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Dorra J, Jarraya S. The Effect of a Short-Term Mindfulness Program on Motor Skills and on Psychological and Social Behavior in Preschool Children: A Randomized Controlled Trial. Percept Mot Skills 2024:315125241267348. [PMID: 39038803 DOI: 10.1177/00315125241267348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
We assessed the effect of a one-week mindfulness-based intervention on resilience, social behavior, and motor skills in four to five-year-old children. In this randomized controlled trial, 45 children (22 females; 23 males; M age = 4.5, SD = 0.4 years) from the same preschool were randomly assigned to three groups: (a) a mindfulness group (MG; n = 15) that participated in five 30-min mindfulness sessions; (b) a physical activity group (PAG; n = 15) that engaged in five 45-min physical exercise sessions; and a control group (CG; n = 15) that received no intervention. Training sessions were held on five consecutive days. Prior to (T0) and after the five mindfulness sessions (T1), all participants blindly completed the Movement Assessment Battery for Children-2 (to assess their motor skills), the Strength and Difficulties Questionnaire (to evaluate their behavior), and the Child and Youth Resilience Measure-28 (to measure their resilience). At baseline (T0), there were no significant differences between the groups. The mindfulness group experienced the strongest positive effects after the intervention (T1), with improvements in both motor skills and social behavior, though there was no significant effect on resilience. Our results suggest that a brief mindfulness training intervention is a promising strategy for improving motor skills and social behavior in early childhood settings.
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Affiliation(s)
- Jalleli Dorra
- Research Laboratory (EM2S), High Institute of Sport and Physical Education, Sfax University, Sfax, Tunisia
| | - Sana Jarraya
- Research Laboratory (EM2S), High Institute of Sport and Physical Education, Sfax University, Sfax, Tunisia
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2
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Colling R, Indave I, Del Aguilla J, Cierco Jimenez R, Campbell F, Chechlinska M, Kowalewska M, Holdenrieder S, Trulson I, Worf K, Pollán M, Plans-Beriso E, Pérez-Gómez B, Craciun O, García-Ovejero E, Michalek IM, Maslova K, Rymkiewicz G, Didkowska J, Tan PH, Diyana Bte Md Nasir N, Myles N, Giesen C, Goldman-Lévy G, Lokuhetty D, Cree IA. Moving Forward on Tumor Pathology Research Reporting: A Guide for Pathologists From the World Health Organization Classification of Tumors Living Evidence Gap Map by Tumour Type Group. Mod Pathol 2024; 37:100515. [PMID: 38763419 DOI: 10.1016/j.modpat.2024.100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/30/2024] [Accepted: 05/04/2024] [Indexed: 05/21/2024]
Abstract
Evidence-based medicine (EBM) can be an unfamiliar territory for those working in tumor pathology research, and there is a great deal of uncertainty about how to undertake an EBM approach to planning and reporting histopathology-based studies. In this article, reviewed and endorsed by the Word Health Organization International Agency for Research on Cancer's International Collaboration for Cancer Classification and Research, we aim to help pathologists and researchers understand the basics of planning an evidence-based tumor pathology research study, as well as our recommendations on how to report the findings from these. We introduce some basic EBM concepts, a framework for research questions, and thoughts on study design and emphasize the concept of reporting standards. There are many study-specific reporting guidelines available, and we provide an overview of these. However, existing reporting guidelines perhaps do not always fit tumor pathology research papers, and hence, here, we collate the key reporting data set together into one generic checklist that we think will simplify the task for pathologists. The article aims to complement our recent hierarchy of evidence for tumor pathology and glossary of evidence (study) types in tumor pathology. Together, these articles should help any researcher get to grips with the basics of EBM for planning and publishing research in tumor pathology, as well as encourage an improved standard of the reports available to us all in the literature.
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Affiliation(s)
- Richard Colling
- Nuffield Department of Surgical Sciences, University of Oxford, Level 4, John Radcliffe Hospital, Oxford, United Kingdom; Department of Cellular Pathology, Oxford University Hospitals NHS FT, Oxford, United Kingdom.
| | - Iciar Indave
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Javier Del Aguilla
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Ramon Cierco Jimenez
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Fiona Campbell
- Population Health Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Magdalena Chechlinska
- Department of Cancer Biology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Magdalena Kowalewska
- Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Stefan Holdenrieder
- Institute of Laboratory Medicine, German Heart Centre Munich, Munich, Germany
| | - Inga Trulson
- Institute of Laboratory Medicine, German Heart Centre Munich, Munich, Germany
| | - Karolina Worf
- Institute of Laboratory Medicine, German Heart Centre Munich, Munich, Germany
| | - Marina Pollán
- National Center for Epidemiology. Instituto de Salud Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Elena Plans-Beriso
- National Center for Epidemiology. Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology. Instituto de Salud Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Oana Craciun
- National Center for Epidemiology. Instituto de Salud Carlos III, Madrid, Spain
| | | | - Irmina Maria Michalek
- Department of Cancer Pathomorphology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Kateryna Maslova
- Department of Cancer Biology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Grzegorz Rymkiewicz
- Department of Cancer Pathomorphology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Joanna Didkowska
- Polish National Cancer Registry, Department of Epidemiology and Cancer Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | | | - Nickolas Myles
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Christine Giesen
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Gabrielle Goldman-Lévy
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Dilani Lokuhetty
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Ian A Cree
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
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Mahanani S, Kertia N, Madyaningrum E. Combination of Curcuminoids and Acupressure for Inflammation and Pain in Older People with Osteoarthritis Genu: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54970. [PMID: 38771152 PMCID: PMC11231618 DOI: 10.2196/54970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/03/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Curcuminoids and acupressure have beneficial effects in reducing pain and inflammation in patients with osteoarthritis. However, only a few clinical trials are investigating biomarkers to prove this objectively. OBJECTIVE This study aims to investigate the effect of acupressure and curcuminoids on inflammatory markers and pain in older people with osteoarthritis genu. METHODS A randomized controlled trial (RCT) was conducted among older people with osteoarthritis. All participants were randomized to a group that received 30 mg of curcuminoids in turmeric extract capsules and acupressure (group 1) or a group that received a placebo and sham acupressure (group 2) for 3 weeks. RESULTS The study was approved by the research ethics board; ClinicalTrials.gov reviewed this protocol. The extracts were manufactured from May 2023 to June 2023. Participant recruitment was conducted in September and October 2023; a total of 72 participants aged 60 years or older participated, of whom 75% (n=54) were female. Data were analyzed in April 2024, and dissemination of results is expected by the end of 2024. CONCLUSIONS Primary outcomes were assessed at baseline and after the intervention. Relationships were assessed with inflammatory markers, endorphin hormones, and blood level of cycloxygenase-2 hormone. Additionally, secondary outcomes included pain, ability to perform activities of daily living, and quality of life. The beneficial effects that may be found in this trial may be exceptionally relevant in clinical practice, justifying this scientific inquiry. The benefits of herbs and acupressure can be helpful as additional options in treating inflammation and pain in patients with osteoarthritis. TRIAL REGISTRATION ClinicalTrials.gov NCT06105840; https://clinicaltrials.gov/study/NCT06105840. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54970.
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Affiliation(s)
- Srinalesti Mahanani
- Doctorate Program of Medical and Health Science, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Nursing, STIKES RS Baptis Kediri, Kediri, Indonesia
| | - Nyoman Kertia
- Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ema Madyaningrum
- Department of Mental and Community Health Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Singla A, Khanna R, Kaur M, Kelm K, Zaiane O, Rosenfelt CS, Bui TA, Rezaei N, Nicholas D, Reformat MZ, Majnemer A, Ogourtsova T, Bolduc F. Developing a Chatbot to Support Individuals With Neurodevelopmental Disorders: Tutorial. J Med Internet Res 2024; 26:e50182. [PMID: 38888947 PMCID: PMC11220430 DOI: 10.2196/50182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/27/2023] [Accepted: 04/19/2024] [Indexed: 06/20/2024] Open
Abstract
Families of individuals with neurodevelopmental disabilities or differences (NDDs) often struggle to find reliable health information on the web. NDDs encompass various conditions affecting up to 14% of children in high-income countries, and most individuals present with complex phenotypes and related conditions. It is challenging for their families to develop literacy solely by searching information on the internet. While in-person coaching can enhance care, it is only available to a minority of those with NDDs. Chatbots, or computer programs that simulate conversation, have emerged in the commercial sector as useful tools for answering questions, but their use in health care remains limited. To address this challenge, the researchers developed a chatbot named CAMI (Coaching Assistant for Medical/Health Information) that can provide information about trusted resources covering core knowledge and services relevant to families of individuals with NDDs. The chatbot was developed, in collaboration with individuals with lived experience, to provide information about trusted resources covering core knowledge and services that may be of interest. The developers used the Django framework (Django Software Foundation) for the development and used a knowledge graph to depict the key entities in NDDs and their relationships to allow the chatbot to suggest web resources that may be related to the user queries. To identify NDD domain-specific entities from user input, a combination of standard sources (the Unified Medical Language System) and other entities were used which were identified by health professionals as well as collaborators. Although most entities were identified in the text, some were not captured in the system and therefore went undetected. Nonetheless, the chatbot was able to provide resources addressing most user queries related to NDDs. The researchers found that enriching the vocabulary with synonyms and lay language terms for specific subdomains enhanced entity detection. By using a data set of numerous individuals with NDDs, the researchers developed a knowledge graph that established meaningful connections between entities, allowing the chatbot to present related symptoms, diagnoses, and resources. To the researchers' knowledge, CAMI is the first chatbot to provide resources related to NDDs. Our work highlighted the importance of engaging end users to supplement standard generic ontologies to named entities for language recognition. It also demonstrates that complex medical and health-related information can be integrated using knowledge graphs and leveraging existing large datasets. This has multiple implications: generalizability to other health domains as well as reducing the need for experts and optimizing their input while keeping health care professionals in the loop. The researchers' work also shows how health and computer science domains need to collaborate to achieve the granularity needed to make chatbots truly useful and impactful.
