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CONCLUSIONS | This trial was registered at clinicaltrials.gov as NCT00858312 . |
###24846454 | null |
BACKGROUND | Endovascular repair of abdominal aortic aneurysm ( AAA ) has recently been made a class I indication in the treatment of AAA . |
BACKGROUND | In comparison to the conventional open surgical treatment , endovascular AAA repair ( EVAR ) is associated with equivalent long-term morbidity and mortality rates . |
BACKGROUND | Vascular surgeons perform majority of EVAR . |
BACKGROUND | There are no reports for the long-term results of this intervention performed by interventional cardiologists . |
BACKGROUND | We present one of the first reports of periprocedural and long-term outcomes of EVAR performed by interventional cardiologists . |
METHODS | Retrospective chart review on patients with attempted EVAR between September 2005 and January 2011 was performed . |
METHODS | Included cases were all consecutive patients who had attempted EVAR by interventional cardiologists . |
RESULTS | During the study period EVAR was attempted in 170 patients , with 27 % being women . |
RESULTS | The mean age was 74 years ( range 52-93 ) . |
RESULTS | The endovascular graft placement was successful in 96 % ( 163/170 ) of patients . |
RESULTS | Procedure failures were more common in women ( 6 of 46 vs 1 of 124 , P = 0.003 ) . |
RESULTS | The 30-day mortality was 1.8 % ( 3 of 170 ) . |
RESULTS | In patients with successful EVAR the mean follow-up was 30 months and mean length of hospital stay was 3.53.2 days . |
RESULTS | Major periprocedural complications were noted in 9 % patients ( 15 of 167 ) . |
RESULTS | During follow-up , six patients ( 3.5 % ) required re-intervention and additional 16 patients died with no aneurysm related deaths . |
CONCLUSIONS | EVAR primarily performed by interventional cardiologists demonstrates high periprocedural and long-term success rates . |
CONCLUSIONS | A higher EVAR failure rate has been observed in women . |
###24488838 | null |
OBJECTIVE | Anorexia nervosa ( AN ) is a severe illness with high rates of relapse . |
OBJECTIVE | Exposure and Response Prevention for AN ( AN-EXRP ) is a new approach that specifically addresses maladaptive eating behavior by targeting eating-related fear and anxiety . |
OBJECTIVE | The aim of this study was to evaluate AN-EXRP as an adjunctive strategy to improve eating behavior during weight restoration , at a pivotal moment when treatment goals shift toward relapse prevention . |
METHODS | A randomized controlled trial was conducted to compare AN-EXRP with a comparison condition , Cognitive Remediation Therapy ( CRT ) . |
METHODS | Hospitalized patients with AN ( n = 32 ) who had achieved weight restoration to a BMI > 18.5 kg/m ( 2 ) received 12 sessions of either AN-EXRP or CRT . |
METHODS | Outcome was assessed by change in caloric intake in an objective assessment of eating behavior . |
RESULTS | The average test meal caloric intake of participants who received AN-EXRP increased from 352263 kcal at baseline to 401215 kcal post-treatment , while that of participants who received CRT decreased from 501232 kcal at baseline to 424221 kcal post-treatment [ t ( 28 ) = 2.5 , p = .02 ] . |
RESULTS | Improvement in intake was significantly associated with improvement in eating-related anxiety ( Spearman 's = 0.40 , p = .03 ) . |
CONCLUSIONS | These data demonstrate that AN-EXRP , compared to a credible comparison intervention , is associated with better caloric intake in a laboratory meal over time in AN . |
CONCLUSIONS | Additional studies are required to determine whether incorporation of these techniques into a longer treatment program leads to enduring and clinically significant change . |
###25007421 | null |
OBJECTIVE | Aggressive behaviour in psychosis is not uncommon . |
OBJECTIVE | Community provision for people with psychosis has left informal caregivers to take on a greater role in their care . |
OBJECTIVE | However , few studies have explored links between patient-initiated violence in mental health caregiving relationships and caregiver functioning . |
OBJECTIVE | Our study investigated caregiver reports of aggressive acts committed by their relative with psychosis and their links to caregiver appraisals of the caregiving relationship and caregiver outcomes . |
METHODS | Caregivers of patients with a recent relapse of psychosis , recruited to a psychological therapy trial , completed the audiotaped Camberwell Family Interview at baseline . |
METHODS | This semi-structured interview includes questions on the quality of the relationship between caregiver and patient , and patient history of violence . |
METHODS | Seventy-two transcripts of interviews were assessed for reports of patient-initiated violence . |
