scholarly journals Undescended testes: a consensus on management

2008 ◽  
Vol 159 (suppl_1) ◽  
pp. S87-S90 ◽  
Author(s):  
E Martin Ritzén
Keyword(s):  
Hormonal Treatment ◽  
Nordic Countries ◽  
Controlled Study ◽  
Optimal Time ◽  
Paediatric Surgery ◽  
Undescended Testes ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Meta Analyses ◽  
Local Traditions

The mode of treatment best for undescended testes is controversial, and local traditions often override knowledge gained from randomized controlled studies. In order to reach a consensus within the Nordic countries on the current state-of-the-art of treatment, a group of specialists in testicular physiology, paediatric surgery/urology, endocrinology, andrology, pathology and anaesthesiology from all the Nordic countries met for 2 days. Before the meeting, reviews of the literature had been prepared by the participants. Judging from published meta-analyses, hormonal treatment has low efficacy. Although 15–20% of retained testes descend during hormonal treatment, one-fifth of these re-ascend later on. Also, treatment with human chorionic gonadotropin (hCG) may be harmful to future spermatogenesis through increased apoptosis of germ cells. Orchiopexy, on the contrary, results in about 95% anatomical success, with a low (about 1%) risk of complications. The optimal time for orchiopexy has also been debated. However, a recent randomized controlled study shows that surgery at 9 months of age is followed by a better post-operative growth of the testes than surgery at 3 years, which supports previous arguments for early surgery. The unanimous conclusion of the group was that surgery is generally the preferred mode of treatment, rather than hCG or GnRH treatments. Orchiopexy should be performed between 6 and 12 months of age, or soon after diagnosis, if that occurs later. If a testis is found to be undescended at any age after 6 months, the patient should be referred for surgery. Referral should be to paediatric rather than general surgeons/urologists if the boy is less than 1 year old, if he has bilateral or non-palpable testes, or if he has got relapse of cryptorchidism.

Daflon 500 mg: Symptoms and Edema

Angiology ◽  
2005 ◽  
Vol 56 (6_suppl) ◽  
pp. S25-S32 ◽  
Author(s):  
Albert-Adrien Ramelet
Keyword(s):  
Quality Of Life ◽  
Controlled Study ◽  
Venous Disease ◽  
Double Blind Study ◽  
Life Questionnaire ◽  
Double Blind ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Significant Difference

Patients suffering from any class of the Clinical, Etiological, Anatomical, Pathophysiological (CEAP) classification of chronic venous disease (CVD) may be symptomatic (C0s-C6s). Leg heaviness, discomfort, itching, cramps, pain, paresthesia, and edema (C3) are the most frequent manifestations of CVD and a major reason for medical consultation. Daflon 500 mg (micronized purified flavonoid fraction [MPFF]) is an effective treatment for symptoms and edema in CVD as demonstrated in several randomized controlled studies. A 2-month, double-blind study in 40 patients established the superiority of Daflon 500 mg over placebo with regard to symptoms and objective signs. This was confirmed in another double-blind, placebo-controlled trial (2 months’ treatment, 160 patients), and in the Reflux assEssment and quaLity of lIfe improvEment with micronized Flavonoids (RELIEF) study. The latter included 5,052 patients in 23 countries, using a visual analog scale for evaluating pain, leg heaviness, cramps, and a sensation of swelling. All symptoms showed significant and progressive improvement. The quality-of-life results (scores on the ChronIc Venous Insufficiency quality of life Questionnaire [CIVIQ]) paralleled those of symptoms. The decrease in the ankle and calf circumferences was significantly greater (p<0.001) in the group of patients treated with Daflon 500 mg in two studies, and correlated well with the improvement in the sensation of swelling (p<0.001). This was confirmed with more sophisticated measurement techniques as in the RELIEF study or in a trial assessing edema with an optoelectronic volumeter in 20 patients. A further double-blind, randomized, controlled study established a statistically significant difference in favor of Daflon 500 mg in comparison with diosmin, both on symptoms and edema. The therapeutic efficacy of Daflon 500 mg on CVD symptoms and edema has been demonstrated in double-blind, randomized, controlled studies. Further studies using a new approach may define the most precise and validated methodology for application in future research in phlebology.

