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METHODS One hundred six couples with borderline semen who were undergoing IVF and ICSI on sibling oocytes . |
METHODS Performing IVF and ICSI on sibling oocytes . |
METHODS Fertilization and pregnancy rates . |
RESULTS One thousand five hundred eighteen oocytes were collected in 106 oocyte retrievals : 849 oocytes were randomly allocated to ICSI , of which 761 were microinjected , and 669 oocytes were randomly assigned to IVF . |
RESULTS In 26 of the 106 patients , there was fertilization only after ICSI and not after IVF ( IVF - group ) . |
RESULTS The fertilization rate was 51 % ( 92/182 oocytes ) . |
RESULTS In 78 patients , there was fertilization after both IVF and ICSI ( IVF + group ) ; the fertilization rate was 51 % for both the IVF - and ICSI-treated oocytes ( 271/528 oocytes and 334/658 oocytes , respectively ) . |
RESULTS In 2 patients , there was no fertilization after either IVF ( 0/6 oocytes ) or ICSI ( 0/9 oocytes ) . |
RESULTS Patients of the IVF + group had a higher total motile sperm count after preparation than did those of the IVF - group . |
RESULTS More high-quality embryos were obtained after ICSI in patients of the IVF + group . |
RESULTS In 101 patients , embryo transfer was performed : 26 in the IVF - group and 75 in the IVF + group . |
RESULTS No significant differences were found with regard to pregnancy rates between those two groups : pregnancy rates were 54 % in the IVF - group and 48 % in the IVF + group . |
CONCLUSIONS Performing ICSI on at least some of the oocytes will avoid unnecessary fertilization failure in patients with borderline semen : in this study , 26 of 104 cycles ( 25 % ) were rescued by ICSI . |
###17904899 |
OBJECTIVE To explore the quality of data recording by practices and identify issues to be considered and addressed before such data can be used as a continuous measure of immunisation delivery . |
METHODS One hundred and twenty-four randomly selected general practices visited to measure immunisation coverage using the various practice management systems ( PMS ) in use . |
METHODS To capture all target children it was necessary to build two queries : one generated a list of all children aged between 6 weeks and 2 years who had been to the practice , regardless of enrollment status ; the other asked dates and nature of all immunisations given . |
METHODS Each different PMS required a unique query to extract the necessary information . |
RESULTS Variability encountered included different types and versions of PMS and operating systems ; variable degree of staff technical competence with their PMS ; proportion of enrolled children ranging from nearly 0 to 100 % ; lack of consistency of the nature and location of data entry and coding ; and unreliability of dates relating to some vaccination events . |
CONCLUSIONS To improve recording of immunisation coverage we recommend a standard early age of registration and enrollment ; standard definitions of the denominator and of immunisation delay ; greater uniformity of PMS ; improved staff training ; intrinsic data quality checks ; integration of PMS with changes in the immunisation schedule ; incentives and interval electronic checks to improve data quality . |
###23321194 |
OBJECTIVE The impact of preoperative gabapentin on tramadol consumption using patient-controlled analgesia ( PCA ) and postoperative pain was assessed in patients undergoing radical retropubic prostatectomy ( RRP ) . |
METHODS In this prospective , randomized trial , 51 patients undergoing RRP were randomized into two groups : the gabapentin group received 900 mg gabapentin orally 2 h before surgery ; the control group did not receive gabapentin . |
METHODS Postoperative analgesia was provided by tramadol PCA . |
METHODS Pain was assessed using a visual analogue scale for 24 h , postoperatively . |
RESULTS Mean cumulative tramadol consumption at 24 h was comparable in the two groups . |
RESULTS Pain scores at 45 min , 60 min and 2 h postoperatively , and the number of patients who required rescue analgesia , were significantly lower in the gabapentin group than in the control group . |
RESULTS Side-effects were similar in the two groups . |
CONCLUSIONS Preoperative administration of 900 mg gabapentin did not decrease tramadol consumption , but was associated with lower pain scores in the early postoperative phase and a reduced need for rescue analgesia , compared with controls , in patients undergoing RRP . |
