Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Method Acceptability”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources
PubMed2006

Effectiveness of behavioral graded activity in patients with osteoarthritis of the hip and/or knee: A randomized clinical trial.

OBJECTIVE: To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to increase activity in the long term and consists of an exercise program with booster sessions, using operant treatment principles. METHODS: We conducted a cluster randomized trial involving 200 patients with hip and/or knee OA. Primary outcome measures were pain (visual analog scale [VAS] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), physical function (WOMAC), and patient global assessment, assessed at weeks 0, 13, 39, and 65. Secondary outcome measures comprised tiredness (VAS), patient-oriented physical function (McMaster Toronto Arthritis Patient Preference Disability Questionnaire [MACTAR]), 5-meter walking time, muscle strength, and range of motion. Data were analyzed according to intent-to-treat principle. RESULTS: Both treatments showed short-term and long-term beneficial within-group effects. The mean differences between the 2 groups for pain and functional status were not statistically significant. Significant differences in favor of BGA were found for the MACTAR functional scale and 5-meter walking test at week 65. CONCLUSION: Because both interventions resulted in beneficial long-term effects, the superiority of BGA over UC has not been demonstrated. Therefore, BGA seems to be an acceptable method to treat patients with hip and/or knee OA, with equivalent results compared with UC.

Aged↗
PubMedDate not supplied

Iris claw phakic intraocular lens for high myopia.

BACKGROUND: The implantation of a Worst-Fechner iris claw intraocular lens (IOL) is one of the surgical procedures used for the correction of high myopia. This technique reduces myopia with stable refractive results; however, its potential long-term risks have not been evaluated. We report results in 94 eyes with a minimum follow-up of 3 years. METHODS: We studied 94 eyes of 62 patients with myopia > or = -7.00 diopters (D) who underwent Worst-Fechner IOL implantation. Lens decentration, permeability of the blood-aqueous barrier by iris angiography, and changes in corneal endothelial density were analyzed. RESULTS: Mean follow-up time was 48.9 months (range 36 to 72 mo). Three years after surgery, 58 eyes (61%) had an uncorrected visual acuity > or = 20/40, and 77 eyes (82%) gained two or more lines of spectacle-corrected visual acuity with respect to the preoperative value; 75 eyes (79%) were within +/- 1.00 D of emmetropia and 46 eyes (48%) were within +/- 0.50 D of emmetropia. The mean endothelial cell loss was 17.9% at 5 years after surgery, while the percentage of hexagonality and the coefficient of cell variation tended toward preoperative levels. No vision threatening complications were seen. CONCLUSIONS: The implantation of a Worst-Fechner iris claw phakic IOL reduced high myopia with a stable refractive outcome. Endothelial cell damage was within acceptable limits. The absence of major complications makes this procedure an acceptable method for correcting high myopia.

Adult↗
PubMed2001

Primary epithelial ovarian carcinoma in Taiwanese women.

PURPOSE OF INVESTIGATION: Primary epithelial ovarian carcinoma is common in industrial countries but rare in the Orient. In fact, it is still a rare disease in Taiwan. In this article, we report the general data of Taiwanese patients with primary epithelial ovarian carcinoma. METHODS: In this retrospective study we used univariate and multivariate analysis models to analyze the prognosis of patients with surgically confirmed primary epithelial ovarian carcinoma. One hundred and ninety-four patients from 1990 to 1996 were identified and enrolled in this study. RESULTS: The mean follow-up time was 44.7 months with an interval between 15.1 months and 105.9 months. Univariate analysis showed postmenopausal status, advanced stage, presence of lymph node metastasis, poor differentiation, and suboptimal surgery as risk factors for disease recurrence and subsequent deaths. Multivariate analysis demonstrated stage as the most important factor correlated with recurrent disease (risk ratio: 7.303 and 5.409, respectively), followed by optimal surgery (RR: 2.447), and cellular differentiation (RR: 1.677). CONCLUSIONS: Our data on the Taiwan population were consistent with other reports of different races. Early detection for primary epithelial ovarian cancer is of great importance because stage is still the most important predictor in disease-free survival and disease-related deaths. Application of the most reliable and acceptable methods of screening is our goal in the next century after weighing benefits over costs.

