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Sample records for nnts khfti ehlektronnyj

  1. A computational study on the application of AlN nanotubes in Li-ion batteries

    NASA Astrophysics Data System (ADS)

    Anaraki-Ardakani, Hossein

    2017-03-01

    We investigated the potential application of the AlN nanotubes (AlNNTs) in Li-ion batteries by means of the density functional theory calculations. To this aim, the interaction of Li atom and Li+ cation with (3 , 3), (4 , 4), (5 , 5), (6 , 6), and (7 , 7) armchair AlNNTs was investigated. By decreasing the curvature of these nanotubes, the HOMO and LUMO levels are shifted to lower and higher energies, thereby enlarging the energy gap. It was found that AlNNTs can produce larger cell voltage in comparison to the carbon nanotubes and may be promising candidate for application in the anode electrode of Li-ion batteries. The calculated cell voltage is in the range of 1.66 to 1.84 V which is significantly increased by increasing the diameter of AlNNTs. The adsorptions of Li and Li+ on the exterior surface of AlNNTs are more favorable than those on its exterior surface. We showed that the interaction of atomic Li with the surface of the AlNNT plays the main rule in determining the cell voltage because of its large dependency on the tube diameter. While the interaction of Li+ is nearly independent of the tube diameter because of the electrostatic nature of the interaction.

  2. Thermal Modeling and Performance Measurements of Radiometric Arrays for Near Space Propulsion

    DTIC Science & Technology

    2012-07-16

    Newtons [8]. The thrust stand was calibrated by means of the Electro Static Comb Calibration System ( ESCCS ) [9] before each test. This calibration...stand calibration curve generated prior to the experiment with the ESCCS . A typical thrust stand trace used to find the force produced by a given...in order to better characterize a propulsion array. Figure 4. The nNTS with a 3 vane array and the ESCCS and LVDT. C. Surface Proximity The

  3. High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study

    PubMed Central

    Hadaegh, Farzad; Bozorgmanesh, Mohammad Reza; Ghasemi, Asghar; Harati, Hadi; Saadat, Navid; Azizi, Fereidoun

    2008-01-01

    Background To estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and combined IFG/IGT in a large urban Iranian population aged ≥ 20 years. Methods The study population included 9,489 participants of the Tehran Lipid and Glucose Study with full relevant clinical data. Age-standardized prevalence of diabetes and glucose intolerance categories were reported according to the 2003 American Diabetes Association definitions. Age-adjusted logistic regression models were used to estimate the numbers needed to screen (NNTS) to find one person with undiagnosed diabetes. Results The prevalence of diagnosed and undiagnosed diabetes, isolated IFG, isolated IGT, and combined IFG/IGT were 8.1%, 5.1%, 8.7%, 5.4% and 4.0% in men and 10%, 4.7%, 6.3%, 7.6%, and 4.5% in women respectively. Participants with undiagnosed diabetes had higher age, body mass index (BMI), waist circumference, systolic and diastolic blood pressures, triglycerides (all p values <0.001) and lower HDL-cholesterol (only in women, p < 0.01) compared to normoglycemic subjects. Undiagnosed diabetes was associated with family history of diabetes, increased BMI (≥ 25 kg/m2), abdominal obesity, hypertriglyceridemia, hypertension and low HDL-cholesterol levels. Among men, a combination of increased BMI, hypertension, and family history of diabetes led to a NNTS of 1.6 (95% CI: 1.57–1.71) and among women a combination of family history of diabetes and abdominal obesity, yielded a NNTS of 2.2 (95% CI: 2.1–2.4). Conclusion In conclusion, about one third of Tehranian adults had disturbed glucose tolerance or diabetes. One- third of total cases with diabetes were undiagnosed. Screening individuals with BMI ≥ 25 kg/m2 (men), hypertension (men), abdominal obesity (women) and family history of diabetes may be more efficient. PMID:18501007

  4. Reliable evidence for efficacy of single dose oral analgesics.

    PubMed

    Spivakovsky, Silvia; Spivakovsky, Yael

    2016-06-01

    Data sourcesThe Cochrane library was searched for Cochrane systematic reviews.Study selectionCochrane reviews on single pain medications for the treatment of acute pain were included. Non-Cochrane reviews were included for tramadol.Data extraction and synthesisTwo reviewers independently searched, selected reviews for inclusion, assessed quality and performed data extraction. A protocol in case of disagreement was in place. Data were collected on number of included studies and participants, drug, dose and formulation and pain model. The authors concentrated on the amount of information and the potential for publication bias.Pain relief was calculated using at least 50% maximum pain relief, as a percentage, and as NNTs. Duration of analgesia was measured as mean or median and time to remedication was calculated as percentage of patients.ResultsThirty-nine reviews including 41 interventions were analysed and NNTs for at least 50% maximum pain relief were summarised in a graphic. NNTs range from almost one all the way to five. Only one intervention, codeine 60, had an NNT ≥10. Results judged to be reliable were listed in detail. Mean or median time to remedication was also presented in a graphic.The authors conclude that there is a great amount of quality information on single dose analgesics, and highlighted the potential benefit of fast acting formulations and fixed formulations to achieve good long-lasting analgesia.ConclusionsThere is a wealth of reliable evidence on the analgesic efficacy of single dose oral analgesics. Fast acting formulations and fixed dose combinations of analgesics can produce good and often long-lasting analgesia at relatively low doses. There is also important information on drugs for which there are no data, inadequate data, or where results are unreliable due to susceptibility to publication bias. This should inform choices by professionals and consumers.

  5. The microcantilever array: a low-power, compact, and sensitive unattended sensor technology

    NASA Astrophysics Data System (ADS)

    Rogers, B.; Whitten, R.; Adams, J. D.

    2005-10-01

    In an unattended, implanted or mobile ground sensor scenario, the microcantilever platform is well suited: sensor power consumption has been demonstrated at the nanowatt level and, as a microelectromechanical system, the platform is inherently compact. In addition, the remarkable sensitivity, low cost, scalability, durability and versatility of microcantilever sensors make this technology among the most promising solutions for unattended ground sensing of chemical and biological agents, as well as explosives. Nevada Nanotech Systems, Inc (NNTS) is developing a microcantilever- based detection system that will measure trace concentrations of explosives, toxic chemicals, and biological agents in air. A baseline sensor unit that includes the sensor array, electronics, power supply and air handling has been designed and preliminary demonstrations of the microcantilever platform have been conducted. The envisioned device would measure about two cubic inches, run on a small watch battery and cost a few hundred dollars. Finally, the NNTS microcantilever sensor has potential as a multifunctional transducer for enhancing detection and discrimination. Recent test results using this platform will be discussed.

