The New Zealand medical journal
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Randomized Controlled Trial
An open-label six-month extension study to investigate the safety and efficacy of an extract of Artemisia annua for managing pain, stiffness and functional limitation associated with osteoarthritis of the hip and knee.
This six-month single-centre open-label extension study, conducted at the University of Otago, Dunedin, follows from a previously published 12-week pilot double-blind randomised placebo-controlled study of dietary supplement, Arthrem® (ART) in patients with osteoarthritis (OA) of the hip or knee. The pilot double-blind study showed that treatment with ART 150 mg twice-daily was associated with clinically relevant pain reduction. The extension study aims were to assess longer-term safety and efficacy during six months' treatment following the pilot trial. ⋯ ART appears to be a safe and effective alternative for managing the symptoms of OA over an extended period.
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Randomized Controlled Trial Comparative Study
Costs of bariatric surgery in a randomised control trial (RCT) comparing Roux en Y gastric bypass vs sleeve gastrectomy in morbidly obese diabetic patients.
To provide a longitudinal analysis of the direct healthcare costs of providing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery service in the context of a randomised control trial (RCT) of obese patients with type 2 diabetes in Waitemata District Health Board, Auckland, New Zealand. ⋯ Among patients with type 2 diabetes and morbid obesity undergoing LSG and LRYGB, health service costs were greater in the year after surgery than in the year before, although prescription costs were lower post-operatively. There was no significant difference in reduction in prescription cost by surgical procedure at 12 months. However, the LRYGB surgery was more expensive than LSG, primarily because of the longer operative time required.
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Randomized Controlled Trial Comparative Study
An assessment of the Hua Oranga outcome instrument and comparison to other outcome measures in an intervention study with Maori and Pacific people following stroke.
Health outcomes research for Maori has been hampered by the lack of adequately validated instruments that directly address outcomes of importance to Maori, framed by a Maori perspective of health. Hua Oranga is an outcome instrument developed for Maori with mental illness that uses a holistic view of Maori health to determine improvements in physical, mental, spiritual and family domains of health. Basic psychometric work for Hua Oranga is lacking. We sought to explore the psychometric properties of the instrument and compare its responsiveness alongside other, more established tools in an intervention study involving Maori and Pacific people following acute stroke. ⋯ The Hua Oranga instrument, developed for Maori people with mental illness, showed good responsiveness and adequate psychometric properties in Maori and Pacific people after stroke. Its simplicity, relative brevity, minimal cost and adequate psychometric properties should favour its use in future studies with both Maori and Pacific people. Suggestions are made for refinements to the measure. These should be tested in a new population before Hua Oranga is recommended for general use in a clinical setting.
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Randomized Controlled Trial
Blinded randomised controlled study of the effect of a discharge communication template on proton pump inhibitor prescribing.
To evaluate whether the inclusion of advice in the hospital discharge letter regarding published guidelines for the review of PPI therapy can increase the number of patients that have documented PPI therapy review, consistent with the published guidelines, following hospital discharge. ⋯ We were not able to demonstrate a beneficial change in PPI prescribing practice from the inclusion of PPI prescribing advice in the discharge letter.
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Randomized Controlled Trial
Prospective 10-year study of postmenopausal women with asymptomatic primary hyperparathyroidism.
There are few prospective studies of people with asymptomatic primary hyperparathyroidism (PHPT) who have not had parathyroidectomy. We followed a group of postmenopausal women with asymptomatic PHPT for up to 10 years to determine whether they could be managed conservatively without parathyroidectomy. ⋯ Many postmenopausal women with asymptomatic PHPT do not develop symptoms or complications of PHPT, and their biochemical parameters remains stable. Therefore, such asymptomatic women with PHPT can often be managed conservatively without parathyroidectomy.