Adenocarcinoma, Clear Cell↗
PubMed2005

FemCap with removal strap: ease of removal, safety and acceptability.

OBJECTIVES: FemCap is a silicone-rubber barrier contraceptive approved for marketing in the United States. To address reported problems with removal and dislodgment, the device's developer added a strap to the device and increased the height of the brim. This trial assessed whether the new design reduced removal difficulties and had any effects on dislodgment, genital pain/discomfort, safety, and acceptability. METHODS: Women used the strapped device for 8 weeks with follow-up visits at 2 and 8 weeks. Outcome measures were obtained through diary cards, questionnaires, and naked eye examination. Data from these 120 women were compared with data from 419 women who used the unstrapped FemCap in a previous contraceptive effectiveness study. RESULTS: The strapped device was not significantly easier for users to remove than the unstrapped device. Similar odds of dislodgment and cervical/vaginal irritation were seen with the two devices. Both female and male participants were significantly more likely to report pain/discomfort with use of the strapped device. Female users of the strapped device were significantly more likely to say they disliked their device. In six weeks, two pregnancies were observed, but pregnancy was not an endpoint in the study and no conclusions should be drawn regarding pregnancy rates. CONCLUSIONS: The modifications to the FemCap did not significantly improve the ease of device removal and appears to have resulted in significantly more female and male partner pain/discomfort and decreased acceptability, compared with the unstrapped device.

Contraceptive Devices, Female↗
PubMed1993

Photorefraction screening in premature infants.

BACKGROUND: Photorefraction is a screening technique capable of detecting potentially amblyogenic ophthalmic abnormalities. This screening technique was included as part of a longitudinal outpatient follow-up program of premature infants. The purpose of this investigation is to test the applicability of this screening method in a population of infants at risk for visual compromise. METHODS: One-hundred eighty-two premature infants older than 3 months chronologic age were screened using a commercially available, off-axis photorefraction device. Ophthalmic examinations were performed concomitant with each photorefraction. In most cases, photorefractions were performed before and after administration of cycloplegic medications. All photorefractions were analyzed by an observer masked to the results of the ophthalmic examination. RESULTS: For the 182 patients, the mean birth weight and mean gestational age were 1034.5 g and 28.2 weeks, respectively. The prevalence of ophthalmic abnormalities in the study population was 18%. Sensitivity and specificity rates for the overall screening were 77% and 90%, respectively. Photorefractions were analyzable in 77% of patients studied, with the remaining 23% of our study population unsuccessfully screened. Very young infants (younger than 3 months corrected age) were particularly difficult to photograph, as evidenced by the preponderance of these patients (85%) in the nonanalyzable group. The readability of photorefractions in black infants was improved when cycloplegia was used for the photorefraction. CONCLUSION: Photorefraction screening was an acceptable method of screening for ophthalmic abnormalities in a group of premature infants. Future studies of photorefraction screening techniques in premature infants will need to improve the success rate in young infants, perhaps by improving the fixation device.

Amblyopia↗
PubMedDate not supplied

Closed reduction and lag screw fixation of sacroiliac luxations and fractures.

