No description available.

No / Intermittent pneumatic compression (IPC) is a mechanical method of delivering compression to swollen limbs that can be used to treat venous leg ulcers and limb swelling due to lymphoedema. This review analyses the evidence for the effectiveness of IPC as a treatment for venous leg ulcers. OBJECTIVES: To determine whether IPC increases the healing of venous leg ulcers. To determine the effects of IPC on health related quality of life of venous leg ulcer patients. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Register (December 2007); the Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library Issue 4, 2007; Ovid MEDLINE - 2006 to November Week 2 2007; Ovid EMBASE - 2006 to 2007 Week 49 and Ovid CINAHL - 2006 to December Week 1 2007. SELECTION CRITERIA: Randomised controlled studies either comparing IPC with control (sham IPC or no IPC) or comparisons between IPC treatment regimens, in venous ulcer management were included. DATA COLLECTION AND ANALYSIS: Data extraction and assessment of study quality were undertaken by one author and checked by a second. MAIN RESULTS: Seven randomised controlled trials (including 367 people in total) were identified. Only one trial reported both allocation concealment and blinded outcome assessment. In one trial (80 people) more ulcers healed with IPC than with dressings (62% vs 28%; p=0.002). Four trials compared IPC with compression against compression alone. The first of these trials (45 people) found increased ulcer healing with IPC plus compression than with compression alone (relative risk for healing 11.4, 95% Confidence Interval 1.6 to 82). The remaining three trials (122 people) found no evidence of a benefit for IPC plus compression compared with compression alone. One small trial (16 people) found no difference between IPC (without additional compression) and compression bandages alone. One trial compared different ways of delivering IPC (104 people) and found that rapid IPC healed more ulcers than slow IPC (86% vs 61%; log rank p=0.003). AUTHORS' CONCLUSIONS: IPC may increase healing compared with no compression, but it is not clear whether it increases healing when added to treatment with bandages, or if it can be used instead of compression bandages. Rapid IPC was better than slow IPC in one trial. Further trials are required to determine whether IPC increases the healing of venous leg ulcers when used in modern practice where compression therapy is widely used.

Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1998. / Typescript. Bibliography: leaves 118-128.

Source: Masters Abstracts International, Volume: 47-06, page: 3551. Advisers: Florence J. Dallo; Raul Caetano. Includes bibliographical references.

Background. The randomized controlled clinical trial is currently the most scientific method for evaluating the effect of medical interventions. The sample size of a trial is crucial for reliably estimating the effect. However, many clinical trials may not be sufficiently large in size to detect the effect of interventions assessed. Previous studies of the statistical power, a relative measure of the largeness of a study, were normally small, mainly examined trials with a statistically insignificant result and were flawed because of the biased or purely hypothetical estimate of the effect for the computation of the power. By using meta-analysis, we conducted this study with improved methods for estimating the power and included a larger number of trials. / Findings. A total of 2,923,912 patients from 2,872 clinical trials from 466 systematic reviews were included in the analyses of this thesis. Of the 466 systematic reviews, 24% (113) were identified from the five journals and the remaining 76% (353) were from the Cochrane Library. 1,000 trials and 1,583,204 patients were obtained from 113 systematic reviews identified in the journals, in which 13.7% (95% C.I.: 11.6%, 15.8%) of trials had a sufficient power and the overall power was 34.0% (95% C.I.: 33.7%, 34.3%). 1,872 trials and 1,340,708 patients were obtained from 353 systematic reviews identified in the Cochrane Library, in which 16.7% (95% C.I.: 15.0%, 18.4%) of trials had a sufficient power and the overall power was 37.8% (95% C.I.: 37.6%, 38.0%). (Abstract shortened by UMI.) / Methods. We identified trials from systematic reviews of clinical trials with binary outcomes published in five medical journals and the Cochrane Database of Systematic Reviews. We analyzed the power of trials with a significant result as well as those with an insignificant result. In estimating the power, we used the combined odds ratio of the meta-analysis as the estimate of the effect for trials from systematic reviews with a statistically significant result and a relative risk reduction of 25% for trials from systematic reviews with a statistically insignificant result. In addition to use of the conventional method to estimate the power, we also developed a new "counting method" that does not need any assumption about the effect. Furthermore, the power is also expressed as a relative and absolute difference between the number of subjects required for a power of 80% and that actually recruited by the trials. / Tsoi Kam Fai. / "July 2005." / Adviser: Jin Ling Tang. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0161. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 107-113). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Thesis (Ph.D. in Biostatistics) -- University of Colorado at Denver and Health Sciences Center, 2006. / Typescript. Includes bibliographical references (leaves 72-75). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Thesis (Ph.D. in Biostatistics, Department of Preventive Medicine and Biometrics) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 89-93). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

