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Jacques Bradwejn - One of the best experts on this subject based on the ideXlab platform.

  • Randomized Trial of a meditation based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder
    Behaviour Research and Therapy, 2007
    Co-Authors: Diana Koszycki, Melodie Benger, Jakov Shlik, Jacques Bradwejn
    Abstract:

    Abstract Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a Randomized Trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were Randomized to an 8-week course of MBSR or 12 weekly sessions of cognitive–behavioral group therapy (CBGT). Although patients in both treatment groups improved, patients receiving CBGT had significantly lower scores on clinician- and patient-rated measures of social anxiety. Response and remission rates were also significantly greater with CBGT. Both interventions were comparable in improving mood, functionality and quality of life. The results confirm that CBGT is the treatment of choice of generalized SAD and suggest that MBSR may have some benefit in the treatment of generalized SAD.

Michael K W Li - One of the best experts on this subject based on the ideXlab platform.

  • stapled hemorrhoidopexy vs harmonic scalpel hemorrhoidectomy a Randomized Trial
    Diseases of The Colon & Rectum, 2005
    Co-Authors: C C Chung, Hester Yui Shan Cheung, Eva Szewah Chan, S Y Kwok, Michael K W Li
    Abstract:

    PURPOSE: A Randomized Trial was undertaken to evaluate and compare stapled hemorrhoidopexy with excisional hemorrhoidectomy in which the Harmonic Scalpel was used. METHODS: Patients with Grade III hemorrhoids who were employed during the Trial period were recruited and Randomized into two groups: (1) Harmonic Scalpel hemorrhoidectomy, and (2) stapled hemorrhoidopexy. All operations were performed by a single surgeon. In the stapled group, the doughnut obtained was sent for histopathologic examination to determine whether smooth muscles were included in the specimen. Operative data and complications were recorded, and patients were followed up through a structured pro forma protocol. An independent assessor was assigned to obtain postoperative pain scores and satisfaction scores at six-month follow-up. Patients were also administered a simple questionnaire at follow-up to assess continence functions. RESULTS: Over a 20-month period, 88 patients were recruited. The two groups were matched for age and gender distribution. No significant difference was identified between the two groups in terms of operation time, blood loss, day of first bowel movement after surgery, and complication rates. Despite a similar parenteral and oral analgesic requirement, the stapled group had a significantly better pain score (P = 0.002); these patients also had a significantly shorter length of stay (P = 0.02), and on average resumed work nine days earlier than the group treated with the Harmonic Scalpel (6.7 vs. 15.6, P = 0.002). Although 88 percent of doughnuts obtained in the stapled group contained some smooth muscle fibers, no association was found between smooth muscle incorporation and postoperative continence function, and as a whole the continence outcomes of the stapled group were similar to those after Harmonic Scalpel hemorrhoidectomy. Finally, at six-month follow-up, patients who underwent the stapled procedure had significantly better satisfaction scores (P = 0.001). CONCLUSION: Stapled hemorrhoidopexy is a safe and effective procedure for Grade III hemorrhoidal disease. Patients derive greater short-term benefits of reduced pain, shorter length of stay, and earlier resumption to work. Long-term follow-up is necessary to determine whether these initial results are lasting.

Jakov Shlik - One of the best experts on this subject based on the ideXlab platform.

  • Randomized Trial of a meditation based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder
    Behaviour Research and Therapy, 2007
    Co-Authors: Diana Koszycki, Melodie Benger, Jakov Shlik, Jacques Bradwejn
    Abstract:

    Abstract Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a Randomized Trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were Randomized to an 8-week course of MBSR or 12 weekly sessions of cognitive–behavioral group therapy (CBGT). Although patients in both treatment groups improved, patients receiving CBGT had significantly lower scores on clinician- and patient-rated measures of social anxiety. Response and remission rates were also significantly greater with CBGT. Both interventions were comparable in improving mood, functionality and quality of life. The results confirm that CBGT is the treatment of choice of generalized SAD and suggest that MBSR may have some benefit in the treatment of generalized SAD.

Richard E Kuntz - One of the best experts on this subject based on the ideXlab platform.

  • Randomized Trial of a distal embolic protection device during percutaneous intervention of saphenous vein aorto coronary bypass grafts
    Circulation, 2002
    Co-Authors: Donald S Baim, Dennis W Wahr, Barry S George, Martin B Leon, Joel Greenberg, Donald E Cutlip, Unsal Kaya, Jeffrey J Popma, Kalon K L Ho, Richard E Kuntz
    Abstract:

    Background— Stents provide effective treatment for stenotic saphenous venous aorto-coronary bypass grafts, but their placement carries a 20% incidence of procedure-related complications, which potentially are related to the distal embolization of atherosclerotic debris. We report the first multicenter Randomized Trial to evaluate use of a distal embolic protection device during stenting of such lesions. Methods and Results— Of 801 eligible patients, 406 were randomly assigned to stent placement over the shaft of the distal protection device, and 395 were assigned to stent placement over a conventional 0.014-inch angioplasty guidewire (control group). The primary end point—a composite of death, myocardial infarction, emergency bypass, or target lesion revascularization by 30 days—was observed in 65 patients (16.5%) assigned to the control group and 39 patients (9.6%) assigned to the embolic protection device (P=0.004). This 42% relative reduction in major adverse cardiac events was driven by myocardial inf...

Waltraud Nagell - One of the best experts on this subject based on the ideXlab platform.

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