scholarly journals Ultrarapid Endoscopic-Aided Hematoma Evacuation in Patients with Thalamic Hemorrhage

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kuan-Yu Chen ◽  
Woon-Man Kung ◽  
Lu-Ting Kuo ◽  
Abel Po-Hao Huang
Keyword(s):  
Controlled Trial ◽  
Hematoma Evacuation ◽  
Evacuation Rate ◽  
Thalamic Hemorrhage ◽  
Primary Endpoints ◽  
Prospective Randomized Controlled Trial ◽  
The Mean ◽  
Ich Score

Thalamic hemorrhage bears the worst outcome among supratentorial intracerebral hemorrhage (ICH). Minimally invasive endoscopic-aided surgery (MIS) has been proved to be safe and effective in evacuating ICH. However, the ideal timing of MIS is still a controversy. In this study, we present our experience in the treatment of patients with thalamic hemorrhage by ultrarapid MIS evacuation. This retrospective analysis enrolled seven patients treated with ultrarapid MIS evacuation of thalamic hemorrhage. Seven patients treated with EVD with similar ICH score were included as match control. Primary endpoints included rebleeding, morbidity, and mortality. Hematoma evacuation rate was evaluated by comparing the pre- and postoperative computed tomography (CT) scans. Glasgow Outcome Scale Extended (GOSE) and modified Rankin Score (mRS) were noted at the 6-month and 1-year postoperative follow-up. Among the seven patients, six were accompanied with intraventricular hemorrhage. All patients received surgery within 6 hours after the onset of stroke. The mean hematoma volume was 35 mL, and the mean operative time was 116.4 minutes. The median hematoma evacuation rate was 74.9%. There was no rebleeding or death reported after the surgery. The median GOSE and mRS were 3 and 5, respectively, at 6 months postoperatively. Further, 1-year postoperative median GOSE and mRS were 3 and 5, respectively. The data suggest that the ultrarapid MIS technique is a safe and effective way in the management of selected cases with thalamic hemorrhage, with favorable long-term functional outcomes. However, a large, prospective, randomized-controlled trial is needed to confirm these findings.

Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results

2011 ◽  
Vol 30 (4) ◽  
pp. E9 ◽  
Author(s):  
Lu-Ting Kuo ◽  
Chien-Min Chen ◽  
Chien-Hsun Li ◽  
Jui-Chang Tsai ◽  
Hsiu-Chu Chiu ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Intracerebral Hemorrhage ◽  
Morbidity And Mortality ◽  
Long Term Results ◽  
Hematoma Evacuation ◽  
Evacuation Rate ◽  
Case Selection ◽  
The Mean

Object Currently, the effectiveness of minimally invasive evacuation of intracerebral hemorrhage (ICH) utilizing the endoscopic method is uncertain and the technique is considered investigational. The authors analyzed their experience with this method in terms of case selection, surgical technique, and long-term results. Methods The authors performed a retrospective analysis of the clinical and radiographic data obtained in 68 patients treated with endoscope-assisted ICH evacuation. Rebleeding, morbidity, and mortality were recorded as primary end points. Hematoma evacuation rate was calculated by comparing the pre- and postoperative CT scans. Glasgow Coma Scale scores and scores on the extended Glasgow Outcome Scale (GOSE) were recorded at the 6-month postoperative follow-up. The technical aspect of this report explains details of the procedure, the instruments that are used, the methods for hemostasis, and the role of hemostatic agents in the management of intraoperative hemorrhage. The pertinent literature was reviewed and summarized. Results All surgeries were performed within 12 hours of ictus, and 84% of the surgeries were performed within 4 hours. The mortality rate was 5.9%, and surgery-related morbidity occurred in 3 cases (4.4%). The hematoma evacuation rate was 93% overall—96% in the putaminal group, 86% in the thalamic group, and 98% in the subcortical group. The rebleeding rate was 1.5%. The mean operative time was 85 minutes, and the average blood loss was 56 ml. The mean GOSE score was 4.9 at 6-month follow-up. The authors acknowledge the limitations of these preliminary results in a small number of patients. Conclusions The data suggest that early endoscope-assisted ICH evacuation is safe and effective in the management of supratentorial ICH. The rebleeding, morbidity, and mortality rates are low compared with rates reported in the literature for the traditional craniotomy method. This study also showed that early and complete evacuation of ICH may lead to improved outcomes in selected patients. However, the safety and efficacy of endoscope-assisted ICH evacuation should be further investigated in a large, prospective, randomized trial.

scholarly journals Prospective, Randomized, Controlled Trial Using Best-Selling Smoking-Cessation Book

2017 ◽  
Vol 96 (7) ◽  
pp. 258-263
Author(s):  
James P. Foshee ◽  
Anita Oh ◽  
Adam Luginbuhl ◽  
Joseph Curry ◽  
William Keane ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Controlled Trial ◽  
Smoking Cessation Counseling ◽  
Randomized Controlled ◽  
Quit Smoking ◽  
Stop Smoking ◽  
Prospective Randomized Controlled Trial

