Articles: treatment.
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Randomized Controlled Trial Multicenter Study
Droxidopa in patients with neurogenic orthostatic hypotension associated with Parkinson's disease (NOH306A).
Neurogenic orthostatic hypotension (nOH) is common in Parkinson's disease (PD), and represents a failure to generate norepinephrine responses appropriate for postural change. Droxidopa (L-threo-3,4-dihydroxyphenylserine) is an oral norepinephrine prodrug. ⋯ This exploratory analysis of a small dataset failed to show benefit of droxidopa, as compared with placebo by the primary endpoint. Nonetheless, there were signals of potential benefit for nOH, including improvement in dizziness/lightheadedness and reduction in falls, meriting evaluation in further trials.
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Randomized Controlled Trial Multicenter Study
Cost-effectiveness of endobronchial valve therapy for severe emphysema: a model-based projection based on the VENT study.
Endobronchial valve (EBV) therapy is an innovative treatment that has been shown to be safe and effective in selected subgroups of patients with severe emphysema. ⋯ Our model-based analysis suggests that EBV therapy leads to clinically meaningful changes in disease staging and progression when compared to medical management, with resulting gains in unadjusted and quality-adjusted life expectancy. Our results indicate that EBV therapy is cost-effective in the German health-care system.
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Multicenter Study
Disordered gambling in residential substance use treatment centers: an unmet need.
This study examined prevalence and potential impact of disordered gambling in a sample of individuals (N = 684) undergoing residential treatment for substance use disorders at 13 facilities. Lifetime disordered gambling prevalence was 20.2%, as identified by South Oaks Gambling Screen. ⋯ Meanwhile, 30.4% identified gambling as a concern in their recovery efforts. The presence of a gambling problem, either historical or current, potentially affects residential treatment outcomes and warrants clinical attention within these programs.
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Scand J Trauma Resus · Dec 2013
Multicenter StudyTriage performance of Swedish physicians using the ATLS algorithm in a simulated mass casualty incident: a prospective cross-sectional survey.
In a mass casualty situation, medical personnel must rapidly assess and prioritize patients for treatment and transport. Triage is an important tool for medical management in disaster situations. Lack of common international and Swedish triage guidelines could lead to confusion. Attending the Advanced Trauma Life Support (ATLS) provider course is becoming compulsory in the northern part of Europe. The aim of the ATLS guidelines is provision of effective management of single critically injured patients, not mass casualties incidents. However, the use of the ABCDE algorithms from ATLS, has been proposed to be valuable, even in a disaster environment. The objective for this study was to determine whether the mnemonic ABCDE as instructed in the ATLS provider course, affects the ability of Swedish physician's to correctly triage patients in a simulated mass casualty incident. ⋯ The mnemonic ABCDE doesn't significantly affect the ability of triage among Swedish physicians. Actions to increase Swedish physicians' knowledge of triage, within the ATLS context or separately, are warranted.
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Am. J. Respir. Crit. Care Med. · Dec 2013
Randomized Controlled Trial Multicenter StudyLoss of salmeterol bronchoprotection against exercise in relation to ADRB2 Arg16Gly polymorphism and FeNO.
β2-Agonists are the treatment of choice for exercise-induced bronchoconstriction (EIB) and act through specific receptors (ADRB2). Arg16Gly polymorphisms have been shown to affect responses to regular use of β2-agonists. ⋯ The LOB that occurs with chronic long-acting β2-agonists use is not affected by ADRB2 Arg16Gly polymorphisms. High FE(NO) was associated with marked LOB. Use of long-acting β2-agonists before achieving a reduction in FeNO may need to be avoided. Clinical trial registered with www.clinicaltrials.gov (NCT 00595361).