RESULTS | One-half of the caregiver sample ( 52.9 % ) reported an incident of patient-initiated violence during their interview ; 62.2 % of these involved violence toward themselves , and 24.3 % toward property . |
RESULTS | Reports of patient violence were associated with caregiver ratings of hostility expressed toward patients , lower self-esteem , and emotion-focused coping . |
RESULTS | People caring on their own were more likely to report incidents of patient violence . |
RESULTS | Younger patients , males , and inpatients were more frequently identified as having a history of this kind of violence . |
CONCLUSIONS | Our findings suggested that caregiver reports of patient-initiated violence in psychosis are not uncommon . |
CONCLUSIONS | Mental health staff need to be aware of the risks of such violence for caregivers of people with psychosis , and consider appropriate procedures for minimizing it . |
###24958362 | null |
BACKGROUND | Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device . |
BACKGROUND | Of these devices , self-inflating resuscitators ( SIR ) and flow-inflating resuscitators ( FIR ) constitute the two major types used . |
BACKGROUND | Selection of a particular device for transport , however , remains largely an institutional practice . |
OBJECTIVE | To evaluate the hypothesis that transport ventilation goals of intubated pediatric patients are better achieved using an FIR compared to an SIR . |
METHODS | This randomized crossover simulation study compared the performance of SIR and FIR among anesthesia providers in a pediatric transport scenario . |
METHODS | Subjects hand-ventilated a test lung while simultaneously maneuvering a stretcher bed to simulate patient transport . |
METHODS | Hand ventilation was carried out using a Jackson-Rees circuit ( FIR ) and a Laerdal pediatric silicone resuscitator ( SIR ) . |
METHODS | The primary outcome was the proportion of total breaths delivered within the predefined target PIP/PEEP range ( 30 + / - 3 , 10 + / - 3 cm H2O ) . |
METHODS | Secondary outcomes included proportion of total breaths delivered with operationally defined unacceptable breath variables ( PIP > 35 cm H2O or PEEP < 5 cm H2O ) . |
RESULTS | Overall , participants were four times more likely to deliver target breaths and one-third less likely to deliver unacceptable breaths using the FIR compared to the SIR . |
RESULTS | When comparing device performance , a 44 % increase in the proportions of target breaths and a 40.4 % decrease in unacceptable breaths using the FIR were observed ( P < 0.0001 for both ) . |
CONCLUSIONS | Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles . |
###25446547 | null |
OBJECTIVE | To examine efficacy of hysteroscopic removal of polyps and myomas on health-related quality of life and symptom severity at 1-year postprocedure . |
METHODS | Randomized , prospective , comparative setting clinical trial ( Canadian Task Force classification II-2 ) . |
METHODS | Nine outpatient obstetrics and gynecology practices and hospitals in the United States . |
METHODS | Women 18 to 55years of age with polyps and/or type 0 or I myomas 1.5 and 3.0 cm . |
METHODS | Treatment of polyps and fibroids with the MyoSure device . |
RESULTS | A total of 118 lesions ( 76 polyps , 42 myomas ) were removed . |
RESULTS | Among the 118 pathologies removed , 53 were removed in an office setting ( 28 myomas , 25 polyps ) , and 55 were removed in an ambulatory surgical center ( ASC ) setting ( 14 myomas , 41 polyps ) . |
RESULTS | The mean percentage of pathology removed was 95.96.8 % for fibroids and 99.9 0.7 % for polyps . |
RESULTS | Symptom severity as measured by the Uterine Fibroid Symptom-Quality of Life ( UFS-QOL ) scale improved significantly ( p < .01 ) between baseline ( mean score of 67.515.4 ) and 12months postprocedure ( mean score of 22.322.6 ) . |
RESULTS | The Health-Related Quality of Life ( HRQOL ) scale also improved significantly ( p < .01 ) between baseline ( mean score 38.723.3 ) and 12months postprocedure ( mean score of 83.924.4 ) . |
RESULTS | Both the office and ASC groups demonstrated a statistically significant ( p < .01 ) improvement in UFS-QOL and HRQOL . |
CONCLUSIONS | For women with intrauterine polyps and/or myomas who experienced abnormal uterine bleeding , hysteroscopic morcellation with the MyoSure device provided significant , durable health-related , quality-of-life improvements up to 12months postprocedure . |
CONCLUSIONS | These findings were the same for patients treated in both an office-based setting and ASCs . |
###24530651 | null |
