A total of 105 patients with post-traumatic stress disorder (PTSD) were randomly allocated to eye-movement desensitization and reprocessing (EMDR) .n = 39/ versus exposure plus cognitive restructuring (E Y CR) (n = 37) versus waiting list (WL) (n = 29) in a primary care setting. EMDR and E Y CR patients received a maximum of 10 treatment sessions over a 10-week period. All patients were assessed by blind raters prior to randomization and at end of the 10-week treatment or waiting list period. EMDR and E Y CR patients were also assessed by therapists at the mid-point of the 10-week treatment period and on average at 15 months follow-up. Patients were assessed on a variety of assessor-rated and self-report measures of PTSD symptomatology including the Clinician Administered PTSD Scale (CAPS), the Impact of Events Scale (IOE) and a self-report version of the SI-PTSD Checklist. Measures of anxiety and depression included the Montgomery Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Scale (HAM-A) and the Hospital Anxiety and Depression Scale (HADS). A measure of social function, the Sheehan Disability Scale was also used. Drop-out rates between the three groups were 12 EMDR, 16 E Y CR and five WL. Treatment end-point analyses were conducted on the remaining 72 patients. Repeated measures analysis of variance of treatment outcome at 10 weeks revealed significant time, interaction and group effects for all the above measures. In general there were significant and substantial
The CAGE can effectively discriminate elderly patients with a history of drinking problems from those without such a history. The chosen cut-off score should consider the prevalence of drinking problems in the population being tested.
Objective To compare the effectiveness of carbetocin and oxytocin when they are administered after caesarean section for prevention of postpartum haemorrhage (PPH).Study design Double-blind randomised single centre study (1:1 ratio).Setting Teaching hospital in Bristol, UK with 6000 deliveries per annum.Population Women at term undergoing elective or emergency caesarean section under regional anaesthesia, excluding women with placenta praevia, multiple gestation and placental abruption.Methods Women were randomised to receive either carbetocin 100 lg or oxytocin 5 IU intravenously after the delivery of the baby. Perioperative care was otherwise normal and use of additional oxytocics was at the discretion of the operating obstetrician. Analysis was by intention to treat.Primary outcome measure The proportion of women in each arm of the trial that needed additional pharmacological oxytocic interventions.Results Significantly more women needed additional oxytocics in the oxytocin group (45.5% versus 33.5%, Relative risk 0.74, 95% CI 0.57-0.95). The majority of women had oxytocin infusions. There were no significant differences in the secondary outcomes, including major PPH, blood transfusions and fall in haemoglobin.Conclusions Carbetocin is associated with a reduced use of additional oxytocics. It is unclear whether this may reduce rates of PPH and blood transfusions.
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