BMJ open
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Comparative Study
Comparison of the efficacy and safety of drug therapies for macular edema secondary to central retinal vein occlusion.
To evaluate the efficacy and safety of anti-vascular endothelial growth factor (VEGF) agents and corticosteroids for the treatment of macular oedema (ME) secondary to central retinal vein occlusion (CRVO). ⋯ CRD42017064076.
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Multicenter Study
Impact of the SIGN head injury guidelines and NHS 4-hour emergency target on hospital admissions for head injury in Scotland: an interrupted times series.
Head injury is a common reason for emergency department (ED) attendance. Around 1% of patients have life-threatening injuries, while 80% of patients are discharged. National guidelines (Scottish Intercollegiate Guidelines Network (SIGN)) were introduced in Scotland with the aim of achieving early identification of those with acute intracranial lesions yet safely reducing hospital admissions.This study aims to assess the impact of these guidelines and any effect the national 4-hour ED performance target had on hospital admissions for head injury. ⋯ Increased CT imaging of head injured patients recommended by SIGN guidelines reduced hospital admissions. The 4-hour ED target and the increased identification of TBI by CT imaging acted to undermine this effect.
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Randomized Controlled Trial
A randomised controlled trial to assess whether prehabilitation improves fitness in patients undergoing neoadjuvant treatment prior to oesophagogastric cancer surgery: study protocol.
Neoadjuvant therapy prior to oesophagogastric resection is the gold standard of care for patients with T2 and/or nodal disease. Despite this, studies have taught us that chemotherapy decreases patients' functional capacity as assessed by cardiopulmonary exercise (CPX) testing. We aim to show that a multimodal prehabilitation programme, comprising supervised exercise, psychological coaching and nutritional support, will physically, psychologically and metabolically optimise these patients prior to oesophagogastric cancer surgery so they may better withstand the immense physical and metabolic stress placed on them by radical curative major surgery. ⋯ This study has been approved by the London-Bromley Research Ethics Committee and registered on ClinicalTrials.gov. The results will be disseminated in a peer-reviewed journal.
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Total knee arthroplasty is a highly effective treatment for end-stage knee osteoarthritis, and it is usually performed under spinal or general anaesthesia with or without a surgical tourniquet. Some debate about the preferred mode of anaesthesia regarding patient outcomes remains. The aim of this study, which compares general and spinal anaesthesia with and without a tourniquet on the outcomes of total knee arthroplasty, is to determine the optimal type of anaesthesia regimen and assess the effect of a tourniquet on the patient's recovery following total knee arthroplasty. ⋯ This study's protocol is in accordance with the declaration of Helsinki. The results of this study will be disseminated in international peer-reviewed journals.
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eHealth is critically important to build strong health systems, and accelerate the achievement of sustainable development goals, particularly universal health coverage. To support and strengthen the health system, the eHealth architecture needs to be formulated and established prior to the implementation and development of any national eHealth applications and services. The aim of this study is to design and validate a standard questionnaire to assess the current status of national eHealth architecture (NEHA) components. ⋯ The Ethics Committee for Research at the Tehran University of Medical Sciences approved the study protocol. We will obtain informed consent from each participant and collect data anonymously to maintain confidentiality. The translation of the findings into future policy planning will include the production of a series of peer-reviewed articles, presentation of the findings at relevant eHealth conferences and preparation of policy reports to the international organisations aiming to strengthen national capacity for better-informed eHealth architecture.