A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers

2003 ◽  
Vol 57 (3) ◽  
pp. 324-328 ◽  
Author(s):  
Yuh-Chyi Chou ◽  
Ping-I. Hsu ◽  
Kwok-Hung Lai ◽  
Ching-Chu Lo ◽  
Hoi-Hung Chan ◽  
...  
Keyword(s):  
High Risk ◽  
Randomized Trial ◽  
Water Injection ◽  
Prospective Randomized Trial ◽  
Distilled Water ◽  
Bleeding Ulcers

scholarly journals Comparison of Hemostatic Efficacy of Argon Plasma Coagulation with and without Distilled Water Injection in Treating High-Risk Bleeding Ulcers

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yuan-Rung Li ◽  
Ping-I Hsu ◽  
Huay-Min Wang ◽  
Hoi-Hung Chan ◽  
Kai-Ming Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Hospital Stay ◽  
Combined Therapy ◽  
Argon Plasma Coagulation ◽  
Water Injection ◽  
Argon Plasma ◽  
Distilled Water ◽  
Plasma Coagulation ◽  
Hemostatic Efficacy ◽  
Bleeding Ulcers

Background. Argon plasma coagulation (APC) is useful to treat upper gastrointestinal bleeding, but its hemostatic efficacy has received little attention.Aims. This investigation attempted to determine whether additional endoscopic injection before APC could improve hemostatic efficacy in treating high-risk bleeding ulcers.Methods. From January 2007 to April 2011, adult patients with high-risk bleeding ulcers were included. This investigation compared APC plus distilled water injection (combined group) to APC alone for treating high-risk bleeding ulcers. Outcomes were assessed based on initial hemostasis, surgery, blood transfusion, hospital stay, rebleeding, and mortality at 30 days posttreatment.Results. Totally 120 selected patients were analyzed. Initial hemostasis was accomplished in 59 patients treated with combined therapy and 57 patients treated with APC alone. No significant differences were noted between these groups in recurred bleeding, emergency surgery, 30-day mortality, hospital stay, or transfusion requirements. Comparing the combined end point of mortality plus the failure of initial hemostasis, rebleeding, and the need for surgery revealed an advantage for the combined group(P=0.040).Conclusions. Endoscopic therapy with APC plus distilled water injection was no more effective than APC alone in treating high-risk bleeding ulcers, whereas combined therapy was potentially superior for patients with poor overall outcomes.

scholarly journals Prospective, randomized trial comparing fluids and dobutamine optimization of oxygen delivery in high-risk surgical patients [ISRCTN42445141]

Critical Care ◽  
2006 ◽  
Vol 10 (3) ◽  
Author(s):  
Suzana M Lobo ◽  
Francisco R Lobo ◽  
Carlos A Polachini ◽  
Daniela S Patini ◽  
Adriana E Yamamoto ◽  
...  
Keyword(s):  
High Risk ◽  
Randomized Trial ◽  
Oxygen Delivery ◽  
Prospective Randomized Trial ◽  
Surgical Patients

Letter to the Editor

PEDIATRICS ◽  
1978 ◽  
Vol 61 (6) ◽  
pp. 940-940
Author(s):  
Peter Camfield ◽  
Carol Camfield
Keyword(s):  
High Risk ◽  
Natural History ◽  
Randomized Trial ◽  
Febrile Seizure ◽  
Febrile Seizures ◽  
Prospective Randomized Trial ◽  
Risk Of Recurrence ◽  
Letter To The Editor ◽  
History Of ◽  
Phenobarbital Administration

The riddle of febrile seizures is that despite their high risk of recurrence (35% to 50%), the natural history of the disorder is benign for the vast majority of children.1 If daily phenobarbital administration for several years is to be recommended after the first febrile seizure, it must be shown to be exceedingly effective and safe. The commendable study of Woff et al. is the second2 prospective randomized trial with concurrent controls of the efficacy of phenobarbital to prevent recurrent febrile seizures.

scholarly journals Body Mass Index and Survival in a Prospective Randomized Trial of Localized High-Risk Renal Cell Carcinoma

2016 ◽  
Vol 25 (9) ◽  
pp. 1326-1332 ◽  
Author(s):  
Nicholas M. Donin ◽  
Allan Pantuck ◽  
Pia Klöpfer ◽  
Paul Bevan ◽  
Barbara Fall ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Renal Cell Carcinoma ◽  
High Risk ◽  
Randomized Trial ◽  
Cell Carcinoma ◽  
Body Mass ◽  
Renal Cell ◽  
Prospective Randomized Trial

scholarly journals Adrenaline Injection Plus Argon Plasma Coagulation versus Adrenaline Injection Plus Hemoclips for Treating High-Risk Bleeding Peptic Ulcers: A Prospective, Randomized Trial