Our prospective, randomized, controlled trial aimed to evaluate the efficacy of the self-help book, The Easy Way to Stop Smoking, by Allen Carr, in promoting smoking cessation in patients with head and neck cancer. We assessed active smokers for their willingness to read a smoking cessation book. Participants were randomized to either receive the book from our department or recommended to purchase the book. All patients received smoking cessation counseling at recruitment. Phone surveys were conducted at short- and long-term intervals to determine if the patients had purchased and/or read the book and whether they were still smoking. One hundred twelve patients were recruited, 52 of whom completed follow-up surveys. Those who received the book for free were more likely to read the book (p = 0.05). Reading the book did not correlate with successful smoking cessation (p = 0.81). Some 26% of the 27 patients who received the book quit smoking compared with 32% of the 25 patients who were recommended the book (p = 0.76). Patients who indicated motivation to quit smoking were more likely to succeed. In our study, smoking cessation did not appear to be influenced by reading The Easy Way to Stop Smoking. Despite 80.8% of the cohort indicating at least a readiness to quit smoking at recruitment, only 28.8% of patients managed to achieve successful smoking cessation at long-term follow-up. Patient motivation remains an important factor in achieving long-term smoking abstinence. Quitting smoking remains a daunting challenge for patients, with multiple interventions likely needed to achieve cessation.

scholarly journals Desarda repair no Mesh and Lichtenstein repair for inguinal hernia (A study of 2793 patients)

2021 ◽  
Vol 3 (9) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
Duration Of Surgery ◽  
The Mean ◽  
Location Type

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair.

scholarly journals Desarda Repair No Mesh and Lichtenstein Repair for Inguinal Hernia a Study of 2793 Patients

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
Duration Of Surgery ◽  
The Mean ◽  
Location Type

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair

A 12-month follow-up study of “RedUSe”: a trial aimed at reducing antipsychotic and benzodiazepine use in nursing homes

2011 ◽  
Vol 23 (8) ◽  
pp. 1260-1269 ◽  
Author(s):  
Juanita Westbury ◽  
Lisette Tichelaar ◽  
Gregory Peterson ◽  
Peter Gee ◽  
Shane Jackson
Keyword(s):  
Nursing Homes ◽  
Controlled Trial ◽  
Study Data ◽  
Follow Up Study ◽  
Benzodiazepine Use ◽  
The Mean ◽  
Long Term Impact ◽  
Dose Reductions

ABSTRACTBackground: To assess the long-term impact of the “Reducing Use of Sedatives” (RedUSe) trial on antipsychotic and benzodiazepine prevalence and dosage.Methods: RedUSe was a six-month controlled trial conducted in 25 Tasmanian nursing homes in 2008–9 which led to significant reductions in benzodiazepine and antipsychotic use and a doubling of dose reductions of these agents. In a follow-up study, data on psychotropic use was collected from all nursing homes a year after the final RedUSe measure. Mean daily doses for each home were calculated by converting antipsychotic and benzodiazepine doses to chlorpromazine and diazepam equivalents, respectively. To determine the long-term impact of the project, 6-month and initial baseline data were compared to the 18-month follow-up data.Results: 1578 residents were audited for the follow-up measure. In the 18 months since the RedUSe project was instigated, benzodiazepine prevalence fell by 25% in intervention nursing homes. Similarly, the mean daily diazepam equivalence in these homes had fallen by 24%. In contrast, after a significant reduction during the RedUSe trial, antipsychotic prevalence returned to baseline levels in intervention nursing homes, with mean chlorpromazine equivalence remaining relatively constant with time. There was a delayed reduction in benzodiazepine and antipsychotic use in the control homes.Conclusions: Both benzodiazepine usage and mean daily diazepam equivalence continued to decline in intervention nursing homes in the year following the RedUSe trial. However, the effect of the RedUSe intervention on antipsychotic prevalence and dosage was not sustained.

ShishuPushti Trial: a cluster randomized controlled trial to evaluate extended peer counselling for improving feeding practices and reducing undernutrition in children aged 0-48 months in urban Bangladesh. (Preprint)

2021 ◽  
Author(s):  
Seema Mihrshahi ◽  
Gulshan Ara ◽  
Mansura Khanam ◽  
Sabrina Rasheed ◽  
Kingsley Agho ◽  
...  
Keyword(s):  
Complementary Feeding ◽  
Controlled Trial ◽  
Feeding Practices ◽  
Child Growth ◽  
Control Group ◽  
The Mean ◽  
Cluster Randomized ◽  
Peer Counselling