OBJECTIVE: To describe a technique for closed reduction and percutaneous insertion of a lag screw for fixation of sacroiliac fracture-luxations, and to report the success of this technique in stabilizing sacroiliac fracture-luxations. STUDY DESIGN: A retrospective clinical study. STUDY POPULATION: 13 consecutive client-owned dogs with sacroiliac fracture-luxations. METHODS: Sacroiliac fracture-luxations were stabilized by using a closed reduction and percutaneous lag screw fixation technique. Preoperative, postoperative, and last re-examination radiographs were used to assess the location and number of pelvic injuries, other orthopedic injuries, percent reduction of the sacroiliac joint, percent sacral width screw depth, position of the screw, pelvic canal diameter ratio, hemipelvic canal width ratio, and complications. Information on signalment, weight, weight-bearing status, neurologic status, and complications was obtained from the medical record. RESULTS: Mean percent reduction of the sacroiliac joint was 92.33%. All screws were placed within the sacral body with a mean screw depth/sacral width of 79.03%. No screw loosening occurred. Mean pelvic canal diameter ratios were 0.99, 1.20, and 1.14 preoperatively, immediately postoperatively, and at the last re-examination, respectively. Nine of 13 dogs were willing to walk on the ipsilateral rear leg the day after surgery. CONCLUSIONS: Closed reduction and percutaneous insertion of a lag screw for stabilization of fracture-luxation of the sacroiliac joint is an acceptable method of repair. CLINICAL RELEVANCE: Sacroiliac fracture-luxations can be successfully reduced and stabilized using a minimally invasive technique.

Animals↗
PubMed1982

Potency determination for vecuronium (ORG NC45): comparison of cumulative and single-dose techniques.

To compare two methods of estimating the potency of neuromuscular relaxants of medium duration, the authors determined the potency of vecuronium (ORG NC45) using cumulative dose-response (CDR) techniques, and compared these data with published values from our group obtained using the single bolus technique. During 60% N2O-halothane anesthesia, patients received 10 micrograms/kg vecuronium; additional incremental doses of vecuronium, 5 micrograms/kg, were given when no change occurred in the height of three successive twitches. Using these dose-response data, the authors determined least-squares regression lines and ED20, ED50, and ED80. These results were compared to values obtained by the single bolus technique under comparable conditions. The CDR and single bolus technique yielded ED50 values of 19.9 and 15.0 micrograms/kg, respectively. All potency estimates by CDR were larger than those obtained by the single bolus dose technique. It was concluded that, for vecuronium, a medium duration neuromuscular relaxant, CDR yields potency estimates which are larger than those obtained by the traditional single bolus dose technique. Because the single bolus dose technique is the accepted method for construction of dose-response curves, the authors recommended that CDR not be used for potency determination of muscle relaxants of medium and short duration such as vecuronium.

Adult↗
PubMed2002

Deep vein thrombosis prophylaxis: the effectiveness and implications of using below-knee or thigh-length graduated compression stockings.

Potential complications of reduced mobility in both acute and chronically ill patients continue to challenge nurses on a daily basis. Deep vein thrombosis (DVT) is one of the most serious of these complications. Graduated compression stockings, also known as antiembolism stockings, are among the most commonly available and accepted methods of external compression for the prophylaxis of DVT. Currently, there are 2 lengths of graduated compression stockings in common use, thigh-length and below-knee. Although thigh-length stockings are widely perceived to be more effective in prophylaxis, difficulties associated with therapeutic application and maintenance are often encountered in different clinical settings. Below-knee stockings are easier to apply and maintain and appear to be tolerated better by patients. The aim of this article is to examine existing support for both lengths of stockings in terms of their effectiveness in DVT prophylaxis and to discuss the implications for practice.

Bandages↗
PubMed2006

A randomised controlled trial comparing computer-assisted with face-to-face sexual history taking in a clinical setting.

