title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
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Appearance-based rejection sensitivity (ARS-D) | As hypothesized, the ARS-D decreased between pretreatment and posttreatment by | PMC10683190 | ||
Preliminary findings on acceptance | PMC10683190 | |||
Dropout rates | PHYSICAL ILLNESS | Of the 24 patients enrolled at pretreatment assessment, 11 patients (45.8%) terminated the BEAT program prematurely (dropouts): Of these, one (9.1%) dropped out after the pretreatment assessment in the waiting-time period, seven (63.6%) during the nine treatment sessions of the active treatment, and three (27.3%) durin... | PMC10683190 | |
Patient’s subjective evaluation of the BEAT program | Mean treatment satisfaction of the completers (Treatment satisfaction with different aspects of BEAT | PMC10683190 | ||
Limitations | There are limitations with respect to the findings of the current pilot study. First of all, the sample size was small and our findings need to be reevaluated in larger samples. In order to prevent the risk of early dropout due to lack of motivation, we further kept the waiting period short (two weeks), which contrasts... | PMC10683190 | ||
Conclusion | eating disorder, eating disorders, depressive symptoms | PATHOLOGY | The present pilot study documents initial evidence of the effects of a blended treatment program (BEAT) for youth aged 14 to 24 suffering from LOC, including elements of CBT for eating disorders and interventions to improve interpersonal emotion regulation. Large preliminary treatment effects were found for LOC psychop... | PMC10683190 |
Acknowledgements | RECRUITMENT | We would like to thank the participating patients and postgraduate psychologist in psychotherapy training for trusting us with the scientific analysis of their work. We thank Master and Bachelor students at the University of Fribourg who helped with recruitment and study procedures. | PMC10683190 | |
Authors’ contributions | SM, FF, and AHM contributed to the conception and conduction of the study. SM designed and supervised the study, including data collection and safety of included patients. FF carried out the data collection, study organization and administration. AHM carried out data analysis and interpretations were discussed with SM,... | PMC10683190 | ||
Funding | This study was funded by the Research Pool of the University of Fribourg, Switzerland (no project number available). The funder was not involved in any part of this study. | PMC10683190 | ||
Availability of data and materials | The datasets generated and/or analyzed during the current study are not publicly available due to sensible data but are available from the last author (simone.munsch@unifr.ch) on reasonable request. | PMC10683190 | ||
Declarations | PMC10683190 | |||
Ethics approval and consent to participate | All participants provided written informed consent before participating. The study complied with the Declaration of Helsinki and was reviewed and approved by the Ethics Committee of the Canton Bern, Switzerland (ID: 2018–00230).In Switzerland, young people even under the age of 14 have the right of non-information of t... | PMC10683190 | ||
Consent for publication | Not applicable. | PMC10683190 | ||
Competing interests | The authors declare no competing interests. | PMC10683190 | ||
References | PMC10683190 | |||
Materials and methods | IUT, depression | RECRUITMENT | 64 patients with GAD at a large primary health care center in Stockholm, Sweden, were randomized to IUT or MCT. Feasibility outcomes included participant recruitment and retention, willingness to receive psychological treatment, and therapists’ competence in and adherence to treatment protocols. Self-reported scales we... | PMC10266649 |
Results | IUT | RECRUITMENT | Recruitment was satisfactory, and dropout was low. On a scale from 0 to 6, participants were satisfied with participating in the study (M = 5.17, SD = 1.09). Following brief training, therapists’ competence was rated as moderate, and adherence was rated as weak to moderate. From pre- to post-treatment, reductions on th... | PMC10266649 |
Conclusion | IUT, GAD in primary health care. | It is feasible to carry out a full-scale RCT to compare the effects of IUT to MCT for patients with GAD in primary health care. Both protocols seem effective, and MCT seems superior to IUT, but a full-scale RCT is needed to confirm these conclusions. | PMC10266649 | |