BACKGROUND Lack of exclusive breastfeeding and inappropriate complementary feeding are critical factors in reducing child undernutrition, morbidity and mortality. There are reported trials of peer counselling to improve breastfeeding; however, they did not examine the efficacy of peer counselling to improve complementary feeding or the long-term impacts on child growth and development. OBJECTIVE To assess if peer counselling of women improves breastfeeding and complementary feeding practices, child growth and reduces the prevalence of undernutrition in their children up to four years of age. METHODS This study will use a community-based, cluster randomized controlled trial (cRCT) with a superiority design and two parallel treatment arms. It will assess the impact of a peer-counselling starting in the late pregnancy to one year after delivery on child feeding practices, growth and development with follow-up until 48 months of age. The study site will be in Mirpur, a densely populated area in Dhaka. Using satellite maps and GIS mapping, we will construct 36 clusters with an average population of 5,000 people. We will recruit pregnant women in the third trimester aged 16-40 years, with no more than three living children. Trained peer counsellors will visit women at home twice before delivery, four times in the first month; then monthly from 2 to 6 months, and again at 9 and 12 months. Trained research assistants will collect anthropometric measurements. The primary outcome will be differences in child stunting and mean length-for-age at 6, 12, 15, 18 months. Secondary outcomes will be differences in the percentage of women exclusively breastfeeding, in the mean duration of any breastfeeding, in the percentage of children at 6 and 9 months of age who receive solid, semi-solid or soft foods and the percentage of children consuming foods from 4 or more food groups at 9, 12, 15 and 18 months. We will assess the mean cognitive function scores from the Ages and Stages Questionnaire (9 and 18 months) and Bayley tests (24 and 36 months). RESULTS We identified 65,535 people in mapped residences, from which we defined 36 clusters and randomly allocated them equally to intervention or control groups stratified by cluster socio-economic status. From July 2011 to May 2013, we identified 1056 pregnant women and 993 births in the intervention and 994 pregnancies and 890 births in the control group. At 18 months, 692 children remained in the intervention, and 551 in the control group. From January 2015 to February 2017, we conducted the long term follow-up of the cohort. We have now completed the data collection and processing and have started analyses. CONCLUSIONS This study will help fill the evidence gap about the short- and long-term impact of peer counselling on improving infant feeding, preventing childhood undernutrition, and enhancing child cognitive development. CLINICALTRIAL NCT01333995

scholarly journals Prospective, Randomized, Controlled Trial using Best-Selling Smoking-Cessation Book

2017 ◽  
Vol 96 (7) ◽  
pp. 258-262
Author(s):  
James P. Foshee ◽  
Anita Oh ◽  
Adam Luginbuhl ◽  
Joseph Curry ◽  
William Keane ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Controlled Trial ◽  
Smoking Cessation Counseling ◽  
Randomized Controlled ◽  
Quit Smoking ◽  
Stop Smoking ◽  
Prospective Randomized Controlled Trial

Our prospective, randomized, controlled trial aimed to evaluate the efficacy of the self-help book, The Easy Way to Stop Smoking, by Allen Carr, in promoting smoking cessation in patients with head and neck cancer. We assessed active smokers for their willingness to read a smoking cessation book. Participants were randomized to either receive the book from our department or recommended to purchase the book. All patients received smoking cessation counseling at recruitment. Phone surveys were conducted at short- and long-term intervals to determine if the patients had purchased and/or read the book and whether they were still smoking. One hundred twelve patients were recruited, 52 of whom completed follow-up surveys. Those who received the book for free were more likely to read the book (p = 0.05). Reading the book did not correlate with successful smoking cessation (p = 0.81). Some 26% of the 27 patients who received the book quit smoking compared with 32% of the 25 patients who were recommended the book (p = 0.76). Patients who indicated motivation to quit smoking were more likely to succeed. In our study, smoking cessation did not appear to be influenced by reading The Easy Way to Stop Smoking. Despite 80.8% of the cohort indicating at least a readiness to quit smoking at recruitment, only 28.8% of patients managed to achieve successful smoking cessation at long-term follow-up. Patient motivation remains an important factor in achieving long-term smoking abstinence. Quitting smoking remains a daunting challenge for patients, with multiple interventions likely needed to achieve cessation.

scholarly journals SHOULDICE VERSUS LICHTENSTEIN REPAIR

2010 ◽  
Vol 17 (03) ◽  
pp. 355-359
Author(s):  
WASEEM SADIQ AWAN ◽  
MUHAMMAD REHMAN GULZAR ◽  
GHULAM MUSTAFA ARAIN ◽  
Raza Younus
Keyword(s):  
Controlled Trial ◽  
Lichtenstein Repair ◽  
Tension Free ◽  
Shouldice Repair ◽  
Medical College ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference ◽  
The Mean ◽  
Surgical Unit

Objective: To compare the results of tissue based Shouldice repair with the Lichtenstein tension free repair of inguinal hernia. Design: A prospective randomized controlled trial. Period: From Jan 2004 to Dec 2006. Setting: Surgical Unit-II, Allama Iqbal Medical College / Jinnah Hospital Lahore, Pakistan. Patients & Methods: A total of 156 patients were included in this study were equally divided into two groups. Results: The mean age was 45 years. After a follow up of upto 2 years there was significant difference in the recurrence rate. It was 5% in the Shouldice group and 1.28 %in the Lichtenstein group. Similarly chronic pain was also much higher i.e. 5% in the Shouldice group compared to 1.28% in Lichtenstein Group. The rate of hematoma and seroma formation was the same (1.28%) in both groups, however infection was seen slightly more in Lichtenstein repair (3.84%) as compared to Shouldice repair (2.56%). Conclusion: Tension free Lichtenstein technique was found to be superior to the tissue based Shouldice repair with respect to post operative complications and recurrence.

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