69 research outputs found
Surgical Interventions for Cervical Radiculopathy without Myelopathy:A Systematic Review and Meta-Analysis
BACKGROUND: The effectiveness of surgical interventions for cervical degenerative disorders has been investigated in multiple systematic reviews. Differences in study population (e.g., patients with myelopathy and/or radiculopathy) were often neglected. Therefore, the objective of this study was to investigate the effectiveness of surgical interventions for patients with symptoms of cervical radiculopathy without myelopathy by conducting a systematic review and meta-analysis based on randomized controlled trials (RCTs). METHODS: A comprehensive systematic search was conducted in MEDLINE, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) to identify RCTs that investigated the effectiveness of surgical interventions using an anterior or posterior approach compared with other interventions for patients with pure cervical radiculopathy. Outcomes were success rates (Odom criteria, similar rating scales, or percentage of patients who improved), complication and reoperation rates, work status, disability (Neck Disability Index), and pain (arm and neck). The Cochrane risk-of-bias tool was used to assess the likelihood of the risk of bias. A random-effects model was used. Heterogeneity among study results (I ≥ 50% or p < 0.05) was explored by conducting subgroup analyses. Funnel plots were used to assess the likelihood of publication bias. RESULTS: A total of 21 RCTs were included, comprising 1,567 patients. For all outcomes, among all surgical techniques, only 1 pooled estimate showed a significant effect on success rate, which was in favor of anterior cervical discectomy with fusion compared with anterior cervical discectomy without an intervertebral spacer (p = 0.02; risk ratio [RR] = 0.87; 95% confidence interval [CI] = 0.77 to 0.98). Complication rates were higher when autologous bone graft from the iliac crest was used as an intervertebral spacer (p < 0.01; RR = 3.40; 95% CI = 1.56 to 7.43), related to donor-site morbidity. CONCLUSIONS: This meta-analysis demonstrated consistent results regarding clinical outcome for pure cervical radiculopathy among all studied interventions. Complication and reoperation rates were also similar, with the exception of higher complication rates in patients in whom autologous bone grafts were used. On the basis of clinical outcome and safety, there is no superior surgical intervention for pure cervical radiculopathy. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence
Insights on multiple myeloma treatment strategies
The introduction of new agents and management strategies over the past decade has resulted in a major step change in treatment
outcomes with deepening responses and increased survival for patients with multiple myeloma. In daily clinical practice, healthcare
professionals are now faced with challenges including, optimal treatment sequencing and changing treatment goals. In light of this, a
group of experts met to discuss diagnostic and treatment guidelines, examine current clinical practice, and consider how new clinical
trial data may be integrated into the management of multiple myeloma in the future
Prevention and management of adverse events of novel agents in multiple myeloma: a consensus of the European Myeloma Network
During the last few years, several new drugs have been introduced for treatment of patients with multiple myeloma, which have significantly improved the treatment outcome. All of these novel substances differ at least in part in their mode of action from similar drugs of the same drug class, or are representatives of new drug classes, and as such present with very specific side effect profiles. In this review, we summarize these adverse events, provide information on their prevention, and give practical guidance for monitoring of patients and for management of adverse events
Efficacy of halopeRIdol to decrease the burden of Delirium In adult Critically ill patiEnts (EuRIDICE): study protocol for a prospective randomised multi-centre double-blind placebo-controlled clinical trial in the Netherlands
Introduction Delirium in critically ill adults is associated
with prolonged hospital stay, increased mortality and
greater cognitive and functional decline. Current practice
guideline recommendations advocate the use of nonpharmacological strategies to reduce delirium. The
routine use of scheduled haloperidol to treat delirium is
not recommended given a lack of evidence regarding its
ability to resolve delirium nor improve relevant short-term
and longer-term outcomes. This study aims to evaluate
the efficacy and safety of haloperidol for the treatment of
delirium in adult critically ill patients to reduce days spent
with coma or delirium.
Methods and analysis EuRIDICE is a prospective, multicentre, randomised, double-blind, placebo-controlled
trial. Study population consists of adult intensive care
unit (ICU) patients without acute neurological injury who
have delirium based on a positive Intensive Care Delirium
Screening Checklist (ICDSC) or Confusion Assessment
Method for the ICU (CAM-ICU) assessment. Intervention
is intravenous haloperidol 2.5mg (or matching placebo)
every 8 hours, titrated daily based on ICDSC or CAMICU positivity to a maximum of 5mg every 8 hours,
until delirium resolution or ICU discharge. Main study
endpoint is delirium and coma-free days (DCFD) up
to 14 days after randomisation. Secondary endpoints
include (1) 28-day and 1-year mortality, (2) cognitive and
functional performance at 3 and 12 months, (3) patient
and family delirium and ICU experience, (4) psychological
sequelae during and after ICU stay, (4) safety concerns
associated with haloperidol use and (5) cost-effectiveness.
Differences in DCFDs between haloperidol and placebo
group will be analysed using Poisson regression analysis.
Study recruitment started in February 2018 and continues.
Ethics and dissemination The study has been approved
by the Medical Ethics Committee of the Erasmus University
Medical Centre Rotterdam (MEC2017-511) and by the
Institutional Review Boards of the participating sites. Its
results will be disseminated via peer-reviewed publication
and conference presentations
Ribosomally synthesized and post-translationally modified peptide natural products: Overview and recommendations for a universal nomenclature
Covering: 1988 to 2012 This review presents recommended nomenclature for the biosynthesis of ribosomally synthesized and post-translationally modified peptides (RiPPs), a rapidly growing class of natural products. The current knowledge regarding the biosynthesis of the >20 distinct compound classes is also reviewed, and commonalities are discussed
Prevention and management of adverse events of novel agents in multiple myeloma: A consensus of the European Myeloma Network
During the last few years, several new drugs have been introduced for treatment of patients with multiple myeloma, which have significantly improved the treatment outcome. All of these novel substances differ at least in part in their mode of action from similar drugs of the same drug class, or are representatives of new drug classes, and as such present with very specific side effect profiles. In this review, we summarize these adverse events, provide information on their prevention, and give practical guidance for monitoring of patients and for management of adverse events
Notes on European polypores-I
In an attempt to bring the nomenclature of several European polypores up to date Datronia gen. nov. is published to obtain a correct name for Antrodia P. Karst. sensu Murrill; and several new specific combinations are made, viz. with Datronia (2), Antrodia P. Karst. emend. (6), Rigidoporus Murrill (3), Oxyporus (Bourd. & G.) Donk (1), Phellinus Quél. (1). In a few cases annotations are attached to names in current use or to recombinations. Cartilosoma Kotl. & Pouz. is reduced to the synonymy of Antrodia
Paullicorticium curiosum, presumably an imperfect state
Paullicorticium curiosum Parm. werd beschreven als een primitieve vertegenwoordiger van de Corticiaceae. Een nauwgezette studie van de beschrijving en de figuren liet echter weinig twijfel, dat het hier ging om een conidiaal stadium van een soort van Hyphoderma Wallr. emend. Donk, waarschijnlijk H. populneum (Peck) Donk of een nauw verwante soort. De nieuwe combinatie Oedocephalum curiosum (Parm.) Donk wordt voorgesteld
The generic names proposed for Polyporaceae. Additions and corrections
This paper contains some additional information and discussions as well as corrections of statements and of facts recorded in a previously published paper entitled “The generic names proposed for Polyporaceae”
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