AIM: To compare computer-assisted self-interview (CASI) with routine face-to-face interview (FTFI) for sexual history taking from patients in a clinical setting. METHODS: A randomised controlled trial was undertaken at the Melbourne Sexual Health Centre, Melbourne, Victoria, Australia, in 2005. New, walk-in patients triaged into the centre were eligible for the study. Those who consented to the study were randomly allocated (initially at a ratio of 2:1, then 1:1) to either CASI or FTFI. Those randomised to CASI also subsequently undertook FTFI. RESULTS: During the study period, of 713 patients approached, 611 agreed to participate in the study; 356 were randomised to FTFI and 255 to CASI. Overall, the responses to questioning using CASI and FTFI were similar except that women undertaking the CASI reported a significantly higher median number of male partners for the preceding 12 months (3 v 2, p = 0.05) and the CASI participants reported previous hepatitis B vaccination more often (50% v 37%, p = 0.01). Most participants found the CASI either easy (31; 13%) or very easy (193; 82%) to complete; 83 (35%) were comfortable and 121 (51%) were very comfortable with it. CONCLUSIONS: CASI may be a reliable, efficient and highly acceptable method for the screening of sexual risk in clinical sexual health settings and could be used routinely to improve the efficiency of clinical services.

Adult↗
PubMedDate not supplied

[Current research status in pharmaceutical care].

OBJECTIVE: A systematic review of studies on pharmaceutical care research from June 1999 to June 2004 was carried out. METHOD: Medline, Current Contents, Cochrane Library, IDIS, and Teseo were used as data sources. Works were categorized according to evidence levels and recommendation grades in clinical practice guidelines. The JADAD method was used for quality quantification. RESULTS: In all, 129 references were found; 19.4% (n = 25) were randomized studies; 2.3% (n = 3) had blinded assessors; losses to follow-up were documented in 7.8% (n = 10); 4.7% (n = 6) had a Jadad score= 3; 8.5% (n = 11), 14.7% (n = 19), 5.4% (n = 7), and 20.9% (n = 27) had evidence levels Ia, Ib, IIa, and IIb, respectively; 44.2% (n = 57) and 6.2% (n = 8) had levels III and IV, respectively; 23.3% (n = 30) had a recommendation grade A; 26.4% (n = 34) had a grade B; 44% (n = 55) had C and 6.2% (n = 8) had D. Most common study types included: descriptive (39.5%), trials including patients (32.6%), and reviews (17.8%); 59.5% of reviewed clinical trials were controlled, randomized clinical trials (CRCTs). Studies were double-blind in 7.1% of cases. Discontinuations and exclusions were recorded in 23.8% of cases. Randomization was appropriate in 11.9% of cases; 14.3% of clinical trials had 3 points, and 85.7% of studies were of poor quality. CONCLUSIONS: Work methodology should be more rigorous. The use of universally accepted methods is needed to enhance the quality of studies (Jadad system, Consort list). The performance of observational, prospective, multicenter investigations allowing the effectiveness and efficiency of pharmaceutical care to be measured would be most beneficial. Works should measure health-related quality of life (SF-36 questionnaire) and patient satisfaction.

Biomedical Research↗
PubMed1993

Factors affecting uniformity in interpretation of planar thallium-201 imaging in a multicenter trial. The Multicenter Study on Silent Myocardial Ischemia (MSSMI) Thallium-201 Investigators.

OBJECTIVES: This study was designed to assess factors affecting interobserver agreement in interpretation of planar thallium-201 stress imaging in the Multicenter Study on Silent Myocardial Ischemia (MSSMI). BACKGROUND: Five hundred fifty-six planar thallium-201 images were interpreted in 24 clinical centers and in a Radionuclide Core Laboratory. The trial's Coordinating and Data Center observed that the participating clinical centers interpreted a significantly greater number of thallium-201 stress studies as abnormal (i.e., myocardial ischemia or scar) than the Core Laboratory, and overall agreement was poor (kappa 0.27). METHODS: Agreement in image interpretation between clinical centers and the Radionuclide Core Laboratory was analyzed by kappa statistics. The reproducibility of the Core Laboratory results on 41 randomly selected test studies was excellent (kappa 0.77). In contrast, the reproducibility of interpretation in the clinical centers on their own studies was at best fair (kappa 0.45). It was hypothesized that the poor agreement and reproducibility in the clinical centers were caused by lack of standardization of image display and lack of objective criteria for image interpretation. To test the effect of standardization, 13 clinical investigators interpreted the same 41 test studies using 1) uniform image display, and 2) uniform quantification of images. RESULTS: The agreement in interpretation between clinical investigators and the Radionuclide Core Laboratory improved modestly with uniformity of image display (kappa 0.57) but improved markedly (kappa 0.66) with quantitative circumferential profile analysis. CONCLUSIONS: Lack of standardization in image display and lack of objective criteria for interpretation of thallium-201 images are responsible for suboptimal reproducibility and poor interlaboratory agreement in the interpretation of thallium-201 stress imaging. The adoption of a uniformly accepted method for computer quantification of myocardial perfusion images is crucial to improve agreement in interpretation.