  6. Testing for seasonality using circular distributions based on non-negative trigonometric sums as alternative hypotheses.

    PubMed

    Fernández-Durán, J J; Gregorio-Domínguez, M M

    2014-06-01

    In medical and epidemiological studies, the importance of detecting seasonal patterns in the occurrence of diseases makes testing for seasonality highly relevant. There are different parametric and non-parametric tests for seasonality. One of the most widely used parametric tests in the medical literature is the Edwards test. The Edwards test considers a parametric alternative that is a sinusoidal curve with one peak and one trough. The Cave and Freedman test is an extension of the Edwards test that is also frequently applied and considers a sinusoidal curve with two peaks and two troughs as the alternative hypothesis. The Kuiper, Hewitt and David and Newell are common non-parametric tests. Fernández-Durán (2004) developed a family of univariate circular distributions based on non-negative trigonometric (Fourier) sums (series) (NNTS) that can account for an arbitrary number of peaks and troughs. In this article, this family of distributions is used to construct a likelihood ratio test for seasonality considering parametric alternative hypotheses that are NNTS distributions.

  7. How patient outcomes are reported in drug advertisements.

    PubMed Central

    Lexchin, J.

    1999-01-01

    OBJECTIVE: To examine how changes in outcomes are reported in drug advertisements in medical journals. QUALITY OF EVIDENCE: Advertisements from a convenience sample of 38 issues of Canadian Family Physician, Canadian Journal of Anaesthesia, Canadian Journal of Psychiatry, Canadian Medical Association Journal, and the New England Journal of Medicine. MAIN MESSAGE: Method of reporting changes in clinical outcomes (relative risk reduction [RRR], absolute risk reduction [ARR], number needed to treat [NNT]), name of product, and company marketing product were sought. In the 22 advertisements included in the analysis, 11 reported results as RRRs; two reported results as RRRs, but readers could calculate ARRs or NNTs from figures given in the advertisement; and nine gave no measure of results, but readers could calculate RRRs, ARRs, or NNTs from figures given. CONCLUSIONS: Most companies report changes in outcomes as RRRs, and this bias could influence the way physicians prescribe. Changes to the rules governing journal advertising and increased emphasis on critical appraisal skills would help mitigate this bias. PMID:10349065

  8. Stability, electronic structures and transport properties of armchair (10, 10) BN/C nanotubes

    SciTech Connect

    Xiao, H.P.; He, Chaoyu; Zhang, C.X.; Sun, L.Z.; Zhou, Pan; Zhong, Jianxin

    2013-04-15

    Using the first-principle calculations, the stability and electronic properties of two novel types of four-segment armchair (10, 10) BN/C hybrid nanotubes ((BN){sub 5}C{sub 5}(BN){sub 5}C{sub 5}NT and (BN){sub 5}C{sub 5}(NB){sub 5}C{sub 5}NT) as well as two-segment armchair (10, 10) BN/C hybrid nanotubes ((BN{sub 20−n}C{sub n}NTs) are systematically investigated. When n increases from 1 to 4, the band gap of (BN){sub 20−n}C{sub n}NTs gradually decreases to a narrow one. When 4≤n≤17, the electronic structure of carbon segment in (BN){sub 20−n}C{sub n}NTs behaves as zigzag graphene nanoribbons whose band gap is modulated by an inherent electric field of the BN segment. ZGNR-like segments in (BN){sub 5}C{sub 5}(BN){sub 5}C{sub 5}NT and (BN){sub 5}C{sub 5}(NB){sub 5}C{sub 5}NT behave as narrow gap semiconductor and metal, respectively, due to their different chemical environment. Moreover, the (BN){sub 5}C{sub 5}(NB){sub 5}C{sub 5}NT can separate electron and hole carriers, indicating its potential application in solar cell materials. Obvious transport enhancement around the Fermi level is found in the four-segment nanotubes, especially a 6G{sub 0} transmission peak in the metallic (BN){sub 5}C{sub 5}(NB){sub 5}C{sub 5}NT. - Graphical abstract: Structural diagram of four-segment (BN){sub 5}C{sub 5}(NB){sub 5}C{sub 5}NT and its typical two-probe system. The band structures and transport spectra of (BN){sub 5}C{sub 5}(NB){sub 5}C{sub 5}NT are shown in upper and lower panels. Highlights: ► Transport properties of two types of four-segment BNC hybrid nanotubes are studied. ► Transport enhancements are realized in the four-segment BNC hybrid nanotubes. ► Electron and hole separation is found in four-segment BNC hybrid nanotubes.

  9. Electrical breakdown of carbon nanotube devices and the predictability of breakdown position

    NASA Astrophysics Data System (ADS)

    Goswami, Gopal Krishna; Nanda, Karuna Kar

    2012-06-01

    We have investigated electrical transport properties of long (>10 μm) multiwalled carbon nanotubes (NTs) by dividing individuals into several segments of identical length. Each segment has different resistance because of the random distribution of defect density in an NT and is corroborated by Raman studies. Higher is the resistance, lower is the current required to break the segments indicating that breakdown occurs at the highly resistive segment/site and not necessarily at the middle. This is consistent with the one-dimensional thermal transport model. We have demonstrated the healing of defects by annealing at moderate temperatures or by current annealing. To strengthen our mechanism, we have carried out electrical breakdown of nitrogen doped NTs (NNTs) with diameter variation from one end to the other. It reveals that the electrical breakdown occurs selectively at the narrower diameter region. Overall, we believe that our results will help to predict the breakdown position of both semiconducting and metallic NTs.