Challenges of Meta-Analyses Pooling Non-Randomized Controlled Studies

2008 ◽  
Vol 101 (5) ◽  
pp. 743 ◽  
Author(s):  
Marzia Lotrionte ◽  
Giuseppe G.L. Biondi-Zoccai ◽  
Imad Sheiban
Keyword(s):  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Meta Analyses

Power Therapies and Possible Threats to the Science of Psychology and Psychiatry

2005 ◽  
Vol 39 (6) ◽  
pp. 437-445 ◽  
Author(s):  
Grant J. Devilly
Keyword(s):  
Randomized Controlled Trials ◽  
Eye Movement ◽  
Psychiatric Care ◽  
Controlled Trials ◽  
Therapeutic Effectiveness ◽  
New Therapies ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Theories Of Action ◽  
Meta Analyses

Objective: Advocates of new therapies frequently make bold claims regarding therapeutic effectiveness, particularly in response to disorders which have been traditionally treatmentrefractor y. This paper reviews a collection of new therapies collectively self-termed ‘The Power Therapies’, outlining their proposed procedures and the evidence for and against their use. These therapies are then put to the test for pseudoscientific practice. Method: Therapies were included which self-descr ibe themselves as ‘Power Therapies’. Published work searches were conducted on each therapy using Medline and PsychInfo databases for randomized controlled trials assessing their efficacy, except for the case of Eye Movement Desensitization and Reprocessing (EMDR). Eye Movement Desensitization and Reprocessing has more randomized controlled studies conducted on its efficacy than any other treatment for trauma and thus, previous meta-analyses were evaluated. Results and conclusions: It is concluded that these new therapies have offered no new scientifically valid theories of action, show only non-specific efficacy, show no evidence that they offer substantive improvements to extant psychiatric care, yet display many characteristics consistent with pseudoscience.

scholarly journals How to Put It Plainly? Findings From Two Randomized Controlled Studies on Writing Plain Language Summaries for Psychological Meta-Analyses

2021 ◽  
Vol 12 ◽  
Author(s):  
Martin Kerwer ◽  
Marlene Stoll ◽  
Mark Jonas ◽  
Gesa Benz ◽  
Anita Chasiotis
Keyword(s):  
User Experience ◽  
Plain Language ◽  
Quality Of Evidence ◽  
Randomized Controlled ◽  
Societal Relevance ◽  
Randomized Controlled Studies ◽  
Research Findings ◽  
Meta Analyses ◽  
Technical Terms

Plain language summaries (PLS) aim to communicate research findings to laypersons in an easily understandable manner. Despite the societal relevance of making psychological research findings available to the public, our empirical knowledge on how to write PLS of psychology studies is still scarce. In this article, we present two experimental studies investigating six characteristics of PLS for psychological meta-analyses. We specifically focused on approaches for (1) handling technical terms, (2) communicating the quality of evidence by explaining the methodological approach of meta-analyses, (3) explaining how synthesized studies operationalized their research questions, (4) handling statistical terms, (5) structuring PLS, and (6) explaining complex meta-analytic designs. To develop empirically validated guidelines on writing PLS, two randomized controlled studies including large samples stratified for education status, age, and gender (NStudy1=2,288 and NStudy2=2,211) were conducted. Eight PLS of meta-analyses from different areas of psychology were investigated as study materials. Main outcome variables were user experience (i.e., perceived accessibility, perceived understanding, and perceived empowerment) and knowledge acquisition, as well as understanding and knowledge of the quality of evidence. Overall, our hypotheses were partially confirmed, with our results underlining, among other things, the importance of explaining or replacing content-related technical terms (i.e., theoretical concepts) and indicating the detrimental effects of providing too many details on statistical concepts on user experience. Drawing on these and further findings, we derive five empirically well-founded rules on the lay-friendly communication of meta-analytic research findings in psychology. Implications for PLS authors and future research on PLS are discussed.

scholarly journals Improved conflict resolution in romantic couples in mediation compared to negotiation

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
François Bogacz ◽  
Thierry Pun ◽  
Olga M. Klimecki
Keyword(s):  
Conflict Resolution ◽  
Third Party ◽  
Controlled Study ◽  
Romantic Couples ◽  
Couple Conflict ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Beneficial Impact ◽  
The Impact

Abstract Despite the frequency and adverse effects of conflict, randomized controlled studies on interventions that could promote conflict resolution (e.g., among romantic couples) are scarce. One understudied intervention technique is mediation, which is a negotiation facilitated by a neutral third party. To test the impact of a mediator on couple conflict, we conducted a randomized controlled study involving 38 romantic couples who discussed a topic of recurrent disagreement either in the presence of a mediator or by means of a direct negotiation. The results show that romantic couples in the mediation condition, compared with those in direct negotiation, had a probability of reaching an agreement 1.39 times higher and reported higher satisfaction regarding the content and process of their discussions. In addition, the synchronicity of the couple’s skin conductance, a measure of arousal, correlated with the couple’s closeness and with the quality of their relationship. Our findings suggest that interventions based on mediation can have a beneficial impact on conflict resolution.

