scholarly journals Efficiency of phototherapy in patients with mycosis fungoides: preliminary results of a comparative non-randomized study

2020 ◽  
Vol 96 (5) ◽  
pp. 24-30
Author(s):  
A. E. Karamova ◽  
M. B. Zhilova ◽  
L. F. Znamenskaya ◽  
A. A. Vorontsova
Keyword(s):  
Mycosis Fungoides ◽  
Assessment Tool ◽  
Research Evaluation ◽  
Therapy Group ◽  
Randomized Study ◽  
Skin Lesions ◽  
Puva Therapy ◽  
Level Of Evidence ◽  
European Organization ◽  
Significant Difference

Clinical reasoning. There is a need to optimize the use of UV-B-311 nm and PUVA-therapy in patients with mycosis fungoides to determine the duration of the treatment regimen, the number of sessions per week, and ultraviolet irradiation regimen. Goal of research. Evaluation of the effect of the type and duration phototherapy on efficacy in patients with mycosis fungoides. Principle. A comparative, non-randomized study of the effectiveness of phototherapy in patients with mycosis fungoides in the early stages. Evaluation of the effectiveness of UV-B-311 nm and PUVA therapy was performed using the BSA index (area of skin lesions) and Modified Severity-Weighted Assessment Tool (mSWAT), as well as according to the criteria proposed by the International Society for Skin Lymphomas (ISCL), the European Organization for the Study and Cancer Treatment (EORTC) and United States Cutaneous Lymphoma Consortium (USCLC). Results. The study included 14 patients with mycosis fungoides, 5 of whom received treatment with UV-B-311 nm, 9 PUVA therapy. A strong correlation was found between the duration of UV-B-311 nm therapy with mSWAT delta (R = 0.90; p = 0.038) and BSA delta (R = 0.90; p = 0.038), while similar correlation was not found in the PUVA-therapy group (mSWAT (R = 0.24; p = 0.527); BSA (R = 0.09; p = 0.823)). When comparing the effectiveness of therapy between the treatment group UV-B-311 nm and PUVA therapy, delta mSWAT and BSA at the 20th procedure, delta mSWAT and BSA after the end of therapy did not have a statistically significant difference between the UVB-311 nm and PUVA groups. Conclusion. Statistically significant correlation was found between the number of procedures and the effectiveness of therapy In the UV-B-311 nm group. An increase in the number of PUVA therapy procedures (after 20) does not lead to a statistically significant increase in the effectiveness of treatment. Additional research is needed to increase the level of evidence of the results and develop optimal phototherapy regimens.

scholarly journals Efficiency of phototherapy in patients with mycosis fungoides: preliminary results of a comparative non-randomized study

2020 ◽  
Vol 96 (5) ◽  
pp. 24-30
Author(s):  
A. E. Karamova ◽  
M. B. Zhilova ◽  
L. F. Znamenskaya ◽  
A. A. Vorontsova
Keyword(s):  
Mycosis Fungoides ◽  
Assessment Tool ◽  
Research Evaluation ◽  
Therapy Group ◽  
Randomized Study ◽  
Skin Lesions ◽  
Puva Therapy ◽  
Level Of Evidence ◽  
European Organization ◽  
Significant Difference

Clinical reasoning. There is a need to optimize the use of UV-B-311 nm and PUVA-therapy in patients with mycosis fungoides to determine the duration of the treatment regimen, the number of sessions per week, and ultraviolet irradiation regimen. Goal of research. Evaluation of the effect of the type and duration phototherapy on efficacy in patients with mycosis fungoides. Principle. A comparative, non-randomized study of the effectiveness of phototherapy in patients with mycosis fungoides in the early stages. Evaluation of the effectiveness of UV-B-311 nm and PUVA therapy was performed using the BSA index (area of skin lesions) and Modified Severity-Weighted Assessment Tool (mSWAT), as well as according to the criteria proposed by the International Society for Skin Lymphomas (ISCL), the European Organization for the Study and Cancer Treatment (EORTC) and United States Cutaneous Lymphoma Consortium (USCLC). Results. The study included 14 patients with mycosis fungoides, 5 of whom received treatment with UV-B-311 nm, 9 PUVA therapy. A strong correlation was found between the duration of UV-B-311 nm therapy with mSWAT delta (R = 0.90; p = 0.038) and BSA delta (R = 0.90; p = 0.038), while similar correlation was not found in the PUVA-therapy group (mSWAT (R = 0.24; p = 0.527); BSA (R = 0.09; p = 0.823)). When comparing the effectiveness of therapy between the treatment group UV-B-311 nm and PUVA therapy, delta mSWAT and BSA at the 20th procedure, delta mSWAT and BSA after the end of therapy did not have a statistically significant difference between the UVB-311 nm and PUVA groups. Conclusion. Statistically significant correlation was found between the number of procedures and the effectiveness of therapy In the UV-B-311 nm group. An increase in the number of PUVA therapy procedures (after 20) does not lead to a statistically significant increase in the effectiveness of treatment. Additional research is needed to increase the level of evidence of the results and develop optimal phototherapy regimens.