  10. Sumatriptan (oral route of administration) for acute migraine attacks in adults

    PubMed Central

    Derry, Christopher J; Derry, Sheena; Moore, R Andrew

    2014-01-01

    Background Migraine is a highly disabling condition for the individual and also has wide-reaching implications for society, healthcare services, and the economy. Sumatriptan is an abortive medication for migraine attacks, belonging to the triptan family. Objectives To determine the efficacy and tolerability of oral sumatriptan compared to placebo and other active interventions in the treatment of acute migraine attacks in adults. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, online databases, and reference lists for studies through 13 October 2011. Selection criteria We included randomised, double-blind, placebo- and/or active-controlled studies using oral sumatriptan to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used numbers of participants achieving each outcome to calculate relative risk (or ‘risk ratio’) and numbers needed to treat to benefit (NNT) or harm (NNH) compared to placebo or a different active treatment. Main results Sixty-one studies (37,250 participants) compared oral sumatriptan with placebo or an active comparator. Most of the data were for the 50 mg and 100 mg doses. Sumatriptan surpassed placebo for all efficacy outcomes. For sumatriptan 50 mg versus placebo the NNTs were 6.1, 7.5, and 4.0 for pain-free at two hours and headache relief at one and two hours, respectively. NNTs for sustained pain-free and sustained headache relief during the 24 hours postdose were 9.5 and 6.0, respectively. For sumatriptan 100 mg versus placebo the NNTs were 4.7, 6.8, 3.5, 6.5, and 5.2, respectively, for the same outcomes. Results for the 25 mg dose were similar to the 50 mg dose, while sumatriptan 100 mg was significantly better than 50 mg for pain-free and headache relief at two hours, and for sustained pain-free during 24 hours. Treating early, during

  11. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials.

    PubMed

    Sjögren, Petteri; Nilsson, Erika; Forsell, Marianne; Johansson, Olle; Hoogstraate, Janet

    2008-11-01

    The objective of this study was to investigate the preventive effect of oral hygiene on pneumonia and respiratory tract infection, focusing on elderly people in hospitals and nursing homes, by systematically reviewing effect estimates and methodological quality of randomized controlled trials (RCTs) and to provide an overview of additional clinical studies in this area. Literature searches were conducted in the Medline database, the Cochrane library databases, and by hand-searching reference lists. Included publications were analyzed for intervention (or topic) studied, main conclusions, strength of evidence, and study design. RCTs were further analyzed for effect magnitudes and methodological details. Absolute risk reductions (ARRs) and numbers needed to treat (NNTs) were calculated. Fifteen publications fulfilled the inclusion criteria. There was a wide variation in the design and quality of the studies included. The RCTs revealed positive preventive effects of oral hygiene on pneumonia and respiratory tract infection in hospitalized elderly people and elderly nursing home residents, with ARRs from 6.6% to 11.7% and NNTs from 8.6 to 15.3 individuals. The non-RCT studies contributed to inconclusive evidence on the association and correlation between oral hygiene and pneumonia or respiratory tract infection in elderly people. Mechanical oral hygiene has a preventive effect on mortality from pneumonia, and non-fatal pneumonia in hospitalized elderly people and elderly nursing home residents. Approximately one in 10 cases of death from pneumonia in elderly nursing home residents may be prevented by improving oral hygiene. Future research in this area should be focused on high-quality RCTs with appropriate sample size calculations.

  12. Number needed to treat: solid science or a path to pernicious rationing?

    PubMed

    Black, H R; Crocitto, M T

    1998-08-01

    Basing clinical practice decisions on currently available evidence from clinical trials may result in suboptimal care in the real-world practice of medicine. The problem stems from both the quality of data and the means by which the data have been interpreted. In an attempt to remedy the situation, a term based on an assessment of all risk factors and comorbidity has been suggested and made more easily translatable to clinical decision making. This term, the reciprocal of absolute risk reduction, is the number needed to treat (NNT), an idea that has gained wide acceptance. There are, however, risks that the simplicity of the NNT will be misused to guide reimbursement decisions and potentially prevent patients from receiving optimal care. This seemingly objective measure may be seriously flawed if the data on which this measure is based do not necessarily reflect the results that real world doctors achieve in practice. These problems could lead to the misguided allocation of health care resources. It is therefore incumbent upon us to closely evaluate the data on which NNTs are based and, if necessary, to arrive at more accurate NNTs. In our view, such data should be gleaned from effectiveness trials done by real world doctors in real world settings with real world volunteers. Large simple trials, as have already been performed in a number of therapeutic areas, especially for acute management of myocardial infarction and in acquired immune deficiency syndrome, offer the best likelihood of yielding this crucial information. We need to be sure that future trials of chronic conditions such as hypertension are done with this trial paradigm, so that those who pay for care have the accurate knowledge needed to spend their money wisely.

  13. Hormone therapy and radiotherapy for early prostate cancer: A utility-adjusted number needed to treat (NNT) analysis

    SciTech Connect

    Jani, Ashesh B.; Kao, Johnny; Heimann, Ruth; Hellman, Samuel . E-mail: s-hellman@uchicago.edu

    2005-03-01

    Purpose: To quantify, using the number needed to treat (NNT) methodology, the benefit of short-term ({<=}6 months) hormone therapy adjuvant to radiotherapy in the group of patients with early (clinical stage T1-T2c) prostate cancer. Methods and materials: The absolute biochemical control benefit for the use of hormones adjuvant to radiotherapy in early-stage disease was determined by literature review. A model was developed to estimate the utility-adjusted survival detriment due to the side effects of hormone therapy. The NNTs before and after the incorporation of hormone sequelae were computed; the sign and magnitude of the NNTs were used to gauge the effect of the hormones. Results: The absolute NNT analysis, based on summarizing the results of 8 reports including a total of 3652 patients, demonstrated an advantage to the addition of hormones for the general early-stage prostate cancer population as well as for all prognostic groups. After adjustment for hormone-induced functional loss, the advantage of hormones remained considerable in the high- and intermediate-risk groups, with the utility-adjusted NNT becoming weakened in the low-risk group when the utility compromise from complications of hormones was assumed to be considerable. Conclusions: Short-term hormone therapy seems to be beneficial for selected early-stage prostate cancer patients. The advantage seems to be greatest in the intermediate- and high-risk groups; with current follow-up, the side effects of hormones may outweigh their benefit in certain clinical situations in the favorable group. The present investigation demonstrates the significant role of the NNT technique for oncologic and radiotherapeutic management decisions when treatment complications need to be considered and balanced with the beneficial effects of the treatment.