Exercise Test↗
PubMedDate not supplied

Radial pulse character relationships to systolic blood pressure and trauma outcomes.

BACKGROUND: Patient measurements that do not require monitoring equipment may be the only way to evaluate casualties in austere conditions to determine treatment and transport priority. Objective. To test the hypothesis that palpable pulse characteristics in the radial artery would estimate systolic blood pressure (SBP) and predict outcome in trauma patients. METHODS: Data were analyzed from the medical records of 342 trauma patients ranging from 18 to 50 years of age. Prehospital data were collected by helicopter emergency medical personnel at the scene of the injury. Based on radial pulse character, patients were divided into normal (n = 313) and weak (n = 29) groups. Those whose medical records did not describe pulse characters were not considered. Differences in SBP, mortality, and medical interventions between the radial-pulse-character groups were evaluated. RESULTS: The SBP taken at the scene was a mean of 26 mm Hg lower in those patients with weak radial pulse characters (102 mm Hg versus 128 mm Hg). Similarly, the lowest mean SBPs recorded in the field between the normal- and weak-pulse-character groups were 112 mm Hg and 99 mm Hg, respectively. Patient mortality increased with weak pulse character such that the mortality rats were 3% for the normal-pulse-character group and 29% for the weak-pulse-character-group (odds ratio = 15.2). CONCLUSIONS: These preliminary data suggest that a weak radial pulse may be an acceptable method for initial rapid evaluation of trauma patients. This simple and rapid method of pulse evaluation should be considered for the triage of trauma patients in field conditions with limited instrumentation.

Adolescent↗
PubMed2005

Surgical outcome of laparoscopy-assisted gastrectomy with extraperigastric lymph node dissection for gastric cancer.

AIM: The aim of this study was to determine the feasibility of laparoscopy-assisted gastrectomy (LAG) with extraperigastric lymph node dissection for gastric cancer. METHODS: The authors attempted LAG with extraperigastric lymph node dissection in 117 consecutive gastric cancer patients between May 1998 and January 2004. The clinico-pathologic characteristics, operative outcomes, post-operative morbidities and mortalities, and follow-up findings of patients with advanced gastric cancer were evaluated. RESULTS: LAG with extraperigastric lymph node dissection were successfully performed in 114 of 117 patients (success rate, 97%). Of these 114 successful cases, 100 cases were early gastric cancers and 14 cases were advanced gastric cancers. The mean operation time for the 114 cases was 259 (range 150-415) min, and the mean number of retrieved lymph nodes was 23 (range 6-66). Operative mortality, hospital death, and overall post-operative complication rates were 0, 1.7 and 14.7%, respectively. Follow-up was available in 110 of the 112 patients (two post-operative hospital deaths were excluded from the 114). Follow-up ranged from 6 to 74 months (median: 19). 108 patients remain alive without recurrence or port-site metastasis. CONCLUSIONS: LAG with extraperigastric lymph node dissection is a technically feasible and acceptable method for the surgical treatment of gastric cancer.

Feasibility Studies↗
PubMed1999

How long do routine dental restorations last? A systematic review.

