Difference between revisions of "Boyle"
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| − | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:"><span style="color:black">Some poor evidence of improvement in measures of cognition in dementia patients with a combination of hyperbaric oxygen and acetazolamide</span></span></span>'''</span> |
| − | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical Bottom Line</span></span></span>'''</span> |
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| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">1. Some improvement in cognition following combined treatment with acetazolamide and hyperbaric oxygen which trended back to starting values over 8 weeks.<br/> 2. True impacts of either agent difficult to define.</span></span>'''</span> |
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| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1.Boyle E, Aparico A, Canosa F, Owen D, Dash HH. Hyperbaric oxygen and acetazolamide in the treatment of senile cognitive functions. In: Trapp WG, Bannister EW, Davison AJ, Trapp PA, eds. Proceedings of the Fifth International Hyperbaric Conference. Burnaby, Canada: Simon Fraser University, 1974:432-438<br/> '''Lead author's name and fax: '''Boyle. Miami Heart Institute Research Division, Miami Beach, Florida</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">For patients with senile dementia, does the application of either hyperbaric oxygen or acetazolomide result in improved cognition.<br/> '''Search Terms:''' Acetazolamide; cognition; dementia</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">The Study:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Non-blinded randomised controlled trial without intention-to-treat.<br/> '''The Study Patients:''' “Aged senile subjects.”<br/> '''Control group''' (N = 21; ? analysed): Breathing 13% oxygen at 3 ATA for 30 minutes to a total of 10 sessions over two weeks.<br/> '''Experimental group''' (N = 30; ? analysed): As above but breathing 100% oxygen at 3 ATA and given acetazolamide 250mg orally for the same 10 day period.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span> |
{| class="Table" style="border:solid windowtext 1.0pt" | {| class="Table" style="border:solid windowtext 1.0pt" | ||
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| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Non-Event Outcomes</span></span>'''</span> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Time to outcome/s</span></span>'''</span></p> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control group</span></span>'''</span></p> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Experimental group</span></span>'''</span></p> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">P-value</span></span>'''</span></p> |
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| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Bender-Gestalt Test</span></span>'''</span> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">8 weeks</span></span></span></p> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">120 to 130</span></span></span></p> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">109 to102</span></span></span></p> |
| style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | ?? | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | ?? | ||
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| style="border:solid windowtext 1.0pt" | | | style="border:solid windowtext 1.0pt" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Weschler Memory Scale</span></span>'''</span> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">8 weeks</span></span></span></p> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">116 to 125</span></span></span></p> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">110 to 115</span></span></span></p> |
| style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | ?? | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | ?? | ||
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| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Reaction time</span></span>'''</span> |
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">8 weeks</span></span></span></p> |
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| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. Old study poorly conducted and reported by modern standards.<br/> 2. Probably an open label study, incomplete randomisation and an undefined number of crossover patients at eight weeks.<br/> 3. Results are not easily interpreted given undisclosed drop-outs and interrupted comparisons.<br/> 4. No details of the meaning of the numerical outcomes</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett, m.bennett@unsw.edu.au ; Saturday, 22 August 2020<br/> '''Kill or Update By:''' August 2025</span></span></span></span> |
| + | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Neuro_-_miscellaneous|BACK]]</span></p> | ||
Latest revision as of 20:18, 21 August 2020
Some poor evidence of improvement in measures of cognition in dementia patients with a combination of hyperbaric oxygen and acetazolamide
Clinical Bottom Line
|
1. Some improvement in cognition following combined treatment with acetazolamide and hyperbaric oxygen which trended back to starting values over 8 weeks. |
Citation/s:1.Boyle E, Aparico A, Canosa F, Owen D, Dash HH. Hyperbaric oxygen and acetazolamide in the treatment of senile cognitive functions. In: Trapp WG, Bannister EW, Davison AJ, Trapp PA, eds. Proceedings of the Fifth International Hyperbaric Conference. Burnaby, Canada: Simon Fraser University, 1974:432-438
Lead author's name and fax: Boyle. Miami Heart Institute Research Division, Miami Beach, Florida
Three-part Clinical Question:For patients with senile dementia, does the application of either hyperbaric oxygen or acetazolomide result in improved cognition.
Search Terms: Acetazolamide; cognition; dementia
The Study:Non-blinded randomised controlled trial without intention-to-treat.
The Study Patients: “Aged senile subjects.”
Control group (N = 21; ? analysed): Breathing 13% oxygen at 3 ATA for 30 minutes to a total of 10 sessions over two weeks.
Experimental group (N = 30; ? analysed): As above but breathing 100% oxygen at 3 ATA and given acetazolamide 250mg orally for the same 10 day period.
The Evidence:
|
Non-Event Outcomes |
Time to outcome/s |
Control group |
Experimental group |
P-value |
|
Bender-Gestalt Test |
8 weeks |
120 to 130 |
109 to102 |
?? |
|
Weschler Memory Scale |
8 weeks |
116 to 125 |
110 to 115 |
?? |
|
Reaction time |
8 weeks |
?? |
Comments:
1. Old study poorly conducted and reported by modern standards.
2. Probably an open label study, incomplete randomisation and an undefined number of crossover patients at eight weeks.
3. Results are not easily interpreted given undisclosed drop-outs and interrupted comparisons.
4. No details of the meaning of the numerical outcomes
Appraised by:Mike Bennett, m.bennett@unsw.edu.au ; Saturday, 22 August 2020
Kill or Update By: August 2025