Made available in DSpace on 2015-12-06T23:02:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2001 / Qualidade dos ensaios clinicos aleatorios em Cirurgia Plastica. Contexto. A avaliacao da qualidade dos ensaios clinicos aleatorios e importante, pois a observacao dos erros e falhas nos permite evita-los no planejamento. conducao, analise e publicacao de futuros estudos. E e fundamental para se determinar o grau de confiabilidade dos resultados dos estudos publicados. Objetivo. Avaliar a qualidade dos ensaios clinicos aleatorios em Cirurgia Plastica. A hipotese testada foi a de que os estudos sao de ma qualidade. Tipo de estudo. Estudo descritivo com a avaliacao realizada por dois pesquisadores, de maneira independente, seguida de uma reuniao de consenso. Selecao da amostra. Ensaios clinicos aleatorios em Cirurgia Plastica, com sigilo de alocacao descrito adequadamente, realizado por/ou com a participacao de pelo menos um cirurgiao plastico, foram identificados atraves da busca eletronica nas bases de dados LILACS, MEDLINE, EMBASE e CCTR. Variavel estudada. Qualidade dos ensaios clinicos aleatorios, por meio da Lista de Delphi, de uma escala de qualidade (JADAD et al., 1996) e de cinco itens complementares. Resultados. Dos 139 estudos publicados como ensaios clinicos aleatorios, 63 por cento (88/139) nao descreveram o sigilo de alocacao, em 17 por cento (23/139) o sigilo de alocacao foi inadequado e 20 por cento (28/139) descreveram o sigilo de alocacao adequadamente. Dos 28 ensaios clinicos aleatorios, com sigilo de alocacao descrito adequadamente, 25 por cento nao descreveram a geracao da sequencia de alocacao, 82 por cento nao descreveram as perdas e exclusoes, 68 por cento nao descreveram se os grupos eram comparaveis, 50 por cento nao especificaram os criterios de inclusao e exclusao, 68 por cento nao apresentaram as medidas de variabilidade e as estimativas dos pontos para a variavel primaria, 61 por cento nao apresentaram uma analise por intencao de tratar. Na pontuacao pela escala de qualidade (JADAD et al., 1996), 71 por cento (20/28) receberam dois ou menos pontos. Conclusao. Os ensaios clinicos aleatorios em Cirurgia Plastica sao de ma qualidade / Quality of randomized clinical trials in Plastic Surgery. Context. The valuation of the quality of the randomized clinical trials is important since the observation of the mistakes and failures allows us to avoid them during planning, performing, analysis and publishing of future studies. It is fundamental in order to determine the reliability degree of the results of the published studies. Objective. To evaluate the quality of randomized clinical trials in Plastic Surgery. The hypothesis tested was the one stating that the studies are low quality ones. Type of study. Descriptive study with the valuation performed by two appraisers, in an independent way, followed by a consensus meeting. Study selection. Randomized clinical trials in Plastic Surgery, with allocation concealment suitably described, performed by/or with the participation of, at least, one plastic surgeon, were identified through electronic search in the basis of LILACS, EMBASE, MEDLINE and CCTR data. Studied variable. Quality of the randomized clinical trials, through Delphi List, through a quality scale (JADAD et al., 1996) and five complementary items. Results. From 139 studies published as randomized clinical trials, 63% (88/139) didn’t describe allocation concealment, in 17% (23/139) it was unsuited and 20% described it suitably. From 28 randomized clinical trials with allocation concealment suitably described, 25% didn’t describe the formation of the allocation sequence, 82% didn’t describe the loss and exclusion, 68% didn’t describe if the groups were comparable, 50% didn’t specify the inclusion and exclusion criteria, 68% didn’t present the variability measures and the points estimation for a primary variable, 61% didn’t present an analysis for a treating intention. In the punctuation by the quality scale (JADAD et al., 1996), 71% (20/28) got two or less points. Conclusion. The randomized clinical trials in Plastic Surgery are low quality ones. / BV UNIFESP: Teses e dissertações

No description available.