Trial registration | ClinicalTrials.gov (no. | PMC10266649 | ||
Data Availability | Data cannot be shared publicly because of Swedish legal and ethical restrictions related to sensitive patient information. Data are available from Region Stockholm (contact via data protection officer Camilla Heise Löwgren, | PMC10266649 | ||
Introduction | anxiety disorders, IUT, psychiatric, depression, somatic complaints | SECONDARY, RECRUITMENT, DISORDERS | Across the world, primary health care is the setting where most people with common mental disorders receive diagnosis and treatment [Cognitive behavioral therapy (CBT) is an effective treatment for several anxiety disorders [Although CBT is not recommended as the first-hand treatment for GAD, previous meta-analyses sug... | PMC10266649 |
Materials and methods | PMC10266649 | |||
Setting | DISORDERS | The study was conducted between 2018 and 2020 at Liljeholmen Primary Health Care Center, Stockholm, Sweden, which is one of the country’s largest primary health care centers and serves 31,000 patients. The center has a team of therapists who assess and treat patients with mild to moderate common mental disorders in acc... | PMC10266649 | |
Participants | psychiatric disorder, bipolar disorder, cognitive impairment, psychosis | DISORDER | Patients at Liljeholmen Primary Health Care Center with a primary diagnosis of GAD were invited to participate. Patients were excluded from the study if they were younger than 18 years; unable to speak Swedish; or had a severe psychiatric disorder (e.g., psychosis, bipolar disorder), cognitive impairment, substance use... | PMC10266649 |
Treatments | Both treatments were protocol-based. The protocols ( | PMC10266649 | ||
Therapists | IUT | RECRUITMENT | Therapists were recruited from the team that provides psychological treatment at Liljeholmen Primary Health Care Center. The mean age of the ten therapists was 43.9 years (SD = 7.9), nine were women, six were clinical psychologists, and four were social workers. The therapists had a mean of 10.1 years (SD = 5.8) of cli... | PMC10266649 |
Training and supervision | Although therapists already used the Mini International Neuropsychiatric Interview (M.I.N.I.) [ | PMC10266649 | ||
Assessments | PMC10266649 | |||
Feasibility | IUT, worry, anxiety | SESSION, RECRUITMENT | Feasibility was assessed with several measures, including flow of recruitment, retention, participants willingness to receive psychological treatment, and therapist competence in and adherence to the treatment protocols. Participants completed an evaluation form post-treatment. It included items on perceptions of the n... | PMC10266649 |
Treatment effects | depression, worry, anxiety | Severity of worry was assessed with the 16-item Penn State Worry Questionnaire (PSWQ) [Severity of worry and depression was assessed pre-treatment, mid-treatment (following the fifth session), post-treatment, and at follow-up six months after the end of treatment. Functional impairment and quality of life were assessed... | PMC10266649 | |
Procedure | RECRUITMENT | Recruitment started in spring 2018 and ended in autumn 2019. Treatments were completed in January 2020. The last 6-month follow-up, via regular mail and online forms, finished in August 2020.Patients who visited their general practitioner at Liljeholmen Primary Health Care Center for mental health problems and/or medic... | PMC10266649 | |
Flow of participants in the study. | To allocate each participant, a research nurse phoned an independent assistant who had access to a randomization list generated by another independent assistant using an online service (At inclusion, the research nurse collected information in a survey format on the background characteristics of participants ( | PMC10266649 | ||
Baseline characteristics of participants. | IUT, anxiety disorder | Abbreviations: IUT = intolerance-of-uncertainty therapy; MCT = metacognitive therapy; GAD = generalized anxiety disorder; CBT = cognitive behavioral therapy. | PMC10266649 | |
Statistical analyses | IUT | DER | Statistical analyses were performed with SPSS (Version 27, SPSS Inc., Chicago, IL). Proportions, means, and standard deviations (SDs) were calculated for feasibility measures. Differences in session attendance between the IUT and MCT groups were investigated with an independent t-test and differences in dropout with a ... | PMC10266649 |
