Comparison of Peritoneal Closure Versus Non-closure After Non-infected Elective Laparotomy with a Midline Incision: A Randomized Clinical Trial

Background: There is no consensus regarding closure or non-closure of peritoneum in laparotomy, and this topic remains a controversy among surgeons. Objectives: This clinical trial aimed to compare short-term and long-term benefits of peritoneal closure with non-closure in an academic medical center. Methods: In this double-blinded two-arm parallel-group randomized trial, 124 patients undergoing laparotomy with midline incision were assessed from March 2019 to September 2019 at Imam Hossein Medical Center, Tehran, Iran. We used the Rand function of the Excel software to randomly assign 62 patients to the peritoneal closure group and 62 patients to the non-closure group. The patients were evaluated for short-term complications including wound-related fever, infection, need for analgesics, pain in the first 2, 6, 24, and 48 hours postoperatively according to the Visual Analogue scale (VAS), duration of hospitalization, as well as long-term complications including incisional hernia and intraperitoneal adhesion one year after the surgery. Statistical analysis was carried out with SPSS version 22 software. Results: The non-closure peritoneum group had a lower rate of wound-related fever, infection, and analgesic need than the peritoneal closure group, but these differences were not statistically significant (P = 0.488, P = 0.455, and P = 0.062, respectively). The adhesion rate and incisional hernia incidence one year after the surgery were not significantly different between the two groups (P = 0.363, P = 0.586). Pain intensity was significantly lower in the non-closure group than in the closure group in the first two, six, and 24 hours (P = 0.008, P = 0.004, and P = 0.047, respectively) but not significantly at 48 hours (P = 0.146). Conclusions: Peritoneum closure after non-emergency, non-infected laparotomy increases the postoperative pain while it has no benefit for long-term complications like incisional hernia or intra-peritoneal adhesion.

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Deferiprone Versus Sequential Deferiprone-Deferoxamine Treatment in Thalassemia Major: A Five Years Multicenter Randomized Clinical Trial under the Auspices of the Society for the Study of Thalassemia and Hemoglobinopathies (SoSTE).

Blood ◽

10.1182/blood.v110.11.575.575 ◽

2007 ◽

Vol 110 (11) ◽

pp. 575-575 ◽

Cited By ~ 3

Author(s):

Aurelio Maggio ◽

Marcello Capra ◽

Liana Cuccia ◽

Francesco Gagliardotto ◽

Carmelo Magnano ◽

...

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Serum Ferritin ◽

Statistical Significance ◽

Thalassemia Major ◽

Randomised Clinical Trial ◽

Short Term ◽

Long Term Study ◽

One Year

Abstract Three short-term randomised clinical trials suggested not difference of Deferiprone (L1) vs Deferoxamine (DFO) in term of iron overload efficacy in thalassemia major (TM) patients. To assess whether L1 (75mg/Kg) alone was comparable to a sequential treatment using L1 (75mg/Kg) for 4 days and DFO (50mg/Kg) for 3 days, we carried ahead a large long-term randomised clinical trial. One-hundred and forty consecutive patients with TM and serum ferritin between 1,500 and 3,000 ng/ml were randomly assigned to L1 (n°69) or sequential L1-DFO (n°71) and treated for 5 years. The main measure of efficacy was the reduction of serum ferritin levels. Secondary outcomes were liver and heart iron contents assessed by T2* magnetic resonance. After one year-treatment the mean serum feritin reduction was −105 ± 90.4 in L1 and −409 ± 64.2 in sequential L1-DFO treatment (p <0.01), respectively. The greater mean serum ferritin reduction of sequential L1- DFO treatment was also confirmed all over the study (2° year L1 106 ± 713, L1-DFO -321 ± 92 (p <0.01); 3° year L1 137 ± 137, L1-DFO -292 ± 117 (p <0.05); 4° year L1 216 ± 200, L1-DFO-230 ± 170 (p <0.01); 5° year L1 336 ± 244, L1-DFO -598 ± 203 (p <0.01)). After one-year treatment this sequential group showed greater efficacy in term of serum ferritin levels reduction (−409 ± 64.2) in comparison with the DFO alone arm (−232 ± 619) of a previous randomised multicenter clinical trial in which a comparable cohort of patients were studied (p<0.05). Reversible leukocytopenia was shown in 8 (11.5%) L1 and in 7 (9.8%) sequential L1-DFO treated patients. No agranulocythosis was reported on sequential L1-DFO treated patients during the 5 years study. Hypertransaminasemia developed in 13 (18.8%) L1 and in 5 (7%) sequential L1-DFO treated patients. No other major side effects have been reported. Discontinuation of treatment was necessary in 55.6% L1 and in 57.7% sequential L1-DFO treated patients (chi2 0.03, p=0.86). The failures of treatment were less in sequential L1-DFO arm (n°2) in comparison to L1 alone arm (n°8), although this difference not so far reached the statistical significance (chi2 3.4, p=0.06). These findings suggest that sequential L1-DFO treatment in a long-term study is more effective than L1 alone with milder and reversible side effects. Moreover, its efficacy is also higher in comparison with DFO alone at short-term evaluation. Fig. 1 VARIATIONS OF THE FERRITIN LEVELS DURING FIVE YEARS TREATMENT BETWEEN THE TWO ARMS OF THE TRIAL Fig. 1. VARIATIONS OF THE FERRITIN LEVELS DURING FIVE YEARS TREATMENT BETWEEN THE TWO ARMS OF THE TRIAL

