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Items 1 - 25 of 25 |
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Role of intraspinal analgesia in terminal pediatric malignancy.
Saroyan JM, Schechter WS, Tresgallo ME, Granowetter L.
Columbia University College of Physicians and Surgeons, Division of Pediatric Anesthesiology, Morgan Stanley Children's Hospital of New York-Presbyterian, 622 W 168th St BHN4-440, New York, NY 10032, USA.
Publication Types:
- Case Reports
- Review
- Review, Tutorial
PMID: 15718332 [PubMed - indexed for MEDLINE]
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Uncommon presentations of some common malignancies: Case 3. Chronic lymphocytic leukemia involving the colon and presenting with perforation.
Lalani M, Rhee JC, Gutkin DW, Matin K, Ahmad J.
Division of Gastroenterology, Hepatology, & Nutrition, University of Pittsburgh Medical Center, PA, USA.
Publication Types:
PMID: 15718331 [PubMed - indexed for MEDLINE]
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Family experience with palliative sedation therapy for terminally ill cancer patients.
Morita T, Ikenaga M, Adachi I, Narabayashi I, Kizawa Y, Honke Y, Kohara H, Mukaiyama T, Akechi T, Uchitomi Y; Japan Pain, Rehabilitation, Palliative Medicine, and Psycho-Oncology Study Group.
Seirei Hospice, Seirei Mikatabara Hospital, Hamamatsu, Japan.
Symptomatic sedation is often required in terminally ill cancer patients, and could cause significant distress to their family. The aims of this study were to clarify the family experience during palliative sedation therapy, including their satisfaction and distress levels, and the determinants of family dissatisfaction and high-level distress. A multicenter questionnaire survey assessed 280 bereaved families of cancer patients who received sedation in 7 palliative care units in Japan. A total of 185 responses were analyzed(response rate, 73%). The families reported that 69% of the patients were considerably or very distressed before sedation. Fifty-five percent of the patients expressed an explicit wish for sedation, and 89% of families were clearly informed. Overall, 78% of the families were satisfied with the treatment, whereas 25% expressed a high level of emotional distress. The independent determinants of low levels of family satisfaction were: poor symptom palliation after sedation, insufficient information-giving, concerns that sedation might shorten the patient's life, and feelings that there might be other ways to achieve symptom relief The independent determinants of high levels of family distress were: poor symptom palliation after sedation, feeling the burden of responsibility for the decision, feeling unprepared for changes in the patient's condition, feeling that the physicians and nurses were not sufficiently compassionate, and shorter interval to patient death. Palliative sedation therapy was principally performed to relieve severe suffering based on family and patient consent. Although the majority of families were comfortable with this practice, clinicians should minimize family distress by regular monitoring of patient distress and timely modification of sedation protocols, providing sufficient information, sharing the responsibility of the decision, facilitating grief and providing emotional support.
Publication Types:
PMID: 15645586 [PubMed - indexed for MEDLINE]
Analysis of missing data in palliative care studies.
Palmer JL.
Department of Palliative Care & Rehabilitation Medicine and Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-0049, USA.
This report discusses the general problem of the analysis of data that could include missing values. In the palliative care setting, the data may not be missing at random, but instead be related to the outcome of interest, and therefore the use of standard statistical procedures may be problematic. This study summarizes differing results that were found when using three simple methods for estimating missing data in an example data set testing for differences in the use of morphine or methadone for relief of pain. Differences in the conclusions are discussed and recommendations are made to improve the reporting of studies with missing data.
PMID: 15589087 [PubMed - indexed for MEDLINE]
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Stability of admixture containing morphine sulfate, bupivacaine hydrochloride, and clonidine hydrochloride in an implantable infusion system.
Classen AM, Wimbish GH, Kupiec TC.
Trinity Pain Medicine Associates, PA, Fort Worth, Texas, USA.
Intrathecal infusion is often performed using drug combinations. This study was conducted to evaluate the stability of the admixture of morphine sulfate, bupivacaine hydrochloride, and clonidine hydrochloride when used in an implantable pump under simulated clinical use conditions. SynchroMed implantable pumps were filled with an admixture and incubated at 37 degrees C for a period of 90 days. Drug admixture stored in glass vials at 4 degrees C and at 37 degrees C served as controls. Samples which included pump reservoir and catheter delivered aliquots were collected every 30 days and analyzed for drug concentrations using a stability-indicating HPLC method. All drugs contained in the admixture were stable and the original concentrations remained greater than 96%. Over 90 days, and with the pump at the simulated body temperature of 37 degrees C, there were no evident heat catalyzed or device catalyzed reactions.