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Affiliation(s)
- Ashwani Singla
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Ritvik Khanna
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Manpreet Kaur
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Karen Kelm
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Osmar Zaiane
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | | | - Truong An Bui
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Navid Rezaei
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - David Nicholas
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Marek Z Reformat
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Annette Majnemer
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Tatiana Ogourtsova
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Francois Bolduc
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Enyinna KP, Eleje GU, Odugu BU, Nevo CO, Ofor IJ, Mbachu II, Eze CC, Okoh DS, Ikwuka DC, Awkadigwe FI, Okafor CC, Malachy DE, Ortuanya KE, Eze HT, Okoro CC, Okafor CG. Impact of early versus delayed umbilical cord clamping on term neonates' haemoglobin levels: a randomized controlled trial. J Int Med Res 2024; 52:3000605241255836. [PMID: 38851870 PMCID: PMC11162598 DOI: 10.1177/03000605241255836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/02/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE To compare the effects of early and delayed cord clamping on the haemoglobin levels of neonates delivered at term. METHODS This randomized controlled trial enrolled pregnant women during the second stage of labour. They were randomized into either the early cord clamping (ECC) group or the delayed cord clamping (DCC) group in the ratio of 1:1. Following delivery of the baby, the umbilical cords of participants in the ECC group were clamped within 30 s of delivery of the neonate while those of participants in the DCC group were clamped after 2 min from the delivery of the neonate. The primary outcome measure was the effect of ECC and DCC on the haemoglobin levels of neonates delivered at term. RESULTS A total of 270 pregnant women were enrolled in the study. Their baseline sociodemographic and clinical characteristics were similar in both groups. There was no significant difference in the mean haemoglobin level between ECC and DCC groups at birth. The mean haemoglobin level of the neonates at 48 h postpartum was significantly higher in the DCC group than the ECC group. CONCLUSION DCC at birth was associated with a significant increase in neonatal haemoglobin levels at 48 h postpartum when compared with ECC.Trial Registration: The trial was registered at Pan African Clinical Trial Registry with approval number PACTR202206735622089.
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Affiliation(s)
- Kelechi P. Enyinna
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - George U. Eleje
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria
| | - Boniface U. Odugu
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Calistus O. Nevo
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Ifeanyichukwu J. Ofor
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Ikechukwu I. Mbachu
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria
| | - Chukwuka C. Eze
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Darlington S. Okoh
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - David C. Ikwuka
- Department of Medical Physiology, College of Medicine and Health sciences, University of Rwanda, Kigali City, Rwanda
| | - Fredrick I. Awkadigwe
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Chidinma C. Okafor
- Department of Psychiatry, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Divinefavour E. Malachy
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria
| | - Kelvin E. Ortuanya
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Hyacinth T. Eze
- Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria
| | - Chukwuemeka C. Okoro
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria
| | - Chigozie G. Okafor
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria
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Ilika CP, Eleje GU, Chiemeka ME, Ilika FN, Ikechebelu JI, Ilika VC, Ugwu EO, Ofor IJ, Ogelle OM, Umeononihu OS, Mamah JE, Olisa CL, Ezeigwe CO, Nwankwo ME, Ofojebe CJ, Okafor CC, Ekwebene OC, Nnabuchi OK, Okafor CG. Effects of speculum lubrication on cervical smears for cervical cancer screening: A double blind randomized clinical trial. PLoS One 2024; 19:e0292207. [PMID: 38787830 PMCID: PMC11125561 DOI: 10.1371/journal.pone.0292207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Speculum lubrication may help to reduce the pain experienced during Pap-smear collection and hence increase uptake of cervical cancer screening and repeat testing, but there are fears of its interference with cytological results. AIM To determine and compare the adequacy of cervical cytology smears and the mean pain scores of women undergoing cervical cancer screening with or without speculum lubrication. METHODS This was a randomised controlled study of 132 women having cervical cancer screening at a tertiary hospital in Nigeria. Sixty-six participants were randomly assigned to the 'Gel' and 'No Gel' groups, respectively. Pap smears were collected from each participant with a lubricated speculum ('Gel group') or a non-lubricated speculum ('No Gel group'). The primary outcome measures were the proportion of women with unsatisfactory cervical cytology smears and the mean numeric rating scale pain scores, while the secondary outcome measures were the proportion of women who were willing to come for repeat testing and the cytological diagnosis of Pap-smear results. RESULTS The baseline socio-demographic variables were similar in both groups. There was no significant difference in the proportion of unsatisfactory cervical smear results between the two groups (13.6% vs. 21.2%, p = 0.359). However, the mean pain scores were significantly lower in the gel group than in the no gel group (45.04 vs. 87.96; p<0.001). An equal proportion of the participants in each group (90.9% vs. 90.9%; p > 0.999) were willing to come for repeat cervical smears in the future. CONCLUSION Speculum lubrication did not affect the adequacy of cervical smears but significantly reduced the pain experienced during pap smear collection. Also, it did not significantly affect the willingness to come for repeat cervical smears in the future. TRIAL REGISTRATION The trial was registered with the Pan-African Clinical Trial Registry with a unique identification and registration number: PACTR2020077533364675.
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Affiliation(s)
- Chito P. Ilika
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - George U. Eleje
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Michael E. Chiemeka
- Department of Anatomic Pathology and Forensic Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Joseph I. Ikechebelu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Valentine C. Ilika
- Department of Internal medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Emmanuel O. Ugwu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Ifeanyichukwu J. Ofor
- Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University Teaching, Parklane, Enugu State, Nigeria
| | - Onyecherelam M. Ogelle
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Osita S. Umeononihu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | | | - Chinedu L. Olisa
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Pharmacology and Therapeutics, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Chijioke O. Ezeigwe
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Malarchy E. Nwankwo
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Chukwuemeka J. Ofojebe
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Chidinma C. Okafor
- Department of Psychiatry, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Onyeka C. Ekwebene
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, United States of America
| | - Obinna K. Nnabuchi
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Chigozie G. Okafor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
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7
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Galicia KE, Thompson CM, Lewis AE, Joyce CJ, Hill DM, Schneider JC, Nyygard RM, Harrington DM, Holmes JH, Moffatt LT, Shupp JW, Kubasiak JC. American Burn Association (ABA) Burn Care Quality Platform (BCQP) and Large Data Set Analysis Considerations: A Practical Guide to Investigating Clinical Questions in Burns via Large Data Sets. J Burn Care Res 2024; 45:557-564. [PMID: 37339870 PMCID: PMC10733540 DOI: 10.1093/jbcr/irad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
The Burn Care Quality Platform (BCQP) consolidates data previously collected from the National Burn Repository and the Burn Quality Improvement Program into a single registry. Its data elements and their associated definitions are tailored to create consistency across other national trauma registries, namely the National Trauma Data Bank implemented by the American College of Surgeons Trauma Quality Improvement Program (ACS TQIP). The BCQP now includes 103 participating burn centers and has captured data from 375,000 total patients as of 2021. With 12,000 patients entered under the current data dictionary, the BCQP represents the largest registry of its kind. On behalf of the American Burn Association Research Committee, the aim of this whitepaper is to provide a succinct overview of the BCQP, showcasing its unique features, strengths, limitations, and relevant statistical considerations. This whitepaper will highlight the resources available to the burn research community and offer insight on proper study design when preparing to conduct a large data set investigation for burn care. All recommendations herein were formulated through the consensus of a multidisciplinary committee and based on the available scientific evidence.
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Affiliation(s)
- Kevin E Galicia
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
| | | | - Aislinn E Lewis
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Cara J Joyce
- Department of Medicine, Biostatistics Core, Loyola University Medical Center, Maywood, ILUSA
| | - David M Hill
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jeffery C Schneider
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA
| | - Rachel M Nyygard
- Department of Surgery, Hennepin County Medical Center, Minneapolis, MN, USA
| | - David M Harrington
- Department of Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - James H Holmes
- Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Lauren T Moffatt
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University School of Medicine, Washington, DC, USA
| | - Jeff W Shupp
- Department of Surgery, MedStar Washington Hospital Center, DC, USA
| | - John C Kubasiak
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
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8
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Tong J, Luo C, Sun Y, Duan R, Saine ME, Lin L, Peng Y, Lu Y, Batra A, Pan A, Wang O, Li R, Marks-Anglin A, Yang Y, Zuo X, Liu Y, Bian J, Kimmel SE, Hamilton K, Cuker A, Hubbard RA, Xu H, Chen Y. Confidence score: a data-driven measure for inclusive systematic reviews considering unpublished preprints. J Am Med Inform Assoc 2024; 31:809-819. [PMID: 38065694 PMCID: PMC10990515 DOI: 10.1093/jamia/ocad248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVES COVID-19, since its emergence in December 2019, has globally impacted research. Over 360 000 COVID-19-related manuscripts have been published on PubMed and preprint servers like medRxiv and bioRxiv, with preprints comprising about 15% of all manuscripts. Yet, the role and impact of preprints on COVID-19 research and evidence synthesis remain uncertain. MATERIALS AND METHODS We propose a novel data-driven method for assigning weights to individual preprints in systematic reviews and meta-analyses. This weight termed the "confidence score" is obtained using the survival cure model, also known as the survival mixture model, which takes into account the time elapsed between posting and publication of a preprint, as well as metadata such as the number of first 2-week citations, sample size, and study type. RESULTS Using 146 preprints on COVID-19 therapeutics posted from the beginning of the pandemic through April 30, 2021, we validated the confidence scores, showing an area under the curve of 0.95 (95% CI, 0.92-0.98). Through a use case on the effectiveness of hydroxychloroquine, we demonstrated how these scores can be incorporated practically into meta-analyses to properly weigh preprints. DISCUSSION It is important to note that our method does not aim to replace existing measures of study quality but rather serves as a supplementary measure that overcomes some limitations of current approaches. CONCLUSION Our proposed confidence score has the potential to improve systematic reviews of evidence related to COVID-19 and other clinical conditions by providing a data-driven approach to including unpublished manuscripts.