scholarly journals Effect of Resistance Training in the Treatment of Pre-Sarcopenia or Sarcopenia and Pre-Frailty or Frailty in Older People: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

2019 ◽  
Author(s):  
Karolina Talar ◽  
Tomas Vetrovsky ◽  
Ewa Kalamacka ◽  
Michal Steffl
Keyword(s):  
Resistance Training ◽  
Search Strategy ◽  
Web Of Science ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Meta Analyses ◽  
Strength Effect

Abstract Background: Resistance training (RT) is considered as an effective method to increase muscle strength and physical performance in elderly people. Methods: A search from the earliest record up to and including June 2019 was carried out using the following electronic databases: PubMed, Scopus and Web of Science. The search strategy employed combined the terms related to the population (e.g. ‘sarcopenia’, ‘frailty’) with terms for the intervention (e.g. ‘resistance training’, ‘strength training’). Results: 11 studies including 2691 subjects were included in our meta-analysis (aged 64-98). Training duration ranged from 8 to 48 weeks and intensity up to 80% of 1-RM. According to the meta-analyses, RT had statistically significant effect on all the measures except handgrip strength. In handgrip strength Effect size (ES) was 0.58 (95 % CI: - 0.10 to 1.26) p = 0.076 with the moderate heterogeneity (I 2 = 58.6%). ES in legs strength was 0.52 (95 % CI 0.11 to 0.92) p = 0.022, I 2 = 42.0 %. The biggest ES was in TUG test where ES was 0.90 (95 % CI 0.19 to 1.60) p = 0.022, however, there was a high heterogeneity I 2 = 89.6. The high ES was found also in FFM 0.69 (95 % CI 0.17 to 1.20) p = 0.025, and gait speed 0.41 (95 % CI 0.11 to 0.72) p = 0.017. In both cases, there was small heterogeneity I 2 = 13.2 % respective 38.3 %. The overall ES was estimated 0.67 (95 % CI 0.40 to 0.93) p <0.001. Nevertheless, the heterogeneity was high I 2 = 78.1 %.Conclusion: RT interventions in pre-frail, frail, pre-sarcopenic and sarcopenic older adults, provided evidence that RT has positive effects on most of the outcome measurements included in the current revision except handgrip strength.

scholarly journals 1151. A Comparison of Periurethral Cleaning Between Normal Saline and Savlon Solutions Before Indwelling Urinary Catheterization in Reducing Catheter-Associated Bacteriuria: A Randomized Controlled Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S411-S411
Author(s):  
Sarin Khahakaew ◽  
Gompol Suwanpimolkul ◽  
Thanittha Wongkeskij ◽  
Napawan Punakabutra ◽  
Chusana Suankratay
Keyword(s):  
Emergency Room ◽  
Normal Saline ◽  
Foley Catheter ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Urinary Catheterization ◽  
Antiseptic Solution ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Significant Difference

Abstract Background Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections. To date, there have been no randomized controlled studies to recommend the most appropriate antiseptic solution for periurethral cleaning before indwelling urinary catheterization. This study was aimed to compare normal saline solution (NSS) and Savlon solution for periurethral cleaning before indwelling urinary catheterization in reducing catheter-associated bacteriuria. Methods A randomized controlled, noninferiority, cross-over study to determine the incidence of significant bacteriuria (SB) on day 5 after Foley catheterization, using 2 different solutions for periurethral cleaning (NSS and Savlon solutions), was carried out in all adult patients admitted in the 2 medical intensive care units (ICUs), 1 surgical ICU, 2 neurosurgical ICUs, 4 medical wards, 4 surgical wards and 1 emergency room (ER) of King Chulalongkorn Memorial Hospital, Thailand, from June 2018 to March 2019. The acceptable prespecified noninferiority margin was set to be 10%. Each solution was used alternately every 3 months in each unit. Urine culture was collected on day 1, 3, and 5 of Foley catheter. Results During the study period, there were 207 and 160 patients in the NSS and Savlon groups, respectively. 202 (55%) patients had received Foley catheterization in the emergency room. There were no significant differences in the indication, the current illness, and preexisting condition between the 2 groups. The overall incidence of SB on day 3 and 5 after catheterization was 4% and 8.2%. The incidence of CAUTI was 3.43/1,000 catheter-day. The median duration of catheterization was 5 (IQR 3, 7) days. On day 5 after catheterization, noninferiority was demonstrated for the incidence of SB with an adjusted difference of 4 (95% CI of the difference: −2.1% to 8.9%, P = 0.05). Regarding the incidence of CAUTI, there was no significant difference between the 2 groups. Conclusion To the best of our knowledge, our study was the first randomized controlled study to compare the 2 solutions for periurethral cleaning before indwelling urinary catheterization in different departments. This study demonstrates the noninferiority of NSS to Savlon solution in reducing the incidence of SB. Disclosures All authors: No reported disclosures.