PMID: 15589086 [PubMed - indexed for MEDLINE]
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What is the risk of distress in palliative care survey research?
Takesaka J, Crowley R, Casarett D.
Division of Geriatric Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
To determine whether caregivers believe that interviews about end-of-life care are distressing and to identify patient and respondent characteristics associated with an increased risk of distress, distress was assessed in four studies that used family interviews. The setting was four Medicare certified hospice organizations, the University of Pennsylvania Memory Disorders Clinic, and two nursing homes, and participants included 296 family members of seriously ill or recently deceased patients. For three of the studies, respondents described their distress on a 5-point scale. Distress was reported as either present or absent in the fourth study. Sixty-four respondents (22%) reported experiencing distress. Intensity of distress was higher for younger respondents (Spearman rho -0.16; P=0.013), younger patients (Spearman rho -0.28; P < 0.001), and family members of patients with cancer (mean 0.55 vs. 0.24; Rank sum test P < 0.001). In a multivariable model, after adjusting for study population, younger patient age and cancer diagnosis were independently associated with the severity of distress. Sensitive questions about death and dying are unlikely to cause distress for family members. Although the likelihood of distress is low overall, investigators recruiting from these populations may improve the research by incorporating methods to assess and manage distress.
Publication Types:
- Clinical Trial
- Multicenter Study
PMID: 15589084 [PubMed - indexed for MEDLINE]
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Oxcarbazepine (Trileptal) monotherapy dramatically improves quality of life in two patients with postherpetic neuralgia refractory to carbamazepine and gabapentin.
Criscuolo S, Auletta C, Lippi S, Brogi F, Brogi A.
Publication Types:
PMID: 15589078 [PubMed - indexed for MEDLINE]
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The use of subcutaneous omeprazole in the treatment of dyspepsia in palliative care patients.
Agar M, Webster R, Lacey J, Donovan B, Walker A.
Publication Types:
PMID: 15589074 [PubMed - indexed for MEDLINE]
Different pain patterns in patients with vertebral artery dissections.
de Sousa JE, Halfon MJ, Bonardo P, Reisin RC, Fernandez Pardal MM.
Department of Neurology, Hospital Britanico de Buenos Aires, Argentina.
PMID: 15753446 [PubMed - in process]
Hospital staff and family perspectives regarding quality of pediatric palliative care.
Contro NA, Larson J, Scofield S, Sourkes B, Cohen HJ.
Pediatric Palliative Care Program, Lucile Salter Packard Children's Hospital at Stanford, Stanford University Medical Center, 725 Welch Rd, Palo Alto, CA 94304, USA. nancy.contro@medcenter.stanford.edu
BACKGROUND: Development of a pediatric palliative care program was preceded by a needs assessment that included a staff survey and family interviews regarding improving pediatric palliative care. METHODS: Four hundred forty-six staff members and community physicians responded to a written survey regarding comfort and expertise in delivering end of life care. Sixty-eight family members of 44 deceased children were interviewed regarding treatment, transition to palliative care, and bereavement follow-up contact. Frequencies were generated for responses to the staff survey. Five interviewers reviewed the families' narratives and identified frequently occurring themes. RESULTS: Staff members reported feeling inexperienced in communicating with patients and families about end of life issues, transition to palliative care, and do not resuscitate status. Families reported distress caused by uncaring delivery of bad news and careless remarks made by staff members. Staff members reported feeling inexperienced in symptom and pain management and described occasions when pain could have been better managed. Families believed pain had been managed as well as possible despite observing their children suffer. Fifty-four percent of staff members reported that adequate support was not provided for those who treat dying children. Staff members and family members stated their desire for more support. Staff members who described their most difficult experiences caring for a dying child referenced personal pain and inadequate support most frequently. CONCLUSIONS: Albeit from different perspectives, staff members and family members shared common concerns and experiences regarding pediatric palliative care. These experiences emphasize the need for additional systematic study, improved education and support for staff members, and continued development of more effective and compassionate delivery of pediatric palliative care.