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Clinical Outcomes, Structure, and Function Improve With Both Heavy and Moderate Loads in the Treatment of Patellar Tendinopathy: A Randomized Clinical Trial

The American Journal of Sports Medicine ◽

10.1177/0363546520988741 ◽

2021 ◽

Vol 49 (4) ◽

pp. 982-993

Author(s):

Anne-Sofie Agergaard ◽

Rene B. Svensson ◽

Nikolaj M. Malmgaard-Clausen ◽

Christian Couppé ◽

Mikkel H. Hjortshoej ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Outcome ◽

Randomized Clinical Trial ◽

Clinical Outcomes ◽

Rating Scale ◽

Power Doppler ◽

Patellar Tendinopathy ◽

Short Term ◽

Level Of Evidence

Background: Loading interventions have become a predominant treatment strategy for tendinopathy, and positive clinical outcomes and tendon tissue responses may depend on the exercise dose and load magnitude. Purpose/Hypothesis: The purpose was to investigate if the load magnitude influenced the effect of a 12-week loading intervention for patellar tendinopathy in the short term (12 weeks) and long term (52 weeks). We hypothesized that a greater load magnitude of 90% of 1 repetition maximum (RM) would yield a more positive clinical outcome, tendon structure, and tendon function compared with a lower load magnitude of 55% of 1 RM when the total exercise volume was kept equal in both groups. Study Design: Randomized clinical trial; Level of evidence, 1. Methods: A total of 44 adult participants with chronic patellar tendinopathy were included and randomized to undergo moderate slow resistance (MSR group; 55% of 1 RM) or heavy slow resistance (HSR group; 90% of 1 RM). Function and symptoms (Victorian Institute of Sport Assessment–Patella questionnaire [VISA-P]), tendon pain during activity (numeric rating scale [NRS]), and ultrasound findings (tendon vascularization and swelling) were assessed before the intervention, at 6 and 12 weeks during the intervention, and at 52 weeks from baseline. Tendon function (functional tests) and tendon structure (ultrasound and magnetic resonance imaging) were investigated before and after the intervention period. Results: The HSR and MSR interventions both yielded significant clinical improvements in the VISA-P score (mean ± SEM) (HSR: 0 weeks, 58.8 ± 4.3; 12 weeks, 70.5 ± 4.4; 52 weeks, 79.7 ± 4.6) (MSR: 0 weeks, 59.9 ± 2.5; 12 weeks, 72.5 ± 2.9; 52 weeks, 82.6 ± 2.5), NRS score for running, NRS score for squats, NRS score for preferred sport, single-leg decline squat, and patient satisfaction after 12 weeks, and these were maintained after 52 weeks. HSR loading was not superior to MSR loading for any of the measured clinical outcomes. Similarly, there were no differences in functional (strength and jumping ability) or structural (tendon thickness, power Doppler area, and cross-sectional area) improvements between the groups undergoing HSR and MSR loading. Conclusion: There was no superior effect of exercising with a high load magnitude (HSR) compared with a moderate load magnitude (MSR) for the clinical outcome, tendon structure, or tendon function in the treatment of patellar tendinopathy in the short term. Both HSR and MSR showed equally good, continued improvements in outcomes in the long term but did not reach normal values for healthy tendons. Registration: NCT03096067 (ClinicalTrials.gov identifier)

