Case series and exposure series: the role of studies without controls in providing information about the etiology of injury or disease

Cummings, Peter; Weiss, Noel S.

doi:10.1136/ip.4.1.54

Cited by 23 publications

(9 citation statements)

References 19 publications

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“…However, while some have argued that under certain circumstances benefit can be obtained from the careful, conservative evaluation of studies without controls (Cummings & Weiss, 1998), a controlled clinical trial is still imperative before a confident interpretation of these results can be made. This research utilized a naturalistic design where participants applied to be included in the course.…”

Section: Discussionmentioning

confidence: 99%

The psychological effects of a lifestyle management course on war veterans and their spouses

Devilly

2002

J Clin Psychol

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This research assessed the effect on a war-veteran outpatient group in a week-long residential lifestyle-management course. This course also included the veterans' partners, and all participants were assessed at intake, postintervention, and at three-and six-month follow-ups. In summary, it was found that while there was a statistically significant drop in PTSD symptomatology for the veterans, the clinical utility of this improvement was minimal, with an estimated effect size of d ϭ 0.19 by six-month follow-up. However, the veterans displayed a significant decrease in measures of depression, anxiety, and stress by six-month follow-up, all with small-tomoderate effect sizes. Likewise, ratings of anger showed statistically significant improvement with a moderate effect size. While dyadic adjustment displayed a significant improvement to six-month follow-up, the derived effect size was small for the veterans. The spouses (all females in this study) displayed larger effect sizes on all measures, with the exception of ratings of anger, where a small effect was noted. Subjective quality-of-life indices displayed a significant change in the desired direction, although with a minimal effect for the veterans and a small effect size for the females. It was not feasible to have a control group during this naturalistic investigation and, therefore, caution is advised in over-generalizing from these data. However, these results warrant further 'controlled' investigation into the inclusion of spouses in the treatment of veterans and the utility of lifestyle-management courses as a first step in the treatment of trauma related problems that have become chronic in nature within the veteran community.

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Section: Discussionmentioning

confidence: 99%

The psychological effects of a lifestyle management course on war veterans and their spouses

Devilly

2002

J Clin Psychol

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“…20 Furthermore, identified as exposure series observation (exposure = CSFK), its favorable final outcome is valid: only 8.6% with mild renal injury, none had proteinuria, hypertension, and growth-retardation. 21 One cannot ignore the effect of the intervention.…”

Section: Discussionmentioning

confidence: 99%

Dietary Therapy for Children With Congenital Solitary Functioning Kidney

Katzir

Biro

Cernes

et al. 2015

ICAN: Infant, Child, & Adolescent Nutrition

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Background. Renal injury, proteinuria, and hypertension, are consequences of congenital solitary functioning kidney (CSFK). Renal injury appears around 10 years of age and requires dialysis by the age of 30 years. Low protein intake attenuated renal damage in animal experimental models, uninephrectomized patients, and kidney transplant donors and recipients. Low salt intake facilitates blood pressure control. Objective. Relevant data concerning CSFK patients have not been described so far. We decided to examine long-term preventing effects of protein restriction and low-salt diet on proteinuria, kidney function, and hypertension, in this distinct polulation. Methods. Twenty-eight children with CSFK were included in a prospective observational exposure series. Following parents’ agreement, protein and salt restriction—0.85 × recommended daily allowance (RDA)—was started under dietitian supervision. Compliance verification was performed by (a) monitoring urinary urea nitrogen and body weight, (b) measuring 24-hour urine sodium. Follow-up (8-22 years, mean 15.8 years) included clinical, growth and developmental assessment, renal function, and urine protein excretion. Results. Baseline data showed normal physical assessment, arterial blood pressure kidney functions, and urinalysis. One patient had ipsilateral kidney malformation and 2 patients had systemic pathologies. Adherence to dietary restrictions: 89 ± 8% for protein and 93 ± 5% salt. At the end of follow-up, 2 patients had chronic kidney disease grade I. None had hypertension, proteinuria, or growth and development deterioration. Conclusion. Strict follow-up and controlled dietary supervision for mild protein and salt restriction prevent kidney injury proteinuria and hypertension in CSFK, without insults on growth and development.

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“…Emergency ascent then followed as the most common disabling agent, in 55% of 332 deaths where the disabling agent could be identified [119]. Factors involved in cases of DCI reported to BSAC between 1998 and 2008 are listed in table 10 (note, more than one factor may have been attributed to each case) [120]. Although diving to >30 m appeared over the period to be decreasing in prevalence as a risk factor, 27% of cases of DCI in the UK primarily involved rapid ascents, only a fifth (20%) involved dives within the accepted recreational time-depth limits and a sixth (16%) involved exceeding those limits and missing the required decompression stops.…”

Section: What Are the Inciting Events?mentioning

confidence: 99%

The Epidemiology of Injury in Scuba Diving

Buzzacott

2012

Medicine and Sport Science

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The epidemiology of injury associated with recreational scuba diving is reviewed. A search of electronic databases and reference lists identified pertinent research. Barotrauma, decompression sickness and drowning-related injuries were the most common morbidities associated with recreational scuba diving. The prevalence of incidents ranged from 7 to 35 injuries per 10,000 divers and from 5 to 152 injuries per 100,000 dives. Recreational scuba diving fatalities account for 0.013% of all-cause mortality aged ≥ 15 years. Drowning was the most common cause of death. Among treated injuries, recovery was complete in the majority of cases. Dive injuries were associated with diver-specific factors such as insufficient training and preexisting medical conditions. Environmental factors included air temperature and flying after diving. Dive-specific factors included loss of buoyancy control, rapid ascent and repetitive deep diving. The most common event to precede drowning was running out of gas (compressed air). Though diving injuries are relatively rare prospective, longitudinal studies are needed to quantify the effects of known risk factors and, indeed, asymptomatic injuries (e.g. brain lesions). Dive injury health economics data also remains wanting. Meanwhile, health promotion initiatives should continue to reinforce adherence to established safe diving practices such as observing depth/time limits, safety stops and conservative ascent rates. However, there is an obvious lack of evaluated diving safety interventions.

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Case series and exposure series: the role of studies without controls in providing information about the etiology of injury or disease

Cited by 23 publications

References 19 publications

The psychological effects of a lifestyle management course on war veterans and their spouses

The psychological effects of a lifestyle management course on war veterans and their spouses

Dietary Therapy for Children With Congenital Solitary Functioning Kidney

The Epidemiology of Injury in Scuba Diving

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