scholarly journals Can the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score Be Reliably Administered Over the Phone? A Randomized Study

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711879151 ◽  
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
Jon Newgren ◽  
Marissa Malaret ◽  
Michael O’Brien ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Power Analysis ◽  
Assessment Tool ◽  
A Priori ◽  
Randomized Study ◽  
Intraclass Correlation ◽  
Level Of Evidence ◽  
Orthopaedic Clinic ◽  
Significant Difference ◽  
A Priori Power Analysis

Background: The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow outcome score is a functional assessment tool for the upper extremity of the overhead athlete, which is currently validated for administration in person. Purpose/Hypothesis: The purpose of this study was to validate the KJOC score for administration over the phone. The hypothesis was that no difference will exist in KJOC scores for the same patient between administration in person versus over the phone. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Fifty patients were randomized to fill out the KJOC questionnaire either over the phone first (25 patients) or in person first (25 patients) based on an a priori power analysis. One week after the patients completed the initial KJOC on the phone or in person, they then filled out the score via the opposite method. Results were compared per question and for overall score. Results: There was a mean ± SD of 8 ± 5 days between when patients completed the first and second questionnaires. There were no significant differences in the overall KJOC score between the phone and paper groups ( P = .139). The intraclass correlation coefficient comparing paper and phone scores was 0.802 (95% CI, 0.767-0.883; P < .001), with a Cronbach alpha of 0.89. On comparison of individual questions, there were significant differences for questions 1, 3, and 8 ( P = .013, .023, and .042, respectively). Conclusion: The KJOC questionnaire can be administered over the phone with no significant difference in overall score as compared with that from in-person administration.

A comparison of intramedullary cannulated screws versus miniplates for fixation of unstable metacarpal diaphyseal fractures

2021 ◽  
pp. 175319342110215
Author(s):  
Birkan Kibar ◽  
Ali Cavit ◽  
Abdullah Örs
Keyword(s):  
Plate Fixation ◽  
Randomized Study ◽  
Good Alternative ◽  
Active Movement ◽  
Cannulated Screws ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Plate Group ◽  
Significant Difference ◽  
Diaphyseal Fractures

We carried out a prospective randomized study to compare the clinical and radiological results of metacarpal diaphyseal fractures treated with retrograde intramedullary headless cannulated screws (IHCS) and plates. Fractures were fixed with IHCS in 34 patients (37 metacarpals) and locked miniplates in 35 patients (40 metacarpals). The mean age was 33 years (range 18–61) in the IHCS group and 32 years (range 17–68) in plate group. All patients were followed up for 1 year. All fractures in the IHCS group united but there was one nonunion in the plate group. At final follow-up, there was no significant difference between the groups in total active movement, visual analogue pain score, Disabilities of the Arm, Shoulder, and Hand score and grip strength, although the study was not sufficiently powered to exclude differences with certainty. IHCS is a safe and fast technique that is a good alternative to plate fixation in metacarpal diaphyseal fractures. Level of evidence: I

scholarly journals Effect of Head Impact Exposures on Changes in Cognitive Testing

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876103 ◽  
Author(s):  
Eleni Diakogeorgiou ◽  
Theresa L. Miyashita
Keyword(s):  
Reaction Time ◽  
National Collegiate Athletic Association ◽  
Assessment Tool ◽  
Vital Signs ◽  
Head Impact ◽  
Cognitive Testing ◽  
Repeated Impact ◽  
Level Of Evidence ◽  
Head Impacts ◽  
Significant Difference

