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Jafarpour D, El-Amier N, Feine J, Bedos C, Abi-Nader S, Esfandiari S, Shuster T, Zimmermann E, de Souza R. 3D printing vs traditional workflow for the fabrication of mandibular implant overdentures: study protocol for a mixed-methods cross-over RCT. Trials 2024; 25:267. [PMID: 38627819 PMCID: PMC11022432 DOI: 10.1186/s13063-024-08097-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods. METHODS/DESIGN We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs. DISCUSSION This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly. TRIAL REGISTRATION ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic. CLINICALTRIALS gov/ct2/show/NCT06155630.
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Affiliation(s)
- Dana Jafarpour
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Nesma El-Amier
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
- Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Jocelyne Feine
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Christophe Bedos
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Samer Abi-Nader
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Shahrokh Esfandiari
- Faculty of Dental Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Tibor Shuster
- Department of Family Medicine, McGill University, Montreal, Canada
| | - Elizabeth Zimmermann
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Raphael de Souza
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada.
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Lalande E, Clarke H, Undurraga M, Nguyen VQH, Jaksic C, Goffin F, Arbyn M, Jeronimo J, Tille JC, Saiji E, Vassilakos P, Petignat P. Knowledge of cytology results affects the performance of colposcopy: a crossover study. BMC Womens Health 2024; 24:189. [PMID: 38515088 PMCID: PMC10956238 DOI: 10.1186/s12905-024-03025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE To determine whether knowledge of cytology affects the colposcopist's diagnostic accuracy in the identification of cervical intraepithelial neoplasia grade 2 and worse (≥ CIN2). METHOD In this cross-over study, healthcare professionals interpreted colposcopy images from 80 patient cases with known histological diagnoses. For each case, 2 images taken with a colposcope were provided (native and after acetic acid application). Inclusion criteria consisted of women with a transformation zone type 1 or 2, who had both a cytological and histological diagnosis. Cases were distributed across two online surveys, one including and one omitting the cytology. A wash-out period of six weeks between surveys was implemented. Colposcopists were asked to give their diagnosis for each case as < CIN2 or ≥ CIN2 on both assessments. Statistical analysis was conducted to compare the two interpretations. RESULTS Knowledge of cytology significantly improved the sensitivity when interpreting colposcopic images, from 51.1% [95%CI: 39.3 to 62.8] to 63.7% [95%CI: 52.1 to 73.9] and improved the specificity from 63.5% [95%CI: 52.3 to 73.5] to 76.6% [95%CI: 67.2 to 84.0]. Sensitivity was higher by 38.6% when a high-grade cytology (ASC-H, HSIL, AGC) was communicated compared to a low-grade cytology (inflammation, ASC-US, LSIL). Specificity was higher by 31% when a low-grade cytology was communicated compared to a high-grade. CONCLUSIONS Our data suggests that knowledge of cytology increases sensitivity and specificity for diagnosis of ≥ CIN2 lesions at colposcopy. Association between cytology and histology may have contributed to the findings.