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Affiliation(s)
- Jiayi Tong
- The Center for Health Analytics and Synthesis of Evidence (CHASE), Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, United States
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Chongliang Luo
- Division of Public Health Sciences, Washington University School of Medicine in St Louis, St Louis, MO 63110, United States
| | - Yifei Sun
- Department of Biostatistics, Columbia University, New York City, NY 10032, United States
| | - Rui Duan
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA 02115, United States
| | - M Elle Saine
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Lifeng Lin
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ 85724, United States
| | - Yifan Peng
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 11101, United States
| | - Yiwen Lu
- The Center for Health Analytics and Synthesis of Evidence (CHASE), Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, United States
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
- The Graduate Group in Applied Mathematics and Computational Science, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Anchita Batra
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Anni Pan
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Olivia Wang
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Ruowang Li
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, United States
| | - Arielle Marks-Anglin
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Yuchen Yang
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Xu Zuo
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX 77030, United States
| | - Yulun Liu
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Jiang Bian
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, United States
| | - Stephen E Kimmel
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL 32610, United States
| | - Keith Hamilton
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Adam Cuker
- Department of Medicine and Department of Pathology & Laboratory Medicine, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Rebecca A Hubbard
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Hua Xu
- Section of Biomedical Informatics & Data Science, Yale School of Medicine, New Haven, CT 06510, United States
| | - Yong Chen
- The Center for Health Analytics and Synthesis of Evidence (CHASE), Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, United States
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, United States
- The Graduate Group in Applied Mathematics and Computational Science, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, United States
- Leonard Davis Institute of Health Economics, Penn Medicine, Philadelphia, PA 19104, United States
- Center for Evidence-based Practice (CEP), Philadelphia, PA 19104, United States
- Penn Institute for Biomedical Informatics (IBI), Philadelphia, PA 19104, United States
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9
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Huda AU, Mughal MZ. Adding intrathecal midazolam to local anesthetics improves sensory and motor block and reduces pain score without increasing side effects in lower limb surgeries: A meta-analysis and systematic review. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2024; 71:248-256. [PMID: 38145787 DOI: 10.1016/j.redare.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/31/2023] [Indexed: 12/27/2023]
Abstract
This meta-analysis was done to investigate the role of intrathecal midazolam in lower limb surgeries regarding prolongation of spinal block, postoperative pain control and associated side effects. The included studies reported onset and duration of sensory and motor block, time to first request analgesia, 24h opioid consumption, postoperative pain control, and associated side effects following use of intrathecal midazolam for lower limb surgeries. This review was performed following the PRISMA guidelines and using the online databases, Medline, Science Direct, Google scholar and Cochrane library. We registered this review with the PROSPERO database (ID-CRD42022346361) in August 2022. A total of 10 randomised controlled trials were included in this meta-analysis. Our results showed patients receiving 1mg intrathecal midazolam showed significantly faster onset of sensory block [P=.001 (CI: -0.98, -0.31)]. Duration of sensory and motor block were also significantly prolonged in intrathecal midazolam group [P<.00001 (CI: 18.08, 39.12), P=.002 (CI: 0.45, 2). Intrathecal midazolam also increased the time to first request analgesia [P=.0003, (CI: 1.22, 4.14)]. Pain scores at 4 and 12h postoperatively were significantly lower in patients receiving intrathecal midazolam [P=.00001 (CI: -1.20, -0.47) and P=.05 (CI: -0.52, -0.01) respectively]. In conclusion, the addition of intrathecal midazolam to local anesthetics in lower limb surgeries results in early onset of sensory and motor block. It also increases the duration of sensory and motor block. The time to first request analgesia is increased. VAS pain scores at 4 and 12h postoperatively were also lower without any increased side effects.
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Affiliation(s)
- A U Huda
- Hamad Medical Corporation, Doha, Qatar.
| | - M Z Mughal
- Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia
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10
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Okaforcha EI, Eleje GU, Ikechebelu JI, Ezeama CO, Igbodike EP, Ugwu EO, Okpala BC, Mbachu II, Umeononihu OS, Ogabido CA, Onwusulu DN, Oguejiofor CB, Okafor CC, Olisa CL, Ikwuka DC, Ofor IJ, Okafor CG. Intravenous versus intramuscular oxytocin injection for preventing uterine atonic primary postpartum haemorrhage in third stage of labour: A double-blind randomised controlled trial. SAGE Open Med 2024; 12:20503121241230484. [PMID: 38406581 PMCID: PMC10894536 DOI: 10.1177/20503121241230484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/18/2024] [Indexed: 02/27/2024] Open
Abstract
Objectives To compare the efficacy and safety of intravenous and intramuscular oxytocin in preventing atonic primary postpartum haemorrhage in the third stage of labour. Methods A double-blind randomised clinical study on consenting women without risk factors for primary postpartum haemorrhage in labour at term. Two hundred and thirty-two women were randomly allotted into intravenous (n = 115) and intramuscular (n = 117) oxytocin groups in the active management of the third stage of labour. All participants received 10 IU of oxytocin, either IV or IM, and 1 ml of water for injection as a placebo via a route alternate to that of administration of oxytocin within 1 min of the baby's delivery. The primary outcome measures were mean postpartum blood loss and haematocrit change. Trial Registration No.: PACTR201902721929705. Results The baseline socio-demographic and clinical characteristics were similar between the two groups (p > 0.05). There was no statistically significant difference between the two groups with regards to the mean postpartum blood loss (254.17 ± 34.85 ml versus 249.4 ± 39.88 ml; p = 0.210), haematocrit change (2.4 (0.8%) versus 2.1 (0.6%); p = 0.412) or adverse effects (p > 0.05). However, the use of additional uterotonics was significantly higher in the intravenous group (25 (21.73%) versus 17 (14.53%); p = 0.032). Conclusion Although oxytocin in both study groups showed similar efficacy in terms of preventing atonic primary postpartum haemorrhage, participants who received intravenous oxytocin were more likely to require additional uterotonics to reduce their likelihood of having an atonic primary postpartum haemorrhage. However, both routes have similar side effect profiles.
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Affiliation(s)
| | - George Uchenna Eleje
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Joseph Ifeanyichukwu Ikechebelu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Chukwuemeka Okwudili Ezeama
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | | | - Emmanuel Onyebuchi Ugwu
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria
| | - Boniface Chukwuneme Okpala
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ikechukwu Innocent Mbachu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Osita Samuel Umeononihu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Chukwudi Anthony Ogabido
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Daniel Nnaemeka Onwusulu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Charlotte Blanche Oguejiofor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | | | - Chinedu Lawrence Olisa
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - David Chibuike Ikwuka
- Department of Medical Physiology, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | | | - Chigozie Geoffrey Okafor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
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11
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Ortuanya KE, Eleje GU, Ezugwu FO, Odugu BU, Ikechebelu JI, Ugwu EO, Eke AC, Awkadigwe FI, Ezenwaeze MN, Ofor IJ, Okafor CC, Okafor CG. Prophylactic tranexamic acid for reducing intraoperative blood loss during cesarean section in women at high risk of postpartum hemorrhage: A double-blind placebo randomized controlled trial. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057231225311. [PMID: 38279808 PMCID: PMC10822094 DOI: 10.1177/17455057231225311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/16/2023] [Accepted: 12/20/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Postpartum hemorrhage remains a leading cause of maternal mortality especially in developing countries. The majority of previous trials on the effectiveness of tranexamic acid in reducing blood loss were performed in low-risk women for postpartum hemorrhage. A recent Cochrane Systematic Review recommended that further research was needed to determine the effects of prophylactic tranexamic acid for preventing intraoperative blood loss in women at high risk of postpartum hemorrhage. OBJECTIVE This study aimed to evaluate the effectiveness and safety of tranexamic acid in reducing intraoperative blood loss when given prior to cesarean delivery in women at high risk of postpartum hemorrhage. STUDY DESIGN The study is a double-blind randomized controlled trial. METHODS The study consisted of 200 term pregnant women and high-risk preterm pregnancies scheduled for lower-segment cesarean delivery at Enugu State University of Science and Technology, Teaching Hospital, Parklane, Enugu, Nigeria. The participants were randomized into two arms (intravenous 1 g of tranexamic acid or placebo) in a ratio of 1:1. The participants received either 1 g of tranexamic acid or placebo (20 mL of normal saline) intravenously at least 10 min prior to commencement of the surgery. The primary outcome measures were the mean intraoperative blood loss and hematocrit change 48 h postoperatively. RESULTS The baseline sociodemographic characteristics were similar in both groups. The tranexamic acid group when compared to the placebo group showed significantly lower mean blood loss (442.94 ± 200.97 versus 801.28 ± 258.68 mL; p = 0.001), higher mean postoperative hemoglobin (10.39 + 0.96 versus 9.67 ± 0.86 g/dL; p = 0.001), lower incidence of postpartum hemorrhage (1.0% versus 19.0%; p = 0.001), and lower need for use of additional uterotonic agents after routine management of the third stage of labor (39.0% versus 68.0%; p = 0.001), respectively. However, there was no significant difference in the mean preoperative hemoglobin (11.24 ± 0.88 versus 11.15 ± 0.90 g/dL; p = 0.457), need for other surgical intervention for postpartum hemorrhage (p > 0.05), and reported side effect, respectively, between the two groups. CONCLUSION Prophylactic administration of tranexamic acid significantly decreases postpartum blood loss, improves postpartum hemoglobin, decreases the need for additional uterotonics, and prevents postpartum hemorrhage following cesarean section in pregnant women at high risk of postpartum hemorrhage. Its routine use during cesarean section in high-risk women may be encouraged.The trial was registered in the Pan-African Clinical Trial Registry with approval number PACTR202107872851363.
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Affiliation(s)
- Kelvin E Ortuanya
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology Teaching Hospital Parklane, Enugu, Nigeria
| | - George U Eleje
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Frank O Ezugwu
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology Teaching Hospital Parklane, Enugu, Nigeria
| | - Boniface U Odugu
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology Teaching Hospital Parklane, Enugu, Nigeria
| | - Joseph I Ikechebelu
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Emmanuel O Ugwu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Ahizechukwu C Eke
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fredrick I Awkadigwe
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology Teaching Hospital Parklane, Enugu, Nigeria
| | - Malachy N Ezenwaeze
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology Teaching Hospital Parklane, Enugu, Nigeria
| | - Ifeanyichukwu J Ofor
- Department of Obstetrics & Gynaecology, Enugu State University of Science and Technology Teaching Hospital Parklane, Enugu, Nigeria
| | - Chidinma C Okafor
- Department of Psychiatry, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Chigozie G Okafor
- Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
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12
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Ooi SL, Micalos PS, Zielinski R, Pak SC. Rice Bran Arabinoxylan Compound and Quality of Life (RBAC-QoL) of Cancer Patients: An Interim Analysis of the RBAC-QoL Study. Cureus 2024; 16:e53188. [PMID: 38425632 PMCID: PMC10901676 DOI: 10.7759/cureus.53188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Background The effect of rice bran arabinoxylan compound (RBAC), a plant-based immunomodulator, on the quality of life (QoL) in cancer patients and underlying physiological pathways remains unclear. Trial design The RBAC-QoL study, a double-blind, randomised, controlled pilot feasibility study, aimed to determine RBAC's effects on QoL and the associated action mechanisms. Primary outcomes were the EORTC QLQ-C30 functional, symptom, and global QoL scores with inflammatory, nutritional, and cytokine parameters as secondary and exploratory outcomes. Methods Participants were adults diagnosed with solid organ tumours (≥ stage II) undergoing active treatment in several outpatient centres in New South Wales, Australia. Interventions were RBAC or matched placebo at 3g/day for 24 weeks allocated through stratified randomisation with participants, oncologists, and data collectors blinded. Data was collected from five study visits six weeks apart. The trial remained ongoing as of December 2023. An interim intention-to-treat analysis was performed using repeated measure ANOVA with pairwise comparisons where statistical significance was observed and adjusted with covariates. Results Global QoL scores from currently available data (n = 16; RBAC = 7, placebo = 9) were statistically different between groups (F1,8 = 8.6, p = 0.019, eta2[g] = 0.267). Pairwise comparisons found significant differences at Week 6 (p = 0.032, Cohen's d = 1.454) and marginally at Week 12 (p = 0.069, d = 1.427). Age-adjusted analysis showed a continuous upward trend in QoL improvement over time with RBAC, while the placebo group did not deviate from baseline QoL. Significant elevations of serum white blood cell count (Week 18) and total protein (Weeks 12 and 18) were detected in the RBAC group compared to placebo. The total protein levels correlated highly with white blood cell count (Pearson's r = 0.539, p < 0.001) and moderately with the global QoL scores (r = 0.338, p = 0.01). No intervention-related adverse events were reported in both groups. Conclusions RBAC improves QoL beyond placebo during active cancer treatment, possibly through the immuno-nutritional pathway - these findings, though preliminary, are valuable for future research. Funding and registration: Daiwa Pharmaceutical Co., Ltd, Japan; BioMedica Nutraceuticals Pty Ltd., Australia. ANZCTR Reg No: ACTRN12619000562178p.