Background: Gaining a better understanding of head impact exposures may lead to better comprehension of the possible effects of repeated impact exposures not associated with clinical concussion. Purpose: To assess the correlation between head impacts and any differences associated with cognitive testing measurements pre- and postseason. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 34 National Collegiate Athletic Association Division I men’s lacrosse players wore lacrosse helmets instrumented with an accelerometer during the 2014 competitive season and were tested pre- and postseason with the Sport Concussion Assessment Tool (SCAT 3) and Concussion Vital Signs (CVS) computer-based neurocognitive tests. The number of head impacts >20 g and results from the 2 cognitive tests were analyzed for differences and correlation. Results: There was no significant difference between pre- and postseason SCAT 3 scores, although a significant correlation between pre- and postseason cognitive scores on the SCAT 3 and total number of impacts sustained was noted ( r = –0.362, P = .035). Statistically significant improvements on half of the CVS testing components included visual reaction time ( P = .037, d = 0.37), reaction time ( P = .001, d = 0.65), and simple reaction time ( P = .043, d = 0.37), but no correlation with head impacts was noted. Conclusion: This study did not find declines in SCAT 3 or CVS scores over the course of a season among athletes who sustained multiple head impacts but no clinical concussion. Thus, it could not be determined whether there was no cognitive decline among these athletes or whether there may have been subtle declines that could not be measured by the SCAT 3 or CVS.

scholarly journals The Effectiveness and Safety of Thunder Fire Moxibustion for Treating Allergic Rhinitis: A PRISMA Compliant Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Ting Yuan ◽  
Jun Xiong ◽  
Jun Yang ◽  
Xue Wang ◽  
Yunfeng Jiang ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Adverse Events ◽  
Assessment Tool ◽  
Total Effective Rate ◽  
Meta Analysis ◽  
Effective Rate ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Significant Difference

Background. Allergic rhinitis (AR) is a noninfectious inflammatory disease caused by allergic individuals exposed to allergens. Western medicine therapy for treating AR causes obvious adverse events, while thunder fire moxibustion (TFM) is known as a safe and effective treatment for AR. Therefore, we conducted this meta-analysis to evaluate the effectiveness and safety of TFM for treating AR. Methods. PubMed, Web of Science, Embase, the Cochrane Library, CNKI, WanFang, VIP, and CBM from inception to April 5, 2020, were searched without any language restriction. Reviewers identified studies, extracted data, and assessed the quality, independently. The primary outcomes were the total effective rate and the TNSS. The secondary outcomes included TNNSS, RQLQ, VAS, serum IgE, IgA, or IgG level, and adverse events. Randomized controlled trials (RCTs) were collected; methodological quality was evaluated using the Cochrane risk of bias assessment tool (RoB), and the level of evidence was rated using the GRADE approach. Meta-analysis was performed using the RevMan5.3.0 software. Results. A total of 18 RCTs were included, including 1600 patients. The results of this meta-analysis showed a statistically significant effect in a total effective rate of T = TFM (RR = 1.07; 95% CI [1.03, 1.12]; P=0.45; I2 = 0%) and T = TFM + other treatments (RR = 1.18; 95% CI [1.11, 1.25]; P=0.03; I2 = 53%). In addition, TFM intervention also showed significant difference in total symptom score (T = TFM + other treatments) (MD = −1.42; 95% CI [−1.55, −1.29]; P=0.03; I2 = 60%) in patients with AR. Conclusion. Existing evidence shows that TFM is safe and effective for AR. Due to the universal low quality of the eligible trials and low evidence level, we should draw our conclusions with caution. Therefore, clinical researchers should carry out more large-sample, multicentre, high-quality randomized controlled clinical trials in the future to verify the clinical efficacy of TFM in treating AR.

scholarly journals A comparison of subtraction MRI with the standard contrast-enhanced imaging in Perthes’ disease

2019 ◽  
Vol 13 (1) ◽  
pp. 82-88 ◽  
Author(s):  
K. Jamil ◽  
T. Walker ◽  
E. Onikul ◽  
C. F. Munns ◽  
D. G. Little
Keyword(s):  
Femoral Head ◽  
Randomized Study ◽  
Perfusion Index ◽  
Perthes Disease ◽  
Diagnostic Study ◽  
Subtraction Technique ◽  
Level Of Evidence ◽  
Enhanced Mri ◽  
Significant Difference ◽  
Before And After

Purpose Perthes’ disease (PD) results from loss of blood supply to the hip and can progress to femoral head deformity. MRI in the early course of the disease can provide data on the initial extent of infarct. Vascularity of the femoral head is assessed by gadolinium-enhanced MRI (contrast MRI), which may be improved by the digital subtraction technique (subtraction MRI). We hypothesized that gadolinium-enhanced MRI without subtraction was comparable with subtraction MRI in depicting the femoral head perfusion. Methods In all, 34 patients (34 hips) with unilateral PD had gadolinium-enhanced MRI as part of a prospectively randomized study. Nine patients had three MRIs, 15 had two and ten had a single MRI. Measurement of perfusion of the femoral head (MRI perfusion index) was obtained using digital image analysis on all the MRIs, including both before and after subtraction. A paired sample t-test was performed to compare the measurements. Results The mean age of the patients was 8.9 years (sd 1.6). At the time of diagnosis, the subtraction MRI did not elicit a statistically significant difference in MRI perfusion index measurements when compared with the contrast MRI (p = 0.19). The same findings were found when including all patients at various stages of the disease (p = 0.30). Qualitatively, although some subtraction MRI images showed superior delineation of epiphysis, there are no significant differences throughout the whole series. Conclusion Although the current literature supports the increasing role of the subtraction MRI for PD management, our study proposed that the contrast MRI without subtraction technique appears adequate in assessing femoral head perfusion. Level of Evidence: Level I - Diagnostic study