Ethical approval and consent to participate | Ethical approval for this study was obtained from the Regional Ethical Review Board in Stockholm, Sweden (2018/505-31). The research was conducted in accordance with the World Medical Association Declaration of Helsinki, and all patients and therapists provided written informed consent. | PMC10266649 | ||
Results | PMC10266649 | |||
Feasibility | IUT | RECRUITMENT | Of the 69 patients who met the study criteria, 64 provided written informed consent and were included in the study. The flow of recruitment, an important measure of future RCT feasibility, was good, with an average of 4.6 (SD = 2.7, range = 1–10) patients consenting to participate and being included in the study per mo... | PMC10266649 |
Treatment effects | PMC10266649 | |||
Changes in symptoms of worry | IUT, worry | Within-group analyses showed that both IUT and MCT resulted in statistically significant reductions in the severity of worry as assessed with the PSWQ ( | PMC10266649 | |
Estimated marginal means and standard deviations for the PSWQ, PHQ-9, WHODAS, and the SWLS from pretreatment to 6-month follow-up. | IUT | Abbreviations: PSWQ: Penn State Worry Questionnaire; PHQ-9: Patient Health Questionnaire 9; WHODAS: World Health Organization Disability Assessment Schedule 2.0; SWLS: Satisfaction with Life Scale; IUT: intolerance-of-uncertainty therapy; MCT: metacognitive therapy.We observed large within-group effect sizes from pre-t... | PMC10266649 | |
Within-group and between-group effect sizes with 95% confidence intervals for the PSWQ, PHQ-9, WHODAS, and the SWLS from pre-treatment to 6-month follow-up. | IUT | Abbreviations: PSWQ: Penn State Worry Questionnaire; PHQ-9: Patient Health Questionnaire 9; WHODAS: World Health Organization Disability Assessment Schedule 2.0; SWLS: Satisfaction with Life Scale; IUT: intolerance-of-uncertainty therapy; MCT: metacognitive therapy; d = model-based Cohen’s d effect sizeBetween post-tre... | PMC10266649 | |
Changes in depressive symptoms | IUT, depressive symptoms | Between pre-treatment and mid-treatment, IUT and MCT both statistically significantly reduced depressive symptoms as measured by the PHQ-9 (IUT: F(61.54) = 5.32, p = .024; MCT: F(57.00) = 12.97, p = .001) ( | PMC10266649 | |
Changes in functional impairment | IUT, MCT reduced functional impairment | Between pre-treatment and post-treatment, only MCT reduced functional impairment statistically significant as measured by the WHODAS (IUT: F(63.51) = 3.72, p = .058; MCT: F(58) = 51.29, p < .001) ( | PMC10266649 | |
Changes in quality of life | IUT | Between pre-treatment and post-treatment, MCT resulted in a significant improvement in quality of life as measured by the SWLS (F(55) = 13.01, p = .001), whereas IUT did not (F(63.84) = 1.58, p = .213) ( | PMC10266649 | |
Changes in pharmaceutical treatment | IUT | Consistent with the study protocol, pharmaceutical treatment for mental health problems remained stable during the treatment period for most participants. However, four participants in the IUT group initiated pharmaceutical treatment during the study of which three ceased pharmaceutical treatment prior to post-treatmen... | PMC10266649 | |
Changes in sick leave | IUT, depression, stress disorders, stress disorder | At pre-treatment, six participants (two in the IUT group, four in the MCT group) were on sick leave between 25% of full time and full time: three for stress disorders, two for depression, and one for GAD. Of these participants, one in the IUT group remained on full-time sick leave for depression at post-treatment and f... | PMC10266649 | |
Additional treatment received at follow-up | IUT, depression, anxiety | At 6-month follow-up, four of the 48 participants who responded to the follow-up questionnaire (8.3%) had received additional CBT since the end of the study, two in each group. Twelve participants (25.0%) had received pharmaceutical treatment for anxiety or depression, seven in the IUT group and five in the MCT group. ... | PMC10266649 | |
Discussion | PMC10266649 | |||
Main findings | IUT, depressive symptoms | RECRUITMENT, RECRUITMENT, SECONDARY | The primary aim of the present pilot study was to investigate the feasibility of a future RCT designed to compare the effectiveness of IUT and MCT in primary health care patients with GAD. There were several uncertainties about feasibility because, to the best of our knowledge, neither treatment had previously been eva... | PMC10266649 |
Comparison to other studies | PMC10266649 | |||