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Affiliation(s)
- Soo Liang Ooi
- Integrative/Complementary Medicine, School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst, AUS
| | - Peter S Micalos
- Anatomy and Physiology, School of Dentistry and Medical Sciences, Charles Sturt University, Port Macquarie, AUS
| | - Rob Zielinski
- Oncology, Central West Cancer Centre, Orange Health Service, Orange, AUS
- Oncology, School of Medicine, Western Sydney University, Penrith, AUS
| | - Sok Cheon Pak
- Integrative/Complementary Medicine, School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst, AUS
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13
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Fairman CM, Owens OL, Kendall KL, Steele J, Schumpp AR, Latella C, Jones MT, Marcotte L, Dawson JM, Peddle-McIntyre CMJ, McDonnell KK. Hybrid delivery of cluster-set resistance training for individuals previously treated for lung cancer: the results of a single-arm feasibility trial. Pilot Feasibility Stud 2023; 9:177. [PMID: 37848969 PMCID: PMC10580552 DOI: 10.1186/s40814-023-01405-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Individuals with non-small cell lung cancer (NSCLC) are burdened by long-lasting symptoms (e.g., dyspnea and fatigue) post-treatment. These symptoms often reduce physical activity levels and increase the risk of functional decline. Though we have previously proposed cluster-set resistance training to mitigate symptom burden in lung cancer, there is currently no data on the feasibility or acceptability of this mode of exercise in cancer. Therefore, the purpose of this study was to investigate the feasibility and acceptability of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC stages I-III (i.e., early stage). METHODS This study aimed to recruit individuals with NSCLC stages I-III post-treatment to participate in 8 weeks of home-based resistance training, 3 days per week. The program included supervised sessions in the participants' homes and virtual supervision via videoconferencing. The primary outcome measure of feasibility was evaluated through recruitment, retention, and intervention fidelity (i.e., proportion of exercise completed, relative to what was prescribed). Intervention acceptability (i.e., ease and quality of virtual delivery, level of difficulty, and home-based approach) was assessed using a 4-point Likert-type scale from "strongly disagree" to "strongly agree". RESULTS Fourteen participants were recruited over a 6-month period, with 11 completing the intervention (2 withdrew due to unrelated illness, 1 withdrew due to requiring active treatment), yielding a retention rate of 79%. Characteristics of the participants who completed the intervention (n = 11) were as follows: mean age: 71 ± 10 years, mean BMI: 29.1 ± 6.5, and average time since diagnosis was 62 ± 51 months. Of completers, 27% were male, and 36% were Black; 10 were stage I (91%), and one was stage II (9%). Mean session attendance was 86.4 ± 9.5%. Mean intervention fidelity was 83.1 ± 13.1%. With regard to acceptability, > 90% of participants positively rated all aspects of the intervention delivery. No adverse events related to exercise were recorded. CONCLUSIONS The hybrid delivery of a home-based resistance exercise program for individuals previously treated for early-stage NSCLC was found to be safe and feasible. Adaptations to the program for future interventions are required, particularly surrounding resistance exercise programming, and intervention delivery with home visits. TRIAL REGISTRATION ClinicalTrials.gov: NCT05014035 . Registered January 20, 2021.
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Affiliation(s)
- C M Fairman
- Department of Exercise Science, University of South Carolina, Columbia, USA.
| | - O L Owens
- College of Social Work, University of South Carolina, Columbia, USA
| | - K L Kendall
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - J Steele
- Faculty of Sport, Health, and Social Science, Solent University, Southampton, UK
| | - A R Schumpp
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - C Latella
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - M T Jones
- Department of Exercise Science, University of South Carolina, Columbia, USA
- Department of Kinesiology, The University of Alabama, Tuscaloosa, USA
| | - L Marcotte
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - J M Dawson
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - C M J Peddle-McIntyre
- Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - K K McDonnell
- College of Nursing, University of South Carolina, Columbia, USA
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14
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Huda AU, Ghafoor H. The Use of Erector Spinae Plane Block Reduces Opioid Consumption and Pain Score in Postoperative Period After Hip Surgery: A Meta-Analysis. Cureus 2023; 15:e47477. [PMID: 38022340 PMCID: PMC10662936 DOI: 10.7759/cureus.47477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Erector spinae plane block (ESPB) is a relatively new regional anesthesia block that has been used in thoracic and abdominal surgeries with variable success. ESPB can easily be administered using an ultrasound technique with a safer profile. Recently, there have been few randomized controlled trials (RCTs) regarding the role of ESPB in hip surgeries. A current meta-analysis was done to evaluate the role of ESPB block in controlling postoperative pain after hip surgeries. PRISMA guidelines were followed to perform this meta-analysis. We used online databases including Science Direct, PubMed, Google Scholar, and Cochrane Library. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database as ID-CRD42023445516 in July 2023. We included studies that reported opioid use, pain control after surgery, and side effects associated with ESPB for hip surgeries. The ReviewManager software, i.e., RevMan for Mac 5.4 (Cochrane Collaboration, Oxford, UK), was utilized to conduct this meta-analysis. We included five RCTs during this meta-analysis. Our results demonstrated that the use of ESPB in hip surgery caused a significant decrease in 24-hour postoperative opioid consumption (p=0.02). ESPB also resulted in a significant decrease in pain scores up to nine hours postoperatively (p<0.05).
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Affiliation(s)
- Anwar U Huda
- Anesthesiology, Hamad Medical Corporation, Doha, QAT
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15
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Jensen TW, Ersbøll AK, Folke F, Andersen MP, Blomberg SN, Holgersen MG, Andersen LB, Lippert F, Torp-Pedersen C, Christensen HC. Geographical Association Between Basic Life Support Courses and Bystander Cardiopulmonary Resuscitation and Survival from OHCA in Denmark. Open Access Emerg Med 2023; 15:241-252. [PMID: 37342237 PMCID: PMC10278866 DOI: 10.2147/oaem.s405397] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/20/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction Annually, approximately 4% of the entire adult population of Denmark participate in certified basic life support (BLS) courses. It is still unknown whether increases in BLS course participation in a geographical area increase bystander cardiopulmonary resuscitation (CPR) or survival from out-of-hospital cardiac arrest (OHCA). The aim of the study was to examine the geographical association between BLS course participation, bystander CPR, and 30-day survival from OHCA. Methods This nationwide register-based cohort study includes all OHCAs from the Danish Cardiac Arrest Register. Data concerning BLS course participation were supplied by the major Danish BLS course providers. A total of 704,234 individuals with BLS course certificates and 15,097 OHCA were included from the period 2016-2019. Associations were examined using logistic regression and Bayesian conditional autoregressive analyses conducted at municipality level. Results A 5% increase in BLS course certificates at municipality level was significantly associated with an increased likelihood of bystander CPR prior to ambulance arrival with an adjusted odds ratio (OR) of 1.34 (credible intervals: 1.02;1.76). The same trends were observed for OHCAs in out-of-office hours (4pm-08am) with a significant OR of 1.43 (credible intervals: 1.09;1.89). Local clusters with low rate of BLS course participation and bystander CPR were identified. Conclusion This study found a positive effect of mass education in BLS on bystander CPR rates. Even a 5% increase in BLS course participation at municipal level significantly increased the likelihood of bystander CPR. The effect was even more profound in out-of-office hours with an increase in bystander CPR rate at OHCA.
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Affiliation(s)
- Theo Walther Jensen
- Emergency Medical Services Region Zealand, Naestved, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Fredrik Folke
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Herlev Gentofte University Hospital, Gentofte, Denmark
| | | | - Stig Nikolaj Blomberg
- Emergency Medical Services Region Zealand, Naestved, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark
| | - Mathias Geldermann Holgersen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Paediatric Pulmonary Service, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Freddy Lippert
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Nordsjaellands Hospital, Hilleroed, Denmark
- Aalborg University Hospital, Aalborg & Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Helle Collatz Christensen
- Emergency Medical Services Region Zealand, Naestved, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Danish Clinical Quality Program (RKKP), National Clinical Registries & Department of Clinical Medicine, Copenhagen, Denmark
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Hadar-Frumer M, Ten Napel H, Yuste-Sánchez MJ, Rodríguez-Costa I. The International Classification of Functioning, Disability and Health: Accuracy in Aquatic Activities Reports among Children with Developmental Delay. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050908. [PMID: 37238456 DOI: 10.3390/children10050908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
Functioning, as described in the International Classification of Functioning, Disability and Health (ICF), increasingly raises interest in the world of child rehabilitation, especially because its application empowers patients and parents by not putting the emphasis on disability in terms of the medical diagnosis but on the person's lived experience and the level of functioning that might be achieved. However, this requires the correct understanding and application of the ICF framework to overcome differences in the often locally used models or the understanding of disability, including mental aspects. To evaluate the level of accurate use and understanding of the ICF, a survey was performed on studies of aquatic activities in children aged 6-12 with developmental delay published between the years 2010 and 2020. In the evaluation, 92 articles were found that matched the initial keywords (aquatic activities and children with developmental delay). Surprisingly, 81 articles were excluded for not referring to the ICF model at all. The evaluation was performed by methodological critical reading according to the ICF reporting criteria. The conclusion of this review is that despite the rising awareness in the field of AA, the ICF is used inaccurately and often not according to the model's biopsychosocial principles. For the ICF to become a guiding tool in evaluations and goal-setting for aquatic activity, the level of knowledge and understanding of the framework and language needs to be increased via curricula and studies on the effect of interventions on children with developmental delay. Even more so, the level of understanding on how to apply functioning among instructors and researchers working in the aquatic environment needs to be increased.
