Cost-effectiveness of laparoscopic ileocaecal resection versus infliximab treatment of terminal ileitis in Crohn`s disease: the LIR!C Trial Evaluate the cost-effectiveness of laparoscopic ileocaecal resection compared with infliximab in patients with ileocaecal Crohn's disease failing conventional therapy.A multicentre randomised controlled trial was performed in 29 centres in The Netherlands and the UK. Adult patients with Crohn's disease of the terminal ileum who failed >3 months (...) ). The probability of resection being cost-effective compared with infliximab was 0.96 at a willingness to pay (WTP) of €0 per QALY gained and per point improvement in IBDQ Score. This probability increased to 0.98 at a WTP of €20 000/QALY gained and 0.99 at a WTP of €500/point of improvement in IBDQ Score.Laparoscopic ileocaecal resection is a cost-effective treatment option compared with infliximab.Dutch Trial Registry NTR1150; EudraCT number 2007-005042-20 (closed on 14 October 2015).© Author(s

Effects of vitamin D supplementation on cognitive function and blood Abeta-related biomarkers in older adults with Alzheimer`s disease: a randomised, double-blind, placebo-controlled trial Our study aimed to assess the effect of a 12-month vitamin D supplementation on cognitive function and amyloid beta (Aβ)-related biomarkers in subjects with Alzheimer's disease (AD). METHODS : This was a randomised, double-blind, placebo-controlled trial. 210 AD patients were randomly divided (...) the control group. According to mixed-model analysis, vitamin D group had significant increase in full scale IQ during follow-up period (p<0.001).Daily oral vitamin D supplementation (800 IU/day) for 12 months may improve cognitive function and decrease Aβ-related biomarkers in elderly patients with AD. Larger scale longer term randomised trials of vitamin D are needed.ChiCTR-IIR-16009549.© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Randomized clinical trial of open suture repair versus totally extraperitoneal repair for treatment of sportsman`s hernia Sportsman's hernia/athletic pubalgia is a recognized cause of chronic groin pain in athletes. Both open and laparoscopic surgical repairs have been described for treatment, but there are no comparative studies. The hypothesis here was that relief of pain would be achieved earlier in patients treated with open minimal suture repair than totally extraperitoneal repair.A

Aquatic exercise improves motor impairments in people with Parkinson`s disease, with similar or greater benefits than land-based exercise: a systematic review What are the effects of aquatic exercise on disease severity, (non-)motor impairments, activity performance, fear of falling, and quality of life in people with Parkinson's disease (PD)? Does aquatic exercise have greater effects on these outcomes than other forms of exercise in people with PD?Systematic review and meta-analysis

Health-related quality of life and costs in Sjogren`s syndrome Health-related quality of life (HRQoL) has an increasing role in medical decision-making. This review of the literature aims to provide an overview on HRQoL, costs, and work disability in SS, a disease characterized by focal lymphocytic infiltration of exocrine glands with no therapeutics of proven immunomodulatory potential. HRQoL is markedly reduced in SS in multiple studies across many countries when compared with HRQoL (...) -blind, placebo-controlled randomized controlled trial. Although primary SS does not, in general, impair life expectancy and is often inappropriately considered a benign 'nuisanvce' disease for those patients without systemic manifestations, the associated costs and work disability are striking. This, together with the significant reduction in HRQoL, strongly argues for the development of new therapeutic approaches to manage this neglected disease.© The Author(s) 2019. Published by Oxford University

A randomized controlled trial of Dilapan-S vs Foley balloon for preinduction cervical ripening (DILAFOL trial) The objective of the study was to test the hypothesis that Dilapan-S is not inferior to the Foley balloon for preinduction cervical ripening at term.Pregnant women ≥37 weeks scheduled for induction with unfavorable cervix (≤3 cm dilated and ≤60% effaced) were randomly assigned to 12 hours of either Foley balloon inflated with 60 mL saline or Dilapan-S for cervical ripening (...) balloon; 210 to Dilapan-S). In the intent-to-treat analysis, vaginal delivery was more common in Dilapan-S vs Foley balloon (81.3% vs 76.1%), with an absolute difference with respect to the Foley balloon of 5.2% (95% confidence interval, -2.7% to 13.0%) indicating noninferiority for the prespecified margin. The difference was not large enough to show superiority. Noninferiority was confirmed in the per-protocol population (n = 204 in the Foley balloon, n = 188 in Dilapan-S), supporting the robustness