PMID: 15520103 [PubMed - indexed for MEDLINE]
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Neurotoxicities in infants seen with the consumption of star anise tea.
Ize-Ludlow D, Ragone S, Bruck IS, Bernstein JN, Duchowny M, Pena BM.
Department of Pediatrics, Miami Children's Hospital, Miami, FL 33155, USA.
Chinese star anise (Illicium verum Hook f.) is a well-known spice used in many cultures. Many populations use it as a treatment for infant colic. Japanese star anise (Illicium anisatum L), however, has been documented to have both neurologic and gastrointestinal toxicities. Recently, concern has been raised regarding the adulteration of Chinese star anise with Japanese star anise. We report 7 cases of adverse neurologic reactions in infants seen with the home administration of star anise tea. In addition, we have found evidence that Chinese star anise has been contaminated with Japanese star anise. More strict federal regulation of the import of star anise into the United States is warranted. Star anise tea should no longer be administered to infants because of its potential danger in this population.
Publication Types:
PMID: 15492355 [PubMed - indexed for MEDLINE]
Comment in:
Paralysis after transforaminal epidural injection and previous spinal surgery.
Huntoon MA, Martin DP.
Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, MN 55905, USA. huntoon.marc@mayo.edu
OBJECTIVE: This case discusses a rare but devastating complication of transforaminal epidural injection. Elements in the patient's history that may be risk factors are discussed. CASE REPORT: A 64-year-old man was evaluated for chronic low-back pain after multiple spine surgeries. After the most recent surgery, he suffered transient cauda equina symptoms. Because conservative therapy was not helpful for spinal stenosis and neuroclaudication, a left L2 transforaminal epidural injection was attempted, but a posterolateral fusion mass made this procedure impossible. A left L1 transforaminal approach was successful, and 1 mL of iopamidol (Isovue) contrast was injected, followed by 5 mL of a solution of 0.125% bupivacaine and 40 mg of triamcinolone. Approximately 1 to 2 minutes after injection, the patient described discomfort in the lower abdomen, and 1 minute later, he was unable to move his lower extremities. An MRI showed T2 signal change in the conus medullaris gray matter at T11-12, consistent with an acute vascular infarct. Spinal shock protocol with high-dose methylprednisolone was begun without change. More than 4 years later, the patient continues to be troubled by persistent paraparesis and chronic pain. CONCLUSIONS: This case report is part of a new and growing body of literature that demonstrates the potential risk of transforaminal injection. Further study is necessary to ensure that spinal vascular injuries can be kept to an acceptably rare level.
Publication Types:
PMID: 15372396 [PubMed - indexed for MEDLINE]
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Neuraxial and sympathetic blocks in herpes zoster and postherpetic neuralgia: an appraisal of current evidence.
Kumar V, Krone K, Mathieu A.
Olentangy Pain Clinic, Columbus, OH 43235, USA. vkumarmd@att.net
BACKGROUND AND OBJECTIVES: Epidural, intrathecal, and sympathetic blocks are used for the treatment of pain caused by herpes zoster (HZ) and postherpetic neuralgia (PHN). This study was undertaken to evaluate and synthesize existing evidence for using these nerve blocks with various injectates (local anesthetic [LA] alone, LA + steroids) in treating pain of HZ, PHN (>6 months), and its prevention. METHODS: A computerized search of published trials in the English language from 1966 to 2001 was carried out on Medline, EMBASE, and Cochrane Clinical Trial databases. Levels of evidence and grades of recommendations were made based on criteria published by the Oxford Centre for Evidence-Based Medicine. RESULTS: Among the studies meeting inclusion criteria, treatment was initiated during acute pain in 71% (15/21) and PHN in 29% (6/21). Randomized controlled trials (RCTs, level 1b evidence) constituted 19% (4/21), individual cohort (levels 2b, 3b) 29% (6/21), and case series (level 4) 43% (9/21). Overall, 80% (15/21) of trials showed a positive outcome with these blocks. The use of sympathetic (LA) and epidural blocks (LA + steroid) for pain of HZ was supported by 1 RCT each, and intrathecal block (LA + steroid) for PHN was supported by 2 RCTs. CONCLUSIONS: Evidence for the beneficial effect of epidural LA + steroid in HZ, and intrathecal LA + steroid in PHN appears to be consistent (grade A). If given within 2 months of HZ, epidural LA + steroid may reduce the incidence of PHN after 1 year (grade A). Evidence for use of sympathetic blocks in HZ and PHN, although generally useful (Grade B), requires RCTs for validation.