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Contrarian and Momentum Strategies in the Indian Capital Market

Vikalpa The Journal for Decision Makers ◽

10.1177/0256090920020103 ◽

2002 ◽

Vol 27 (1) ◽

pp. 13-20 ◽

Cited By ~ 22

Author(s):

Sanjay Sehgal ◽

I Balakrishnan

Keyword(s):

Stock Returns ◽

Indian Market ◽

Momentum Effect ◽

Short Term ◽

Momentum Strategy ◽

Momentum Strategies ◽

Holding Period ◽

The Us ◽

One Year

The study attempts to evaluate if there are any systematic patterns in stock returns for the Indian market. The empirical findings reveal that there is a reversal in long-term returns, once the short-term momentum effect has been controlled by maintaining a one year gap between portfolio formation period and the portfolio holding period. A contrarian strategy based on long-term past returns provides moderately positive returns. Further, there is a continuation in short-term returns and a momentum strategy based on it provides significantly positive payoffs. The results in general are in conformity with those for developed capital markets such as the US.

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Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – a one-year follow-up

BMC Psychiatry ◽

10.1186/s12888-017-1480-2 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 9

Author(s):

Ana Isabel Penzlin ◽

Kristian Barlinn ◽

Ben Min-Woo Illigens ◽

Kerstin Weidner ◽

Martin Siepmann ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Short Term ◽

Heart Rate Variability Biofeedback ◽

One Year ◽

Alcohol Dependent

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Effects of treadmill training on the balance, functional capacity and quality of life in Parkinson’s disease: A randomized clinical trial

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2018-0245 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Paria Arfa-Fatollahkhani ◽

Afsaneh Safar Cherati ◽

Seyed Amir Hasan Habibi ◽

Gholam Ali Shahidi ◽

Ahmad Sohrabi ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Clinical Trial ◽

Functional Capacity ◽

Treadmill Training ◽

Moderate Intensity ◽

P Value ◽

Short Term

AbstractBackgroundThere is growing evidence that exercise modalities have considerable effects on Parkinson’s disease (PD). This trial aimed to provide a more detailed viewpoint of short-term and long-term treadmill training (TT) effects on some motor and non-motor features of PD.MethodsIn this prospective, randomized, single-blind clinical trial, 20 mild to moderate PD patients, admitted in Rasoul-e-Akram hospital in Tehran, Iran, were randomly allocated in case (11) and control (9) groups. Treadmill intervention was performed at moderate intensity with 60% of heart rate reserved (HRR) in two 30-min sessions/week for a duration of 10 weeks. Both the groups were evaluated for three times; at the baseline, 2 months later and then 2 months after the second evaluation. We assigned the Timed Up and Go test (TUG), 6-min walk test (6MW), and the SF-8 healthy questionnaire, for assessment of balance, functional capacity, and Quality of life (QoL), respectively.ResultsBalance and functional capacity were significantly improved in the case group after the intervention (TUG p-value: 0.003, 6MW p-value: 0.003). Moreover, the long-term analysis revealed significant results as well (TUG p-value: 0.001, 6MW p-value: 0.004). Mental condition’s scores of SF-8 in cases were not statistically different in short-term follow-up (F/U). However, analysis illustrated p-value: 0.016 for long-term assessment. The intervention induced significant changes in physical condition’s scores in both of the F/Us (PC p-value: 0.013).ConclusionsThis study provides evidence that a TT of mild to moderate intensity has significant and persistent benefits for the balance, functional capacity, and QoL in PD.