2009 ◽  
Vol 23 (10) ◽  
pp. 699-704 ◽  
Author(s):  
Seyed Alireza Taghavi ◽  
Seyed Mohammad Soleimani ◽  
Seyed Mohammad Kazem Hosseini-Asl ◽  
Ahad Eshraghian ◽  
Hajar Eghbali ◽  
...  
Keyword(s):  
High Risk ◽  
Randomized Trial ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Prospective Randomized Trial ◽  
Peptic Ulcers ◽  
Plasma Coagulation ◽  
End Point ◽  
Bleeding Peptic Ulcers ◽  
Adrenaline Injection

BACKGROUND/OBJECTIVE: Several combination endoscopic therapies are currently in use. The present study aimed to compare argon plasma coagulation (APC) + adrenaline injection (AI) with hemoclips + AI for the treatment of high-risk bleeding peptic ulcers.METHODS: In a prospective randomized trial, 172 patients with major stigmata of peptic ulcer bleeding were randomly assigned to receive APC + AI (n=89) or hemoclips + AI (n=83). In the event of rebleeding, the initial modality was used again. Patients in whom treatment or retreatment was unsuccessful underwent emergency surgery. The primary end point of rebleeding rate and secondary end points of initial and definitive hemostasis need for surgery and mortality were compared between the two groups.RESULTS: The two groups were similar in all background variables. Definitive hemostasis was achieved in 85 of 89 (95.5%) of the APC + AI and 82 of 83 (98.8%) of the hemoclips + AI group (P=0.206). The mean volume of adrenaline injected in the two groups was equal (20.7 mL; P=0.996). There was no significant difference in terms of initial hemostasis (96.6% versus 98.8%; P=0.337), rate of rebleeding (11.2% versus 4.8%; P=0.124), need for surgery (4.5% versus 1.2%; P=0.266) and mortality (2.2% versus 1.2%; P=0.526). When compared for the combined end point of mortality plus rebleeding and the need for surgery, there was an advantage for the hemoclip group (6% versus 15.7%, P=0.042).CONCLUSION: Hemoclips + AI has no superiority over APC + AI in treating patients with high-risk bleeding peptic ulcers. Hemoclips + AI may be superior when a combination of all negative outcomes is considered.

Adjuvant chemoradiotherapy after radical cystectomy in advanced high risk bladder cancer: A prospective randomized trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4545-4545 ◽  
Author(s):  
M. S. Zaghloul ◽  
H. M. Khaled ◽  
M. Lotayef ◽  
H. William
Keyword(s):  
Bladder Cancer ◽  
Risk Factor ◽  
High Risk ◽  
Randomized Trial ◽  
Radical Cystectomy ◽  
Locally Advanced ◽  
Prospective Randomized Trial ◽  
Adjuvant Chemoradiotherapy ◽  
Nodal Involvement ◽  
Pathological Stage

4545 Background: High risk locally advanced bladder cancer patients experienced low survival rates, high local recurrence and extensive distant metastasis. Postoperative radiotherapy (PORT) though improved the survival through improving local control. Methods: A prospective randomized trial was performed at NCI, Cairo, Egypt including 142 patients in 2 arms. Patients who underwent radical cystectomy and pelvic lymphadenectomy had to have one more of the following: P3b or P4a stage, G3 or involved lymphadenopathy. Arm I (71 patients) received PORT 45 G/30 fractions/3 weeks. Arm II (71 patients) received 2 courses of adjuvant chemotherapy (Gemcitabine 1 gm/m2 D1 and D8 and cisplatin 70 mg/m2 D2), same PORT regimen followed by another 2 courses of Gemcitabine-cisplatin. Results: Chemotherapy was tolerated with grade 1/2 toxicities. Early radiation reactions were also tolerable in both arms, slightly more in arm II. Delayed toxicity was comparable in both arms. The 2-year DFS was 67.6 ± 5.9% in the whole group. This was affected significantly by performance status (p = 0.009), pathological stage (p = 0.001), tumor cell type (p = 0.053), nodal involvement (p = 0.07) and number of risk factors (p = 0.09). Though there was improvement of DFS from 61.5 ± 7.4% in PORT group to 70.9 ± 6.1% in chemoradiotherapy group, yet it was not statistically significant (p = 0.2). Patients having one risk factor, low pathological stage or no nodal involvement in arm II experienced better DFS than those in arm I (p = 0.07, 0.08 and 0.09 respectively). Conclusions: Adjuvant chemoradiotherapy using Gemcitabine-cisplatin and PORT was tolerable with minimal severe toxicities. There was DFS improvement with the addition of chemotherapy to PORT (not statistically significant yet). Patients with one risk factor, lower pathological stage or no nodal involvement seemed to benefit more from added chemotherapy. No significant financial relationships to disclose.

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