Publication Types:
PMID: 15372391 [PubMed - indexed for MEDLINE]
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Peripheral opioid analgesia in laparoscopic cholecystectomy.
Zajaczkowska R, Wnek W, Wordliczek J, Dobrogowski J.
Department of Anesthesiology, Province Hospital, Rzeszow, Poland.
BACKGROUND: Recent research has revealed that opioids can act directly on the peripheral terminals of afferent nerves to mediate antinociception. The aim of this study was to assess the influence of peripheral morphine administration on the nociception process in the postoperative period. METHODS: One hundred fifty patients for laparoscopic cholecystectomy were randomly divided into 5 groups. Group M patients (n=30) received local infiltration at trocar insertion points with 2 mg morphine in 20 mL of 0.9% NaCl solution (5 mL of solution per point) 10 minutes before the operation. For group B patients (n=30), the solution used for infiltration was 20 mL of 0.25% bupivacaine; for group M+B patients (n=30), the solution was 2 mg morphine in 20 mL of 0.25% bupivacaine; and for group S patients (n=30), the solution was 20 mL 0.9% NaCl. For group S+M patients (n=30), trocar insertion points were infiltrated with 20 mL of 0.9% NaCl, and patients in this group were given 2 mg of subcutaneous morphine 10 minutes before the surgery. Postoperative analgesic therapy was provided by on-demand analgesia with tramadol. After surgery, the following were measured: pain intensity scored on the visual analog scale, total tramadol requirement, time from the end of the surgical procedure to the administration of the first dose of tramadol, and the frequency of undesirable side effects (sedation, nausea, and vomiting). RESULTS: Pain intensity and total tramadol requirement after surgery were lower in groups M, B, and M+B compared with groups S and S+M, but these differences were not statistically significant. The time from the completion of the operation to the administration of the first dose of tramadol was significantly longer in groups M, B, and M+B compared with groups S and S+M. CONCLUSION: Results of the study confirm the possibility of modifying the nociception process in the postoperative period through peripheral opioid administration.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15372386 [PubMed - indexed for MEDLINE]
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Radiofrequency lumbar facet denervation: a comparative study of the reproducibility of lesion size after 2 current radiofrequency techniques.
Buijs EJ, van Wijk RM, Geurts JW, Weeseman RR, Stolker RJ, Groen GG.
Centre for Perioperative Medicine, Anesthesiology, and Pain Clinic, University Medical Centre Utrecht, Utrecht, The Netherlands. ejbuijs@kabelfoon.nl
BACKGROUND AND OBJECTIVES: Radiofrequency facet denervation procedures are widely used for the treatment of chronic low-back pain. Currently, both temperature-controlled and voltage-controlled techniques are used. In this combined in vivo and in vitro study, the electrophysiologic consequences and the effects on lesion size of these techniques were determined. METHODS: Thirty-three patients were randomly assigned to receive a lumbar radiofrequency facet denervation by using either temperature-controlled (80 degrees C, 60 seconds) or voltage-controlled (20 V, 60 s) mode. Electrophysiologic parameters in both groups during radiofrequency lesioning were registered. Observed differences between electrodes were quantified and interpreted, using lesion-size data from egg-white experiments. RESULTS: Seventeen patients in the temperature group were treated with a total of 55 radiofrequency lesions, all considered technically adequate. In the voltage-controlled group, 16 patients received 63 lesions. Of these, 44 (69.8%) procedures were found to be technically inadequate. Voltage-controlled radiofrequency lesioning resulted in uncontrollable fluctuations of temperature, with resultant uncontrollable variations in lesion size. Temperature-controlled mode created reproducible lesion sizes. CONCLUSIONS: There is no consistent relation between voltage and the temperature obtained during radiofrequency lumbar facet denervation. Temperature-controlled radiofrequency lesioning is preferred to create reproducible lesion sizes.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15372382 [PubMed - indexed for MEDLINE]
Comment on:
Transforaminal injection of steroids: should we continue?
Rathmell JP, Benzon HT.