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Affiliation(s)
- Merav Hadar-Frumer
- Israel Sport Centre for the Disabled (ISCD) Ilan Spivak, Ramat Gan 52535, Israel
- Faculty of Medicine and Health Sciences, University of Alcalá, 28807 Alcalá de Henares, Spain
| | - Huib Ten Napel
- Department of Primary and Community Care, Radboud University Medical Center, PB 9101, 6500 HB Nijmegen, The Netherlands
- RIVM/Dutch WHO-FIC Collaborating Centre, PB 1, 3720 BA Bilthoven, The Netherlands
| | | | - Isabel Rodríguez-Costa
- Faculty of Medicine and Health Sciences, University of Alcalá, 28807 Alcalá de Henares, Spain
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Al-Hamoudi N, Ahmed Y, Al Rifaiy MQ, Alwithanani N, Vohra F, Abduljabbar T. Efficacy of surgical periodontal treatment with and without photobiomodulation in the treatment of severe periodontitis: An evaluation of periodontal, microbiological, and cytokine levels. Photodiagnosis Photodyn Ther 2023; 42:103494. [PMID: 36871808 DOI: 10.1016/j.pdpdt.2023.103494] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
AIM To compare the efficacy of surgical periodontal treatment (SPT) alone and PDT-assisted surgery in participants with severe periodontitis MATERIAL AND METHODS: The present clinical trial was completed by 64 participants (n=32 each). The selection was made according to predefined inclusion and exclusion criteria. Patients in group A were treated with SPT only and participants in group B were treated with SPT adjunct to PDT. Microbiological assessment of P.Gingivalis; T. Forsythia and T.Denticola were evaluated using cultural analysis and periodontal parameters plaque score (PSc), bleeding on probing (BoP) periodontal depth (PD), and clinical attachment loss (CAL) at baseline and post-treatment at 6 months and 12 months were performed. The gingival crevicular fluid (GCF) was collected for the estimation of IL-1β and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay (ELISA). For intra-group comparison and post hoc correction, Student's t-test along with Bonferroni was used. For the difference between follow-ups, an analysis of variance (ANOVA) multiple rank tests were incorporated. RESULTS The mean age of participants in the SPT group was 55.25±4.6yrs. Whereas, participants treated with PDT adjunct to SPT were 54.88±3.6yrs. Periodontal parameters (BoP, PD, PSc, CAL) showed no significant difference at baseline. At 6 months and 12 months follow-up, a significant difference in all parameters (BoP, PD, PSc, and CAL) was found in participants treated with SPT alone and PDT adjunct to SPT (p<0.05). Inflammatory biomarkers at 6-month and 12-month follow-ups, a statistically significant difference in the level of biomarkers (IL-1β and TNF-α) were observed in both groups from baseline (p<0.05). However, at baseline, no significant difference was noted in both groups (p> 0.05). The microbiological assessment showed a significant drop in the bacterial count in participants treated with both regimes i.e., SPT alone and PDT adjunct to SPT. CONCLUSION Photodynamic therapy (PDT) adjunct to surgical periodontal treatment (SPT) in severe periodontitis improves microbiological and periodontal parameters and lowers the level of proinflammatory cytokines.
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Affiliation(s)
- Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Yassir Ahmed
- Department of General Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Q Al Rifaiy
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Naif Alwithanani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Taif University, Taif, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
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Aydal P, Uslu Y, Ulus B. The Effect of Preoperative Nursing Visit on Anxiety and Pain Level of Patients After Surgery. J Perianesth Nurs 2023; 38:96-101. [PMID: 35970660 DOI: 10.1016/j.jopan.2022.05.086] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE Preoperative education is an important part of surgical preparation. Nursing visits offer nurses the opportunity to provide personalized care. The aim of this study was to determine the effect of nursing visits before laparoscopic surgery on the anxiety and pain levels of patients in the postoperative period. DESIGN Randomized controlled clinical trial. METHODS Data were collected from 135 patients who underwent laparoscopic surgery between March and October 2019 in Istanbul. During the nursing visits, the experimental group (n = 72) was educated by the operating room nurse, while the control group (n = 63) was educated by the service nurse. Data were collected using the State-Trait Anxiety Inventory and the Visual Analog Scale. The CONSORT checklist was followed. FINDINGS The pre-education state anxiety scores of the control and experimental groups were similar and at a moderate level (P > .05). The state anxiety score of the experimental group visited by operating room nurses decreased more than that of the control group after education (P < .001). The postoperative state anxiety and pain scores of the control and experimental groups were found to be similar (P > .05). CONCLUSIONS Visits by operating room nurses before laparoscopic surgery can be an effective method to reduce the anxiety level of patients. Obtaining the opinions of operating room nurses on care integration and organization of in-service education programs may be necessary.
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Affiliation(s)
- Pınar Aydal
- Acibadem Health Group, Acibadem Altunizade Hospital
| | - Yasemin Uslu
- Istanbul University Nursing Faculty Surgical Nursing Department, Istanbul, Turkey.
| | - Bahire Ulus
- Acibadem Mehmet Ali Aydınlar University, Department of Nursing Retired Lecturer, Istanbul, Turkey
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Eleje GU, Ezebialu IU, Enebe JT, Ezeora NC, Ugwu EO, Ake ID, Nwankwo EU, Enyinna PK, Okoro CC, Asuoha CP, Oguejiofor CB, Obi E, Okafor CG, Ugwu AO, Eleje LI, Malachy DE, Ubammadu CE, Igbodike EP, Anikwe CC, Ajuba IC, Ufoaroh CU, Egeonu RO, Okafor LU, Enechukwu CI, Nweje SI, Anaedu OP, Ikpeze OZ, Okpala BC, Emeka EA, Nzeukwu CS, Aniedu IC, Chukwuka EC, Onwuegbuna AA, Ikwuka DC, Chigbo CG, Agbanu CMK, Onwuka CI, Nwankwo ME, Nneji HC, Onyeukwu KA, Odugu BU, Nweze SO, Onyekpa IJ, Eze KC, Chukwurah SN, Ugboaja JO, Ikechebelu JI. Efficacy and safety of Mojeaga remedy in combination with conventional oral iron therapy for correcting anemia in obstetric population: A phase II randomized pilot clinical trial. PLoS One 2023; 18:e0285474. [PMID: 37155690 PMCID: PMC10166496 DOI: 10.1371/journal.pone.0285474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/21/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND To our knowledge, there is no prior randomized trial on the efficacy of Mojeaga remedy (a special blend of Alchornea cordifolia, Pennisetum glaucum and Sorghum bicolor extracts) when co-administered with standard-of-care for correction of anemia in obstetrics practice. This study determined the efficacy, safety and tolerability of Mojeaga as adjunct to conventional oral iron therapy for correction of anemia in obstetric population. METHODS A pilot open-label randomized clinical trial. Participants with confirmed diagnosis of anemia in three tertiary hospitals in Nigeria were studied. Eligible participants were randomized 1:1 to either Mojeaga syrups 50 mls (200mg/50mls) administered three times daily in conjunction with conventional iron therapy (Mojeaga group) for 2 weeks or conventional iron therapy alone without Mojeaga (standard-of-care group) for 2 weeks. Repeat hematocrit level were done 2 weeks post-initial therapy. Primary outcome measures were changes in hematocrit level and median hematocrit level at two weeks post therapy. Maternal adverse events and neonatal outcomes (birth anomalies, low birthweight, preterm rupture of membranes and preterm labor) were considered the safety outcome measures. Analysis was by intention-to-treat. RESULTS Ninety five participants were enrolled and randomly assigned to the Mojeaga group (n = 48) or standard-of-care group (n = 47). The baseline socio-demographic and clinical characteristics of the study participants were similar. At two weeks follow-up the median rise in hematocrit values from baseline (10.00±7.00% vs 6.00±4.00%;p<0.001) and median hematocrit values (31.00±2.00% vs 27.00±3.00%;p<0.001) were significantly higher in the Mojeaga group. There were no treatment-related serious adverse events, congenital anomalies or deaths in the Mojeaga group and incidence of other neonatal outcomes were similar (p>0.05). CONCLUSION Mojeaga represents a new adjuvants for standard-of-care option for patients with anemia. Mojeaga remedy is safe for treating anemia during pregnancy and puerperium without increasing the incidence of congenital anomalies, or adverse neonatal outcomes. CLINICAL TRIAL REGISTRATION www.pactr.samrc.ac.za: PACTR201901852059636 (https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5822).
