Articles: disease.
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Randomized Controlled Trial Clinical Trial
Intra-vas deferens bupivacaine for prevention of acute pain and chronic discomfort after vasectomy.
We have studied the use of intra-vas deferens local anaesthesia in 70 patients undergoing vasectomy as day-case patients. Patients were allocated randomly to either a control or treatment group. In the treatment group, 0.5% bupivacaine 1 ml or 0.9% saline 1 ml was injected into the lumen of the right or left vas deferens in a randomized blinded design. ⋯ One year after the procedure a second questionnaire was sent out asking about the presence or absence of chronic testicular discomfort, its duration and any surgical intervention required to relieve it. There were no differences between the control group and the saline side of the treatment group in VAS scores on both day 1 and day 7 after operation or in the incidence and duration of chronic testicular discomfort (mean 30 (SD 53) and 34 (50) days, respectively). The VAS scores were, however, significantly less (P < 0.005) and testicular discomfort was absent on the bupivacaine-treated side.
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Randomized Controlled Trial Clinical Trial
Neutralizing pH of lidocaine reduces pain during Norplant system insertion procedure.
The acidity of lidocaine used as a local anesthetic during the insertion of Norplant System capsules can cause patient discomfort. Buffering lidocaine with sodium bicarbonate significantly reduced pain scores reported by 46 women who participated in this randomized, double-blind study. Derived from a pain scale of 1 to 10, the mean difference in reported pain scores with and without buffering was 1.17 (P = 0.0098) with women using themselves as controls, for an average reduction in pain of 29%. Because this added step minimized patient discomfort, it might make the Norplant System a more attractive option for women apprehensive about insertion pain.
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J. Clin. Endocrinol. Metab. · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialOral contraceptive pills, gonadotropin-releasing hormone agonists, or use in combination for treatment of hirsutism: a clinical research center study.
The effectiveness of oral contraceptive pills (OCPs), GnRH agonist (GnRH-a), and a combination of OCPs and GnRH-a in the treatment of hirsute women was compared and the impact of these treatments on hormonal and Ca metabolism was investigated. Thirty-three women were prospectively enrolled and randomized into three treatment groups (11 in each group). The serum levels of LH, estradiol, testosterone, free testosterone, androstenedione, and 17-hydroxyprogesterone declined in all 3 treatment groups, whereas the inclusion of GnRH-a treatment tended to promote a more rapid decrease in these hormone levels. ⋯ Bone density significantly decreased in the lumber spine in women treated with GnRH-a alone, with a less marked decline in the femoral neck. In contrast, women receiving OCPs plus GnRH had increased bone density in the lumbar spine. It is concluded that: 1) clinical measures of hirsutism are not different after 6 months of treatment with OCPs alone, GnRH-a alone, or a combination of the two; 2) the decline in gonadotropins and steroid hormones and improvement in clinical response were more rapid and pronounced when GnRH-a treatment was added to OCP administration; and 3) the negative impact of GnRH-a alone on Ca balance and bone loss limits its usefulness as a single agent for long-term therapy of hirsutism.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effectiveness of video-based interventions in promoting condom acquisition among STD clinic patients.
This study examined the effectiveness of video-based patient education interventions on promoting condom use among men and women seeking services at a large public STD clinic in New York City. ⋯ Based on extensive formative research that identified barriers to safer sex behaviors, video-based interventions were developed to promote condom use among black and Hispanic men and women attending STD clinics. Designed to be integrated into clinic services, these interventions help improve knowledge, promote positive attitudes about condoms, and increase condom acquisition among individuals at high risk of acquiring and transmitting human immunodeficiency virus infection and other STDs.
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Randomized Controlled Trial Clinical Trial
Preoperative or postoperative diclofenac for laparoscopic tubal ligation.
We have compared the analgesic effects of diclofenac given before operation or immediately after operation in a randomized, double-blind, double-dummy study of 40 healthy female patients undergoing laparoscopic tubal ligation. Group 1 patients received diclofenac 75 mg as a 3-ml i.m. injection 1-2 h before operation and normal saline 3 ml i.m. immediately after surgery. Group 2 patients received normal saline 3 ml i.m. before operation and diclofenac 75 mg i.m. immediately after surgery. ⋯ VRS at 1 and 3 h after operation were, respectively, (median, interquartile range) 2.2 (1.5-3.0) vs 2.7 (2.0-4.0) and 0.8 (0-1.3) vs 0.9 (0-1.5) (ns). Sixteen patients in group 1 compared with 17 in group 2 required postoperative morphine. Time to first morphine administration and dose given were, respectively, (median, interquartile range) 50.6 (39-60) min vs 35.7 (20-49) min (P = 0.1) and 9.0 (5-10) mg vs 9.5 (7.5-10) (P = 0.9).(ABSTRACT TRUNCATED AT 250 WORDS)