Publication Types:
PMID: 15372381 [PubMed - indexed for MEDLINE]
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Adding methylprednisolone to local anesthetic increases the duration of axillary block.
Stan T, Goodman EJ, Bravo-Fernandez C, Holbrook CR.
Publication Types:
PMID: 15305267 [PubMed - indexed for MEDLINE]
Comment on:
Overinflated benefits and de-emphasized risks.
Launcelott G.
Publication Types:
PMID: 15305266 [PubMed - indexed for MEDLINE]
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Ultrasound guidance for difficult lateral popliteal catheter insertion in a patient with peripheral vascular disease.
Minville V, Zetlaoui PJ, Fessenmeyer C, Benhamou D.
Departement d'Anesthesie-Reanimation, Hopital de Bictere, Le Kremlin-Bictere, France.
OBJECTIVE: Interest in ultrasound-guided nerve block is increasing, but clinical utility still is being determined. We report a case in which ultrasound imaging aided nerve localization during popliteal block. CASE REPORT: We report a case in which failure of nerve stimulation to locate the sciatic nerve at the popliteal fossa in a patient with underlying neuropathy was overcome by ultrasound guidance, which allowed quick and easy catheter placement. After failure of the stimulation technique, ultrasound permitted us to observe advancement of the needle, placement of the catheter, and spread of local anesthetic around the nerve. CONCLUSION: Ultrasound guidance can facilitate lateral popliteal catheter insertion in patients in whom electrolocation has failed.
Publication Types:
PMID: 15305259 [PubMed - indexed for MEDLINE]
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Piriformis syndrome in a patient after cesarean section under spinal anesthesia.
Vallejo MC, Mariano DJ, Kaul B, Sah N, Ramanathan S.
Department of Anesthesiology, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. vallejomc@anes.upmc.edu
OBJECTIVES: The diagnosis, pathogenesis, and treatment of piriformis syndrome as a cause of persistent buttock and hip pain after spinal anesthesia are presented in this case report. CASE REPORT: A 29-year-old woman presented 5 days after cesarean delivery with sudden onset of pain in the left buttock and left hip radiating to the posterior knee with fever. She was subsequently diagnosed with piriformis syndrome. CONCLUSIONS: Back pain with radiation into the buttocks after spinal anesthesia is frequently attributed to the spinal procedure itself. However, prolonged sitting and weight bearing in the upright position after cesarean delivery can cause sciatic nerve compression at the sacroiliac joint with concomitant irritation, inflammation, and spasm of the piriformis muscle. Piriformis syndrome is frequently underdiagnosed in the obstetric population. Because the diagnosis of piriformis syndrome is based mainly on clinical signs and symptoms, the clinician must have a high index of suspicion.
Publication Types:
PMID: 15305258 [PubMed - indexed for MEDLINE]
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Cervical epidural analgesia via a thoracic approach using nerve stimulation guidance in an adult patient undergoing elbow surgery.
Tsui BC, Bateman K, Bouliane M, Finucane B.
Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, Edmonton, Alberta, Canada. btsui@ualberta.ca
OBJECTIVE: This case report describes the placement of a cervical epidural catheter via the thoracic approach, using nerve stimulation, in a patient undergoing elbow surgery. CASE REPORT: An epidural catheter was easily advanced to the C5 dermatome level from the T4-5 interspace, using nerve stimulation guidance. Successful perioperative analgesia was accomplished using an infusion of ropivacaine 0.2% with 0.05 mg/mL morphine at 4 mL/h. CONCLUSIONS: This case report suggests that electrical stimulation may allow one to accurately position epidural catheters in the central neuraxial space to provide reliable, effective analgesia of the upper extremity. This approach might be an alternative way to deliver cervical epidural analgesia for patients undergoing upper extremity surgery.
Publication Types:
PMID: 15305256 [PubMed - indexed for MEDLINE]
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Ropivacaine 3.75 mg/ml, 5 mg/ml, or 7.5 mg/ml for cervical plexus block during carotid endarterectomy.
Umbrain VJ, van Gorp VL, Schmedding E, Debing EE, von Kemp K, van den Brande PM, Camu F.