###9233738 |
OBJECTIVE To evaluate and compare the safety and efficacy of cisatracurium ( 51W89 ) and atracurium administered by continuous infusion to critically ill patients requiring neuromuscular blocking agents to facilitate mechanical ventilation . |
METHODS Open , randomized , multicenter study of patients receiving cisatracurium or atracurium infusion to facilitate mechanical ventilation . |
METHODS Five university teaching hospital intensive care units in the United Kingdom . |
METHODS Sixty-one adult patients requiring neuromuscular blocking agents to facilitate mechanical ventilation . |
METHODS Bolus doses followed by continuous infusions of cisatracurium or atracurium were administered . |
METHODS Onset , maintenance , and recovery of neuromuscular blockade were measured , using transcutaneous ulnar nerve stimulation and an accelerometer . |
RESULTS Forty patients received cisatracurium ( mean duration 48.1 + / - 4.2 [ SEM ] hrs ) , and 21 patients received atracurium ( mean duration 46.1 + / - 5.8 hrs ) . |
RESULTS The infusion rate for patients receiving cisatracurium was 3.1 + / - 0.2 microg/kg/min , and for patients receiving atracurium 10.4 + / - 0.9 microg/kg/min . |
RESULTS There were no significant differences in mean times to 70 % recovery of Train-of-Four ratio ( cisatracurium 60 mins , atracurium 57 mins ) , although there was considerable interpatient variation ( 20 to 175 mins with cisatracurium vs. 35 to 85 mins with atracurium ) . |
RESULTS One patient who received cisatracurium exhibited intermittent bronchospasm during and after the study period . |
CONCLUSIONS Cisatracurium , an isomer of atracurium , appears to be a suitable agent for providing muscle relaxation in critically ill patients . |
###9872200 |
OBJECTIVE To compare the efficacy of standard medical therapy ( ST ) and noninvasive mechanical ventilation additional to standard medical therapy in hypercapnic acute respiratory failure ( HARF ) . |
METHODS Single center , prospective , randomized , controlled study . |
METHODS Pulmonary medicine directed critical care unit in a university hospital . |
METHODS Between March 1993 and November 1996 , 30 HARF patients were randomized to receive ST or noninvasive positive pressure ventilation ( NPPV ) in addition to ST. |
METHODS NPPV was given with an air-cushioned face via a mechanical ventilator ( Puritan Bennett 7200 ) with initial setting of 5 cm H2O continuous positive airway pressure and 15 cm H2O pressure support . |
RESULTS At the time of randomization , patients in the ST group had ( mean + / - SD ) PaO2 of 54 + / -13 mm Hg , PaCO2 of 67 + / -11 mm Hg , pH of 7.28 + / -0.02 , and respiratory rate of 35.0 + / -5.8 breaths/min . |
RESULTS Patients in the NPPV group had PaO2 of 55 + / -14 , PaCO2 of 69 + / -15 , pH of 7.27 + / -0.07 , and respiratory rate of 34.0 + / -8.1 breaths/min . |
RESULTS With ST , there was significant improvement of only respiratory rate ( p < 0.05 ) . |
RESULTS However , with NPPV , PaO2 ( p < 0.001 ) , PaCO2 ( p < 0.001 ) , pH ( p < 0.001 ) , and respiratory rate ( p < 0.001 ) improved significantly compared with baseline . |
RESULTS Six hours after randomization , pH ( p < 0.01 ) and respiratory rate ( p < 0.01 ) in NPPV patients were significantly better than with ST. Hospital stay for NPPV vs ST patients was , respectively , 11.7 + / -3.5 and 14.6 + / -4.7 days ( p < 0.05 ) . |
RESULTS One patient in the NPPV group required invasive mechanical ventilation . |
RESULTS The conditions of six patients in the ST group deteriorated and they were switched to NPPV ; this was successful in four patients , two failures were invasively ventilated . |
CONCLUSIONS This study suggests that early application of NPPV in HARF patients facilitates improvement , decreases need for invasive mechanical ventilation , and decreases the duration of hospitalization . |
###23810678 |
OBJECTIVE Patients with Crohn 's disease ( CD ) often require surgery over their clinical course . |
OBJECTIVE However , endoscopic and clinical recurrence of disease appear respectively in up to 80 % and 30 % of patients after one year . |
OBJECTIVE Thus , a prophylactic treatment is needed to reduce the possibility of recurrence . |
OBJECTIVE Both azathioprine and infliximab have been demonstrated to be effective , but head to head studies have not been performed so far . |
OBJECTIVE Aim of this open-label prospective study was to analyse endoscopic , histological and clinical recurrence after one year of treatment with azathioprine or infliximab as postoperative therapies in CD patients with `` high risk '' of recurrence . |