  14. Ibuprofen with or without an antiemetic for acute migraine headaches in adults

    PubMed Central

    Rabbie, Roy; Derry, Sheena; Moore, R Andrew; McQuay, Henry J

    2014-01-01

    Background Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers do not seek professional help, relying instead on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce symptoms commonly associated with migraine headaches. Objectives To determine efficacy and tolerability of ibuprofen, alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies through 22 April 2010. Selection criteria We included randomised, double-blind, placebo- or active-controlled studies using self-administered ibuprofen to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and number needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment. Main results Nine studies (4373 participants, 5223 attacks) compared ibuprofen with placebo or other active comparators; none combined ibuprofen with a self-administered antiemetic. All studies treated attacks with single doses of medication. For ibuprofen 400 mg versus placebo, NNTs for 2-hour pain-free (26% versus 12% with placebo), 2-hour headache relief (57% versus 25%) and 24-hour sustained headache relief (45% versus 19%) were 7.2, 3.2 and 4.0, respectively. For ibuprofen 200 mg versus placebo, NNTs for 2-hour pain-free (20% versus 10%) and 2-hour headache relief (52% versus 37%) were 9.7 and 6.3, respectively. The higher dose was significantly better for 2-hour headache relief than the lower dose. Soluble formulations of ibuprofen 400 mg were better than standard tablets for 1-hour, but not 2-hour headache relief

  15. Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations

    PubMed Central

    Finnerup, Nanna B; Attal, Nadine; Haroutounian, Simon; McNicol, Ewan; Baron, Ralf; Dworkin, Robert H; Gilron, Ian; Haanpaa, Maija; Hansson, Per; Jensen, Troels S; Kamerman, Peter R; Lund, Karen; Moore, Andrew; Raja, Srinivasa N; Rice, Andrew SC; Rowbotham, Michael; Sena, Emily; Siddall, Philip; Smith, Blair H; Wallace, Mark

    2015-01-01

    Summary Background Neuropathic pain is difficult to treat. New treatments, clinical trials and standards of quality for assessing evidence justify an update of evidence-based recommendations for its pharmacological treatment. Methods The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain conducted a systematic review of randomised double-blind studies of oral and topical pharmacotherapy for neuropathic pain, including unpublished trials (retrieved from clinicaltrials.gov and pharmaceutical websites). Meta-analysis used Numbers Needed to Treat (NNT) for 50 % pain relief as primary measure and assessed publication bias. Recommendations used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Findings In total 229 studies were included. Analysis of publication bias suggested a 10% overstatement of treatment effects. Studies published in peer-review journals reported greater effects than online studies (R2=9·3%, p<0·01). Trial outcomes were generally modest even for effective drugs : in particular NNTs were 3·6 (95 % CI 3·0–4·4) for tricyclic antidepressants (TCAs), 6·4 (95 % CI 5·2–8·4) for serotonin- noradrenaline reuptake inbibitor (SNRI) antidepressants duloxetine and venlafaxine, 7·7 (95 % CI 6·5–9·4) for pregabalin and 6·3 (95 % CI 5·0–8·3) for gabapentin. NNTs were higher for gabapentin ER/enacarbil and capsaicin high concentration patches, lower for opioids and botulinum toxin A (BTX-A) and undetermined for lidocaine patches. Final quality of evidence was lower for lidocaine patches and BTX-A. Tolerability/safety and values/preferences were high for lidocaine patches and lower for opioids and TCAs. This permitted a strong GRADE recommendation for use and proposal as first line for TCAs, SNRIs, pregabalin, gabapentin and gabapentin ER/enacarbil in neuropathic pain, a weak recommendation for use and proposal as second line for lidocaine patches, capsaicin

  16. Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis.

    PubMed

    Cusack, Karen; Jonas, Daniel E; Forneris, Catherine A; Wines, Candi; Sonis, Jeffrey; Middleton, Jennifer Cook; Feltner, Cynthia; Brownley, Kimberly A; Olmsted, Kristine Rae; Greenblatt, Amy; Weil, Amy; Gaynes, Bradley N

    2016-02-01

    Numerous guidelines have been developed over the past decade regarding treatments for Posttraumatic stress disorder (PTSD). However, given differences in guideline recommendations, some uncertainty exists regarding the selection of effective PTSD therapies. The current manuscript assessed the efficacy, comparative effectiveness, and adverse effects of psychological treatments for adults with PTSD. We searched MEDLINE, Cochrane Library, PILOTS, Embase, CINAHL, PsycINFO, and the Web of Science. Two reviewers independently selected trials. Two reviewers assessed risk of bias and graded strength of evidence (SOE). We included 64 trials; patients generally had severe PTSD. Evidence supports efficacy of exposure therapy (high SOE) including the manualized version Prolonged Exposure (PE); cognitive therapy (CT), cognitive processing therapy (CPT), cognitive behavioral therapy (CBT)-mixed therapies (moderate SOE); eye movement desensitization and reprocessing (EMDR) and narrative exposure therapy (low-moderate SOE). Effect sizes for reducing PTSD symptoms were large (e.g., Cohen's d ~-1.0 or more compared with controls). Numbers needed to treat (NNTs) were <4 to achieve loss of PTSD diagnosis for exposure therapy, CPT, CT, CBT-mixed, and EMDR. Several psychological treatments are effective for adults with PTSD. Head-to-head evidence was insufficient to determine these treatments' comparative effectiveness, and data regarding adverse events was absent from most studies.

  17. The microcantilever array: a low power, compact, and sensitive unattended ground sensor

    NASA Astrophysics Data System (ADS)

    Adams, J. D.; Rogers, B.; Whitten, R.

    2005-05-01

    In an unattended implanted or mobile ground sensor scenario, the microcantilever platform is well suited: sensor power consumption has been demonstrated at the nanowatt level and, as a microelectromechanical system, the platform is inherently compact. In addition, the remarkable sensitivity, low cost, scalability, and versatility of microcantilever sensors make this technology among the most promising solutions for unattended ground sensing of chemical and biological agents, as well as explosives. The University of Nevada, Reno, and Nevada Nanotech Systems, Inc (NNTS) are currently developing a microcantilever-based detection system that will measure trace concentrations of explosives, toxic chemicals, and biological agents in air. A baseline sensor unit that includes the sensor array, electronics, power supply and air handling has been designed and preliminary demonstrations of the microcantilever platform have been conducted. The envisioned device would measure about two cubic inches, run on a small watch battery and cost a few hundred dollars. This first design is tailored to shipping container monitoring, but is a broadly applicable device for passive or active monitoring scenarios.

  18. Microcantilever technology for law enforcement and anti-terrorism applications: chemical, biological, and explosive material detection

    NASA Astrophysics Data System (ADS)

    Adams, J. D.; Rogers, B.; Whitten, R.