OBJECTIVE: To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth, and to identify and examine factors influencing its variability. METHOD: Accepted guidelines were followed. An advisory group oversaw the project. Simple Class I and Class II amalgam, composite resin, glass ionomer and cast gold restorations were covered. Comprehensive searching of electronic databases, hand-searching, and location of 'grey' literature, generated 124 research reports. Those considered relevant were assessed for validity and quality according to agreed criteria. The analysis was descriptive. RESULTS: Eight of 58 relevant research reports were categorised, according to agreed criteria, as being of satisfactory validity and quality. They suggested that 50% of all restorations last 10 to 20 years, although both higher and lower median survival times were reported. The findings were supported by the totality of studies reviewed. However, variability was substantial. Restoration type, materials, the patient, the operator, the practice environment and type of care system appeared to influence longevity. CONCLUSIONS: Many studies were imperfect in design. Those considered to be the most appropriate for analysis were too limited to undertake a formal statistical exploration. Therefore there remains a need for definitive randomised controlled trials of restoration longevity, of sound design and adequate power, employing standardised assessments and appropriate methods of analysis.

Bicuspid↗
PubMed2004

In situ diagnosis of central venous catheter-related bloodstream infection without peripheral blood culture.

BACKGROUND: Catheter-related bloodstream infections (CRBIs) are frequent complications of the use of long term central venous catheters (CVCs). Comparative quantitative culture of blood obtained via the CVC and a peripheral vein (PV) is a well-accepted method of diagnosing CRBI; however, an alternative definition for use when a PV culture is not available is desirable. METHODS: A computerized search of patient records identified all positive blood culture results from the St. Jude Children's Research Hospital Microbiology Laboratory between January 1996 and May 2001. Demographic data, catheter information and culture results were abstracted. Sensitivity, specificity, positive predictive value (PPV), and likelihood ratio were calculated for 2 alternative definitions of CRBI. RESULTS: Review of the medical records revealed 136 episodes of bacteremia that were evaluable for alternative definition 1 and 241 episodes that were evaluable for alternative definition 2. In patients with a double lumen CVC, CRBI can be diagnosed by a > or = 5-fold difference in colony-forming units/mL between the 2 lumens (alternative definition 1) with sensitivity, specificity, PPV and likelihood ratio of 61.8, 93.3, 92.2 and 9.22, respectively. In patients with a single or double lumen CVC, CRBI can be diagnosed when the CVC culture yields > or = 100 colony-forming units/mL (alternative definition 2) with sensitivity, specificity, PPV and likelihood ratio of 75.5, 69.1, 79.3, and 2.44, respectively. CONCLUSIONS: Our study suggests that comparison of colony counts from 2 lumens of a double lumen catheter is acceptable for diagnosis of CRBI when a PV culture is not available. Further validation is needed before discontinuing the recommendation to obtain a PV culture.

Adolescent↗
PubMed2000

Evaluation of the measurement of leukotriene B4 concentrations in exhaled condensate as a noninvasive method for assessing mediators of inflammation in the lungs of calves.

OBJECTIVE: To determine whether measurement of an inflammatory mediator in exhaled condensate could provide a noninvasive method for evaluating lungs of calves. ANIMALS: 84 calves < or = 2 months old. PROCEDURE: Concentration of leukotriene B4 (LTB4) was evaluated in the exhaled condensate of healthy calves and calves with experimentally induced respiratory tract infections. For collection of samples of exhaled condensate, the total amount of exhaled air was directed into a cooled double-jacketed tube. Each tube was sealed and stored at -80 C. The LTB4 concentration was measured, using an ELISA. RESULTS: In exhaled condensates of clinically healthy calves, normally distributed and highly reproducible LTB4 concentrations (mean +/- SD, 116.1 +/- 55.4 pg/ml) were measured. After experimentally induced infection with Pasteurella multocida serovar D, LTB4 in exhaled condensate increased significantly (mean, 179% increase), compared with basal concentrations before infection; this increase in LTB4 was significantly correlated with deterioration in lung function. In 2 of 4 calves experimentally infected with bovine respiratory syncytial virus, the LTB4 concentration in exhaled condensate increased (300 to 400% increase), compared with baseline values, which was associated with development of bronchial hyperresponsiveness after infection. CONCLUSIONS AND CLINICAL RELEVANCE: Collection of exhaled condensate is tolerated well by calves and is an acceptable method for obtaining fluid from exhaled air originating from the lungs. This method provides alternatives for diagnosing and evaluating treatment of naturally acquired and experimentally induced diseases of the lungs and airways in calves.

