It is thus concluded that immunomodulation of metabolic inflammation, rather than an anti-inflammatory intervention aiming at its suppression, may be a more promising strategy to increase thermogenesis for the treatment or prevention of obesity and its associated diseases.”
“Objective: Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended PARP activation effects in comparative

effectiveness reviews (CERs).

Study Design and Setting: The conceptual model and recommendations were developed using a consensus

process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality.

Results: In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions MK-2206 nmr on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions.

Conclusions: Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions

of benefit. SBI-0206965 price Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. (C) 2011 Elsevier Inc. All rights reserved.”
“The objective of this study was to assess the accuracy of blind placement of caudal epidural needles and the usefulness of the radio-contrast epidurogram. The study involves a prospective case series of 147 consecutive patients with radiological assessment of blind needle placement and epidurogram assessing the accuracy of blind needle placement in caudal epidurals. When the surgical miss rate (26%) and failure of flow of the therapeutic agents (6%) are combined, it can be deduced that up to 32% of non-radiologically guided caudal epidurals may fail to deliver the therapeutic agents to the site of pathology. There was no significant difference in the accuracy of needle placement in adequately trained and experienced middle grade surgeons when compared with consultant surgeons performing these procedures regularly.