Background: Opioid use disorder (OUD) and deaths related to the chronic use of opioids have increased significantly over the last two decades. Chronic consumption of opioids has been documented in many patients with traumatic injuries. Preliminary research findings have shown that interventions using cognitive-behavioral strategies were a promising adjunct in decreasing the burden associated with opioid consumption. Accordingly, the Tapering Opioids Prescription Program in Trauma (TOPP-Trauma) was developed.
Purpose: To assess the feasibility of the TOPP-Trauma intervention and its research methods; and explore the potential efficacy of TOPP-Trauma in reducing opioid consumption.
Methods: A 2-arm pilot randomized controlled trial (RCT) will be conducted in patients presenting a high risk for chronic opioid consumption. Fifty participants at high risk for chronic consumption of opioid will receive either TOPP-Trauma or an educational pamphlet. The feasibility assessment of TOPP-Trauma will be based on the ability to provide its components as initially planned. Several parameters will be evaluated to determine the feasibility of the research methods, including the adequacy of the sampling pool, the dropout rate, and the ease of data collection. The morphine equivalent dose (MED) per day between both groups will be measured at 6 and 12 weeks. Pain intensity and pain interference with activities will also be evaluated at the same time points.
Discussion: This study will provide evidence on the feasibility of a preventive program aimed at reducing chronic opioid use in high risk trauma patients. Information will also be gathered on the methods that should be used to test the efficacy of such programs.
Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 40263056. Registered 26 May 2018.
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http://dx.doi.org/10.1186/s40814-019-0444-3 | DOI Listing |
Objective: Elevated blood pressure (BP), even at prehypertensive levels, increases cardiovascular disease risk among people with HIV (PWH); yet international guidelines in low-income countries recommend treatment initiation at BP at least 140/90 mmHg. We determined the efficacy, feasibility, and acceptability of treating prehypertension in PWH in Haiti.
Design: An unblinded randomized clinical trial (enrolled April 2021-March 2022) with 12-month follow-up.
Ann Intern Med
January 2025
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (K.K.).
Background: Dialysis patients have high rates of fracture morbidity, but evidence on optimal management strategies for osteoporosis is scarce.
Objective: To determine the risk for cardiovascular events and fracture prevention effects with denosumab compared with oral bisphosphonates in dialysis-dependent patients.
Design: An observational study that attempts to emulate a target trial.
Chaos
January 2025
School of Public Health, Chongqing Medical University, Chongqing 400016, China.
The impact of resource allocation on the dynamics of epidemic spreading is an important topic. In real-life scenarios, individuals usually prioritize their own safety, and this self-protection consciousness will lead to delays in resource allocation. However, there is a lack of systematic research on the impact of resource allocation delay on epidemic spreading.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota.
Background: Posttraumatic retroclival hematomas are rare pathologies among pediatric patients and can result in cranial nerve palsies. The authors sought to survey the literature and characterize the risk factors, treatment considerations, and overall outcomes for pediatric patients experiencing posttraumatic retroclival hematomas.
Observations: A search of the Ovid Embase, Scopus, PubMed, and Web of Science databases from January 1986 to May 2024 was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Hum Reprod
January 2025
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
Study Question: Are empirically derived adolescent overweight/obesity phenotypes differentially associated with polycystic ovary syndrome (PCOS) in young adulthood?
Summary Answer: Self-reported PCOS diagnosis risk in young adulthood varied by empirically derived adolescent overweight/obesity phenotypes, with the highest risk observed among those in the 'mothers with obesity' and 'early puberty' phenotypes.
What Is Known Already: Overweight and obesity during puberty are postulated to promote the development of PCOS. Much of the prior literature in this area is cross-sectional and defines weight status based solely on BMI, yet emerging research suggests that not all people with overweight/obesity have the same risk for chronic health conditions, including PCOS.
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