scholarly journals Efficacy of a small-caliber colonoscope for pain in female patients during unsedated colonoscopy: a randomized controlled study

2021 ◽  
Vol 09 (07) ◽  
pp. E1055-E1061
Author(s):  
Yasuhiko Hamada ◽  
Kyosuke Tanaka ◽  
Masaki Katsurahara ◽  
Noriyuki Horiki ◽  
Reiko Yamada ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Analysis Of Covariance ◽  
Randomized Controlled Study ◽  
Pelvic Surgery ◽  
Controlled Study ◽  
Patient Acceptance ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Maximum Pain ◽  
Cecal Intubation Rate

Abstract Background and study aims Female sex has been identified as a factor increasing patients’ pain during colonoscopy. The aim of this randomized controlled study was to investigate the efficacy of a small-caliber colonoscope, PCF-PQ260 L, for limiting pain in women during unsedated colonoscopy. Patients and methods Women who underwent unsedated colonoscopy were randomly allocated to either the small-caliber or standard colonoscope group. The primary outcome was overall pain and secondary outcomes were maximum pain and procedural measures. In addition, the effects of colonoscope type were analysed using analysis of covariance and logistic regression with adjustment for stratification factors, age and prior abdomino-pelvic surgery. Results A total of 220 women were randomly assigned to the small-caliber (n = 110) or standard (n = 110) colonoscope groups. Overall and maximum pain scores were significantly lower in the small-caliber colonoscope group than the standard colonoscope group (overall pain, 20.0 vs. 32.4, P < 0.0001; maximum pain, 28.9 vs. 47.2, P < 0.0001). The small-caliber colonoscope group achieved a superior cecal intubation rate (99 % vs. 93 %, P = 0.035). The rate of patient acceptance of unsedated colonoscopy in the future was higher in the small-caliber colonoscope group than in the standard colonoscope group (98 % vs. 87 %, P = 0.003). In addition, the small-caliber colonoscope was superior with respect to reducing pain and improving the rate of patient acceptance of unsedated colonoscopy with adjustment. Conclusions This study demonstrates the efficacy of the small-caliber colonoscope for reducing pain in women and improving their rate of acceptance of unsedated colonoscopy.

Warm or refrigerated local anaesthetic for open carpal tunnel release: a single blind randomized controlled study

2009 ◽  
Vol 35 (3) ◽  
pp. 232-233 ◽  
Author(s):  
P. J. Tomlinson ◽  
J. Field
Keyword(s):  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Room Temperature ◽  
Carpal Tunnel Release ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Open Carpal Tunnel Release ◽  
Patients Experience

The aim of this randomized controlled study was to determine whether administration of lignocaine with adrenaline is less painful when injected at room temperature compared to refrigerated temperature. A cohort of 50 patients undergoing unilateral carpal tunnel decompression was randomized to room temperature or refrigerated local anaesthetic. Pain scores were assessed using a 10 mm visual analogue scale. Mean pain scores were 4.0 (SD ± 1.5) for room temperature and 6.5 (SD ± 1.7) for refrigerated local anaesthetic ( P < 0.001). This study demonstrates that patients experience greater pain levels with administration of local anaesthetic at refrigerated temperatures prior to open carpal tunnel release.

Comparison catheter ablation versus permanent pacemaker implantation in patients with tachycardia-bradycardia syndrome: prospective, randomized trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K.J Choi ◽  
G.B Nam ◽  
J.H Zo ◽  
J.H Lee ◽  
M.S Cho ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Initial Treatment ◽  
Primary Outcome ◽  
Pacemaker Implantation ◽  
Similar Efficacy ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Randomized Controlled

Abstract Background Clinical outcomes after catheter ablation (CA) or pacemaker (PM) implantation for tachycardia-bradycardia syndrome (TBS) has not been well evaluated. Purpose This randomized controlled study compared the efficacy and safety outcomes of CA and PM implantation as an initial treatment for TBS with paroxysmal atrial fibrillation (AF). Methods A total of 70 patients with paroxysmal AF and TBS (mean 64 years, 64.3% male) underwent randomization, and received CA (CA group, n=35) or PM (PM group, n=35) as an initial treatment. The primary outcome was unexpected emergency room visit or hospitalization from any cardiovascular causes. Results The two groups were well-balanced with respect to the baseline characteristics except for difference in age (61.0±8.0 vs. 66.2±7.2, P=0.005). In the intention-to-treatment analysis, the rate of primary outcome was not significantly different between two groups at 2-years of follow-up (19.8% vs. 24.2%; HR 1.25, 95% CI 0.42–3.73, P=0.684). The same trend was noted when the result was adjusted for age (HR 1.16 95% CI 0.26–2.89, P=0.807). The rate of recurrent AF was significantly lower in CA group compared to PM group (24.0% vs. 100% at 2-yreas, P&lt;0.001). Four patients (11.4%) in CA group finally received PM implantation after CA due to syncope. The rate of major or minor procedure related complications was not significantly different between two groups (14.3% vs. 14.3%, P&gt;0.99). Conclusion In this randomized controlled study, CA was associated with a similar efficacy and safety with higher rate of sinus rhythm maintenance. CA could be considered a preferable treatment option over PM implantation in patients with paroxysmal AF and TBS. Funding Acknowledgement Type of funding source: None

scholarly journals Effects of a Differential Diagnosis List of Artificial Intelligence on Differential Diagnoses by Physicians: An Exploratory Analysis of Data from a Randomized Controlled Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5562
Author(s):  
Yukinori Harada ◽  
Shinichi Katsukura ◽  
Ren Kawamura ◽  
Taro Shimizu
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Primary Outcome ◽  
Intervention Group ◽  
Exploratory Analysis ◽  
Differential Diagnoses ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled

A diagnostic decision support system (DDSS) is expected to reduce diagnostic errors. However, its effect on physicians’ diagnostic decisions remains unclear. Our study aimed to assess the prevalence of diagnoses from artificial intelligence (AI) in physicians’ differential diagnoses when using AI-driven DDSS that generates a differential diagnosis from the information entered by the patient before the clinical encounter on physicians’ differential diagnoses. In this randomized controlled study, an exploratory analysis was performed. Twenty-two physicians were required to generate up to three differential diagnoses per case by reading 16 clinical vignettes. The participants were divided into two groups, an intervention group, and a control group, with and without a differential diagnosis list of AI, respectively. The prevalence of physician diagnosis identical with the differential diagnosis of AI (primary outcome) was significantly higher in the intervention group than in the control group (70.2% vs. 55.1%, p < 0.001). The primary outcome was significantly >10% higher in the intervention group than in the control group, except for attending physicians, and physicians who did not trust AI. This study suggests that at least 15% of physicians’ differential diagnoses were affected by the differential diagnosis list in the AI-driven DDSS.

Foreign language learning in older age does not improve memory or intelligence: Evidence from a randomized controlled study.

2020 ◽  
Vol 35 (2) ◽  
pp. 212-219
Author(s):  
Rasmus Berggren ◽  
Jonna Nilsson ◽  
Yvonne Brehmer ◽  
Florian Schmiedek ◽  
Martin Lövdén
Keyword(s):  
Foreign Language ◽  
Language Learning ◽  
Foreign Language Learning ◽  
Older Age ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled
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