Appendectomy versus antibiotic treatment for acute appendicitis
CONCLUSIONS: Antibiotics may be associated with higher rates of unsuccessful treatment for 76 per 1000 people, although differences may not be clinically significant. It is uncertain if antibiotics increase length of hospital stay by half a day. Antibiotics may reduce wound infections. A third of the participants initially treated with antibiotics required subsequent appendectomy or two-thirds avoided surgery within one year, but the evidence is very uncertain. There were too few data from the included studies to comment on major complications.PMID:38682788 | DOI:10.1002/14651858.CD015038.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - April 29, 2024 Category: General Medicine Authors: Brett Doleman Siv Fonnes Jon N Lund Hannah Boyd-Carson Hannah Javanmard-Emamghissi Susan Moug Marianne Hollyman Gillian Tierney Samson Tou John P Williams Source Type: research
Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease
CONCLUSIONS: ACEi or ARB may make little or no difference to all-cause and cardiovascular death compared to placebo or no treatment in people with diabetes and kidney disease but may prevent kidney failure. ARB may prevent the doubling of SCr and the progression from microalbuminuria to macroalbuminuria compared with a placebo or no treatment. Despite the international guidelines suggesting not combining ACEi and ARB treatment, the effects of ACEi or ARB monotherapy compared to dual therapy have not been adequately assessed. The limited data availability and the low quality of the included studies prevented the assessment ...
Source: Cochrane Database of Systematic Reviews - April 29, 2024 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Sankar D Navaneethan Jonathan C Craig Giovanni Fm Strippoli Source Type: research
Climate finance opportunities for health and health systems
Bull World Health Organ. 2024 May 1;102(5):330-335. doi: 10.2471/BLT.23.290785. Epub 2024 Feb 29.ABSTRACTClimate change poses significant risks to health and health systems, with the greatest impacts in low- and middle-income countries - which are least responsible for greenhouse gas emissions. The Conference of Parties 28 at the 2023 United Nations Climate Change Conference led to agreement on the need for holistic and equitable financing approaches to address the climate and health crisis. This paper provides an overview of existing climate finance mechanisms - that is, multilateral funds, voluntary market-based mechanis...
Source: Bulletin of the World Health Organization - April 29, 2024 Category: International Medicine & Public Health Authors: Josephine Borghi Soledad Cuevas Garcia-Dorado Blanca Anton Domenico Gerardo Giulia Gasparri Mark Hanson Agn ès Soucat Flavia Bustreo Etienne V Langlois Source Type: research
Abstracts of the 4th MK FMHS International Conference: Harnessing the Powers of Cell Therapy: Advances from Bench to Bedside, organised by the M. Kandiah Faculty of Medicine & amp; Health Sciences, Universiti Tunku Abdul Rahman on 18-19 September 2023
Malays J Pathol. 2024 Apr;46(1):119-133.ABSTRACTNo abstract available.PMID:38682854 (Source: Malaysian Journal of Pathology)
Source: Malaysian Journal of Pathology - April 29, 2024 Category: Pathology Source Type: research
Frequency of self-directed dying in the Netherlands: research protocol of a cross-sectional mixed-methods study
Introduction
In the Netherlands, assisting in suicide is allowed for physicians and regulated by the Termination of Life on Request and Assisted Suicide (review procedures) Act. However, some people decide to end their lives outside the medical domain, without a physician’s help. Two approaches for such self-directed dying are voluntary stopping eating and drinking (VSED) and independently taking lethal medication attended by a confidant (ILMC). The frequency of deaths by either of these methods in the Netherlands was examined in 2007. Since then, there have been societal, political and healthcare developments which ...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Bosma, F., Stoppelenburg, A., van der Heide, A., van de Vathorst, S. Tags: Open access, Public health Source Type: research
Evaluation of the early use of norepinephrine in major abdominal surgery on medical and surgical postoperative complications: study protocol for a randomised controlled trial (EPON STUDY)
This study aims to assess the benefit of norepinephrine versus ephedrine at the induction of anaesthesia to prevent postoperative complications following major abdominal surgery by preventing IOH.