Department of Anesthesiology (V.J.U., V.L.V.G., F.C.), Academisch Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium. Vincent.Umbrain@az.vub.ac.be
OBJECTIVE: To examine the effect of 225 mg (7.5 mg/mL), 150 mg (5 mg/mL), and 112.5 mg (3.75 mg/mL) ropivacaine on quality of cervical plexus block during carotid endarterectomy. METHODS: Patients (n = 93) scheduled for carotid endarterectomy were randomized to receive a cervical plexus block with deep infiltration of 10 mL and superficial infiltration of 20-mL volumes of ropivacaine 7.5, 5.0, or 3.75 mg/mL. Pain, coughing, hemodynamic consequences of the block, postoperative visual analog scores, and pain satisfaction index were recorded. If necessary, anesthesia supplements with aliquots of 3 mL lidocaine 1% were given during surgery. RESULTS: Incidences of coughing and hoarseness were similar in all groups. More local anesthetic infiltrations were required in the ropivacaine 3.75-mg/mL and 5-mg/mL groups. Postoperatively, no intragroup differences were observed. A trend toward better pain satisfaction was observed in the ropivacaine 7.5-mg/mL group. CONCLUSION: The best quality of cervical plexus block associated with the smallest incidence of pain for patients undergoing carotid endarterectomy was obtained with 30 mL of 225 mg and 150 mg of ropivacaine, respectively.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15305249 [PubMed - indexed for MEDLINE]
Comment in:
Comment on:
The injectionists.
Rathmell JP.
Publication Types:
PMID: 15305247 [PubMed - indexed for MEDLINE]
Economic evaluation of a behavioral-graded activity program compared to physical therapy for patients following lumbar disc surgery.
Ostelo RW, Goossens ME, de Vet HC, van den Brandt PA.
Department of Epidemiology, Maastricht University, The Netherlands. r.ostelo@vumc.nl
STUDY DESIGN: An economic evaluation was conducted alongside a randomized controlled trial. SUMMARY OF BACKGROUND DATA: Little is known about the effectiveness of cognitive-behavioral treatment options for patients following lumbar disc surgery. If the knowledge available was supported by an economic evaluation, the information could then be used to make recommendations for the implementation of cognitive-behavioral treatment in the routine of rehabilitation following lumbar disc surgery. OBJECTIVE: To examine the cost-effectiveness of a behavioral-graded activity program, which is an operant treatment, compared to usual care as delivered by a physical therapist for patients following first-time lumbar disc surgery. METHODS: For the economic evaluation, a societal viewpoint was applied. The primary outcome measures (measured at the 12-month follow-up) were global perceived effect and functional status. To evaluate the economic consequences of the treatments, direct health care and non-health care costs were considered, as well as indirect costs. RESULTS: The clinical outcomes showed no relevant differences between behavioral-graded activity (n = 52) and UC (n = 53). Treatment costs were almost identical in the two intervention groups. The difference in direct health care costs was, although not statistically significant, 264 EURO [95% CI: -3-525] higher in behavioral-graded activity than in usual care per patient-year. It was mainly the excess cost of visiting the physiotherapist in the behavioral-graded activity group that accounted for this difference. The difference in direct non-health care costs, although not statistically significant, was 388 EURO [95% CI: -217; 992] lower in the usual care group due to unpaid help by friends or family. Consequently, although again not statistically significant, the total direct costs in behavioral-graded activity are 639 EURO [95% CI: -91; 1368] higher than in usual care. For the indirect costs, there was a statistically significant difference, behavioral-graded activity being more expensive. The sensitivity analysis showed that these results are fairly robust. CONCLUSIONS: This study concludes that there are no differences between the two treatment conditions on any of the clinical outcome measures but that behavioral-graded activity is associated with higher costs. Consequently, there is no reason for the implementation of behavioral-graded activity as the standard treatment for patients following lumbar disc surgery.
Publication Types:
- Clinical Trial
- Multicenter Study
- Randomized Controlled Trial
PMID: 15014270 [PubMed - indexed for MEDLINE]
Oral administration of vinorelbine can overcome intractable endovenous-vinorelbine-associated acute tumor pain.
De Pas T, Sbanotto A, Catania C, Banfi MG, Curigliano G, Nole F, Fazio N, Formica V, Veronesi G, de Braud F.
Department of Medical Oncology, European Institute of Oncology, Milan, Italy. tommaso.de-pas@ieo.it
PMID: 15761704 [PubMed - in process]
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