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Mitochondrial and Oxidative Impacts of Short and Long-term Administration of HAART on HIV Patients

Current Clinical Pharmacology ◽

10.2174/1574884714666190905162237 ◽

2020 ◽

Vol 15 (2) ◽

pp. 110-124

Author(s):

Joy E. Ikekpeazu ◽

Oliver C. Orji ◽

Ikenna K. Uchendu ◽

Lawrence U.S. Ezeanyika

Keyword(s):

Treatment Group ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Hiv Patients ◽

Long Term Treatment ◽

Term Administration ◽

Short And Long Term ◽

One Year

Background and Objective: There may be a possible link between the use of HAART and oxidative stress-related mitochondrial dysfunction in HIV patients. We evaluated the mitochondrial and oxidative impacts of short and long-term administration of HAART on HIV patients attending the Enugu State University Teaching (ESUT) Hospital, Enugu, Nigeria following short and long-term therapy. Methods: 96 patients categorized into four groups of 24 individuals were recruited for the study. Group 1 comprised of age-matched, apparently healthy, sero-negative individuals (the No HIV group); group 2 consisted of HIV sero-positive individuals who had not started any form of treatment (the Treatment naïve group). Individuals in group 3 were known HIV patients on HAART for less than one year (Short-term treatment group), while group 4 comprised of HIV patients on HAART for more than one year (Long-term treatment group). All patients were aged between 18 to 60 years and attended the HIV clinic at the time of the study. Determination of total antioxidant status (TAS in nmol/l), malondialdehyde (MDA in mmol/l), CD4+ count in cells/μl, and genomic studies were all done using standard operative procedures. Results: We found that the long-term treatment group had significantly raised the levels of MDA, as well as significantly diminished TAS compared to the Short-term treatment and No HIV groups (P<0.05). In addition, there was significantly elevated variation in the copy number of mitochondrial genes (mtDNA: D-loop, ATPase 8, TRNALEU uur) in the long-term treatment group. Interpretation and Conclusion: Long-term treatment with HAART increases oxidative stress and causes mitochondrial alterations in HIV patients.

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General Assessment of the Operational Utility of National Water Model Reservoir Inflows for the Bureau of Reclamation Facilities

Water ◽

10.3390/w12102897 ◽

2020 ◽

Vol 12 (10) ◽

pp. 2897

Author(s):

Francesca Viterbo ◽

Laura Read ◽

Kenneth Nowak ◽

Andrew W. Wood ◽

David Gochis ◽

...

Keyword(s):

Water Model ◽

Short Term ◽

Bureau Of Reclamation ◽

Hydrologic Processes ◽

One Year ◽

Inflow Performance ◽

Basin Area ◽

National Water ◽

Total Inflow

This work investigates the utility of the National Oceanic and Atmospheric Administration’s National Water Model (NWM) for water management operations by assessing the total inflow into a select number of reservoirs across the Central and Western U.S. Total inflow is generally an unmeasured quantity, though critically important for anticipating both floods and shortages in supply over a short-term (hourly) to sub-seasonal (monthly) time horizon. The NWM offers such information at over 5000 reservoirs across the U.S., however, its skill at representing inflow processes is largely unknown. The goal of this work is to understand the drivers for both well performing and poor performing NWM inflows such that managers can get a sense of the capability of NWM to capture natural hydrologic processes and in some cases, the effects of upstream management. We analyzed the inflows for a subset of Bureau of Reclamation (BoR) reservoirs within the NWM over the long-term simulations (retrospectively, seven years) and for short, medium and long-range operational forecast cycles over a one-year period. We utilize ancillary reservoir characteristics (e.g., physical and operational) to explain variation in inflow performance across the selected reservoirs. In general, we find that NWM inflows in snow-driven basins outperform those in rain-driven, and that assimilated basin area, upstream management, and calibrated basin area all influence the NWM’s ability to reproduce daily reservoir inflows. The final outcome of this work proposes a framework for how the NWM reservoir inflows can be useful for reservoir management, linking reservoir purposes with the forecast cycles and retrospective simulations.

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The use of borehole inclinometry in determining basal sliding and internal deformation at Haut Glacier d’Arolla, Switzerland

Annals of Glaciology ◽

10.1017/s0260305500012404 ◽

1997 ◽

Vol 24 ◽

pp. 331-337 ◽

Cited By ~ 8

Author(s):

Luke Copland ◽

Jon Harbor ◽

Marie Minner ◽

Martin Sharp

Keyword(s):

Hot Water ◽

Short Term ◽

Digital Inclinometer ◽

Basal Sliding ◽

Internal Deformation ◽

One Year ◽

Annual Scale ◽

Insight Into ◽

Displacement Measurements

A series of boreholes were drilled with high-pressure hot water across a section of Haut Glacier d’Arolla, Switzerland, in summer 1995. Twenty-three of the boreholes were profiled with a digital inclinometer soon aller drilling, and 14 were re-profiled up to 6 weeks later to determine changes in the longitudinal shape of boreholes with time. In addition to the main surveys, three boreholes were surveyed 14 times each to assess the accuracy and reproducibility of inclinometry measurements. These repeat surveys suggest that caution is needed in the interpretation of short-term borehole displacement measurements, and that the reoccupation of boreholes from one year to the next may be a better way to determine patterns of internal deformation and basal sliding. The annual scale may also have advantages in providing more long-term insight into glaciological processes than short term (single season) measurements.