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Affiliation(s)
- Eva Lalande
- Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Holly Clarke
- Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
| | - Manuela Undurraga
- Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Vu Quoc Huy Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hué, Vietnam
| | - Cyril Jaksic
- Clinical Research Center, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Frederic Goffin
- Department of Obstetrics and Gynecology, University of Liege, Liege, Belgium
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, University Ghent, Ghent, Belgium
| | | | - Jean-Christophe Tille
- Diagnostic Department, Division of clinical pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Essia Saiji
- Diagnostic Department, Division of clinical pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre Vassilakos
- Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Geneva Foundation for Medical Education and Research, Geneva, Switzerland
| | - Patrick Petignat
- Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
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Razmpoosh E, Safi S, Mazaheri M, Khalesi S, Nazari M, Mirmiran P, Nadjarzadeh A. A crossover randomized controlled trial examining the effects of black seed (Nigella sativa) supplementation on IL-1β, IL-6 and leptin, and insulin parameters in overweight and obese women. BMC Complement Med Ther 2024; 24:22. [PMID: 38178093 PMCID: PMC10768077 DOI: 10.1186/s12906-023-04226-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/17/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Nigella sativa (NS) oil has been found to have advantageous benefits in the management of inflammation and obesity. This study investigated the effect of NS supplementation on blood mRNA expressions and serum levels of IL-1β, IL-6, leptin, and insulin concentrations in overweight/obese women. METHODS In a crossover design, participants were randomized to receive either NS supplements(2000 mg/day) or placebo for 2 durations(8 weeks). With between-subject and within-subject components and interactions, a repeated-measure ANOVA model was used considering the treatment, time, and the carryover effects. Cohen's d(d) was used to measure the magnitude of the effects. RESULTS Forty-six eligible participants were included. NS supplementation significantly reduced the mRNA expressions(d=-0.68, P = 0.03) and serum levels of IL-1β with medium-high effect sizes(d=-1.6, P < 0.001). Significant reductions with large effect sizes were observed in the gene expression and serum levels of IL-6(d=-1.8, d=-0.78, respectively; P < 0.01) and Leptin(d=-1.9, d=-0.89, respectively; P < 0.01, serum leptin P carryover < 0.001). Despite the meaningful carryover effect for serum leptin, results remained significant following the first intervention period analysis(P < 0.001). A significant but low effect size decrease in serum insulin was observed(d=-0.3, P = 0.02). CONCLUSIONS The clinical significance of present findings regarding improvements in obesity-related pro-inflammatory markers must be interpreted with caution due to some observed medium-low effect sizes. TRIAL REGISTRATION IRCT20180430039475N1 (Date:25/6/2018).
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Affiliation(s)
- Elham Razmpoosh
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran
| | - Sara Safi
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran
- Faculty School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahta Mazaheri
- Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Mother and Newborn, Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saman Khalesi
- Appleton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Brisbane, Australia
| | - Majid Nazari
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Nutrition and Clinical Dietetics, Faculty of Nutrition Sciences and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Azadeh Nadjarzadeh
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran.
- Faculty School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Jablonski RY, Coward TJ, Bartlett P, Keeling AJ, Bojke C, Pavitt SH, Nattress BR. IMproving facial PRosthesis construction with contactlESs Scanning and Digital workflow (IMPRESSeD): study protocol for a feasibility crossover randomised controlled trial of digital versus conventional manufacture of facial prostheses in patients with orbital or nasal facial defects. Pilot Feasibility Stud 2023; 9:110. [PMID: 37400919 DOI: 10.1186/s40814-023-01351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Facial prostheses can have a profound impact on patients' appearance, function and quality of life. There has been increasing interest in the digital manufacturing of facial prostheses which may offer many benefits to patients and healthcare services compared with conventional manufacturing processes. Most facial prosthesis research has adopted observational study designs with very few randomised controlled trials (RCTs) documented. There is a clear need for a well-designed RCT to compare the clinical and cost-effectiveness of digitally manufactured facial prostheses versus conventionally manufactured facial prostheses. This study protocol describes the planned conduct of a feasibility RCT which aims to address this knowledge gap and determine whether it is feasible to conduct a future definitive RCT. METHODS The IMPRESSeD study is a multi-centre, 2-arm, crossover, feasibility RCT with early health technology assessment and qualitative research. Up to 30 participants with acquired orbital or nasal defects will be recruited from the Maxillofacial Prosthetic Departments of participating NHS hospitals. All trial participants will receive 2 new facial prostheses manufactured using digital and conventional manufacturing methods. The order of receiving the facial prostheses will be allocated centrally using minimisation. The 2 prostheses will be made in tandem and marked with a colour label to mask the manufacturing method to the participants. Participants will be reviewed 4 weeks following the delivery of the first prosthesis and 4 weeks following the delivery of the second prosthesis. Primary feasibility outcomes include eligibility, recruitment, conversion, and attrition rates. Data will also be collected on patient preference, quality of life and resource use from the healthcare perspective. A qualitative sub-study will evaluate patients' perception, lived experience and preference of the different manufacturing methods. DISCUSSION There is uncertainty regarding the best method of manufacturing facial prostheses in terms of clinical effectiveness, cost-effectiveness and patient acceptability. There is a need for a well-designed RCT to compare digital and conventional manufacturing of facial prostheses to better inform clinical practice. The feasibility study will evaluate key parameters needed to design a definitive trial and will incorporate early health technology assessment and a qualitative sub-study to identify the potential benefits of further research. TRIAL REGISTRATION ISRCTN ISRCTN10516986). Prospectively registered on 08 June 2021, https://www.isrctn.com/ISRCTN10516986 .