scholarly journals The Gaseous Ozone Therapy as a Promising Antiseptic Adjuvant of Periodontal Treatment: A Randomized Controlled Clinical Trial

2022 ◽  
Vol 19 (2) ◽  
pp. 985
Author(s):  
Biagio Rapone ◽  
Elisabetta Ferrara ◽  
Luigi Santacroce ◽  
Skender Topi ◽  
Antonio Gnoni ◽  
...  
Keyword(s):  
Therapy Group ◽  
Randomized Study ◽  
Periodontal Treatment ◽  
Controlled Clinical Trial ◽  
Ozone Therapy ◽  
Periodontal Tissues ◽  
Gaseous Ozone ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: the establishment of periodontitis is regulated by the primary etiological factor and several individual conditions including the immune response mechanism of the host and individual genetic factors. It results when the oral homeostasis is interrupted, and biological reactions favor the development and progression of periodontal tissues damage. Different strategies have been explored for reinforcing the therapeutic effect of non-surgical periodontal treatment of periodontal tissue damage. Gaseous ozone therapy has been recognized as a promising antiseptic adjuvant, because of its immunostimulating, antimicrobial, antihypoxic, and biosynthetic effects. Then, we hypothesized that the adjunct of gaseous ozone therapy to standard periodontal treatment may be leveraged to promote the tissue healing response. Methods: to test this hypothesis, we conducted a prospective randomized study comparing non-surgical periodontal treatment plus gaseous ozone therapy to standard therapy. A total of 90 healthy individuals with moderate or severe generalized periodontitis were involved in the study. The trial was conducted from September 2019 to October 2020. Forty-five patients were randomized to receive scaling and root-planning (SRP) used as conventional non-surgical periodontal therapy plus gaseous ozone therapy (GROUP A); forty-five were allocated to standard treatment (GROUP B). The endpoint was defined as the periodontal response rate after the application of the ozone therapy at 3 months and 6 months, defined as no longer meeting the criteria for active periodontitis. Statistical analysis was performed employing SPSS v.18 Chicago: SPSS Inc. Results: periodontal parameters differed significantly between patients treated with the two distinct procedures at 3 months (p ≤ 0.005); a statistically significant difference between groups was observed from baseline in the CAL (p ≤ 0.0001), PPD (p ≤ 0.0001) and BOP (p ≤ 0.0001) scores. Conclusions: The present study suggests that SRP combined with ozone therapy in the treatment of periodontitis revealed an improved outcome than SRP alone.

A randomized study comparing cisplatin or carboplatin with etoposide in patients with advanced non-small-cell lung cancer: European Organization for Research and Treatment of Cancer Protocol 07861.

1990 ◽  
Vol 8 (9) ◽  
pp. 1556-1562 ◽  
Author(s):  
J Klastersky ◽  
J P Sculier ◽  
H Lacroix ◽  
G Dabouis ◽  
G Bureau ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Randomized Study ◽  
Working Party ◽  
Small Cell ◽  
Small Cell Lung ◽  
European Organization ◽  
Significant Difference ◽  
Function Impairment

The European Organization for Research and Treatment of Cancer (EORTC) Lung Cancer Working Party conducted a randomized trial comparing cisplatin (CDDP; 120 mg/m2, day 1) and carboplatin (CBDCA; 325 mg/m2, day 1) in combination with etoposide (VP16; 100 mg/m2, days 1, 2, and 3) in advanced non-small-cell lung cancer (NSCLC). Two hundred twenty-eight patients were eligible for survival and 202 assessable for response. We obtained 27 of 100 objective responses (ORs; 27%) in the CDDP arm and 16 of 102 (16%) in the CBDCA arm (P = .07). There was no significant difference in survival. Toxicity, consisting mainly of myelosuppression and renal function impairment, was significantly increased in the patients receiving the CDDP treatment. We conclude that CDDP plus VP16 was more active but also more toxic than CBDCA plus VP16 in advanced NSCLC.