    2005-05-01

    The remarkable sensitivity, compactness, low cost, low power-consumption, scalability, and versatility of microcantilever sensors make this technology among the most promising solutions for detection of chemical and biological agents, as well as explosives. The University of Nevada, Reno, and Nevada Nanotech Systems, Inc (NNTS) are currently developing a microcantilever-based detection system that will measure trace concentrations of explosives, toxic chemicals, and biological agents in air. A baseline sensor unit design that includes the sensor array, electronics, power supply and air handling has been created and preliminary demonstrations of the microcantilever platform have been conducted. The envisioned device would measure about two cubic inches, run on a small watch battery and cost a few hundred dollars. The device could be operated by untrained law enforcement personnel. Microcantilever-based devices could be used to "sniff out" illegal and/or hazardous chemical and biological agents in high traffic public areas, or be packaged as a compact, low-power system used to monitor cargo in shipping containers. Among the best detectors for such applications at present is the dog, an animal which is expensive, requires significant training and can only be made to work for limited time periods. The public is already accustomed to explosives and metal detection systems in airports and other public venues, making the integration of the proposed device into such security protocols straightforward.

  19. Pharmacotherapy for Pediatric Generalized Anxiety Disorder: A Systematic Evaluation of Efficacy, Safety and Tolerability

    PubMed Central

    Dobson, Eric T.; Strawn, Jeffrey R.

    2016-01-01

    Background Randomized controlled trials consistently support the efficacy of antidepressants in treating youth with generalized anxiety disorder (GAD), although integrated examinations of efficacy, safety, and tolerability of psychotropic medications in GAD specifically are rare. With this in mind, we sought to describe the efficacy, safety and tolerability of psychopharmacologic interventions in youth with GAD. Methods Randomized, double-blind, placebo-controlled, prospective trials of psychopharmacologic interventions in youth with GAD were identified through a PubMed/Medline (1966–2015) search. Both authors manually reviewed trials and, to evaluate comparative efficacy and tolerability across medications, numbers needed to treat (NNT) (based on Pediatric Anxiety Rating Scale (PARS) remission criteria (PARS ≤8 [1]), and number needed to harm (NNH) for selected treatment-emergent adverse events (TEAEs) were calculated. Finally, treatment-emergent suicidality and taper-emergent/post-study adverse events are reported descriptively. Results Five trials that involved 1,186 patients and evaluated four medications were reviewed and efficacy data were extracted with regard to dimensional measures of anxiety. SSRI/SNRIs demonstrated efficacy in the reduction of anxiety symptoms with NNTs ranging from 2.8 to 9.3. TEAEs varied considerably between studies but tended to be mild and generally did not lead to discontinuation. Conclusions Data from five trials of SSRI/SNRI in youth with GAD, many of whom had co-occurring separation and social anxiety disorders, suggest superiority to placebo and favorable tolerability profiles. PMID:26660158

  20. NMR and NQR study of Si-doped (6,0) zigzag single-walled aluminum nitride nanotube as n or P-semiconductors.

    PubMed

    Baei, Mohammad T; Peyghan, Ali Ahmadi; Tavakoli, Khadijeh; Babaheydari, Ali Kazemi; Moghimi, Masoumeh

    2012-09-01

    Density functional theory (DFT) calculations were performed to investigate the electronic structure properties of pristine and Si-doped aluminum nitride nanotubes as n or P-semiconductors at the B3LYP/6-31G* level of theory in order to evaluate the influence of Si-doped in the (6,0) zigzag AlNNTs. We extended the DFT calculation to predict the electronic structure properties of Si-doped aluminum nitride nanotubes, which are very important for production of solid-state devices and other applications. To this aim, pristine and Si-doped AlNNT structures in two models (Si(N) and Si(Al)) were optimized, and then the electronic properties, the isotropic (CS(I)) and anisotropic (CS(A)) chemical shielding parameters for the sites of various (27)Al and (14)N atoms, NQR parameters for the sites of various of (27)Al and (14)N atoms, and quantum molecular descriptors were calculated in the optimized structures. The optimized structures, the electronic properties, NMR and NQR parameters, and quantum molecular descriptors for the Si(N) and Si(Al) models show that the Si(N) model is a more reactive material than the pristine or Si(Al) model.

  1. A conservative method of testing whether combination analgesics produce additive or synergistic effects using evidence from acute pain and migraine.

    PubMed

    Moore, R A; Derry, C J; Derry, S; Straube, S; McQuay, H J

    2012-04-01

    Fixed-dose combination analgesics are used widely, and available both on prescription and over-the-counter. Combination drugs should provide more analgesia than with any single drug in the combination, but there is no evidence in humans about whether oral combinations have just additive effects, or are synergistic or even subadditive. We suggest that the measured result for the combination would be the summation of the absolute benefit increase (effect of active drug minus effect of placebo) of each component of a combination if effects were (merely) additive, and greater than the sum of the absolute benefits if they were synergistic. We tested measured effects of combination analgesics against the sum of the absolute benefits in acute pain and migraine using meta-analysis where individual components and combinations were tested against placebo in the same trials, and verified the result with meta-analyses where individual components and combinations were tested against placebo in different trials. Results showed that expected numbers needed to treat (NNT) for additive effects were generally within the 95% confidence interval of measured NNTs. This was true for combinations of paracetamol plus ibuprofen and paracetamol plus opioids in acute pain, and naproxen plus sumatriptan in migraine, but not where efficacy was very low or very high, nor combinations of paracetamol plus dextropropoxyphene. There was no evidence of synergy, defined as supra-additive effects.

  2. Providing additional information about the benefits of statins in a leaflet for patients with coronary heart disease: a qualitative study of the impact on attitudes and beliefs

    PubMed Central

    Dickinson, Rebecca; Raynor, David K; MacDonald, Jan

    2016-01-01

    Objective To explore the impact of providing additional information about the potential benefits of simvastatin in a patient leaflet on attitudes and beliefs. Design Interview-based study using a generic qualitative approach and framework analysis. Participants 21 participants receiving a prescription for simvastatin were recruited from a general practitioner practice (from a total of 120). 8 participants were women; the age range was 55–92. Intervention Participants were provided with leaflets showing one of 3 types of additional benefit information: (1) textual statement, (2) number needed to treat (NNT) or (3) natural frequency. Semistructured interviews explored patient's attitudes and beliefs. Results A descriptive narrative of preferences for format suggested patients prefer textual as opposed to numerical benefit information. Significant barriers to the acceptance of numerical benefit information included difficulty in understanding the numbers. Patients overestimated the benefits of statins and expressed surprise at the numerical information. Conclusions Textual information was preferred but numerical information, in particular in the form of a natural frequency, may help patients make judgements about their medicines. NNTs were found to be very difficult to understand. This raises the prospect that some patients might reject medicines because of disappointment with the perceived low benefits of their medicines. The self-reported impact on behaviour appeared minimal with reports of intentions to ‘do what the doctor tells me’. Further research is needed to explore the impact of such statements on people who are yet to be prescribed a statin. PMID:27913558

