Pharmacologic Treatment of Agitation in Dementia: A Comprehensive Review

1996 ◽  
Vol 9 (3) ◽  
pp. 107-119 ◽  
Author(s):  
Melinda S. Lantz ◽  
Deborah Marin
Keyword(s):  
Sample Size ◽  
Diagnostic Criteria ◽  
Disruptive Behavior ◽  
Small Sample Size ◽  
Treatment Strategies ◽  
Small Sample ◽  
Pharmacologic Treatment ◽  
Comprehensive Review ◽  
Pharmacologic Treatments ◽  
Growing Population

Agitated behaviors are a common and nearly universal occurrence among patients suffering from dementing illnesses. The pharmacologic treatments available for this troubling syndrome are varied, but treatment studies are limited. Clinicians are frequently faced with the challenging management of patients with disruptive behavior who fail to respond to trials with multiple agents. This review summarizes available treatment studies of agitation in dementia and offers a guide to therapy and management. Reports of therapies for agitation in dementia are limited by lack of controlled studies, variability of diagnostic criteria and outcome measures, and small sample size. The need for carefully designed, well-controlled studies of outcome in this growing population is formidable. It is imperative to identify effective and well-tolerated treatment strategies to reduce the morbidity of these distressing and burdensome symptoms.

Application of Ultrasound Elastography for Assessing Intestinal Fibrosis in Inflammatory Bowel Disease: Fiction or Reality?

2020 ◽  
Vol 21 ◽  
Author(s):  
Roberto Gabbiadini ◽  
Eirini Zacharopoulou ◽  
Federica Furfaro ◽  
Vincenzo Craviotto ◽  
Alessandra Zilli ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Sample Size ◽  
Bowel Disease ◽  
Small Sample Size ◽  
Shear Wave Elastography ◽  
Small Sample ◽  
Ultrasound Elastography ◽  
Invasive Technique ◽  
Intestinal Fibrosis ◽  
Inflammatory Bowel

Background: Intestinal fibrosis and subsequent strictures represent an important burden in inflammatory bowel disease (IBD). The detection and evaluation of the degree of fibrosis in stricturing Crohn’s disease (CD) is important to address the best therapeutic strategy (medical anti-inflammatory therapy, endoscopic dilation, surgery). Ultrasound elastography (USE) is a non-invasive technique that has been proposed in the field of IBD for evaluating intestinal stiffness as a biomarker of intestinal fibrosis. Objective: The aim of this review is to discuss the ability and current role of ultrasound elastography in the assessment of intestinal fibrosis. Results and Conclusion: Data on USE in IBD are provided by pilot and proof-of-concept studies with small sample size. The first type of USE investigated was strain elastography, while shear wave elastography has been introduced lately. Despite the heterogeneity of the methods of the studies, USE has been proven to be able to assess intestinal fibrosis in patients with stricturing CD. However, before introducing this technique in current practice, further studies with larger sample size and homogeneous parameters, testing reproducibility, and identification of validated cut-off values are needed.

scholarly journals Treatment strategies for cerebrospinal shunt infections: a systematic review of observational studies

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038978
Author(s):  
Joan L Robinson ◽  
Dolores Freire ◽  
Liza Bialy
Keyword(s):  
Systematic Review ◽  
Small Sample Size ◽  
Treatment Strategies ◽  
Small Sample ◽  
Cochrane Library ◽  
Csf Shunt ◽  
Entry Site ◽  
Recurrence Rates ◽  
Ovid Medline ◽  
Shunt Infections

ObjectiveA systematic review was conducted of studies comparing time to cerebrospinal fluid (CSF) sterilisation or rate of recurrence with different treatment strategies for CSF shunt infections.MethodsA librarian-directed search was conducted of Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid Medline Daily and Ovid Medline, Ovid Embase, Wiley Cochrane Library, CINAHL Plus with Full Text via EBSCOhost, Scopus Advanced Search, and Web of Science Core Collection from 1990 to May 2019. Studies of any design that compared outcomes in groups of any age with different management strategies were included. Studies that compared complete versus incomplete shunt removal were excluded. Quality assessment was performed with the Newcastle-Ottawa Scale.ResultsThe search identified 2208 records, of which 8 met the inclusion criteria. All were cohort studies of moderate quality. Four studies compared the duration of antibiotics; none demonstrates that a longer course prevented recurrences. Two studies analysed addition of rifampin, with one showing a decrease in recurrences while the other had a small sample size. No studies analysed the addition of intraventricular antibiotics, but one showed equally good results with once versus twice daily administration. One study reported no difference in recurrences with placement of antibiotic-impregnated catheters. Recurrence rates did not differ with shunt replacement minimum of 7 days vs less than 7 days after CSF became sterile. There were no recurrences in either group when shunt replacement was performed after sterile CSF cultures were obtained at 24 vs 48 hours after antibiotics were discontinued. A new shunt entry site did not decrease recurrences.DiscussionThe main limitations are the lack of high-quality studies, the small sample sizes and the heterogeneity which precluded meta-analysis. Addition of rifampin for staphylococcal infections may decrease relapse but requires further study.