Animals↗
PubMed2005

[Reconstruction of the tongue with rectus abdominis musculoperitoneal flap].

OBJECTIVE: To investigate the outcome of surgical reconstruction of the tongue after hemiglossectomy with reinnervated rectus abdominis musculoperitoneal flaps in the treatment of tongue cancer. METHODS: Five patients underwent immediate reconstruction of the tongue and oral floor defects with rectus abdominis musculoperitoneal flaps after resection of squamous cell carcinoma of tongue. The rectus abdominis musculoperitoneal flap consists of the rectus muscle, posterior rectus sheath, peritoneum, the 10 th, 11th, 12th intercostal nerves and the vascular pedicle that includes the deep inferior epigastric artery and veins. During the operation a reinnervated rectus abdominis musculoperitoneal free flap, in which the intercostal nerves were anastomosed to the descending branch of hypoglossal nerve, was grafted to remaining tongue stump. RESULTS: All patients recovered uneventfully from surgery, with no immediate postoperative complications. All transplanted flaps survived. The peritoneum was replaced by squamous epithelium 8 weeks after surgery. The average follow-up period was 10 months. During the follow-up period the contour of the reconstructed tongues was satisfactory. The patients demonstrated good functional mobility of the reconstructed and remaining tongue. The swallowing and speech function was nearly at normal levels and the patients could ingest a solid or semisolid diet. CONCLUSIONS: Reconstruction of the tongue with rectus abdominis musculoperitoneal flaps after hemiglossectomy is a suitable, cosmetically acceptable method. Long-term follow-up is needed for reaching some final conclusions.

Female↗
PubMed2002

Initiation of CPAP therapy for OSA: does prophylactic humidification during CPAP pressure titration improve initial patient acceptance and comfort?

BACKGROUND: Heated humidifiers (HH) enable effective treatment of upper airway dryness during nasal continuous positive airway pressure (nCPAP) therapy for obstructive sleep apnoea (OSA), but the role of prophylactic use of HH during the initiation of nCPAP treatment has not been studied so far. OBJECTIVES: The aim of the present study was to investigate whether prophylactic HH during the initiation of CPAP would result in improved initial patient comfort and acceptance. METHODS: In 44 consecutive, previously untreated OSA patients with no history of upper airway dryness, CPAP titration with and without HH was performed on two consecutive nights in a randomised order. The patients were interviewed after each treatment night in order to establish the comfort of the treatment, and, after the second treatment, they were asked which of the two nights they considered more pleasant, and which treatment they would prefer for long-term use. RESULTS: Following CPAP titration with HH, 32 patients (73%) claimed to have had a better night's sleep than usual (i.e. without CPAP treatment) compared with 33 patients (75%) saying the same following CPAP treatment without HH. For 21 patients (47.7%) treatment with HH was more pleasant, 23 (52.3%) saw no difference or said that treatment without HH was more pleasant. Nineteen patients (43.2%) gave preference to treatment with HH for long-term use, while 25 patients (56.8%) had no preference or said they would prefer treatment without HH. CONCLUSIONS: The use of HH during the initiation phase of CPAP treatment was associated neither with an initial improvement in comfort nor with greater initial treatment acceptance.

Adult↗