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Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis

Open Heart ◽

10.1136/openhrt-2018-000901 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000901

Author(s):

Anette Borger Kvaslerud ◽

Amjad Iqbal Hussain ◽

Andreas Auensen ◽

Thor Ueland ◽

Annika E Michelsen ◽

...

Keyword(s):

Iron Deficiency ◽

Aortic Stenosis ◽

Severe Aortic Stenosis ◽

Iron Status ◽

Transferrin Saturation ◽

Short Term ◽

Prognostic Implication ◽

Wide Range ◽

One Year

ObjectiveThe aim of this study was to evaluate the prevalence and prognostic implication of iron deficiency (ID) and anaemia in patients with severe aortic stenosis (AS).MethodsIn an observational study of consecutive patients referred for aortic valve replacement (AVR), we assessed a wide range of biomarkers of iron status, including the definition of ID commonly applied in patients with chronic heart failure (ferritin <100 µg/L or ferritin 100–299 µg/L with a transferrin saturation <20%). The endpoints were short-term (one-year) and long-term (median 4.7 years, IQR: 3.8–5.5) mortality and major adverse cardiovascular events (MACE) within the first year after inclusion.Results464 patients were included in this substudy. 91 patients (20%) received conservative treatment and 373 patients (80%) received AVR. ID was detected in 246 patients (53%). 94 patients (20%) had anaemia. Patients with ID had an overall worse clinical profile than patients without ID. During follow-up, 129 patients (28%) died. Neither ID as defined above, soluble transferrin receptor nor hepcidin were associated with short-term or long-term mortality or MACE independent on treatment allocation. Anaemia was associated with one-year mortality in conservatively treated patients.ConclusionsID and anaemia are prevalent in patients with severe AS. In our cohort, ID did not provide independent prognostic information on top of conventional risk factors. More studies are required to determine how to correctly diagnose ID in patients with AS.Trial registration numberNCT01794832.

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Simple Techniques for Monitoring Footpath Erosion in Mountain Areas of North-West England

Environmental Conservation ◽

10.1017/s0376892900025443 ◽

1977 ◽

Vol 4 (2) ◽

pp. 145-148 ◽

Cited By ~ 5

Author(s):

Rosalind A. Coleman

Keyword(s):

Aerial Photography ◽

Technical Expertise ◽

Short Term ◽

Mountain Areas ◽

North West ◽

Different Types ◽

Different Seasons ◽

One Year ◽

Site Types

Very precise measurements of the movement of coarse-textured, unconsolidated materials may be meaningless. Therefore the study of individual processes operating on footpaths may require a different approach. However, for identification of changes of reasonable dimensions, methods such as those described above are inexpensive, quick, and require no technical expertise. It may be argued that, for path management, erosion that is too limited to be measured by these methods is too limited to be a problem. It can certainly be argued that the problem of spatial correlation implies a large number of measurements. What is lost in lack of precision may be more than compensated for by the gain in data from the larger area and wider variation in site-types that it is possible to monitor with such simple techniques.To monitor the effects of recreation in mountain areas, it is desirable to be able to measure any change in path-state and relate this to recreation factors at different seasons and under different sit; -conditions. Three methods of measurement have been considered in this paper, corresponding to three time-scales. Aerial photography has been used to demonstrate trends over the long term, and has proved adequate to differentiate between path sections with differing resistance to erosion.Short-term measurement has been carried out relative to known fixed positions. Two methods are suggested. One is less precise, but simple and widely applicable, and can be used for measurement intervals of six months to one year. The other is more detailed and can be used for measurement intervals of a few days, but is limited in its application by practical considerations.It is suggested that simple techniques used at a large number of different types of site may be more effective than detailed measurements at a few sites.

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