scholarly journals Confirming known planetary trends using a photometrically selected Kepler sample

2020 ◽  
Author(s):  
Jonah T Hansen ◽  
Luca Casagrande ◽  
Michael J Ireland ◽  
Jane Lin
Keyword(s):  
Sample Size ◽  
Robust Statistics ◽  
Narrow Band ◽  
Small Sample Size ◽  
Small Sample ◽  
Fitting Algorithm ◽  
Statistical Studies ◽  
The Rich ◽  
Host Stars ◽  
High Metallicity

Abstract Statistical studies of exoplanets and the properties of their host stars have been critical to informing models of planet formation. Numerous trends have arisen in particular from the rich Kepler dataset, including that exoplanets are more likely to be found around stars with a high metallicity and the presence of a “gap” in the distribution of planetary radii at 1.9 R⊕. Here we present a new analysis on the Kepler field, using the APOGEE spectroscopic survey to build a metallicity calibration based on Gaia, 2MASS and Strömgren photometry. This calibration, along with masses and radii derived from a Bayesian isochrone fitting algorithm, is used to test a number of these trends with unbiased, photometrically derived parameters, albeit with a smaller sample size in comparison to recent studies. We recover that planets are more frequently found around higher metallicity stars; over the entire sample, planetary frequencies are 0.88 ± 0.12 percent for [Fe/H] < 0 and 1.37 ± 0.16 percent for [Fe/H] ≥ 0 but at two sigma we find that the size of exoplanets influences the strength of this trend. We also recover the planet radius gap, along with a slight positive correlation with stellar mass. We conclude that this method shows promise to derive robust statistics of exoplanets. We also remark that spectrophotometry from Gaia DR3 will have an effective resolution similar to narrow band filters and allow to overcome the small sample size inherent in this study.

scholarly journals The use of diversity indices for local assessment of marine sediment quality

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinya Hosokawa ◽  
Kyosuke Momota ◽  
Anthony A. Chariton ◽  
Ryoji Naito ◽  
Yoshiyuki Nakamura
Keyword(s):  
Community Structure ◽  
Sample Size ◽  
Small Sample Size ◽  
Benthic Communities ◽  
Sediment Quality ◽  
Diversity Indices ◽  
Small Sample ◽  
Species Density ◽  
Local Case ◽  
Two Indices

AbstractDiversity indices are commonly used to measure changes in marine benthic communities. However, the reliability (and therefore suitability) of these indices for detecting environmental change is often unclear because of small sample size and the inappropriate choice of communities for analysis. This study explored uncertainties in taxonomic density and two indices of community structure in our target region, Japan, and in two local areas within this region, and explored potential solutions. Our analysis of the Japanese regional dataset showed a decrease in family density and a dominance of a few species as sediment conditions become degraded. Local case studies showed that species density is affected by sediment degradation at sites where multiple communities coexist. However, two indices of community structure could become insensitive because of masking by community variability, and small sample size sometimes caused misleading or inaccurate estimates of these indices. We conclude that species density is a sensitive indicator of change in marine benthic communities, and emphasise that indices of community structure should only be used when the community structure of the target community is distinguishable from other coexisting communities and there is sufficient sample size.

scholarly journals Reliability estimation for drive axle of wheel loader under extreme small sample

2019 ◽  
Vol 11 (3) ◽  
pp. 168781401983684 ◽  
Author(s):  
Leilei Cao ◽  
Lulu Cao ◽  
Lei Guo ◽  
Kui Liu ◽  
Xin Ding
Keyword(s):  
Sample Size ◽  
Promising Result ◽  
Small Sample Size ◽  
Bootstrap Method ◽  
Estimation Method ◽  
Small Sample ◽  
Reliability Estimation ◽  
Fatigue Reliability ◽  
Drive Axle ◽  
Semi Empirical

It is difficult to have enough samples to implement the full-scale life test on the loader drive axle due to high cost. But the extreme small sample size can hardly meet the statistical requirements of the traditional reliability analysis methods. In this work, the method of combining virtual sample expanding with Bootstrap is proposed to evaluate the fatigue reliability of the loader drive axle with extreme small sample. First, the sample size is expanded by virtual augmentation method to meet the requirement of Bootstrap method. Then, a modified Bootstrap method is used to evaluate the fatigue reliability of the expanded sample. Finally, the feasibility and reliability of the method are verified by comparing the results with the semi-empirical estimation method. Moreover, from the practical perspective, the promising result from this study indicates that the proposed method is more efficient than the semi-empirical method. The proposed method provides a new way for the reliability evaluation of costly and complex structures.

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