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Affiliation(s)
- George Uchenna Eleje
- Effective care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Ifeanyichukwu Uzoma Ezebialu
- Department of Obstetrics and Gynecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Joseph Tochukwu Enebe
- Department of Obstetrics and Gynecology, ESUT Teaching Hospital, Parklane, Enugu, Nigeria
| | | | - Emmanuel Onyebuchi Ugwu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Enugu, Nigeria
| | - Iffiyeosuo Dennis Ake
- Clinical Trial Division, Drug Evaluation and Research Directorate, NAFDAC, Lagos, Nigeria
| | - Ekeuda Uchenna Nwankwo
- Rural Community Clinical School, School of Medicine, Deakin University, Victoria, Australia
| | | | - Chukwuemeka Chukwubuikem Okoro
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Chika Prince Asuoha
- Department of Chemical Pathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Charlotte Blanche Oguejiofor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Ejeatuluchukwu Obi
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Chigozie Geoffrey Okafor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Angela Ogechukwu Ugwu
- Department of Haematology and Immunology, College of Medicine, University of Nigeria Ituku-Ozalla, Enugu, Nigeria
| | - Lydia Ijeoma Eleje
- Measurement, Evaluation and Research Unit, Department of Educational Foundations, Nnamdi Azikiwe University, Awka, Nigeria
| | | | | | - Emeka Philip Igbodike
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Chidebe Christian Anikwe
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Ifeoma Clara Ajuba
- Department of Haematology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi, Nigeria
| | | | - Richard Obinwanne Egeonu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Lazarus Ugochukwu Okafor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Chukwunonso Isaiah Enechukwu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | | | - Onyedika Promise Anaedu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Odigonma Zinobia Ikpeze
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Boniface Chukwuneme Okpala
- Effective care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Ekene Agatha Emeka
- Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - Chijioke Stanley Nzeukwu
- Department of Obstetrics and Gynecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Ifeanyi Chibueze Aniedu
- Department of Obstetrics and Gynecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Emmanuel Chidi Chukwuka
- Department of Obstetrics and Gynecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | | | - David Chibuike Ikwuka
- Department of Human Physiology, Nnamdi Azikiwe University, Nnewi, Anambra State, Nigeria
| | - Chisom God'swill Chigbo
- Department of Executive MPH, School of Public Health, University of Port-Harcourt, Port-Harcourt, Rivers State, Nigeria
| | - Chiemezie Mac-Kingsley Agbanu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Chidinma Ifechi Onwuka
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Enugu, Nigeria
| | - Malarchy Ekwunife Nwankwo
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Henry Chinedu Nneji
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | | | | | | | | | - Kenneth Chukwudi Eze
- Department of Radiology, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Shirley Nneka Chukwurah
- Department of Internal Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Joseph Odirichukwu Ugboaja
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
| | - Joseph Ifeanyichukwu Ikechebelu
- Effective care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra State, Nigeria
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Novaes IC, Clementino LC, Flores-Mir C, Marques LS, Martins-Júnior PA. How to use the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) in orthodontic research. Dental Press J Orthod 2022; 27:e2220290. [PMID: 35792787 PMCID: PMC9255961 DOI: 10.1590/2177-6709.27.3.e2220290.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/28/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction: Clinical trial protocols are essential documents that serve as a basis for research planning. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement aimed to increase the transparency and integrity of clinical trial protocols. Objectives: This paper described the main aspects of the SPIRIT, highlighting the importance of using this guideline in Orthodontics. Results: The SPIRIT is composed of 33 items and the diagram, which were presented and explained. Conclusion: The use of the SPIRIT checklist must become essential to increase the transparency and integrity of more reliable and less biased clinical trials in orthodontic research, improving the quality of future publications in this field.
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Affiliation(s)
- Isabela Coelho Novaes
- Department of Child and Adolescent Oral Health, School of Dentistry, Federal University of Minas Gerais (Belo Horizonte, Minas Gerais, Brazil)
| | - Luna Chagas Clementino
- Department of Child and Adolescent Oral Health, School of Dentistry, Federal University of Minas Gerais (Belo Horizonte, Minas Gerais, Brazil)
| | - Carlos Flores-Mir
- Department of Orthodontics, University of Alberta (Edmonton, Alberta, Canada)
| | - Leandro Silva Marques
- Department of Pediatric Dentistry and Orthodontics, Federal University of Vales do Jequitinhonha e Mucuri (Diamantina, Minas Gerais, Brazil)
| | - Paulo Antônio Martins-Júnior
- Department of Child and Adolescent Oral Health, School of Dentistry, Federal University of Minas Gerais (Belo Horizonte, Minas Gerais, Brazil)
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Influences of Gender on Intravenous Nalbuphine Actions After Major Abdominal Surgery: A Multicenter Study. Pain Ther 2021; 10:1215-1233. [PMID: 34110603 PMCID: PMC8586316 DOI: 10.1007/s40122-021-00277-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/27/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Nalbuphine, a synthetic kappa-opioid receptor (KOR) agonist and a partial µ-opioid receptor (MOR) antagonist, has been used for years as an effective analgesic. It has been shown to have a better safety profile than morphine. Considering the long history of use of this drug, it is interesting that only a limited amount of information exists on how gender differences influence nalbuphine responses. In this randomized double-blind comparative trial after major abdominal surgery, the analgesic effects of two doses of continuous intravenous infusion of nalbuphine were evaluated based on gender. METHODS Enrolled patients were divided into four groups (two females and two males with 32 patients in each group). Two of them (groups A1 and A2), one male and one female, received postoperative continuous intravenous infusions of nalbuphine at 2 mg/h via patient-controlled analgesia (PCA). Each patient had the potential of receiving a rescue bolus of 1 mg of nalbuphine with a lock out time of 15 min. The other two groups (groups B1 and B2) received half the infusion dose, 1 mg/h, and half the nalbuphine rescue dose with the PCA pump, 0.5 mg maximum every 15 min as needed. Patients' vital signs, numerical pain rating scores, rescue nalbuphine, and incidence of side effects were assessed immediately after the operation, and every 3 h during the first 12 h. RESULTS Nalbuphine 2 mg/h dosing led to significantly lower pain scores amongst females compared to males at 6, 9, and 12 h; while the 1 mg/h infusion pain scores were only lower at the 9-h time period. Females receiving the nalbuphine 2 mg dose at 6 h, and the 1 mg dose at 6, 9, and 12-h measurements needed significantly lower doses of rescue nalbuphine. Females on the 1 mg dose experienced significantly more nausea, vomiting, and sedation at the 6-, 9-, and 12-h measurement times. In the multivariate analysis, female gender was a negative predictor at all measurement times. CONCLUSIONS The current study supports the hypothesis that although nalbuphine was found to be an effective and well-tolerated analgesic after major abdominal surgery, females were statistically more responsive than males. TRIAL REGISTRATION The study was registered at the Pan African Clinical trials Registry PACTR201304000486309, and approved for the Ethical aspects.
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von Heideken J, Chowdhry S, Borg J, James K, Iversen MD. Reporting of Harm in Randomized Controlled Trials of Therapeutic Exercise for Knee Osteoarthritis: A Systematic Review. Phys Ther 2021; 101:pzab161. [PMID: 34180534 PMCID: PMC8557852 DOI: 10.1093/ptj/pzab161] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 03/19/2021] [Accepted: 05/19/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The Consolidated Standards of Reporting Trials (CONSORT) recommends reporting adverse events (AEs) and dropouts (DOs) with their definitions. The purpose of this study was to identify how AEs and DOs were reported in randomized controlled trials of therapeutic exercise for knee osteoarthritis (OA). METHODS Data sources were the Cochrane Library, Embase, PubMed, and CINAHL. Databases were searched to identify randomized controlled trials of therapeutic exercise for knee OA published from January 1, 1980, through July 23, 2020. Researchers independently extracted participant and intervention characteristics and determined whether a clear statement of and reasons for AEs and DOs existed. The primary outcome was exercise-related harm. Physiotherapy Evidence Database (PEDro) scoring described study quality and risk of bias. Descriptive and inferential statistics characterized results. Meta-analysis was not performed due to data heterogeneity. RESULTS One hundred and thirteen studies (152 arms) from 25 countries were included, with 5909 participants exercising. PEDro scores ranged from 4 to 9. Exercise intensity was not specified in 57.9% of exercise arms. Fifty studies (44.2%) included an AE statement and 24 (21.2%) reported AEs, yielding 297 patients. One hundred and three studies (91.2%) had a DO statement. Sixteen studies (15.5%) provided reasons for DOs that could be classified as AEs among 39 patients, yielding a 13.1% increase in AEs. Thus, 336 patients (6.0%) experienced exercise-related harm among studies with a clear statement of AEs and DOs. A significant difference existed in misclassification of DOs pre- and post-CONSORT-2010 (12.2% vs 3.1%; $\chi^{2}_{1} = 21.2$). CONCLUSIONS In some studies, the reason for DOs could be considered AEs, leading to potential underreporting of harm. Improvements in reporting of harm were found pre- and post-CONSORT-2010. Greater clarity regarding AE and DO definitions and therapeutic exercise intensity are needed to determine safe dosing and mode of therapeutic exercise for knee OA. IMPACT More adherence to the CONSORT statement is needed regarding reporting of and defining of AEs, DOs, and therapeutic exercise intensity; however, despite this, therapeutic exercise seems to be associated with minimal risk of harm.
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Affiliation(s)
- Johan von Heideken
- Department of Women’s and Children’s Health, Karolinska Intitutet, Stockholm, Sweden
| | - Sana Chowdhry
- College of Health Professions, Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Joanna Borg
- College of Health Professions, Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Khara James
- Department of Rehabilitation and Movement Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Maura D Iversen
- Department of Women’s and Children’s Health, Karolinska Intitutet, Stockholm, Sweden
- Department of Rehabilitation and Movement Sciences, Northeastern University, Boston, Massachusetts, USA
- College of Health Professions, Departments of Public Health and Physical Therapy and Movement Sciences, Sacred Heart University, Fairfield, Connecticut, USA
- Section of Clinical Sciences, Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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The Effect of Parenting Programme on the Symptoms and the Family Functioning of Children with Attention Deficit and Hyperactivity Disorder Who Have Residual Symptoms Despite Medical Treatment. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
This study aims to determine the effects of the Parents Plus Children's Programme (PPCP) on children's symptoms of attention deficit and hyperactivity disorder (ADHD) and on family functionality and parenting stress. The children in the study were aged 6–11 years, and they had been diagnosed with ADHD and had residual symptoms despite effective dosage and timing of their medication. Forty-six couples, who with their children met the eligibility criteria, were enrolled and randomly allocated to the PPCP or the control group. The intervention involved a 9-week, 2 h a week, parenting group exercise. Those in the PPCP group improved significantly more over time on Conners’ Parent Rating Scale-Revised, Family Assessment Device, and Parent Stress Index than those in the control condition. The trial is the first clinical study involving the parents of children with ADHD that addresses residual symptoms and functional impairments that remain despite the administration of the maximum effective dose of pharmacological treatment.