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Affiliation(s)
- Rachael Y Jablonski
- Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK.
| | - Trevor J Coward
- Academic Centre of Reconstructive Science, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Paul Bartlett
- Maxillofacial Laboratory, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Andrew J Keeling
- Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Chris Bojke
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Sue H Pavitt
- Dental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, UK
| | - Brian R Nattress
- Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK
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Chen J, Wu Z, Gao H, Li L, Wang Y, Han J, Zhang C, Ding P, Wu J. Association between air temperature and emergency admission for esophagogastric variceal bleeding: a case-crossover study in Beijing, China. BMC Gastroenterol 2023; 23:52. [PMID: 36841754 PMCID: PMC9960463 DOI: 10.1186/s12876-023-02683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/17/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND AND AIMS Studies concerning the impact of air temperature on esophagogastric variceal bleeding (EGVB) have yielded conflicting results. Our study aimed to evaluate the correlation between air temperature and EGVB. METHODS A time-stratified case-crossover study design was performed. Patients received emergency gastroscopic hemostasis for upper gastrointestinal bleeding between Jan 1, 2014, and Dec 31, 2018 in the Fifth Medical Center of PLA General Hospital were enrolled. Conditional logistic regression analysis was applied to determine the association between air temperature and EGVB for different lag structures. RESULTS A total of 4204 cirrhotic patients diagnosed with EGVB and received emergency gastroscopic hemostasis were enrolled. The mean number of daily EGVB cases peaked in October (2.65 ± 1.69) and fell to the lowest level in July (1.86 ± 1.38), and was 2.38 ± 1.58 in spring, 2.00 ± 1.46 in summer, 2.37 ± 1.58 in autumn, and 2.45 ± 1.58 in winter, respectively (P < 0.0001). In conditional logistic regression analysis, no significant correlations between air temperature and EGVB were observed and no significant difference were found when stratified by age, sex, etiology, liver cancer status, and grade of varices. CONCLUSION Emergency admission for EGVB showed significant monthly and seasonal fluctuations, while in conditional logistic regression analysis, no association between minimum temperature and emergency admission for EGVB were observed.
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Affiliation(s)
- Jianhong Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ziting Wu
- grid.11135.370000 0001 2256 9319School of Public Health, Peking University, Beijing, China
| | - Hui Gao
- grid.8658.30000 0001 2234 550XNational Climate Center, China Meteorological Administration, Beijing, China
| | - Li Li
- grid.24696.3f0000 0004 0369 153XDepartment of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yanling Wang
- grid.414252.40000 0004 1761 8894Cirrhosis Diagnosis and Treatment Center, Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Jingjing Han
- grid.414252.40000 0004 1761 8894Cirrhosis Diagnosis and Treatment Center, Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Chuan Zhang
- Department of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
| | - Pengpeng Ding
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Jing Wu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; National Clinical Research Center for Digestive Diseases; Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China.
