Alstonsharpe0996
ctive therapeutic alliances with strong affective bonds and agreement on treatment goals and how to achieve them.
Enhancing contextual components in musculoskeletal healthcare could improve patient outcomes. Interventions should focus on helping practitioners and patients forge effective therapeutic alliances with strong affective bonds and agreement on treatment goals and how to achieve them.
To examine the safety of an agonist-type treatment, lisdexamfetamine (LDX), at 250 mg/day among adults with methamphetamine (MA) dependence.
A dose-escalating, phase-2, open-label, single-group study of oral LDX at two Australian drug treatment services.
The study was conducted at two Australian stimulant use disorder treatment clinics.
There were 16 participants at least 18 years old, MA dependent for at least the preceding 2 years using ICD-10 criteria, reporting use of MA on at least 14 of the preceding 28 days.
Daily, supervised LDX of 100-250 mg, single-blinded to dose, ascending-descending regimen over 8 weeks (100-250 mg over 4 weeks; followed by 4-week dose reduction regimen, 250-100 mg). Participants were followed through to week 12.
Primary outcomes were safety, drug tolerability and regimen completion at the end of week 4. Participants were followed to week 12. Secondary outcomes included change in MA use; craving; withdrawal; severity of dependence; risk behaviour; change in other substance use; medication acceptability; potential for non-prescription use; adherence and neurocognitive functioning.
Fourteen of 16 participants (87.5%) completed escalation to 250 mg/day. Two participants withdrew from the trial in the first week one relocated away from the study site, the other self-withdrew due to a possible, known side effect of LDX (agitation). There was one serious adverse event of suicidal ideation which resolved. All other adverse events were mild or moderate in severity and known side effects of LDX. No participant was withdrawn due to adverse events. MA use decreased from a median of 21 days (IQR 16-23) to 13 days (IQR 11-17) over the 4-week escalation period (p=0.013).
LDX at a dose of up to 250 mg/day was safe and well tolerated by study participants, warranting larger trials as a pharmacotherapy for MA dependence.
ACTRN12615000391572.
ACTRN12615000391572.
Estimation of the net survival of breast cancer helps in assessing breast cancer burden at a population level. Thus, this study aims to estimate the net survival of breast cancer at different cancer staging and age at diagnosis in the east coast region of West Malaysia.
Kelantan, Malaysia.
All breast cancer cases diagnosed in 2007 and 2011 identified from Kelantan Cancer Registry.
This retrospective cohort study used a relative survival approach to estimate the net survival of patients with breast cancer. Thus, two data were needed; breast cancer data from Kelantan Cancer Registry and general population mortality data for Kelantan population.
Net survival according to stage and age group at diagnosis at 1, 3 and 5 years following diagnosis.
The highest net survival was observed among stage I and II breast cancer cases, while the lowest net survival was observed among stage IV breast cancer cases. In term of age at diagnosis, breast cancer cases aged 65 and older had the best net survival compared with the other age groups.
The age at diagnosis had a minimal impact on the net survival compared with the stage at diagnosis. The finding of this study is applicable to other populations with similar breast cancer profile.
The age at diagnosis had a minimal impact on the net survival compared with the stage at diagnosis. The finding of this study is applicable to other populations with similar breast cancer profile.
To investigate the effect that particulate matter with a diameter of 2.5 μg (PM
) had on mortality in Asian populations in years 2000-2015.
Mortality and level of PM
data from the United Nations, Global Burden of Disease and University of Chicago were used.
Age pattern of mortality and the number of life-years lost (LYL) attributable to PM
in years 2000-2015. LYL were further separated into causes of death to quantify the contribution of each cause.
Ischaemic heart disease (IHD) mortality increased to represent over 31% of the LYL attributable to PM
between 2005-2010 and 2010-2015 in Asia (females 31% and males 35%). However, great diversity in LYL attributable to PM
by causes-of-death were found across the region, with IHD proportions of LYL ranging from 25% to 63% for males from Eastern and Central Asia, respectively. Similar diversity was observed for mortality attributable to PM
for other causes of death across Asia chronic obstructive pulmonary disease (LYL ranging from 6% to 28%), lung cancer (4% to 20%) and stroke (11% to 22%).
PM
is a crucial component in the rising health effects in Asia. The diverse trends in cause-specific mortality attributable to PM
creates a further challenge for health systems in the region. These findings highlight that immediate interventions are needed to mitigate the increasing levels of air pollution and with that reduce its detrimental effect on the health and mortality of Asian populations.
PM2.5 is a crucial component in the rising health effects in Asia. The diverse trends in cause-specific mortality attributable to PM2.5 creates a further challenge for health systems in the region. These findings highlight that immediate interventions are needed to mitigate the increasing levels of air pollution and with that reduce its detrimental effect on the health and mortality of Asian populations.