scholarly journals EXPRESS: Evolution of randomized, controlled studies of medical therapy in chronic thromboembolic pulmonary hypertension

2021 ◽  
pp. 204589402110073
Author(s):  
Nick H Kim ◽  
Demosthenes G. Papamatheakis ◽  
Timothy M. Fernandes
Keyword(s):  
Pulmonary Hypertension ◽  
Medical Therapy ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Controlled Study ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Need To Evaluate ◽  
Thromboembolic Pulmonary Hypertension ◽  
Phosphodiesterase Type

Although pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), many patients have inoperable disease, and some have persistent or recurrent pulmonary hypertension (PH) after surgery. Alternative options (balloon pulmonary angioplasty [BPA] and PH-targeted medical therapy) are, therefore, required. Studies of medical therapies for CTEPH have evolved since AIR, the first randomized, controlled study of a PH-targeted therapy (inhaled iloprost) to include patients with CTEPH. Key learnings from these studies include the need to evaluate CTEPH separately from other types of PH, the importance of prospective operability adjudication as part of the protocol, and the need for sufficient duration to allow treatment benefits to become apparent. The 16-week CHEST-1 study was the first to operationalize these learnings, demonstrating a significant mean improvement in 6-minute walk distance (+46 m) and improvements in hemodynamic endpoints with riociguat versus placebo. Findings from previous studies will inform the design of future studies to address key issues related to combination medical therapy. Data on combinations of macitentan with phosphodiesterase type 5 inhibitors or oral prostanoids are available from MERIT, the first study to allow such regimens. No data on combinations including riociguat, the only licensed medical therapy for CTEPH, are available. Studies are also needed for multi-modality treatment, including medical therapy plus BPA, and medical therapy as a bridge to PEA in selected operable patients. To address these issues and improve patient outcomes, it is vital that we learn from current studies to improve future trial design.

scholarly journals Randomized controlled study on the effects of triple therapy including vonoprazan or rabeprazole for the second-line treatment of Helicobacter pylori infection

2020 ◽  
Vol 13 ◽  
pp. 175628482096624
Author(s):  
Mariko Hojo ◽  
Daisuke Asaoka ◽  
Tsutomu Takeda ◽  
Yuji Shimada ◽  
Kenshi Matsumoto ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Acid Secretion ◽  
Gastric Acid Secretion ◽  
Gastric Acid ◽  
Triple Therapy ◽  
Controlled Study ◽  
Line Treatment ◽  
Second Line ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

Background and Aim: Inhibition of gastric acid secretion is important for eradicating Helicobacter pylori. Vonoprazan (VPZ) is a strong, long-lasting inhibitor of gastric acid secretion. Studies that examined the effectiveness of VPZ-based triple therapy in second-line treatment have been performed. However, there have been no randomized controlled studies to compare the effect between VPZ-based triple therapy and proton pump inhibitor (PPI)-based triple therapy in second-line treatment, and it is not known which is more effective between VPZ-based and PPI-based therapies. This study aimed to compare the effectiveness of second-line triple therapies including VPZ or rabeprazole (RPZ) as the PPI. Methods: Eligible patients with H. pylori infection who failed first-line triple therapy were assigned randomly to the VPZ [VPZ40 mg/day, amoxicillin (AMPC) 1500 mg/day, metronidazole (MNZ) 500 mg/day] or RPZ (RPZ20 mg/day, AMPC1500 mg/day, MNZ500 mg/day) group. A 13C-urea breath test result of less than 2.5% was considered as successful eradication. Results: In total, 46 and 41 patients were analyzed as intention to treat (ITT) and per protocol (PP), respectively. Eradication rates in the VPZ and RPZ groups were 73.9% [95% confidence interval (CI) 51.6–89.8%] and 82.6% (95% CI 61.2–95.0%) based on ITT analysis, respectively ( p = 0.72). Based on PP analysis, the eradication rates in the VPZ and RPZ groups were 89.5% (95% CI 66.9–98.7%) and 86.4% (95% CI 65.1–97.1%), respectively ( p = 1.00). Two patients in the VPZ group and one in the RPZ group discontinued treatment due to side effects ( p = 1.00). Conclusion: There were no significant differences in efficacy and safety between second-line therapies including VPZ or RPZ.

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