OBJECTIVE | To evaluate the effects of a home-monitoring device with tele-monitoring compared with standard care in detection of progression to choroidal neovascularization ( CNV ) associated with age-related macular degeneration ( AMD ) , the leading cause of blindness in the US . |
METHODS | Participants , aged 55 to 90 years , at high risk of developing CNV associated with AMD were recruited to the HOme Monitoring of Eye ( HOME ) Study , an unmasked , multi-center , randomized trial of the ForeseeHome ( FH ) device plus standard care vs. standard care alone . |
METHODS | The FH device utilizes preferential hyperacuity perimetry and tele-monitoring to detect changes in vision function associated with development of CNV , potentially prior to symptom and visual acuity loss . |
METHODS | After establishing baseline measurements , subsequent changes on follow-up are detected by the device , causing the monitoring center to alert the clinical center to recall participants for an exam . |
METHODS | Standard care consists of instructions for self-monitoring visual changes with subsequent self-report to the clinical center . |
METHODS | The primary objective of this study is to determine whether home monitoring plus standard care in comparison with standard care alone , results in earlier detection of incident CNV with better present visual acuity . |
METHODS | The primary outcome is the decline in visual acuity at CNV diagnosis from baseline . |
METHODS | Detection of CNV prior to substantial vision loss is critical as vision outcome following anti-angiogenic therapy is dependent on the visual acuity at initiation of treatment . |
CONCLUSIONS | HOME Study is the first large scale study to test the use of home tele-monitoring system in the management of AMD patients . |
###24807156 | null |
BACKGROUND | Avastin Biomarkers In lunG And 3D Innovative anaLysis ( ABIGAIL ) , which is a phase II , open-label , randomized study , investigated correlations between biomarkers and best overall response to bevacizumab plus platinum-doublet chemotherapy for patients with advanced/recurrent non-small-cell lung cancer . |
METHODS | Patients received bevacizumab ( 7.5 or 15 mg/kg , 3-weekly until disease progression/unacceptable toxicity ) plus carboplatin/gemcitabine or carboplatin/paclitaxel ( maximum six cycles ) . |
METHODS | Plasma samples ( baseline/throughout treatment ) were analyzed for vascular endothelial growth factor ( VEGF ) - A ( baseline only ) , VEGF receptors ( VEGFR-1 / VEGFR-2 ) , basic fibroblast growth factor , E-selectin , intercellular adhesion molecule-1 , and placental growth factor ( baseline only ) . |
METHODS | Tumor samples ( primary specimen ) were analyzed for VEGF-A , VEGFR-1 / VEGFR-2 , neuropilin ( NRP ) , and CD31 . |
METHODS | Response was evaluated at baseline and every 6 weeks ( Response Evaluation Criteria in Solid Tumors ) . |
RESULTS | Patients were randomized to receive chemotherapy plus 7.5 mg/kg ( n = 154 ) or 15 mg/kg ( n = 149 ) bevacizumab . |
RESULTS | For the primary analysis , none of the baseline plasma biomarkers correlated with best overall response . |
RESULTS | Exploratory analyses showed that low VEGF-A levels were associated with longer progression-free survival ( 7.4 versus 6.1 months ; hazard ratio , 1.57 ; 95 % confidence intervals , 1.17 to 2.09 ; p = 0.002 ) and overall survival ( 19.8 versus 11.1 months ; hazard ratio , 1.57 ; 95 % confidence interval , 1.15-2 .13 ; p = 0.004 ) compared with these in high baseline plasma VEGF-A levels . |
RESULTS | No plasma biomarkers changed significantly over time . |
RESULTS | No significant correlations were observed between tumor biomarkers and clinical outcomes . |
RESULTS | No new safety signals were observed . |
CONCLUSIONS | Baseline and/or dynamic changes in plasma basic fibroblast growth factor , E-selectin , intercellular adhesion molecule-1 , placental growth factor , VEGFR-1 and VEGFR-2 , and tumor biomarkers did not correlate statistically with treatment outcomes for bevacizumab plus chemotherapy . |
CONCLUSIONS | Only baseline plasma VEGF-A was significantly correlated with progression-free survival/overall survival . |
###24716478 | null |
BACKGROUND | Evidence from armed conflict settings points to high levels of intimate partner violence ( IPV ) against women . |
BACKGROUND | Current knowledge on how to prevent IPV is limited-especially within war-affected settings . |
BACKGROUND | To inform prevention programming on gender-based violence in settings affected by conflict , we evaluated the impact of adding a targeted men 's intervention to a community-based prevention programme in Cte d'Ivoire . |
METHODS | We conducted a two-armed , non-blinded cluster randomized trial in Cte d'Ivoire among 12 pair-matched communities spanning government-controlled , UN buffer , and rebel-controlled zones . |