No abstract

No. 102 Uterine artery embolization followed by elective myomectomy for the treatment of intracavitary fibroids: preliminary experience

Purpose: Uterine fibroid embolization (UFE) is associated with post-procedural pain and nausea. In this double-blind randomized controlled study, we compared pre-procedure intravenous (IV) acetaminophen/ibuprofen to postprocedure IV ketorolac in UFE patients. Methods:After institutional review board approval, UFE candidates 21-60 years old were screened and randomly assigned to one of four arms: acetaminophen (1 g), ibuprofen (800 mg), acetaminophen (1 g) and ibuprofen (800 mg) combined, and an active comparator, ketorolac (30 mg). All received rescue patient-controlled hydromorphone for 24 h post-procedure. Primary outcome was measurement of pain intensity (visual analog scale: VAS) between the acetaminophen/ibuprofen group and the ketorolac group. The secondary outcomes were opioid and anti-emetic requirements and nausea intensity (VAS).Results: 40 subjects were analysed: acetaminophen/ ibuprofen (N=16); acetaminophen (N=4); ibuprofen (N=4); ketorolac (N=16). The maximum and mean VAS scores for pain were not different between the acetaminophen/ ibuprofen group and the ketorolac group without adjusting for opioid consumption (p=0. 243 and p=0.208, respectively). Total opioid consumption in morphine equivalents (mean [±SE]) was 28.09 mg (±4.58) in the acetaminophen/ibuprofen group and 40.33 mg (±7.79) in the ketorolac group (p=0.087), demonstrating a trend favouring the acetaminophen/ibuprofen group. The mean and maximum nausea scores showed a trend and significant difference (p=0.095 and p=0.003), respectively, favouring the ketorolac group. Conclusion:IV acetaminophen/ibuprofen demonstrated comparable pain control, although there was less opioid requirement for the acetaminophen/ibuprofen group compared to the ketorolac group. Maximum nausea scores were significantly increased with similar ondansetron requirements. Therefore, antiemetic prophylaxis is needed regardless of group.

Purpose: The purpose of this study is to determine if computer-based videos successfully educate patients on a whole food, plant-based diet (WFPBD) during clinic wait time. We recognize the importance of nutrition in disease prevention and treatment, particularly for diabetes, obesity, hypertension, and vascular disease. We investigated the effectiveness of this model in increasing patient knowledge and confidence about diet. Methods: Subjects (n = 77) were recruited at a radiology clinic. A 19-question survey was administered using an iPad. Patients completed the survey before and after watching a 5-minute computer-based video about the beneficial health effects of WFPBD. To assess knowledge, patients’ responses to the survey’s 10 knowledge-based (KB) questions were scored on a dichotomous incorrect/correct scale. To assess confidence in their knowledge, patients’ responses to the survey’s 9 confidence-based (CB) questions were scored on a Likert scale from 1 (strongly disagree) to 5 (strongly agree). Two paired difference scores (knowledge and confidence) were calculated and independently analyzed using a Related-Samples Wilcoxon Signed Rank Test. A Stepwise Linear Regression was used to investigate which survey questions were most educational. Results: The Related-Samples Wilcoxon Signed Rank Test showed a statistically significant improvement in both patients’ knowledge and confidence in their knowledge of nutrition. Patients scored significantly higher on KB survey questions (p < 0.001) and CB survey questions (p < 0.001) post-video. Stepwise Linear Regression showed that the most educational survey questions included information on fiber, plant-based foods, and saturated fats. Conclusion: Our findings indicate that providing patients with a computer-based educational video during clinic wait time significantly increases patient knowledge on the benefits of a WFPBD. Future studies can test a larger sample of patients and gauge the longevity of knowledge gained. Disclosure K. Cole: None. D. Wenger: None. A. Guha: None. C. Yarosh: None. C. Hoffman: None. Funding University of California, Los Angeles

Purpose: The purpose of this study is to determine if computer-based videos can successfully educate patients about the health benefits of a whole-food, plant-based diet (WFPBD) during the clinic wait time. As physicians, we recognize the importance of nutrition in disease prevention and treatment. Therefore, we investigated the effectiveness of a video-based educational model in increasing patient knowledge and confidence regarding diet. Methods: Subjects (n = 77) were recruited from an outpatient clinic. An electronic survey was developed and administered to patients before and after watching a 5-minute educational computer-based video about the beneficial health effects of WFPBD. Responses to the survey’s 10 knowledge-based (KB) questions were scoredon a dichotomous incorrect/correct scale, and the survey’s 9 confidence-based (CB) questions were scored on a likert scale from 1 (strongly disagree) to 5 (strongly agree). Paired pre- to post-video intervention difference scores (knowledge and confidence) were calculated for each patient and independently analyzed using a related-samples Wilcoxon signed rank test. one-way ANoVA tests were used to investigate survey questions demonstrating the greatest improvement post-video intervention. Results: Statistically significant improvements in patient knowledge and confidence in their knowledge of nutrition after watching the brief educational video on nutrition were found. Patients scored significantly higher post-video intervention than pre-video intervention on KB survey questions (z = 5.748; P< .001) and CB survey questions (z= 6.605; P< .001). Statistical significance remained across all self-reported chronic condition groups, except for obesity (oB) and atherosclerosis (AS) groups for total knowledge and AS group for total confidence. one-way ANoVA tests confirmed that self-reported chronic conditions did not significantly predict baseline (pre-intervention) total KB or CB scores. The exploratory question-specific analysis demonstrated that the survey questions regarding average daily fiber consumption (P< 0.001) and the association of saturated fats with chronic disease (P= 0.001) were the most significant predictors of the increase in patient knowledge post-intervention. Conclusion: our findings indicate that providing patients with a short computerbased educational video during clinic wait time can significantly increase patient knowledge on the health benefits of a WFPBD. Future studies can test the model on a larger, more varied sample of patients and gauge the longevity of the knowledge gained from this educational model.