Tinnitus is the perception of sound without an external stimulus, often experienced as a ringing or buzzing sound. Subjective tinnitus is assumed to origin from changes in neural activity caused by reduced or lack of auditory input, for instance due to hearing loss. Since auditory deprivation is thought to be one of the causes of tinnitus, increasing the auditory input by cochlear implantation might be a possible treatment. In studies assessing cochlear implantation for patients with hearing loss, tinnitus relief was seen as a secondary outcome. Therefore, we will assess the effect of cochlear implantation in patients with primarily tinnitus complaints.
In this randomised controlled trial starting in January 2021 at the ENT department of the UMC Utrecht (the Netherlands), patients with a primary complaint of tinnitus will be included. Fifty patients (Tinnitus Functional Index (TFI)
32, Beck's Depression Index <19, pure tone average at 0.5, 1, 2 and 4 kHz bilateral threshold between 50 and ≤75 dB) will be randomised towards cochlear implantation or no intervention. Primary outcome of the study is tinnitus burden as measured by the TFI. Outcomes of interest are tinnitus severity, hearing performances (tinnitus pitch and loudness, speech perception), quality of life, depression and patient-related changes. Outcomes will be evaluated prior to implantation and at 3 and 6 months after the surgery. The control group will receive questionnaires at 3 and 6 months after randomisation. We expect a significant difference between the cochlear implant recipients and the control group for tinnitus burden.
This research protocol was approved by the Institutional Review Board of the University Medical Center (UMC) Utrecht (NL70319.041.19, V5.0, January 2021). The trial results will be made accessible to the public in a peer-review journal.
NL8693; Pre-results.
Trial registration number NL8693; Pre-results.
This study aimed to identify the guiding ethical principles that should be considered for critical resource allocation during pandemic emergency situations, and especially for the COVID-19 outbreak. The secondary objective was to define the priority to be assigned to each principle.
The study was conducted from March to June 2020 within the context of an ethical committee (EC) in Northern Italy.
Eleven EC members and five additional external healthcare and bioethical professionals, forming a multidisciplinary panel, took part in the study.
The compilation of a list of ethical principles (maximum of 10 items) and their priority ranking and application within an emergency pandemic context was established as the expected outcome of this work.
A consensus on 10 guiding ethical principles was reached by the multidisciplinary panel. Transparency ranked first on the priority list as the most frequently voted principle, followed by the number of lives saved, life-years saved, respect for individuals' autonolp to maximise the benefit of resource use for the community, thus reducing inequalities for individuals.
Dyspnoea is common in patients with interstitial lung disease (ILD) and often refractory to conventional treatment. Perifosine purchase Little is known about the efficacy of systemic morphine for dyspnoea in patients with ILD. The aim of this study is to estimate the efficacy of a single subcutaneous morphine injection for dyspnoea in patients with ILD.
We will conduct a multicentre, prospective, randomised, placebo-controlled, single-blinded phase II study of a single subcutaneous morphine injection for dyspnoea in patients with ILD. In patients with ILD who have dyspnoea at rest refractory to conventional treatment will be eligible for participation in this study. The morphine dose will be 2 mg. The primary endpoint is changes in dyspnoea intensity from baseline to 60 min after treatment as measured using an 11-point Numerical Rating Scale and compared between the morphine and placebo groups.
Ethical approval has been obtained by the Osaka City University Certified Review Board. The results of this study will be submitted for publication in an international peer-reviewed journal and the findings will be presented at international scientific conferences.
jRCTs051190030; pre-results.
jRCTs051190030; pre-results.
Patients with peripheral arterial disease (PAD) are at increased risk for systemic arterial thromboembolic events. Females represent a unique subset of patients with PAD, who differ from males in important ways they have smaller diameter vessels, undergo lower extremity bypass less frequently and experience higher rates of graft occlusion, amputation and mortality than males. Females also trend towards higher rates of major coronary events and cardiovascular mortality. Current guidelines recommend monoantiplatelet therapy (MAPT) for secondary prevention in patients with symptomatic PAD. However, indications for more intensive antithrombotic therapy in this cohort-especially among females who are frequently under-represented in randomised controlled trials (RCTs)-remain unclear. As newer antithrombotic therapies emerge, some RCTs have demonstrated differential effects in females versus males. A systematic review is needed to quantify the rates of arterial thromboembolic and bleeding events with different anteviewed journal and for presentation at national and international scientific meetings.
This protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (ID# CRD42020196933).
This protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (ID# CRD42020196933).