scholarly journals PUVA AND INTERFERON Α COMBINED THERAPY IN PATIENTS WITH MYCOSIS FUNGOIDES

2017 ◽  
Vol 20 (3) ◽  
pp. 132-139
Author(s):  
O. Yu Olisova ◽  
K. V Smirnov ◽  
Ekaterina Vladimirovna Grekova
Keyword(s):  
Total Dose ◽  
Mycosis Fungoides ◽  
Combined Therapy ◽  
Skin Lesions ◽  
Response To Treatment ◽  
Interferon Α ◽  
Puva Therapy ◽  
Cutaneous Manifestations ◽  
Stage Ib ◽  
Stage Ivb

The results of mycosis fungoides (MF) treatment using therapy that combines interferon α (IFNα) and PUVA-therapy are presented. We observed 16 patients with MF. The diagnoses were verified with histological, immunohictochemical methods and molecular analysis. The response to treatment was defined by the index of the modified assessment of the severity of skin lesions scale (mSWAT). In addition, the safety and tolerability of IFNα and PUVA-therapy were evaluated. In terms of the stage of the disease, patients were distributed as follows: IB-IB - 1 (6%), IIA - 3 (19%), IIB - 6 (38%), IIIA - 2 (12.5%), IIIB - 1 (6%), IVA - 2 (12.5%), IVB - 1 (6%). PUVA-therapy was performed four times a week with the initial dose of the irradiation 0.5-1.0 J/cm2. The course of therapy consisted of 40 ± 8 procedures. The total dose was 157 ± 45 J/cm2.IFNα was prescribed to patients (3 IU three times a week). The total dose was 96 ± 31 IU. After the therapy 12 (75%) patients with stage IB-IIIA, mSWAT index was reduced by 90-100%, which corresponded to complete clinical remission in the form of the disappearance of cutaneous manifestations and subjective sensations. 3 (19%) patients with stage IIIB-IVA had mSWAT index decreasing from 50 to 75%, i.e. partial remission was observed as decrease of the injury area and rash brightness, reduce scaling, itching. 1 (6%) patient with stage IVB had no effect of the therapy. Studies have shown that PUVA-therapy in combination with interferon α can be successfully used at patients with MF, regardless of the disease stages, however, more positive effect was in patients with stage IB-IIB MF.

Doxorubicin versus CYVADIC versus doxorubicin plus ifosfamide in first-line treatment of advanced soft tissue sarcomas: a randomized study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group.

1995 ◽  
Vol 13 (7) ◽  
pp. 1537-1545 ◽  
Author(s):  
A Santoro ◽  
T Tursz ◽  
H Mouridsen ◽  
J Verweij ◽  
W Steward ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Response Rate ◽  
Randomized Study ◽  
Single Agent ◽  
Soft Tissue Sarcomas ◽  
Bone Sarcoma ◽  
Phase Iii ◽  
Controlled Clinical Trial ◽  
European Organization ◽  
Significant Difference

PURPOSE The aim of this trial was to compare the activity and toxicity of single-agent doxorubicin with that of two multidrug regimens in the treatment of patients with adult advanced soft tissue sarcomas. PATIENTS AND METHODS This was a prospective randomized phase III trial performed by 35 cancer centers within the Soft Tissue and Bone Sarcoma Group of the European Organization for Research and Treatment of Cancer (EORTC). Six hundred sixty-three eligible patients were randomly allocated to receive either doxorubicin 75 mg/m2 (arm A), cyclophosphamide, vincristine, doxorubicin, and dacarbazine (CYVADIC) (arm B), or ifosfamide 5 g/m2 plus doxorubicin 50 mg/m2 (arm C). RESULTS The overall response rate was 24% (95% confidence interval, 20.7% to 27.3%) among eligible patients and 26% among assessable patients. No statistically significant difference was detected among the three study arms in terms of response rate (arm A, 23.3%; arm B, 28.4%; and arm C, 28.1%), remission duration (median, 46 weeks on arm A, 48 weeks on arm B, and 44 weeks on arm C), or overall survival (median, 52 weeks on arm A, 51 weeks on arm B, and 55 weeks on arm C). The degree of myelosuppression was significantly greater for the combination of ifosfamide and doxorubicin than for the other two regimens. Cardiotoxicity was also more frequent in this arm, but other toxicities were similar. CONCLUSION In advanced soft tissue sarcomas of adults, single-agent doxorubicin is still the standard chemotherapy against which more intensive or new drug treatments should be compared. Combination chemotherapy cannot be recommended outside a controlled clinical trial with the exclusion of some subsets of sarcoma patients for whom significant tumor volume reduction may be an important end point of a chemotherapy regimen.

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