Methods and analysis
The EPON STUDY is a prospective single-centre randomised controlled trial with the planned inclusion of 500 patients scheduled for major abdominal surgery at the Amiens University Hospital. The inclusion criteria are patients aged over 50 years weighing more than 50 kg with an American Society of Anesthesiologists physical status score of ≥2 undergoing major abdominal surgery under general anaesthesia. Pa...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Trocheris-Fumery, O., Scetbon, C., Flet, T., Meynier, J., Sellier, M., Rumbach, M., Badaoui, R., Villeret, L., Tarpin, P., Abou-Arab, O., Bar, S., Dupont, H. Tags: Open access, Anaesthesia Source Type: research
What is the ideal time to begin tapering opioid agonist treatment? A protocol for a retrospective population-based comparative effectiveness study in British Columbia, Canada
Introduction
Opioid agonist treatment (OAT) tapering involves a gradual reduction in daily medication dose to ultimately reach a state of opioid abstinence. Due to the high risk of relapse and overdose after tapering, this practice is not recommended by clinical guidelines, however, clients may still request to taper off medication. The ideal time to initiate an OAT taper is not known. However, ethically, taper plans should acknowledge clients’ preferences and autonomy but apply principles of shared informed decision-making regarding safety and efficacy. Linked population-level data capturing real-world tapering prac...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Yan, R., Kurz, M., Guerra-Alejos, B. C., Min, J. E., Bach, P., Greenland, S., Gustafson, P., Karim, E., Korthuis, P. T., Loughin, T., McCandless, L., Platt, R. W., Schnepel, K., Seaman, S., Socias, M. E., Wood, E., Xie, H., Nosyk, B. Tags: Open access, Addiction Source Type: research
The Pediatric Autism Research Cohort (PARC) Study: protocol for a patient-oriented prospective study examining trajectories of functioning in children with autism
Introduction
The developmentally variable nature of autism poses challenges in providing timely services tailored to a child’s needs. Despite a recent focus on longitudinal research, priority-setting initiatives with stakeholders highlighted the importance of studying a child’s day-to-day functioning and social determinants of health to inform clinical care. To address this, we are conducting a pragmatic multi-site, patient-oriented longitudinal investigation: the Pediatric Autism Research Cohort (PARC) Study. In young children (<7 years of age) newly diagnosed with autism, we will: (1) examine variability i...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Kata, A., McPhee, P. G., Chen, Y.-J., Zwaigenbaum, L., Singal, D., Roncadin, C., Bennett, T., Carter, M., Di Rezze, B., Drmic, I., Duku, E., Fournier, S., Frei, J., Gentles, S. J., Georgiades, K., Hanlon-Dearman, A., Hoult, L., Kelley, E., Koller, J., de Tags: Open access, Paediatrics Source Type: research
Use of headphones for the delivery of music programs for people with dementia in long-term care homes: a scoping review protocol
Introduction
Dementia affects the quality of life. Excessive noise in care environments can exacerbate stress and related symptoms. Headphone-based music interventions may help improve the quality of life for people with dementia in long-term care homes. This review aims to explore and synthesise research on headphone-based music interventions for people with dementia in long-term care homes, focusing on enablers and barriers to implementing headphone-based music interventions.
Methods and analysis
Joanna Briggs Institute guidance for scoping review and Preferred Reporting Items for Scoping Reviews and Meta-analyses exten...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Hung, L., Wong, K. L. Y., Huang, K., Cheung, D. S. K., Yeo, M. S., Kim, S. J. Tags: Open access, Geriatric medicine Source Type: research
Liver fat as a dietary target by Chinese Medical Nutrition Therapy (CMNT) diet for treating type 2 diabetes with non-alcoholic fatty liver disease: study protocol for a randomised controlled trial
This study aims to investigate the long-term effect of a Chinese Medical Nutrition Therapy (CMNT) diet accompanied by intermittent energy restriction on reducing liver fat and glycated haemoglobin (HbA1c) in patients with type 2 diabetes and NAFLD.
Methods and analysis
This is a multicentre two-armed parallel randomised controlled trial study. 120 participants with type 2 diabetes and NAFLD will be recruited from the physical examination centres of multiple hospitals in China. Participants will be randomly allocated 1:1 to either the CMNT group or the usual care group. The CMNT group will be instructed to consume the prov...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Luo, W., Xiao, Z., Yang, X., Wu, R., Li, J., Yu, Z., Guo, S., Nie, B., Liu, D. Tags: Open access, Diabetes and Endocrinology Source Type: research
Financial incentive interventions for smoking cessation among Chinese smokers: study protocol for a cluster randomised controlled trial
Introduction
There is an urgent issue to relieve the burdens caused by tobacco use through feasible and effective smoking cessation interventions, particularly in a middle-income country with less accessible smoking cessation services and high demand for quitting smoking. Financial incentives have shown effective in changing health behaviours, thus needing to test its portability to a wider implementation and effectiveness of increasing smoking cessation rates.