Bidirectional relationship between systemic lupus erythematosus and non-Hodgkin`s lymphoma: a nationwide population-based study We conducted this nationwide population-based study in Taiwan to investigate whether there is a bidirectional relationship between SLE and non-Hodgkin's lymphoma (NHL).Using the National Health Insurance Research Database of Taiwan, we identified 16 417 patients with new-onset SLE without previous cancer and 25 069 patients with new-onset NHL without previous SLE

Metformin?s role in type 1 diabetes: the removal trial Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial – Clinical Correlations Search Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial February 14, 2019 5 min read By William Plowe Peer Reviewed Metformin has been the first-line drug in type 2 diabetes for over a decade, but its possible benefit in type 1 diabetes (DM1) is still a matter of study. The American Diabetes Association lists metformin as an investigational agent that may (...) prevalence of overweight children and adolescents at onset of insulin-treated diabetes. Diabetes Care. 2003;26(10):2871-2875. Wulffelé MG, Kooy A, Lehert P, et al. Combination of insulin and metformin in the treatment of type 2 diabetes. Diabetes Care. 2002;25(12):2133-2140. Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med . 2008;358(24):2545-2559. Patel A, Macmahon S, Chalmers

Core IM: 5 pearls on Barrett?s esophagus Core IM: 5 Pearls on Barrett’s Esophagus – Clinical Correlations Search Core IM: 5 Pearls on Barrett’s Esophagus January 30, 2019 3 min read Podcast: | Subscribe: | By Vishal Shah MD, Milna Rufin MD, Marty Fried MD, Shreya P. Trivedi MD || Illustration by Amy Ou MD || Audio Editing by Harit Shah. Quiz yourself on the 5 Pearls we will be covering: What is Barrett’s esophagus? (4:12) Who do we screen for Barrett’s, and why? (8:41) How do we screen (...) . Fletcher J, Wirz A, Henry E, et al. Studies of acid exposure immediately above the gastro-oesophageal junction: Evidence of short segment reflux. Gut 2004; 53:168-73. Hayeck T.J., Kong C.Y., Spechler S.J., Gazelle G.S., Hur C. The prevalence of Barrett’s esophagus in the US: estimates from a simulation model confirmed by SEER data. Dis Esophagus. 2010;23:451–457. Rastogi A, Puli S, El-Serag HB et al. Incidence of esophageal adenocarcinoma in patients with Barrett’s esophagus and high-grade dysplasia

There?s Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 5,000 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care

Path Finder for freezing of gait in people with Parkinson?s disease P Path Finder for freezing of gait in people with ath Finder for freezing of gait in people with P Parkinson arkinson’s disease ’s disease Medtech innovation briefing Published: 25 January 2019 nice.org.uk/guidance/mib170 pathways Summary Summary The technology technology described in this briefing is Path Finder laser shoe attachment. It is used as a walking aid and is designed to help prevent freezing of gait in people (...) of gait, done in a controlled gait laboratory in the Netherlands. Intervention and comparator(s) Intervention: Path Finder laser shoe. No comparator. Path Finder for freezing of gait in people with Parkinson’s disease (MIB170) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 11Key outcomes 2 patients were excluded from the analysis; 1 for inability to see the laser and 1 because freezing of gait episodes could

Safety and efficacy of CVT-301 (levodopa inhalation powder) on motor function during off periods in patients with Parkinson`s disease: a randomised, double-blind, placebo-controlled phase 3 trial Patients with Parkinson's disease chronically treated with levodopa commonly have delayed or unpredictable onset of its benefits after oral intake. In this study, we assessed the safety and efficacy of CVT-301, a self-administered levodopa oral inhalation powder, for the treatment of patients

It`s Not All About Redislocation: A Systematic Review of Complications After Anterior Shoulder Stabilization Surgery The surgical treatment of recurrent shoulder instability has evolved in recent years to include a variety of soft tissue and bone block procedures, undertaken with either an open or arthroscopic approach. Although the utilization of such techniques has rapidly expanded, the associated risk of complications remains poorly defined. This information is vital for clinical decision

