19 research outputs found
Upper secondary school students’ compliance with two Internet-based self-help programmes: a randomised controlled trial
Women's experiences after early versus postponed oxytocin treatment of slow progress in first childbirth--a randomized controlled trial.
OBJECTIVE: The aim was to compare the childbirth experiences of primiparous women with slow labour progress who had received early versus postponed oxytocin augmentation. METHODS: The population included healthy primiparous women with slow labour progress after a normal pregnancy and spontaneous onset of active labour at term who had taken part in a randomized controlled trial at two delivery units in Sweden comparing early versus postponed oxytocin augmentation. A total of 536 women were sent the Childbirth Experience Questionnaire (CEQ) one month postpartum. The 22-item questionnaire assesses four domains of the childbirth experience. Main outcomes were the four domains of the CEQ: Own capacity, Professional support, Perceived safety and Participation. RESULTS: There were no significant differences between the women in the early and expectant oxytocin treatment groups in any of the four domains; however, operative births were associated with significantly worse childbirth experiences. Almost every third woman in both groups had negative and depressing memories from the childbirth process. CONCLUSIONS: Early oxytocin augmentation for slow labour progress does not appear to be more beneficial than expectant management regarding women's perceptions of childbirth one month postpartum. Given the risks for the foetus associated with oxytocin treatment, prudent expectant management seems to be a safe and viable alternative
Patterns of Peripheral Nerve and Tendon Injury in Hand Trauma Patients in a Tertiary Care Hospital of Pakistan
Ticagrelor versus clopidogrel in patients with acute coronary syndromes.
Background
Ticagrelor is an oral, reversible, direct-acting inhibitor of the adenosine diphosphate
receptor P2Y12 that has a more rapid onset and more pronounced platelet
inhibition than clopidogrel.
Methods
In this multicenter, double-blind, randomized trial, we compared ticagrelor (180-mg
loading dose, 90 mg twice daily thereafter) and clopidogrel (300-to-600-mg loading
dose, 75 mg daily thereafter) for the prevention of cardiovascular events in 18,624
patients admitted to the hospital with an acute coronary syndrome, with or without
ST-segment elevation.
Results
At 12 months, the primary end point — a composite of death from vascular causes,
myocardial infarction, or stroke — had occurred in 9.8% of patients receiving ticagrelor
as compared with 11.7% of those receiving clopidogrel (hazard ratio, 0.84;
95% confidence interval [CI], 0.77 to 0.92; P<0.001). Predefined hierarchical testing
of secondary end points showed significant differences in the rates of other composite
end points, as well as myocardial infarction alone (5.8% in the ticagrelor
group vs. 6.9% in the clopidogrel group, P = 0.005) and death from vascular causes
(4.0% vs. 5.1%, P = 0.001) but not stroke alone (1.5% vs. 1.3%, P = 0.22). The rate of
death from any cause was also reduced with ticagrelor (4.5%, vs. 5.9% with clopidogrel;
P<0.001). No significant difference in the rates of major bleeding was found
between the ticagrelor and clopidogrel groups (11.6% and 11.2%, respectively;
P = 0.43), but ticagrelor was associated with a higher rate of major bleeding not related
to coronary-artery bypass grafting (4.5% vs. 3.8%, P = 0.03), including more
instances of fatal intracranial bleeding and fewer of fatal bleeding of other types.
Conclusions
In patients who have an acute coronary syndrome with or without ST-segment elevation,
treatment with ticagrelor as compared with clopidogrel significantly reduced
the rate of death from vascular causes, myocardial infarction, or stroke without an
increase in the rate of overall major bleeding but with an increase in the rate of non–
procedure-related bleeding
Inter- and intra-tester reliability of sensibility testing in digital nerve repair
The aim of this study was to investigate the inter- and intra-tester reliability of the static two-point discrimination and Semmes-Weinstein monofilament tests in digital nerve repair. A total of 100 digital nerves from 67 patients were included into the study. An experienced orthopaedic surgeon and a physiotherapist examined the sensory nerve recovery. The reproducibility score of both tests was at a poor level, but the reliability of the Semmes-Weinstein monofilament test was higher than the static two-point discrimination test. These tests should not be used alone in the quantitative monitoring of sensory recovery, but should be interpreted with the clinical findings. Level 3 non-randomized controlled study