Methods and analysis
This is a three-arm cluster randomised controlled trial. 462 eligible participants will be assigned to 2 financial incentive groups—rewa...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Yang, X., Galarraga, O., Cao, W., Lin, H., Cao, F., Chang, C. Tags: Open access, Smoking and tobacco Source Type: research
Lifetime costs of alcohol consumption in Thailand: protocol for an incidence-based cost-of-illness study using Markov model
Introduction
Several prevalence-based cost-of-illness (COI) studies have been conducted to estimate the economic burden of alcohol consumption borne by a particular society in a given year. Yet there are few studies examining the economic costs incurred by an individual drinker over his/her lifetime. Thus, this study aims to estimate the costs incurred by an individual drinker’s alcohol consumption over his or her lifetime in Thailand.
Methods and analysis
An incidence-based COI approach will be employed. To project individuals’ associated costs over a lifetime, a Markov modelling technique will be used. The f...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Luangsinsiri, C., Thavorncharoensap, M., Chaikledkaew, U., Pattanaprateep, O., Sornpaisarn, B., Rehm, J. Tags: Open access, Health economics Source Type: research
Effect of vitamin D in addition to letrozole on the ovulation rate of women with polycystic ovary syndrome: protocol of a multicentre randomised double-blind controlled trial
The objective of the study is to assess the effect of vitamin D supplementation on (1) the ovulation rate to letrozole and (2) other reproductive, endocrine and metabolic outcomes after 1 year of supplementation in women with PCOS.
Methods and analysis
This is a multicentre, randomised, double-blind, controlled clinical trial. A total of 220 anovulatory women with PCOS diagnosed by the Rotterdam criteria will be recruited. They will be randomly assigned to either the (1) vitamin D supplementation group or (2) placebo group. Those in the vitamin D group will take oral Vitamin D3 50 000 IU/week for 4 weeks, followed by 50 0...
Source: BMJ Open - April 29, 2024 Category: General Medicine Authors: Ko, J. K. Y., Yung, S. S. F., Lai, S. F., Wan, R. S. F., Wong, C. K. Y., Wong, K., Cheung, C.-L., Ng, E. H. Y., Li, R. H. W. Tags: Open access, Obstetrics & Gynaecology Obstetrics and gynaecology Source Type: research
Functional outcomes of bowel resection versus shaving or disc excision of colorectal endometriosis: a systematic review protocol
This study does not require ethics approval. The results of the systematic review described within this protocol will be disseminated through presentations at relevant conferences and publication in a peer-reviewed journal. The methods will be used to inform future reviews.
PROSPERO registration number
CRD42023461711. (Source: BMJ Open)
Source: BMJ Open - April 28, 2024 Category: General Medicine Authors: Qian, W., Gauci, C., Chaudhri, K., Lung, T., Mohtashami, A. Tags: Open access, Surgery Source Type: research
Study protocol to assess aflatoxin M1 health risks versus benefits of dairy consumption in Ethiopian children: an epidemiological trial and risk-benefit analysis
Introduction
In Sidama, Ethiopia, animal-source foods can be difficult to access. Milk has important nutrients for child growth, but carries the risk of aflatoxin M1 (AFM1) contamination. AFM1 is a metabolite of the mycotoxin aflatoxin B1 (AFB1) in dairy feed; cows secrete AFM1 in milk when their feed contains AFB1 produced by Aspergillus fungi in maize, nuts and oilseeds. It is unknown whether AFM1 compromises child growth and health.
Methods and analysis
This protocol paper describes our study in Sidama to determine the impact of milk consumption and AFM1 on child growth in the first 18 months of life. We will collect b...
Source: BMJ Open - April 28, 2024 Category: General Medicine Authors: Wu, F., Headey, D., Hirvonen, K., Pokharel, A., Tessema, M. Tags: Open access, Epidemiology Source Type: research