Feasibility | IUT, psychiatric | The only previous study comparing IUT and MCT was conducted in a psychiatric outpatient setting and did not aim to test feasibility [In the current study, following brief training in the protocols, the therapists from regular primary health care showed some competence in IUT and MCT, but the MCT therapists’ mean adhere... | PMC10266649 | |
Treatment effects | IUT | As in the current study, in earlier studies that compared MCT to CBT for GAD, all treatments reduced worry, but MCT reduced worry significantly more [In this feasibility study, we did not assess potential mediators of effect, which could be of interest to include in the future RCT. However, one explanation for the bett... | PMC10266649 | |
Strengths and limitations | sleep disturbance, fatigue, IUT, worry, depression, irritability | RECRUITMENT | This study had several strengths. Generalizability to other primary health care settings was strengthened by the recruitment of patients and therapists from regular primary health care and by keeping exclusion criteria to a minimum. In addition to measuring symptoms of worry and depression, the study also investigated ... | PMC10266649 |
Conclusions | IUT, depression, psychiatric | We found that primary health care patients were willing to participate in a pilot study that compared two protocols for treating GAD. Therapists working in regular primary health care could provide protocol-based psychological treatment with some competence and adherence after brief training and regular supervision. We... | PMC10266649 | |
Supporting information | PMC10266649 | |||
Consort checklist. | (DOC)Click here for additional data file. | PMC10266649 | ||
Original study protocol translated. | (DOCX)Click here for additional data file. | PMC10266649 | ||
Original study protocol Swedish. | (DOCX)Click here for additional data file. | PMC10266649 | ||
Translated ethical application. | (DOCX)Click here for additional data file.We thank our research nurse, Christina Stalby, and the participating patients and therapists at Liljeholmen Primary Health Care Center. We also thank scientific editor Kimberly Kane for useful comments on the text. | PMC10266649 | ||
Objective | CUTANEOUS LEISHMANIASIS, EPITHELIALIZATION | Autologous platelet gel (APG) is used in most surgeries to treat a variety of tissue defects because of its healing factors composition. This randomized parallel clinical trial was conducted to investigate the healing effects of APG on cutaneous leishmaniasis (CL) wounds. Eighteen male patients with CL wounds were recr... | PMC10493010 | |
Results | Of 18 patients, 15 patients completed the trial (83.3%, mean age 28 years). The use of APG on the wounds was associated with complete and faster healing in 66% of the wounds and partial healing in 34% of the wounds. During the study, none of the control wounds were completely healed. The wound area in the intervention ... | PMC10493010 | ||
Keywords | PMC10493010 | |||
Introduction | Leishmaniasis | LEISHMANIASIS, SCARRING, DISEASE | Leishmaniasis is a protozoan disease transmitted through the bites of female sandflies [At present, there are physical methods (cryotherapy, laser therapy, thermotherapy), topical drugs (injection of Glucantime, Emetine hydrochloride, and application of Paromomycin ointment), and systemic drugs (Pentavalent antimony (S... | PMC10493010 |
Materials and methods | PMC10493010 | |||
Ethical standards | The protocol was approved by the | PMC10493010 | ||
Study design and participants | sepsis, hypovolemic, diabetes | PLATELET DISORDERS, SEPSIS, RECRUITMENT, DIABETES | This randomized, single-center, controlled, parallel clinical trial was carried out from February 2019 to January 2020. There were no important changes to methods after trial commencement.Eighteen eligible patients with confirmed CL were enrolled in this study, out of which 15 completed the trial. The study population ... | PMC10493010 |
Randomization and allocation | Randomization was done by one of the academic expert staff (not involved in this research) using randomly permuted blocks method (block size was two). Enrollment and assignment of participants to interventions was performed by the principal researcher (A.H.T) at | PMC10493010 | ||