A randomized controlled study of whether setting specific goals improves the effectiveness of therapy in people with Parkinson`s disease To evaluate the effects of an intervention based on a specific set of goals on goal attainment, manual dexterity, hand grip strength and finger prehension force compared to a standardized approach in patients with Parkinson's disease.Randomized controlled trial.Home-based.Fifty patients with a clinical diagnosis of Parkinson's disease acknowledging impaired

A Network Meta-Analysis to Compare the Efficacy of Steroid and Antiviral Medications for Facial Paralysis from Bell s Palsy Facial paralysis is the most common cranial nerve injury. Bell's palsy is the name commonly used to describe an acute peripheral facial paralysis of unknown origin. The annual incidence of Bell's palsy is 20-30 cases per 100,000 persons, regardless of age and gender.Our objective was to appraise the efficacy of steroid and antiviral treatments for facial paralysis.We (...) of these therapies.Antiviral combined with steroid therapy is significantly better than antiviral or steroid therapy alone with respect to overall recovery, and the efficacies of single antiviral medications or single steroid treatments are nearly equal. In addition, all 3 therapies are more effective than placebo, according to the SUCRA values.Facial paralysis, Bell´s palsy, steroids, antiviral drugs, efficacy, overall recovery, network meta-analysis, SUCRA.

Physiotherapy versus physiotherapy plus cognitive training on cognition and quality of life in Parkinson´s disease: randomized clinical trial. Verify the effectiveness of physiotherapy associated with cognitive training to improve cognition and quality of life in individuals with Parkinson's disease (PD).randomized clinical trial involving 58 individuals with mild to moderate PD, randomly distributed into two groups: motor group (MG) and cognitive-motor group (CMG). Both groups were assessed

Two?s Company, Three?s a Crowd: Dual versus triple therapy post-PCI Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 5,000 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research. www.acfp.ca (...) . N Engl J Med. 2016; 375:2423-34. 4. Golwala HB, Cannon CP, Steg PG, et al. Eur Heart J. 2018; 39:1726-35. 5. Gong X, Tang S, Li J, et al. PLoS ONE. 2017; 12:e0186449. 6. Connolly SJ, Ezekowitz MD, Yusuf S, et al. NEJM. 2009; 361:1139-51. 7. Camm AJ, Accetta G, Ambrosio G, et al. Heart. 2017; 103:307-14. 8. Mehta SR, Bainey KR, Cantor WJ, et al. Can J Cardiol. 2018; 34:214-33. Tools for Practice is a biweekly article summarizing medical evidence with a focus on topical issues and practice

Recommendations from AABB?s Clinical Transfusion Medicine Committee on Sterile Saline Shortage (0.9% NaCl Solution) Recommendations from AABB’s Clinical Transfusion Medicine Committee on Sterile Saline Shortage (0.9% NaCl Solution) Background: It is standard practice at many hospitals to follow blood component transfusions with a normal saline (0.9% NaCl) flush. This serves the dual purpose of administering to the patient any residual blood left in the administration set (up to 40 mL (...) not adversely affect the blood or component.” Suggested Practice: To flush a line following a blood transfusion, several alternative options may be considered until the saline shortage resolves. The transfusion service medical director should determine the best alternative(s) for each institution. 1. Use a prepackaged 10-mL saline syringe to flush the line. Saline syringes are not in short supply. The syringe can be attached to the line via a Luer lock connection. The use of straight tubing should also

Quantifying cam morphology by the alpha angle: a systematic review on threshold values Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites (...) will attempt to contact authors by e-mail (max. 2 attempts). In case an outcome is measured at multiple time points, data from the time point where efficacy is highest will be included. ">Methods for data extraction Example: Experimental groups, control group(s) and number of animals per group. ">Data to be extracted: study design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac ischemia, duration of ischemia and duration of reperfusion (if applicable

Family planning intervention(s) and infertility in low- and middle-income countries: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any (...) are not reported or unclear, we will attempt to contact authors by e-mail (max. 2 attempts). In case an outcome is measured at multiple time points, data from the time point where efficacy is highest will be included. ">Methods for data extraction Example: Experimental groups, control group(s) and number of animals per group. ">Data to be extracted: study design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac ischemia, duration of ischemia and duration