  3. Electric field effect on (6,0) zigzag single-walled aluminum nitride nanotube.

    PubMed

    Baei, Mohammad T; Peyghan, Ali Ahmadi; Moghimi, Masoumeh

    2012-09-01

    Structural, electronic, and electrical responses of the H-capped (6,0) zigzag single-walled aluminum nitride nanotube was studied under the parallel and transverse electric fields with strengths 0-140 × 10(-4) a.u. by using density functional calculations. Geometry optimizations were carried out at the B3LYP/6-31G* level of theory using a locally modified version of the GAMESS electronic structure program. The dipole moments, atomic charge variations, and total energy of the (6,0) zigzag AlNNT show increases with increase in the applied external electric field strengths. The length, tip diameters, electronic spatial extent, and molecular volume of the nanotube do not significantly change with increasing electric field strength. The energy gap of the nanotube decreases with increases of the electric field strength and its reactivity is increased. Increase of the ionization potential, electron affinity, chemical potential, electrophilicity, and HOMO and LUMO in the nanotube with increase of the applied parallel electric field strengths shows that the parallel field has a much stronger interaction with the nanotube with respect to the transverse electric field strengths. Analysis of the parameters indicates that the properties of AlNNTs can be controlled by the proper external electric field.

  4. First-principles study of nanotubes within the tetragonal, hexagonal and dodecagonal cycle structures

    NASA Astrophysics Data System (ADS)

    BabaeiPour, M.; Safari, E. Keshavarz; Shokri, A. A.

    2017-02-01

    A systematic study has been done on the structural and electronic properties of carbon, boron nitride and aluminum nitride nanotubes with structure consisting of periodically distributed tetragonal (T ≡A2X2), hexagonal (H ≡A3X3) and dodecagonal (D ≡A6X6) (AX=C2, BN, AlN) cycles. The method has been performed using first-principles calculations based on density functional theory (DFT). The optimized lattice parameters, density of state (DOS) curves and band structure of THD-NTs are obtained for (3, 0) and (0, 2) types. Our calculation results indicate that carbon nanotubes of these types (THD-CNTs) behave as a metallic, but the boron nitride nanotubes (THD-BNNTs) (with a band gap of around 4 eV) as well as aluminum nitride nanotubes (THD-AlNNTs) (with a band gap of around 2.6 eV) behave as an semiconductor. The inequality in number of atoms in different directions is affected on structures and diameters of nanotubes and their walls curvature.

  5. Linaclotide: Promising IBS-C Efficacy in an Era of Provisional Study Endpoints

    PubMed Central

    Sayuk, Gregory S.

    2013-01-01

    Recent disappointing developments in the pharmacotherapy of irritable bowel syndrome (IBS) have not dampened the enthusiasm surrounding linaclotide, a novel guanylate cyclase-C agonist for the management of constipation-predominant IBS (IBS-C). Two recent phase 3 studies reporting on a single, daily dose of linaclotide are presented in this issue of the American Journal of Gastroenterology. Importantly, these studies are the first to examine a provisional Food and Drug Administration (FDA) combined response endpoint for IBS-C, which mandates improvements of both abdominal pain and defecatory symptoms. Potential limitations of this FDA endpoint relate to a lack of inclusion of other potentially important IBS symptoms and an inability to directly compare findings with other recent IBS-C trials. Both studies successfully reached this endpoint in approximately one-third of study subjects, resulting in numbers needed to treat (NNT) of five to eight, to achieve an FDA responder. Individual symptom responses to linaclotide were seen in nearly 50% of participants, and potential explanations for these discrepancies when compared with the FDA endpoint are offered. Adequate relief measures also were assessed and, with NNTs of 3.4–6.8, compared favorably with other contemporary IBS-C studies. Overall, both linaclotide trials found the medication to be safe in terms of serious adverse events, though the secretagogue mechanism of action led to diarrhea in approximately one in five subjects. Together, these studies inspire several other important questions regarding linaclotide, including its role in the management of IBS-C relative to existing treatment options, such as lubiprostone. Greater clinical use of linaclotide will reveal whether the observed responses measured with the FDA provisional endpoint will translate into real-world experiences of improvement in IBS patients. “ In seeking absolute truth we aim at the unattainable and must be content with broken portions

  6. Experimental reconstruction of historical WBC measuring procedure in 1986.

    PubMed

    Vasynenko, V V; Ivanova, O M; Lytvynets, L O; Pikta, V O; Zadorozhna, G M; Chepurnyi, M I; Likhtariov, I A

    2016-12-01

    Metoiu doslidzhennia ie eksperymental'ne vidnovlennia protsedury provedennia LVL vymiriuvan' 1986 roku ta otsinka ïkh minimal'no detektovanoï aktyvnosti.Materialy i metody. Doslidzhennia buly provedeni na gamma radiometri SRP 68 01 zi stsyntyliatsiy̆nym detekto rom na osnovi krystalu NaI(Tl) ∅ 30 x 25 mm2 ta odnokanal'nomu spektrometri NC 482 VM (firmy Bicron) zi stsyntyliatsiy̆nym detektorom na osnovi krystalu NaI(Tl) ∅ 52 x 52 mm2. U roboti vykorystano zakhysnu kameru eks pertnogo lichyl'nyka vyprominiuvannia liudyny (LVL), gomogenni fantomy tila liudyny z radioaktyvnym napov niuvachem, rezul'taty LVL vymiriuvan' patsiientiv radiatsiy̆nogo reiestru (RR) NNTsRM, otrymani za dopomogoiu LVL «Skrynner ZM». V roboti vykorystano dozymetrychni ta matematychni metody.Rezul'taty ta vysnovky. Vidnovleno protseduru provedennia LVL vymiriuvan' na pryladakh, iaki vykorystovuva lys' u 1986 rotsi dlia vyznachennia vmistu inkorporovanogo radiotseziiu u naselennia RZT. Za provedenoiu otsinkoiu minimal'no detektovana aktyvnist' LVL vymiriuvan', provedenykh u 1986 rotsi, lezhyt' u mezhakh vid 1,3 kBk · or ganizm 1 (u vypadku zastosuvannia odnokanal'nogo spektrometra NC 482 VM zi stsyntyliatsiy̆nym detektorom na os novi krystalu ∅ 52 x 52 mm2) do 7,4 kBk · organizm 1 (u vypadku zastosuvannia gamma radiometra SRP 68 01 zi stsyntyliatsiy̆nym detektorom na osnovi krystalu NaI(Tl) ∅ 30 x 25 mm2) dlia dorosloï liudyny pry chasi vymiriu vannia 60 s; vid 0,8 kBk · organizm 1 do 5,6 kBk · organizm 1, vidpovidno – dlia pidlitka; ta vid 0,5 kBk · organizm 1 do 3,8 kBk · organizm 1, vidpovidno – dlia dytyny.