Parasitological studies | Skin lesions | SKIN LESIONS, STERILE, LYSIS | In this study, the smears were taken for diagnosis of CL. Skin lesions were cleaned with antiseptic agent (70% alcohol), and then using a sterile lancet, 2–3 mm superficial incisions were made on the edges of the lesions. Two smears of dermal tissue scrapings were prepared from each patient, then air-dried, fixed in me... | PMC10493010 |
Leishmaniasis wound management | STERILE | The control wound received routine treatment, including systemic injection of glucantime in a dose of 20 mg/kg/body weight, intramuscularly, daily for 14 days, and the intervention wound received APG-GF product in addition to the routine treatment. APG-GFs was prepared freshly, and applied to the wound site once per we... | PMC10493010 | |
Follow-up and evaluation of the outcome | infection, erythema, swelling | DELAYED WOUND HEALING, ERYTHEMA, EPITHELIALIZATION, INDURATION, INFECTION, SECONDARY, HEAT, SECONDARY INFECTION, COMPLICATIONS | In this study, patients with CL wounds were evaluated every week for two months at the outpatient clinic by the principal investigator. The investigator was blinded to the type of treatment given to each group. Clinical evaluation of the wounds included assessment of the wound size, wound tissue granulation, epithelial... | PMC10493010 |
Biopsy collection and histopathological analysis | cutaneous lesions, ulcer, acanthosis, spongiosis | DYSKERATOSIS, ULCER, HYPERKERATOSIS, SPONGIOSIS | Biopsy samples from CL lesions were evaluated by expert pathologist before (day 0) and 8 weeks after intervention. The skin biopsy specimens were taken from the edge of cutaneous lesions with a 4 mm in thickness Harris punch, preceded by the application of local anesthesia and anti-septic agent. All specimens were fixe... | PMC10493010 |
Sample size estimation | The study was designed to recruit 18 patients per treatment group. Based on previous studies and considering the following formula as the sample size equation, effect size = 0.8, α = 5%, β = 20%, the sample size was estimated at 15 patients. The sample size was increased from 15 to 18 patients to accommodate drop-outs. | PMC10493010 | ||
Statistical analysis | Data analysis was conducted using SPSS software (version 22.0 SPSS, Inc., Chicago, IL, USA). Control and intervention cases were matched based on the confounding variables (e.g. wound size). Data were described as mean ± standard deviation (SD). Welch test was used for comparing between groups. The Kaplan–Meier method ... | PMC10493010 | ||
Results | PMC10493010 | |||
Histopathological finding | spongiosis, dyskeratosis, hyperkeratosis, acanthosis, TablesAnalysis, ulcer | SPONGIOSIS, INFILTRATE, DYSKERATOSIS, HYPERKERATOSIS, EVENTS, ULCER | The histopathological analysis of the 15 skin biopsies of patients with CL showed morphological alterations in both epidermis and dermis before treatment. In treated wounds with APG and glucantime, alterations of the epidermis were observed in 80% (11/15) of skin biopsies; and were mainly characterized by acanthosis in... | PMC10493010 |
Discussion | ulcer, diabetic foot ulcer, diabetic wounds | DIABETIC FOOT ULCER, EPITHELIALIZATION, INFILTRATES, ULCER, INFLAMMATORY RESPONSE | Partial or poor response of CL to standard pentavalent antimony (SbV) treatment caused by host, parasite factors [We have therefore looked for additional healing effects of a topical treatment of CL wounds in addition to systemic SbV treatment with APG and its plasma secreted growth factors (APG-GF) which has become in... | PMC10493010 |
Limitations | One of the limitations of this study was that we could not use APG continuously due to the short life span of platelets at room temperature, and for optimal healing effect, it should be prepared fresh. In addition, further trials are needed to confirm our preliminary findings by increasing the patient number and the du... | PMC10493010 | ||
Acknowledgements | This study has been supported by the Jahrom University of Medical Sciences. We would particularly like to thank all patients who participated in this study. | PMC10493010 | ||
Author contributions | AHT | All authors contributed to study design. ES and AHT contributed to all parts of the study. KS and FS contributed to study implementation. AHT, AM, and ES collaborated in the analysis and interpretation of data. AT and AHT collaborated in the manuscript writing and revision. All the authors commented on the drafts of th... | PMC10493010 | |
Funding | The research was funded by Jahrom University of Medical Sciences. | PMC10493010 | ||
