Buccal fat applied to transoral robotic lateral oropharyngectomy defects to lessen radical tonsillectomy pain (BOLT): a single-centre, phase II, parallel, randomised control trial study protocol
Introduction
Transoral robotic surgery (TORS) is a minimally invasive technique for surgical removal of tumours of the tonsil and lateral oropharynx. Surgical defects after TORS lateral oropharyngectomy are traditionally left open to heal by secondary intention, resulting in significant postoperati…
Anatomic versus reverse total shoulder replacement for patients with osteoarthritis and intact rotator cuff: the RAPSODI-UK randomised controlled trial protocol
Introduction
Shoulder osteoarthritis most commonly affects older adults, causing pain, reduced function and quality of life. Total shoulder replacements (TSRs) are indicated once other non-surgical options no longer provide adequate pain relief. Two main types of TSRs are widely used: anatomic TSR …
Preferences and predictors driving opioid-involved polysubstance use profiles and trajectories: a prospective cohort study protocol
Introduction
Polysubstance use (PSU), particularly opioid-involved and stimulant-involved PSU, is a growing issue in the USA. PSU increases the risk of negative health consequences, including infectious diseases, worsening physical and mental health conditions, and overdose-related deaths. These co…
Efficacy and moderators of cognitive behavioural therapy versus interpersonal psychotherapy for adult depression: study protocol of a systematic review and individual participant data meta-analysis
Introduction
Cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT) are both efficacious treatments for depression, but it is less clear how both compare on outcome domains other than depression and in the longer term. Moreover, it is unclear which of these two psychotherapies wo…
Screening for Hepatitis C in Emergency Departments—Reply
In Reply We thank Drs Fleurence and Collins, Dr Baird and colleagues, and Dr Gallo and colleagues for their interest in the DETECT Hep C randomized clinical trial. We echo the concern about the relatively low rate of linkage to care and cure among those included in this trial. This lack of linkage …
[Articles] Performance of a modified Sequential Organ Failure Assessment score in pre-hospital critical care to predict short-term mortality: a prospective, multicentre, validation cohort study
Our findings suggest that the mSOFA score shows good discriminatory power for predicting short-term mortality, consistent across different cohorts. Study limitations included not blinded extractors, time limit of primary outcome, and patients’ heterogeneity. This validates score performance in othe…
Switching From Aspirin Monotherapy After Noncardioembolic Stroke: A Systematic Review and Network Meta-Analysis
Stroke, Ahead of Print. BACKGROUND:Patients who experience an ischemic stroke while on aspirin therapy present a clinical dilemma about optimal long-term secondary prevention. While switching to an alternative antithrombotic agent is often considered, the effectiveness of switching remains uncertai…
Smoking affects gut immune system of patients with inflammatory bowel diseases by modulating metabolomic profiles and mucosal microbiota
Background
The aetiology and pathogenesis of IBD are intricate, involving genetic and environmental factors. Notably, cigarette smoking has contrasting effects, being detrimental to Crohn’s disease (CD) and beneficial to UC. However, the mechanisms underlying these opposite effects remain unclear.
…
Outcome of a FODMAP restriction diet with subsequent blinded reintroduction in functional dyspepsia/postprandial distress syndrome
Background
Recent studies have shown increased duodenal mucosal permeability as a possible key player in the pathophysiology of functional dyspepsia (FD). Adverse reaction to nutrients is an important candidate underlying mechanism. Intragastric infusion of fermentable oligo-, di-, monosaccharides …
Performance of the China-CLIF framework in acute-on-chronic liver failure: a multicohort study across all aetiologies
Background
Acute-on-chronic liver failure (ACLF) of various aetiologies is a complex syndrome with high short-term mortality and significant global burden.
Objective
To explore easily applicable diagnostic criteria and an accurate prognostic score for ACLF.
Design
Clinical data from 5288 patients (…
Preop Analgesia for Patients with Hip Fracture: Opioids vs. Nerve Block
In a randomized trial, femoral nerve block provided better short-term analgesia with fewer adverse effects.
Short-Term Trials Underestimate Antidepressant Withdrawal—Reply
In Reply In their response to our systematic review and meta-analysis, Hengartner et al state that our analysis underestimated antidepressant discontinuation effects. We agree that the existing literature with randomized comparisons with a placebo arm is almost all after short-term antidepressant u…
Short-Term Trials Underestimate Antidepressant Withdrawal
To the Editor The meta-analysis by Kalfas et al attempts to examine a safety issue in a sample of trials where strong effects are unlikely to show up. Previous research found that antidepressant withdrawal symptoms are predominantly mild and transient when treatment duration is less than 3 months (…
[Articles] Efficacy of a school-based, universal prevention programme for depression and anxiety in adolescents (OurFutures Mental Health): a two-arm cluster-randomised controlled trial
OurFutures Mental Health may be an efficacious intervention to improve mental health knowledge and prevent anxiety symptoms among adolescents in the short-term. Limitations of this trial include high participant attrition and withdrawal of several schools post-randomisation, limiting generalisabili…
HIV in Italia: casi stabili, diagnosi tardive e prevenzione necessaria
Hiv – Alla vigilia della Giornata mondiale contro l’AIDS, in Italia i casi HIV restano stabili. Serve più prevenzione, test e accesso alla PrEP long acting.