  7. Linaclotide: promising IBS-C efficacy in an era of provisional study endpoints.

    PubMed

    Sayuk, Gregory S

    2012-11-01

    Recent disappointing developments in the pharmacotherapy of irritable bowel syndrome (IBS) have not dampened the enthusiasm surrounding linaclotide, a novel guanylate cyclase-C agonist for the management of constipation-predominant IBS (IBS-C). Two recent phase 3 studies reporting on a single, daily dose of linaclotide are presented in this issue of the American Journal of Gastroenterology. Importantly, these studies are the first to examine a provisional Food and Drug Administration (FDA) combined response endpoint for IBS-C, which mandates improvements of both abdominal pain and defecatory symptoms. Potential limitations of this FDA endpoint relate to a lack of inclusion of other potentially important IBS symptoms and an inability to directly compare findings with other recent IBS-C trials. Both studies successfully reached this endpoint in approximately one-third of study subjects, resulting in numbers needed to treat (NNT) of five to eight, to achieve an FDA responder. Individual symptom responses to linaclotide were seen in nearly 50% of participants, and potential explanations for these discrepancies when compared with the FDA endpoint are offered. Adequate relief measures also were assessed and, with NNTs of 3.4-6.8, compared favorably with other contemporary IBS-C studies. Overall, both linaclotide trials found the medication to be safe in terms of serious adverse events, though the secretagogue mechanism of action led to diarrhea in approximately one in five subjects. Together, these studies inspire several other important questions regarding linaclotide, including its role in the management of IBS-C relative to existing treatment options, such as lubiprostone. Greater clinical use of linaclotide will reveal whether the observed responses measured with the FDA provisional endpoint will translate into real-world experiences of improvement in IBS patients.

  8. Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults.

    PubMed

    Moore, Raeanne C; Depp, Colin A; Wetherell, Julie Loebach; Lenze, Eric J

    2016-04-01

    As mobile data capture tools for patient-reported outcomes proliferate in clinical research, a key dimension of measure performance is sensitivity to change. This study compared performance of patient-reported measures of mindfulness, depression, and anxiety symptoms using traditional paper-and-pencil forms versus real-time, ambulatory measurement of symptoms via ecological momentary assessment (EMA). Sixty-seven emotionally distressed older adults completed paper-and-pencil measures of mindfulness, depression, and anxiety along with two weeks of identical items reported during ambulatory monitoring via EMA before and after participation in a randomized trial of Mindfulness-Based Stress Reduction (MBSR) or a health education intervention. We calculated effect sizes for these measures across both measurement approaches and estimated the Number-Needed-to-Treat (NNT) in both measurement conditions. Study outcomes greatly differed depending on which measurement method was used. When EMA was used to measure clinical symptoms, older adults who participated in the MBSR intervention had significantly higher mindfulness and significantly lower depression and anxiety than participants in the health education intervention at post-treatment. However, these significant changes in symptoms were not found when outcomes were measured with paper-and-pencil measures. The NNT for mindfulness and depression measures administered through EMA were approximately 25-50% lower than NNTs derived from paper-and-pencil administration. Sensitivity to change in anxiety was similar across administration modes. In conclusion, EMA measures of depression and mindfulness substantially outperformed paper-and-pencil measures with the same items. The additional resources associated with EMA in clinical trials would seem to be offset by its greater sensitivity to detect change in key outcome variables.

  9. The Number Needed to Treat: 25 Years of Trials and Tribulations in Clinical Research

    PubMed Central

    Suissa, Samy

    2015-01-01

    The number needed to treat (NNT) is a simple measure of a treatment’s impact, increasingly reported in randomized trials and observational studies, but often incorrectly calculated in studies involving varying follow-up times. We discuss the NNT in these contexts and illustrate the concept using several published studies. While the computation of the NNT is founded on the cumulative incidence of the outcome, several published studies use simple proportions that do not account for varying follow-up times, or use incidence rates per person-time. We show how these approaches can lead to erroneous values of the NNT and misleading interpretations. For example, a trial of 3,845 very elderly hypertensives randomized to a diuretic or placebo reported a NNT of 94 treated for 2 years to prevent one stroke, though the correct approach results in a NNT of 63. Also, meta-analyses involving trials of differing lengths often report a single NNT, such as the meta-analysis of 22 trials of the anticholinergic tiotropium in chronic obstructive pulmonary disease that reported a NNT of 16 patients “over one year,” even if the trials varied in duration from 3 to 48 months, with the actual NNTs varying widely from 15 to 250. Finally, we describe the value of the NNT in assessing benefit–risk, such as low-dose aspirin use in secondary prevention of mortality assessed against the risk of gastrointestinal bleeding. As the “number needed to treat” becomes increasingly used in the comparative effectiveness and safety of therapies, its accurate estimation and interpretation become crucial to avoid distorting clinical, economic, and public health decisions. PMID:26241223

  10. Single dose oral ibuprofen for acute postoperative pain in adults

    PubMed Central

    Derry, Christopher J; Derry, Sheena; Moore, R Andrew; McQuay, Henry J

    2014-01-01

    frequent with higher doses, with 48% remedicating with 200 mg and 42% with 400 mg. The median time to remedication was 4.7 hours with 200 mg and 5.4 hours with 400 mg. Sensitivity analysis indicated that pain model and ibuprofen formulation may both affect the result, with dental impaction models and soluble ibuprofen salts producing better efficacy estimates. Adverse events were uncommon, and not different from placebo. Authors’ conclusions The very substantial amount of high quality evidence demonstrates that ibuprofen is an effective analgesic in treating postoperative pain. NNTs for 200 mg and 400 mg ibuprofen did not change significantly from the previous review even when a substantial amount of new information was added. New information is provided on remedication. PMID:19588326