INTRODUÇÃO: Pacientes com diagnóstico de parafilias e de transtornos relacionados às parafilias ocupam a atenção pública e clínica por se tratarem de indivíduos potencialmente inconvenientes, causadores de problemas à sociedade e a si próprios. Caracteristicamente, apresentam padrões invulgares de comportamento sexual e distinguem-se pela escolha de parcerias ou de contextos sexuais incomuns. JUSTIFICATIVA: O tratamento atual leva em consideração comportamentos, fantasias e necessidades sexuais parafílicas e procura modificá-los por meio de psicoterapia cognitivocomportamental, medicação antidepressiva e antiandrogênica. Apenas a supressão destes comportamentos tem se mostrado insatisfatória e ainda apresenta altas taxas de reincidência. Não há resultados publicados sobre a efetividade de um novo tratamento psicoterapêutico, cujo foco esteja voltado para a identificação e a reestruturação da identidade sexual e cujo principal objetivo seja o de promover maior contato destes pacientes com parcerias sexuais convencionais. MÉTODO: A intervenção foi testada por meio de ensaio clínico de tratamento, randomizado, placebo controlado e unicego, realizado com dois grupos paralelos: experimental (N=6) e controle (N=8). Todos os pacientes apresentavam diagnóstico de parafilias e foram medicados com inibidores seletivos da recaptação de serotonina. As intervenções psicoterapêuticas duraram dezesseis semanas com frequência de uma sessão por semana. As mudanças comportamentais foram monitoradas por meio de um diário e as comorbidades psiquiátricas, a qualidade de vida e a adequação social foram avaliadas por meio de escalas psicométricas, nos três períodos do estudo: início, término e seguimento pósintervenção. RESULTADOS: Não houve melhora estatisticamente significante dos escores de depressão, qualidade de vida e adequação social para ambos os grupos. O grupo experimental apresentou tendência de melhor resposta para depressão ao se tomar esta variável de forma categorial. Ambos os grupos apresentaram: maior incapacidade de adequação social (comparados a populações não clínicas); tendência de aumento do estado de ansiedade; melhora clínica global e redução dos índices de gravidade das parafilias. Houve diferenças estatisticamente significantes entre os grupos. Para o grupo experimental: aumento de fantasias e masturbações normofílicas; maior procura por contatos eróticos normofílicos e diminuição de fantasias parafílicas. Porém, houve diminuição de contatos íntimos normofílicos (beijos, abraços e carícias) para este grupo. Houve diferenças estatisticamente significantes intragrupos. Para o grupo experimental: redução de contatos íntimos parafílicos e totais (parafílicos e normofílicos). Para o grupo placebo: aumento de relações sexuais parafílicas e da totalidade das fantasias sexuais (parafílicas e normofílicas). CONCLUSÕES: Os defechos favoráveis observados no grupo de intervenção evidenciaram a importância em se identificar e trabalhar psicoterapeuticamente o impedimento que os parafílicos apresentam de se relacionar com parcerias sexuais normofílicas, uma vez que para o grupo experimental as mudanças positivas observadas no comportamento, fantasias e necessidades sexuais caminharam em direção a padrões convencionais / INTRODUCTION: Patients diagnosed with paraphilia and paraphilia-related disorders have public and medical attention drawn to them because they are potentially disturbing individuals who cause problems to society and to themselves. Typically, they show unusual patterns of sexual behavior and make unusual choices related to sexual partners or sexual contexts. RATIONALE: Current treatment considers paraphilic behaviors, fantasies, and urges, trying to change these symptoms using cognitive-behavioral psychotherapy, antidepressants, and anti-androgen medication. The elimination of these behaviors has proved unsatisfactory and still has high recurrence rates. We could not find in the literature any studies on the effectiveness of a new psychotherapeutic treatment focused on identifying and restructuring the patients\' sexual identity to allow for the promotion of contact between these patients and conventional sexual partners. METHOD: We conducted a randomized, placebo-controlled, single-blind clinical trial with two groups: experimental (N = 6) and control (N = 8). All patients were diagnosed with paraphilia and were treated with selective serotonin reuptake inhibitors. The psychotherapeutic interventions lasted sixteen weeks, and its frequency was one session a week. Behavioral changes were monitored using a diary, whereas psychiatric comorbidities, quality of life, and social adequacy were assessed using psychometric scales in the three study periods: baseline, end, and post-intervention follow-up. RESULTS: There was no significant improvement of depression, quality of life, and social adequacy scores for both groups. The experimental group showed a trend toward better response to depression when we considered this as categorical variable. Both groups showed higher inability of social adequacy (when compared with non-clinical populations); tendency of increased state of anxiety; improvement of overall clinical status, and reduced levels of paraphilia severity. There were statistically significant differences between the groups. The experimental group showed increased frequency of normophilic fantasies and masturbation; increased demand for normophilic erotic contact, and decreased paraphilic fantasies. However, there was a decrease in normophilic intimate contact (kisses, hugs, and caresses) in this group. There were statistically significant intragroup differences. The experimental group had reduced paraphilic and total (paraphilic and normophilic) intimate contact. The placebo group had increased paraphilic sexual intercourse and higher frequency of sexual fantasies (paraphilic and normophilic). CONCLUSIONS: The positive outcomes found in the intervention group showed the importance of psychotherapy in identifying and treating the paraphilic patients\' impediments that prevent them from having relationships with normophilic sexual partners. This was reinforced by the finding that the experimental group showed positive changes in terms of sexual behaviors, fantasies, and urges, which were closer to conventional standards