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Qi M, Cahan O, Foreman MA, Gruen DM, Das AK, Bennett KP. Quantifying representativeness in randomized clinical trials using machine learning fairness metrics. JAMIA Open 2021; 4:ooab077. [PMID: 34568771 PMCID: PMC8460438 DOI: 10.1093/jamiaopen/ooab077] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/19/2021] [Accepted: 09/03/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE We help identify subpopulations underrepresented in randomized clinical trials (RCTs) cohorts with respect to national, community-based or health system target populations by formulating population representativeness of RCTs as a machine learning (ML) fairness problem, deriving new representation metrics, and deploying them in easy-to-understand interactive visualization tools. MATERIALS AND METHODS We represent RCT cohort enrollment as random binary classification fairness problems, and then show how ML fairness metrics based on enrollment fraction can be efficiently calculated using easily computed rates of subpopulations in RCT cohorts and target populations. We propose standardized versions of these metrics and deploy them in an interactive tool to analyze 3 RCTs with respect to type 2 diabetes and hypertension target populations in the National Health and Nutrition Examination Survey. RESULTS We demonstrate how the proposed metrics and associated statistics enable users to rapidly examine representativeness of all subpopulations in the RCT defined by a set of categorical traits (eg, gender, race, ethnicity, smoking status, and blood pressure) with respect to target populations. DISCUSSION The normalized metrics provide an intuitive standardized scale for evaluating representation across subgroups, which may have vastly different enrollment fractions and rates in RCT study cohorts. The metrics are beneficial complements to other approaches (eg, enrollment fractions) used to identify generalizability and health equity of RCTs. CONCLUSION By quantifying the gaps between RCT and target populations, the proposed methods can support generalizability evaluation of existing RCT cohorts. The interactive visualization tool can be readily applied to identified underrepresented subgroups with respect to any desired source or target populations.
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Affiliation(s)
- Miao Qi
- Department of Computer Science, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - Owen Cahan
- Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - Morgan A Foreman
- Center for Computational Health, IBM Research, Cambridge, Massachusetts, USA
| | - Daniel M Gruen
- Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - Amar K Das
- Center for Computational Health, IBM Research, Cambridge, Massachusetts, USA
| | - Kristin P Bennett
- Department of Computer Science, Rensselaer Polytechnic Institute, Troy, New York, USA
- Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, New York, USA
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Narice BF, Almeida JR, Farrell T, Madhuvrata P. Impact of changing gloves during cesarean section on postoperative infective complications: A systematic review and meta-analysis. Acta Obstet Gynecol Scand 2021; 100:1581-1594. [PMID: 33871059 DOI: 10.1111/aogs.14161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/22/2021] [Accepted: 04/10/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The cesarean section rate around the world, currently estimated at 21.1%, continues to increase. Women who undergo a cesarean section sustain a seven- to ten-fold greater risk of infective morbidity compared with those who deliver vaginally. MATERIAL AND METHODS We aimed to assess the impact of changing gloves intraoperatively on post-cesarean section infective morbidity (PROSPERO CRD42018110529). MEDLINE, Scopus, Web of Science, CINAHL, WHO Global Index Medicus, and Cochrane Central were searched for randomized controlled trials until June 2020. Published randomized controlled trials that evaluated the effects of glove changing during cesarean section on infective complications were considered eligible for the review. Two reviewers independently selected studies, assessed the risk of bias, and extracted data about interventions and adverse maternal outcomes. Dichotomous variables were presented and included in the meta-analyses as risk ratios (RR) with 95% confidence intervals (CI). The quality of evidence was assessed using the GRADE approach in alignment with the recommendations from the Cochrane Review Group. RESULTS We identified seven randomized controlled trials reporting data over 1948 women. Changing gloves during a cesarean section was associated with a statistically significantly lower incidence of wound infective complications (RR 0.41, 95% CI 0.26-0.65, p < 0.0001; GRADE moderate quality evidence). This intervention seemed to be effective only if performed after delivery of the placenta. No significant difference was seen in the incidence of endometritis (RR 0.96, 95% CI 0.78-1.20, p = 0.74; GRADE moderate quality evidence) and/or febrile morbidity (RR 0.73, 95% CI 0.30-1.81, p = 0.50; GRADE moderate quality evidence), regardless of the timing of the intervention. CONCLUSIONS Changing gloves after delivery of the placenta during a cesarean section is associated with a significant reduction in the incidence of post-surgical wound complications compared with keeping the same gloves throughout the whole surgery. However, an adequately powered study to assess the limitations and cost-effectiveness of the intervention is needed before this recommendation can be translated into current clinical practice.
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Affiliation(s)
- Brenda F Narice
- Academic Unit of Reproductive and Developmental Medicine, Jessop Wing, University of Sheffield, Sheffield, UK
| | - Joana R Almeida
- Department of Obstetrics and Gynaecology, Jessop Wing, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Tom Farrell
- Women's Wellness & Research center, Hamad Medical Corporation, Doha, Qatar
| | - Priya Madhuvrata
- Department of Obstetrics and Gynaecology, Jessop Wing, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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Schutz S, Aidar FJ, Souza RLM, dos Santos JL, Voltarelli FA, Vieira Junior RC, Soares NMM, Marçal AC. Different Methods of Physical Training Applied to Women Breast Cancer Survivors: A Systematic Review. Front Physiol 2021; 12:639406. [PMID: 33935799 PMCID: PMC8079809 DOI: 10.3389/fphys.2021.639406] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
Objective: The objective of this systematic review was to identify the effects of different training methods in women who have survived breast cancer (WSBC). Data Sources: Studies were identified by searching SportDiscus, Web of Science, PubMed, Scopus, Scielo, and Bireme. Study Selection: The inclusion criteria were articles that addressed only breast cancer in women, were randomized clinical trials, and interventions involving physical training with Consort ≥80. Data Extraction: The PICO and CONSORT strategies were used for the selection of articles and quality assessment of randomized clinical trials, respectively. Two independent reviewers searched for articles among the databases. Disagreements were discussed, and in the case of an impasse, a third reviewer was consulted. Data Synthesis: Evidence that demonstrated the beneficial effects of physical exercise programs carried out by WSBC. Moderate or high-intensity exercise sessions have been shown to benefit women survivors of breast cancer. Among the modalities, the resistance exercise showed effects from 55% of one-repetition maximum (1 RM), exclusively or associated with other training regimes, such as aerobic (from 48% of heart rate), high-intensity interval training (HIIT), or impact. The main benefits include increased muscle strength, promoted by the practice of resistance exercise in combination with other types of exercises or alone; decreased fatigue; improved quality of life; improved psychosocial effects, and increased leisure time. Conclusions: Physical training performed at a moderate or high intensity (aerobic or anaerobic) can reduce fatigue, improve quality of life, improve sleep quality, and increase bone mineral density in women survivors of breast cancer.
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Affiliation(s)
- Silvia Schutz
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Felipe J. Aidar
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Group of Studies and Research of Performance, Sport, Health, and Paralympic Sports, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | | | - Jymmys Lopes dos Santos
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Department of Physiology, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Fabrício Azevedo Voltarelli
- Graduate Program of Health Sciences, Faculty of Medicine, Universidade Federal de Mato Grosso, Cuiabá, Brazil
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Ather A, Parolia A, Ruparel NB. Efficacy of Mouth Rinses Against SARS-CoV-2: A Scoping Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.648547] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction:The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva and nasopharyngeal secretions has challenged the routine practice of dentistry. Use of preprocedural mouth rinses has been recommended by several organizations to potentially reduce the transmission of SARS-CoV-2. This scoping review aimed at evaluating the available evidence on the efficacy of mouth rinses against SARS-CoV-2.Methods:A thorough literature search on electronic databases (PubMed, Scopus, and Google Scholar) was performed by two independent reviewers and data from articles addressing the aim of this article were extracted.Results:After exclusion of articles not addressing the end point in question, 12 articles were included in this scoping review. Of the 12 articles, seven werein vitrostudies and five werein vivohuman clinical studies. Thein vitrostudies used a standardized methodology (endpoint dilution assay) to evaluate the efficacy of antimicrobial mouth rinses against SARS-CoV-2. Thein vivostudies were done utilizing polymerase chain reaction assay of samples obtained from saliva or nasopharyngeal swab or a combination of both nasopharyngeal and oropharyngeal swab. The reagents tested in these studies included povidone-iodine, chlorhexidine, hydrogen peroxide (H2O2), essential oils, and quaternary ammonium compounds and demonstrated varied efficacy against SARS-CoV-2.Conclusion:Based on the available evidence fromin vitrostudies, it can be concluded that mouth rinses have a potential to reduce SARS-CoV-2 viral load; however, effectiveness inin vivoconditions is still inconclusive. Owing to the substantial heterogeneity in reporting of the anti–SARS-CoV-2 efficacy of mouth rinses, this review highlights the need to conduct future research with robust and standardized methodologies to confirm effectiveness of mouth rinses.
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Letter to the editor "Effect of a brief progressive resistance training program in hospital porters on pain, work ability and physical function". Musculoskelet Sci Pract 2021; 51:102263. [PMID: 33032972 DOI: 10.1016/j.msksp.2020.102263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/26/2020] [Indexed: 11/24/2022]
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Pocai BL, Provensi É, Serighelli F, Rigo G, Artioli DP, de Albuquerque CE, Bertolini GRF. Effect of photobiomodulation in the patellofemoral pain syndrome; randomized clinical trial in young women. J Bodyw Mov Ther 2021; 26:263-267. [PMID: 33992256 DOI: 10.1016/j.jbmt.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/05/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE patellofemoral pain syndrome (PFPS) is one of the most frequent musculoskeletal disorders in the knee joint, affecting mainly physically active adolescents and young adults; its main symptom is pain. Physiotherapy has several therapeutic modalities aimed at pain relief, among which are photobiomodulation (PBM). The aim of the study was to analyze the effects of using PBM in cluster form (Laser + LED) in patients with PFPS. PATIENTS AND METHODS This study is characterized as quantitative, experimental, randomized, composed of 30 women with PFPS, randomized into two groups: Control Group (CG) and PBM Group (PBMG). Both groups underwent three evaluations: pre-intervention, post-intervention, and after one month of follow-up. Participants of the PBMG were presented to the application of the cluster device, three times a week, for four weeks. The intensity of spontaneous pain and movement were evaluated, knee function tests and function questionnaires. The results showed a reduction in pain only for the landing of the jump. As for the other variables there was no interaction of factors; the questionnaires used showed larger effect sizes for PBMG when compared to CG. It is possible to conclude that the use of PBM showed benefit in reducing pain at the time of landing of the jump and functional assessment questionnaires.