  11. Aspirin with or without an antiemetic for acute migraine headaches in adults

    PubMed Central

    Kirthi, Varo; Derry, Sheena; Moore, R Andrew; McQuay, Henry J

    2014-01-01

    Background Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated with migraine headaches. Objectives To determine the efficacy and tolerability of aspirin, alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies through 10 March 2010. Selection criteria We included randomised, double-blind, placebo- or active-controlled studies using aspirin to treat a discrete migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment. Main results Thirteen studies (4222 participants) compared aspirin 900 mg or 1000 mg, alone or in combination with metoclopramide 10 mg, with placebo or other active comparators, mainly sumatriptan 50 mg or 100 mg. For all efficacy outcomes, all active treatments were superior to placebo, with NNTs of 8.1, 4.9 and 6.6 for 2-hour pain-free, 2-hour headache relief, and 24-hour headache relief with aspirin alone versus placebo, and 8.8, 3.3 and 6.2 with aspirin plus metoclopramide versus placebo. Sumatriptan 50 mg did not differ from aspirin alone for 2-hour pain-free and headache relief, while sumatriptan 100 mg was better than the combination of aspirin plus metoclopramide for 2-hour pain-free, but not headache relief; there were no data for 24-hour headache relief. Associated symptoms of nausea, vomiting

  12. Topical NSAIDs for chronic musculoskeletal pain in adults

    PubMed Central

    Derry, Sheena; Moore, R Andrew; Rabbie, Roy

    2014-01-01

    compared a topical NSAID with placebo. Topical NSAIDs were significantly more effective than placebo for reducing pain due to chronic musculoskeletal conditions. The best data were for topical diclofenac in osteoarthritis, where the NNT for at least 50% pain relief over 8 to 12 weeks compared with placebo was 6.4 for the solution, and 11 for the gel formulation. There were too few data of good quality to calculate NNTs for other individual topical NSAIDs compared with placebo. Direct comparison of topical NSAID with an oral NSAID did not show any difference in efficacy. There was an increase in local adverse events (mostly mild skin reactions) with topical NSAIDs compared with placebo or oral NSAIDs, but no increase in serious adverse events. Gastrointestinal adverse events with topical NSAID did not differ from placebo, but were less frequent than with oral NSAIDs. A substantial amount of data from unpublished studies was unavailable. Much of this probably relates to formulations that have never been marketed. Authors’ conclusions Topical NSAIDs can provide good levels of pain relief; topical diclofenac solution is equivalent to that of oral NSAIDs in knee and hand osteoarthritis, but there is no evidence for other chronic painful conditions. Formulation can influence efficacy. The incidence of local adverse events is increased with topical NSAIDs, but gastrointestinal adverse events are reduced compared with oral NSAIDs. PMID:22972108

  13. Gabapentin for chronic neuropathic pain and fibromyalgia in adults

    PubMed Central

    Moore, R Andrew; Wiffen, Philip J; Derry, Sheena; McQuay, Henry J

    2014-01-01

    Background This review updates parts of two earlier Cochrane reviews investigating effects of gabapentin in chronic neuropathic pain (pain due to nerve damage). Antiepileptic drugs are used to manage pain, predominantly for chronic neuropathic pain, especially when the pain is lancinating or burning. Objectives To evaluate the analgesic effectiveness and adverse effects of gabapentin for chronic neuropathic pain management. Search methods We identified randomised trials of gabapentin in acute, chronic or cancer pain from MEDLINE, EMBASE, and CENTRAL. We obtained clinical trial reports and synopses of published and unpublished studies from Internet sources. The date of the most recent search was January 2011. Selection criteria Randomised, double-blind studies reporting the analgesic and adverse effects of gabapentin in neuropathic pain with assessment of pain intensity and/or pain relief, using validated scales. Participants were adults aged 18 and over. Data collection and analysis Two review authors independently extracted data. We calculated numbers needed to treat to benefit (NNTs), concentrating on IMM-PACT (Initiative on Methods, Measurement and Pain Assessment in Clinical Trials) definitions of at least moderate and substantial benefit, and to harm (NNH) for adverse effects and withdrawal. Meta-analysis was undertaken using a fixed-effect model. Main results Twenty-nine studies (3571 participants), studied gabapentin at daily doses of 1200 mg or more in 12 chronic pain conditions; 78% of participants were in studies of postherpetic neuralgia, painful diabetic neuropathy or mixed neuropathic pain. Using the IMMPACT definition of at least moderate benefit, gabapentin was superior to placebo in 14 studies with 2831 participants, 43% improving with gabapentin and 26% with placebo; the NNT was 5.8 (4.8 to 7.2). Using the IMMPACT definition of substantial benefit, gabapentin was superior to placebo in 13 studies with 2627 participants, 31% improving with

  14. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults

    PubMed Central

    Toms, Laurence; McQuay, Henry J; Derry, Sheena; Moore, R Andrew

    2014-01-01

    Background This is an updated version of the original Cochrane review published in Issue 1, 2004 - this original review had been split from a previous title on ‘Single dose paracetamol (acetaminophen) with and without codeine for postoperative pain’. The last version of this review concluded that paracetamol is an effective analgesic for postoperative pain, but additional trials have since been published. This review sought to evaluate the efficacy and safety of paracetamol using current data, and to compare the findings with other analgesics evaluated in the same way. Objectives To assess the efficacy of single dose oral paracetamol for the treatment of acute postoperative pain. Search methods We searched The Cochrane Library, MEDLINE, EMBASE, the Oxford Pain Relief Database and reference lists of articles to update an existing version of the review in July 2008. Selection criteria Randomised, double-blind, placebo-controlled clinical trials of paracetamol for acute postoperative pain in adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Area under the “pain relief versus time” curve was used to derive the proportion of participants with paracetamol or placebo experiencing at least 50% pain relief over four to six hours, using validated equations. Number-needed-to-treat-to-benefit (NNT) was calculated, with 95% confidence intervals (CI). The proportion of participants using rescue analgesia over a specified time period, and time to use, were sought as measures of duration of analgesia. Information on adverse events and withdrawals was also collected. Main results Fifty-one studies, with 5762 participants, were included: 3277 participants were treated with a single oral dose of paracetamol and 2425 with placebo. About half of participants treated with paracetamol at standard doses achieved at least 50% pain relief over four to six hours, compared with about 20% treated with placebo. NNTs for at