METHODS Consecutive CD patients who underwent curative ileocolonic resection were randomized ( 1:1 ) to receive infliximab ( standard induction and maintenance schedule ) or azathioprine ( 2.5 mg/kg/day ) for 1 year . |
METHODS Co-primary endpoints were endoscopic , histological and clinical recurrence after 12 months of therapy . |
RESULTS Twenty-two consecutive CD patients ( 15 male ; median age 32 years , IQR 22-38 ) were enrolled after curative ileocolonic resection . |
RESULTS Eleven patients were treated with infliximab and 11 received azathioprine . |
RESULTS Among patients treated with azathioprine , 4/10 ( 40 % ) had endoscopic recurrence compared to 1/11 ( 9 % ) in the infliximab group ( p = 0.14 ) . |
RESULTS Eight out of 10 ( 80 % ) among those who received azathioprine had severe histological activity , whereas 2/11 ( 18 % ) in the infliximab group presented histological recurrence ( p = 0.008 ) . |
RESULTS No significant clinical differences were found between the two groups . |
CONCLUSIONS Infliximab was more effective than azathioprine in reducing histological , but not endoscopic and clinical recurrence after curative ileocolonic resection in `` high risk '' CD patients . |
###12691651 |
BACKGROUND Immediate loading of osseointegrating implants shortens the treatment time and makes it possible to give the patient an esthetic appearance during the whole treatment period . |
BACKGROUND A previous retrospective clinical study showed a success rate of 94.2 % after 1 year of immediate loading of fixed partial constructions in the maxilla supported by machined-surface implants . |
BACKGROUND The recently introduced Brnemark System TiUnite ( Nobel Biocare AB , Gothenburg , Sweden ) surface has been shown to better maintain primary implant stability and to help achieve secondary stability earlier compared with the machined surface . |
OBJECTIVE The aim of the present study was to compare TiUnite and machined-surfaced Brnemark System implants when applying immediate loading of partial fixed bridges in the posterior mandible . |
METHODS Forty-four patients were randomized for test and control therapy . |
METHODS In the test group , 22 patients received 66 Brnemark System TiUnite surface implants supporting 24 fixed partial bridges , all of which were connected on the day of implant insertion . |
METHODS In the control group , 22 patients received 55 Brnemark System machined-surface implants supporting 22 fixed partial bridges , which also were connected on the day of implant insertion . |
METHODS All constructions were two - to four-unit bridges . |
METHODS Bone quality and quantity were assessed . |
METHODS Radiographic examinations were performed on the day of surgery/loading and at the 1-year follow-up visit . |
RESULTS Three TiUnite and eight machined-surface implants failed during the first 7 weeks of loading . |
RESULTS This resulted in a cumulative success rate of 95.5 % for TiUnite surface implants after 1 year of prosthetic load in the posterior mandible . |
RESULTS The corresponding cumulative success rate for machined-surface implants was 85.5 % . |
RESULTS When using the machined-surface implants , the number of failed implants was significantly higher in smokers and in bone quality 4 sites . |
RESULTS Such findings were not seen with the use of TiUnite implants , despite the fact that there were more smokers and more implants placed in bone quality 4 in this group . |
RESULTS The marginal bone resorption after 1 year of loading was on average 0.9 mm ( SD 0.7 mm ) with the TiUnite implants and 1.0 mm ( SD 0.9 mm ) with the machined implants . |
CONCLUSIONS The present study demonstrated a 10 % higher success rate following immediate loading of partial fixed bridges in the posterior mandible supported by TiUnite surface implants compared with success with machined implants . |
CONCLUSIONS When using the machined implants , the number of failed implants was significantly higher in smokers and in bone quality 4 sites . |
CONCLUSIONS Such findings were not seen following the use of TiUnite implants . |
###12511360 |
OBJECTIVE To compare intracameral levels and clinical efficacy of lidocaine 2 % gel with lidocaine 4 % unpreserved drops . |
METHODS Double-blind , randomized , one-surgeon , controlled trial . |
METHODS One hundred seven consecutive cataract cases eligible for topical anesthesia . |