation for elderly patients has similar results to those found in younger individuals, which does not make age, in and of itself, a contraindication for transplantation. [source] Oral graft-versus-host diseaseORAL DISEASES, Issue 5 2008MM Imanguli Objective:, Graft-versus-host disease (GVHD) is a leading cause of morbidity and mortality in patients receiving hematopoietic cell transplant. It is estimated that 40,70% of engrafted patients surviving the initial transplant eventually develop chronic GVHD (cGVHD), which can persist for months to years and require long-term management from multiple disciplines. This review describes the oral component of this transplant complication. Design:, The search related to GVHD patho-biology, salivary gland disease after hematopoietic cell transplant and treatments for oral GVHD encompassed literature from 1966 through 2008. Searches were limited to the MEDLINE/PubMed database and English language literature in peer-reviewed journals. Results:, Our understanding of the patho-biology of oral cGVHD is based on studies of other affected tissues. It is difficult to determine the prevalence and incidence of salivary gland disease after transplant because there is no universally accepted case definition. In general, clinical trials for treatment of oral cGVHD have been too small to make strong recommendations for use in clinical practice. Conclusions:, Larger well-designed clinical studies are needed to understand the patho-biology of oral cGVHD and determine best treatments for this disease. [source] Randomized, single-blind, trial of sertraline and buspirone for treatment of elderly patients with generalized anxiety disorderPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2010Naghmeh Mokhber MD Aim:, Generalized anxiety disorder (GAD) in elderly people is common, but few systematic studies regarding the best treatments have been performed. The aim of the present study was to evaluate the efficacy and safety of sertraline and buspirone in the treatment of elderly patients with GAD. Methods:, Based on selection criteria, 46 patients were recruited who met DSM-IV criteria for GAD. Patients were randomly assigned to sertraline (50,100 mg/day) or buspirone (10,15 mg/day) for 8 weeks in a single-blind trial. The primary outcome measure used in the present study was the Hamilton Rating Scale for Anxiety (HRSA). Results:, Both sertraline and buspirone had significant anxiolytic efficacy. A steady decrease in the total HRSA scores for both groups was observed throughout the study period. After 2 and 4 weeks, buspirone was found to be significantly superior to sertraline (P < 0.001), but at the end of study period this difference did not reach statistical significance (P = 0.16). The mean HRSA score after 8 weeks significantly decreased in subjects treated with sertraline (P < 0.001), and buspirone (P < 0.001). No clinically adverse events or changes in laboratory test results were observed during the study period. Conclusion:, Both sertraline and buspirone appear to be efficacious and well tolerated in the treatment of GAD in elderly patients. Further studies with larger sample size, evaluating the effect of medical illness, cognitive impairment, depression, and combined therapy with support and psychotherapy are needed. [source] | ||||||||||||||||