Availability of data and materials | The datasets that analyzed during the current study is available through corresponding author on reasonable request. | PMC10493010 | ||
Declarations | PMC10493010 | |||
Ethics approval and consent to participate | The study complied with the guidelines for human studies. The procedures of study were approved by Ethical Committee of Jahrom University of Medical Sciences (IR.JUMS.REC.1397.033), and registered with Iran Randomized Clinical Trial Center under the registration number IRCT20190212042694N1. Written informed consent was... | PMC10493010 | ||
Consent for publication | Not applicable. | PMC10493010 | ||
Competing interests | The authors have no relevant financial or non-financial interests to disclose. | PMC10493010 | ||
References | PMC10493010 | |||
Background | This study investigated the effects of intraoperative goal-directed hemodynamic therapy (GDHT) on postoperative outcomes in patients undergoing open radical cystectomy. | PMC10561433 | ||
Methods | stroke | STROKE, POSTOPERATIVE COMPLICATIONS | This prospective, single-center, randomized controlled trial included 82 patients scheduled for open radical cystectomy between September 2018 and November 2021. The GDHT group (n = 39) received the stroke volume index- and cardiac index-based hemodynamic management using advanced hemodynamic monitoring, while the cont... | PMC10561433 |
Results | POSTOPERATIVE COMPLICATIONS | A total of 75 patients were included in the final analysis. There was no significant difference in the incidence of in-hospital postoperative complications (28/39 [71.8%] vs. 30/36 [83.3%], risk difference [95% CI], -0.12 [-0.30 to 0.07], | PMC10561433 | |
Conclusions | COMPLICATIONS | Intraoperative GDHT did not reduce the incidence of postoperative in-hospital complications during the hospital stay in patients who underwent open radical cystectomy. | PMC10561433 | |
Trial registration | This study was registered at | PMC10561433 | ||
Supplementary Information | The online version contains supplementary material available at 10.1186/s12871-023-02285-9. | PMC10561433 | ||
Keywords | PMC10561433 | |||
Background | POSTOPERATIVE COMPLICATION, INVASIVE BLADDER CANCER, POSTOPERATIVE COMPLICATIONS | Radical cystectomy is the standard surgical treatment for invasive bladder cancer [Postoperative complications may be associated with an imbalance between oxygen demand and supply and impaired peripheral tissue perfusion [Thus, in the present study, we aimed to investigate the effects of intraoperative GDHT on the over... | PMC10561433 | |
Methods | PMC10561433 | |||
Ethics | This study was approved by the Institutional Review Board of Seoul National University Hospital (Seoul, Republic of Korea, Approval number: 1712-125-909) and was registered at ClinicalTrials.gov (registration number: NCT03505112, date of registration: 23/04/2018, principal investigator: Jin-Tae Kim). The study was cond... | PMC10561433 | ||
Participants | We evaluated patients (aged > 20 years) who were scheduled for open radical cystectomy and had American Society of Anesthesiologists (ASA) physical status I–III. We excluded patients who had compromised kidney function (estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73m | PMC10561433 | ||
Sample size calculation | COMPLICATIONS, POSTOPERATIVE COMPLICATIONS | Our preliminary investigation of the incidence of in-hospital postoperative complications after open radical cystectomy at the Seoul National University Hospital showed that 40% of the patients had one or more complications after surgery during the hospital stay. Assuming that the incidence of postoperative complicatio... | PMC10561433 | |
Randomization and blinding | On the day of surgery, patients were randomly assigned to either the group that received GDHT during the surgery (GDHT group) or the group that received standard care at the discretion of the attending anesthesiologists (control group), with 1:1 allocation based on a randomized computer-generated list, consisting of fo... | PMC10561433 | ||
Anesthesia protocol | stroke | STROKE, EDWARDS | After the patients entered the operating room, standard monitoring was started, including pulse oximetry, noninvasive blood pressure, electrocardiogram, and bispectral index (BIS). Cerebral oxygenation was also monitored by cerebral oximetry (INVOS 5100 C; Somanetics Co., Troy, MI, USA). Anesthesia was induced with pro... | PMC10561433 |
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