Varioocelectomny is a management option for patients with painful varicocele. In this study, we assessed the effectiveness of varicocelectomy for painful varicocele and examined the factors that might be predictive of...Varioocelectomny is a management option for patients with painful varicocele. In this study, we assessed the effectiveness of varicocelectomy for painful varicocele and examined the factors that might be predictive of outcome. All patients who underwent a varicocelectomy for pain between February 2007 and July 2009 were includecL A review of patient medical records was conducted; patient age,body mass index （BMI）, uede, iocatien of the vericocele, tasticular volume, duration and quality of the pain （dull, draaing, throbbing or sharp） and surgical technique （ingulnal versus subinguinal） were documented. All parameters were compared with the rasolution of pain （complete, partial or failure）. We followed up on 53 of 104 patients （51.0%）. Complete postopanntive resolution of pain was reported by 28 patients （52.8%）, whereas 22 （41.5%） reported partial resolution, Only three patients （5.7%） mpaded failure. No relationship was observed between postoperative pain resolution and age, BMI, grade of varicoceio, location of varicocele, ipsilateral testicular, quality of pain or surgical technique. The duration of pain before surllery was the only factor that correlated with postopaative pain resolution （univariate, P=-0.004; multivariate, P=0.002）. Our rasults indicatethat varicocelectomy isan effective treatmentfar painful varicocele in properly selected patients, and that duration of pain before surgery may be predictive of outcome.展开更多
AIM: To study the effectiveness of melatonin vs placebo in children with functional dyspepsia(FD).METHODS: The study was conducted as a double blind, randomized, placebo controlled crossover trial. Subjects were aged ...AIM: To study the effectiveness of melatonin vs placebo in children with functional dyspepsia(FD).METHODS: The study was conducted as a double blind, randomized, placebo controlled crossover trial. Subjects were aged 8-17 years and diagnosed with FD based on Rome Ⅲ criteria. All subjects had failed to respond to 4 wk of acid suppression. Subjects receive a continuous two weeks of placebo and a continuous two weeks of melatonin in an order blinded to the participant and the study team. A Global Clinical Score was obtained to assess changes in abdominal pain. Pain was self-reported to be worse(grade 1), no change(grade 2), moderate improvement(grade 3), good(grade 4; minimal pain and not interfering with daily activities), or excellent(grade 5; no pain), respectively. A positive clinical response was defined as a grade 3 or greater response. Subjects wore an actigraph to assess sleep during a one week baseline period and during each treatment period. Subjects' sleep latency and total sleep time were recorded throughout the duration of the study. RESULTS: Fourteen subjects were enrolled and 12 completed the study. One withdrew prior to starting both melatonin and placebo and the other before starting melatonin. A positive clinical response(grade 3-5) was achieved in 42% of subjects on melatonin vs 50% of subjects on placebo(NS). Effect size was calculated and revealed a Cohen's D of 0.343 which demonstrates a medium effect favoring placebo. A grade 4 or grade 5 response was seen in 4 patients on melatonin and 5 patients on placebo. Baseline sleep parameters were in the healthy range with the longest sleep latency being just over 20 min(mean 7.46 ± 8.53 min) and the shortest sleep duration just over 7 h(mean 10.09 ± 2.72 h). The mean latency did not differ between periods of treatment with melatonin as compared to placebo(4.48 ± 6.45 min vs 3.58 ± 4.24 min; NS). The mean sleep duration did not differ between periods of treatment with melatonin as compared to placebo(9.90 ± 3.53 h vs 9.41 ± 2.70 h; NS).CONCLUS展开更多
文摘Varioocelectomny is a management option for patients with painful varicocele. In this study, we assessed the effectiveness of varicocelectomy for painful varicocele and examined the factors that might be predictive of outcome. All patients who underwent a varicocelectomy for pain between February 2007 and July 2009 were includecL A review of patient medical records was conducted; patient age,body mass index （BMI）, uede, iocatien of the vericocele, tasticular volume, duration and quality of the pain （dull, draaing, throbbing or sharp） and surgical technique （ingulnal versus subinguinal） were documented. All parameters were compared with the rasolution of pain （complete, partial or failure）. We followed up on 53 of 104 patients （51.0%）. Complete postopanntive resolution of pain was reported by 28 patients （52.8%）, whereas 22 （41.5%） reported partial resolution, Only three patients （5.7%） mpaded failure. No relationship was observed between postoperative pain resolution and age, BMI, grade of varicoceio, location of varicocele, ipsilateral testicular, quality of pain or surgical technique. The duration of pain before surllery was the only factor that correlated with postopaative pain resolution （univariate, P=-0.004; multivariate, P=0.002）. Our rasults indicatethat varicocelectomy isan effective treatmentfar painful varicocele in properly selected patients, and that duration of pain before surgery may be predictive of outcome.
文摘AIM: To study the effectiveness of melatonin vs placebo in children with functional dyspepsia(FD).METHODS: The study was conducted as a double blind, randomized, placebo controlled crossover trial. Subjects were aged 8-17 years and diagnosed with FD based on Rome Ⅲ criteria. All subjects had failed to respond to 4 wk of acid suppression. Subjects receive a continuous two weeks of placebo and a continuous two weeks of melatonin in an order blinded to the participant and the study team. A Global Clinical Score was obtained to assess changes in abdominal pain. Pain was self-reported to be worse(grade 1), no change(grade 2), moderate improvement(grade 3), good(grade 4; minimal pain and not interfering with daily activities), or excellent(grade 5; no pain), respectively. A positive clinical response was defined as a grade 3 or greater response. Subjects wore an actigraph to assess sleep during a one week baseline period and during each treatment period. Subjects' sleep latency and total sleep time were recorded throughout the duration of the study. RESULTS: Fourteen subjects were enrolled and 12 completed the study. One withdrew prior to starting both melatonin and placebo and the other before starting melatonin. A positive clinical response(grade 3-5) was achieved in 42% of subjects on melatonin vs 50% of subjects on placebo(NS). Effect size was calculated and revealed a Cohen's D of 0.343 which demonstrates a medium effect favoring placebo. A grade 4 or grade 5 response was seen in 4 patients on melatonin and 5 patients on placebo. Baseline sleep parameters were in the healthy range with the longest sleep latency being just over 20 min(mean 7.46 ± 8.53 min) and the shortest sleep duration just over 7 h(mean 10.09 ± 2.72 h). The mean latency did not differ between periods of treatment with melatonin as compared to placebo(4.48 ± 6.45 min vs 3.58 ± 4.24 min; NS). The mean sleep duration did not differ between periods of treatment with melatonin as compared to placebo(9.90 ± 3.53 h vs 9.41 ± 2.70 h; NS).CONCLUS