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Affiliation(s)
- Bruna Lehmkuhl Pocai
- Physiotherapy Academic of the Universidade Estadual Do Oeste Do Paraná (Unioeste), Brazil
| | - Érica Provensi
- Physiotherapy Academic of the Universidade Estadual Do Oeste Do Paraná (Unioeste), Brazil
| | - Fernanda Serighelli
- Physiotherapy Academic of the Universidade Estadual Do Oeste Do Paraná (Unioeste), Brazil
| | - Geórgia Rigo
- Physiotherapy Academic of the Universidade Estadual Do Oeste Do Paraná (Unioeste), Brazil
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Pinheiro PNDC, Kendall BC, Kerr LRFS, Pickett KM, Luna IT, Costa MIFD, Luz LFDC. The south american context of diagnostic disclosure of adolescents infected by HIV/AIDS: a systematic literature review. ACTA ACUST UNITED AC 2020; 66:1139-1145. [PMID: 32935811 DOI: 10.1590/1806-9282.66.8.1139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/26/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyze the scientific evidence on the disclosure of the diagnostic of adolescents infected by HIV/AIDS in the South American context. DATABASE Systematic literature review using the PubMed, Cinahal, Embase, Cochrane, BVS, and Global Health databases and the descriptors: adolescent and HIV and family and Argentina or Bolivia or Brasil or Chile or Colombia or Ecuador or French Guiana or Paraguay or Peru or Uruguay or Venezuela. DATA SYNTHESIS Brasil was the country highlighted. It was verified that parents have a direct and indirect influence over the adolescents' life, especially regarding behaviors and health care. Dialog among family members can reduce adolescents' vulnerability to HIV and encourage diagnostic disclosure. CONCLUSION It is necessary to amplify research involving adolescents with HIV/AIDS and their parents/caregivers and family members to improve care and reduce the cases of the disease. It is suggested that policies of prevention and treatment should involve families, caregivers, partners, and the community.
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Affiliation(s)
| | - Bernard Carl Kendall
- . Tulane University, Research Support & Education Librarian - Tulane, New Orleans, EUA
| | - Ligia Regina Franco Sansigolo Kerr
- Doutora em Medicina pela Universidade de Ribeirão Preto. Professora titular da Universidade Federal do Ceará - UFC, Fortaleza, CE, Brasil
| | - Keith Michael Pickett
- . Master of Library and Information Science. Research Support & Education Librarian, Tulane University, New Orleans, LA, EUA
| | | | | | - Luisa Fânia da Costa Luz
- . Licenciada em Letras. Especialista em Língua Portuguesa pela Universidade Estadual do Ceará - UECE, Fortaleza, CE, Brasil
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Ramos-Barrera GE, DeLucia CM, Bailey EF. Inspiratory muscle strength training lowers blood pressure and sympathetic activity in older adults with OSA: a randomized controlled pilot trial. J Appl Physiol (1985) 2020; 129:449-458. [PMID: 32730174 DOI: 10.1152/japplphysiol.00024.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Previous work has shown lowered casual blood pressure after just 6 wk of inspiratory muscle strength training (IMST), suggesting IMST as a potential therapeutic in the prevention/treatment of hypertension. In this study, we assessed the effects of IMST on cardiovascular parameters in older, overweight adults diagnosed with moderate and severe obstructive sleep apnea (OSA). Subjects were randomly assigned to one of two interventions 1) high-intensity IMST (n = 15, 75% maximal inspiratory pressure), or 2) a control intervention (n = 10, 15% maximum inspiratory pressure). Subjects in both groups trained at home completing 30 training breaths/day, 5 days/wk for 6 wk. Pre- and posttraining measures included maximal inspiratory pressure, casual and ambulatory blood pressures, spontaneous cardiac baroreflex sensitivity, and muscle sympathetic nerve activity. Men and women in the high-intensity IMST group exhibited reductions in casual systolic (SBP), diastolic (DBP), and mean arterial blood pressures (MAP) [SBP: -8.82 ± 4.98 mmHg; DBP: -4.69 ± 2.81 mmHg; and MAP: -6.06 ± 1.03 mmHg; P < 0.002] and nighttime SBP (pre: -12.00 ± 8.20 mmHg; P < 0.01). Muscle sympathetic nerve activities also were lower (-6.97 ± 2.29 bursts/min-1; P = 0.01 and -9.55 ± 2.42 bursts/100 heartbeats; P = 0.002) by week 6. Conversely, subjects allocated to the control group showed no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward higher overnight blood pressures. A short course of high-intensity IMST may offer significant respiratory and cardiovascular benefits for older, overweight adults with OSA. For Clinical Trial Registration, see https://www.clinicaltrials.gov (Identifier: NCT02709941).NEW & NOTEWORTHY Older, obese adults with moderate-severe obstructive sleep apnea who perform 5 min/day high-intensity inspiratory muscle strength training (IMST) exhibit lowered casual and nighttime systolic blood pressure and sympathetic nervous outflow. In contrast, adults assigned to a control (low-intensity) intervention exhibit no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward increased overnight blood pressure. Remarkably, adherence to IMST even among sleep-deprived and exercise-intolerant adults is high (96%).
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Affiliation(s)
| | - Claire M DeLucia
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
| | - E Fiona Bailey
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
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Solikhah S, Nurdjannah S. Assessment of the risk of developing breast cancer using the Gail model in Asian females: A systematic review. Heliyon 2020; 6:e03794. [PMID: 32346636 PMCID: PMC7182726 DOI: 10.1016/j.heliyon.2020.e03794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 02/25/2020] [Accepted: 04/14/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Currently, the Breast Cancer Risk Assessment Tool (BCRAT), also known as the Gail model (GM) has been widely recognized and adapted for to study disparity in racial and ethnic groups in America including Asian and Pacific Islander American females. However, its applicability outside America remains uncertain due to diversity in epidemiology and risk factors of breast cancer in populations especially in Asian females. We sought to evaluate the performance of the GM to predict breast cancer risk in Asian countries. Material and methods This study identified articles published from 2010 by searching PubMed, MEDLINE, Scopus, Web of Science, Google Scholar and gray literature. The initial search terms were breast cancer, mammary, carcinoma, tumor, neoplasm, risk assessment tool, BCRAT, breast cancer prediction, Gail model, Asia, and Asian. Results The search yielded 20 articles, with 7 articles addressing the AUC and/or the expected (E) to observed (O) ratio of predicted breast cancer risk, representing the accuracy of the GM in the Asian population. One publication reported the sensitivity and specificity but no AUC. None of the studies were accepted as the standard for reporting prognostic models. Several studies reported good prognostic testing and likely developed a new model modifying the items in the instrument. Conclusion The results are not strong enough to develop breast cancer risk in the setting of Asian countries. Involving the breast cancer risk of the Asian population in developing a prognostic model with good statistical understanding is particularly important and can reduce flawed or biased models. Identifying the best methods to achieve well-suited prognostic models in the Asian population should be a priority.
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Affiliation(s)
- Solikhah Solikhah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, 55166, Indonesia.,Dynamic Social Study Center, Universitas Ahmad Dahlan, Yogyakarta, 55166, Indonesia
| | - Sitti Nurdjannah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, 55166, Indonesia
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Beishon L, Minhas JS, Nogueira R, Castro P, Budgeon C, Aries M, Payne S, Robinson TG, Panerai RB. INFOMATAS multi-center systematic review and meta-analysis individual patient data of dynamic cerebral autoregulation in ischemic stroke. Int J Stroke 2020; 15:807-812. [PMID: 32090712 PMCID: PMC7534203 DOI: 10.1177/1747493020907003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Rationale Disturbances in dynamic cerebral autoregulation after ischemic stroke may have important implications for prognosis. Recent meta-analyses have been hampered by heterogeneity and small samples. Aim and/or hypothesis The aim of study is to undertake an individual patient data meta-analysis (IPD-MA) of dynamic cerebral autoregulation changes post-ischemic stroke and to determine a predictive model for outcome in ischemic stroke using information combined from dynamic cerebral autoregulation, clinical history, and neuroimaging. Sample size estimates To detect a change of 2% between categories in modified Rankin scale requires a sample size of ∼1500 patients with moderate to severe stroke, and a change of 1 in autoregulation index requires a sample size of 45 healthy individuals (powered at 80%, α = 0.05). Pooled estimates of mean and standard deviation derived from this study will be used to inform sample size calculations for adequately powered future dynamic cerebral autoregulation studies in ischemic stroke. Methods and design This is an IPD-MA as part of an international, multi-center collaboration (INFOMATAS) with three phases. Firstly, univariate analyses will be constructed for primary (modified Rankin scale) and secondary outcomes, with key co-variates and dynamic cerebral autoregulation parameters. Participants clustering from within studies will be accounted for with random effects. Secondly, dynamic cerebral autoregulation variables will be validated for diagnostic and prognostic accuracy in ischemic stroke using summary receiver operating characteristic curve analysis. Finally, the prognostic accuracy will be determined for four different models combining clinical history, neuroimaging, and dynamic cerebral autoregulation parameters. Study outcome(s) The outcomes for this study are to determine the relationship between clinical outcome, dynamic cerebral autoregulation changes, and baseline patient demographics, to determine the diagnostic and prognostic accuracy of dynamic cerebral autoregulation parameters, and to develop a prognostic model using dynamic cerebral autoregulation in ischemic stroke. Discussion This is the first international collaboration to use IPD-MA to determine prognostic models of dynamic cerebral autoregulation for patients with ischemic stroke.
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Affiliation(s)
- L Beishon
- CHIASM Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - J S Minhas
- CHIASM Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - R Nogueira
- Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo, Post Brazil
| | - P Castro
- Stroke Unit and Department of Neurology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - C Budgeon
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - M Aries
- Department of Intensive Care, University Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
| | - S Payne
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - T G Robinson
- CHIASM Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - R B Panerai
- CHIASM Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
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Ochani RK, Shaikh A, Yamani N. Comments on "Reporting quality of randomized controlled trial abstracts in the seven highest-ranking anesthesiology journals". Trials 2019; 20:630. [PMID: 31744527 PMCID: PMC6862748 DOI: 10.1186/s13063-019-3857-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/25/2019] [Indexed: 11/10/2022] Open
Abstract
Randomized controlled trials are considered the gold standard in assessing treatment regimens, and since abstracts may be the only part of a paper that a physician reads, accurate reporting of data in abstracts is essential. The CONSORT checklist for abstracts was designed to standardize data reporting; however, for papers submitted to anesthesiology journals, the level of adherence to the CONSORT checklist for abstracts is unknown. Therefore, we commend Janackovic and Puljak for their efforts in determining the adherence of reports of trials in the highest-impact anesthesiology journals between 2014 and 2016. The results of their study are extremely important; however, we believe that that study had some methodological limitations, which we discuss in this manuscript.
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Affiliation(s)
- Rohan Kumar Ochani
- Department of Internal Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan.
| | - Asim Shaikh
- Department of Internal Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Naser Yamani
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
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