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Auger N, Bilodeau-Bertrand M, Potter BJ. Halloween and myocardial infarction: A case-crossover study. Arch Cardiovasc Dis 2021; 115:57-59. [PMID: 34955438 DOI: 10.1016/j.acvd.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, H2X 0A9, Montreal, QC, Canada; Institut national de santé publique du Québec, H2P 1E2, Montreal, QC, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, H3N 1X9, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, H3A 1A2, Montreal, QC, Canada.
| | | | - Brian J Potter
- University of Montreal Hospital Research Centre, H2X 0A9, Montreal, QC, Canada; Division of Cardiology, Department of Medicine, University of Montreal, H3T 1J4, Montreal, QC, Canada
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Verma S. Exemption from informed consent: When it is possible in investigational product and drug trials? Saudi J Anaesth 2021; 15:428-430. [PMID: 34658731 PMCID: PMC8477774 DOI: 10.4103/sja.sja_159_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/16/2022] Open
Abstract
One of the most important ethical step in conducting investigational product trials or drug trials is obtaining informed consent from the participants. Although consent from the participants regarding participation is of prime importance but is not always practical or feasible. There may be several instances where it is practically impossible to obtain informed consent, whereas in some cases, obtaining informed consent from the trial participants adversely affects the quality and validity of the study data. Obtaining informed consent is a highly complex and technical process if the participants are not literate or suffering from a terminal illness, Also in some instances obtaining informed consent regarding the washout of prior prescribed medicine which may affect the trial outcomes. Although many guidelines exist for obtaining proper informed consent while very scarce literature exists on the instances where it can be waived off. Therefore, this brief narrative review aims to provide insight into currently available knowledge about when to obtain informed consent during testing of investigational product trials and drug trials and other possible scenarios where it can be waived off considering the effects of the washout period.
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Affiliation(s)
- Swati Verma
- Clinical Research Conduct and Management, UC Berkeley extension, University of California, USA
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Rosa CDDRD, de Souza Leão R, Guerra CMF, Pellizzer EP, Silva Casado BGD, Moraes SLDD. Do ball-type attachment systems for overdenture result in better patient-satisfaction? A systematic review of randomized crossover clinical trial. Saudi Dent J 2021; 33:299-307. [PMID: 34434031 PMCID: PMC8376671 DOI: 10.1016/j.sdentj.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 12/27/2022] Open
Abstract
Objective This review is to compare patient-satisfaction with ball-type overdenture attachment systems with others attachment systems. Material and methods This study was registered in PROSPERO (CRD42018097234) and adheres the PRISMA guidelines. Electronic searches on PubMed/MEDLINE, Scopus, Cochrane, and Web of Science databases for published articles were performed before October 2020. The PICO question was: “Do patients with a ball-type overdenture retention system have greater satisfaction, when compared to other attachment systems?” The evaluation of risk of bias was performed using the Cochrane risk of bias tool. Results After searching the databases, seven articles were selected out of a total of 2583. A total of 312 implants were placed in 139 patients, with a mean age of 65.9 years. The risk of bias in the included studies varied according to the different domains in a risk of uncertain bias or low bias risk. No difference was found between the ball attachment systems and the others systems, with respect to patient-satisfaction. The meta-analysis revealed no statistically significant difference between the ball systems and another systems (P = 0.11; MD: 10.90; 95% CI: −2.55 to 24.35). Conclusions Regarding patient general satisfaction, it was not possible to determine differences between the ball system and another types of attachment system for overdenture. The ball-type system was statistically superior only to the magnet system.
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Affiliation(s)
- Cleber Davi Del Rei Daltro Rosa
- Department of Dental Materials and Prosthodontics, Dentistry School, UNESP - São Paulo State University, R: José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, Brazil
| | - Rafaella de Souza Leão
- Dentistry School, UPE - University of Pernambuco, Av. General Newton Cavalcanti, 1650, Tabatinga, Camaragibe, PE, Brazil
| | | | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Dentistry School, UNESP - São Paulo State University, R: José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, Brazil
| | - Bruno Gustavo da Silva Casado
- Dentistry School, UPE - University of Pernambuco, Av. General Newton Cavalcanti, 1650, Tabatinga, Camaragibe, PE, Brazil
| | - Sandra Lúcia Dantas de Moraes
- Dentistry School, UPE - University of Pernambuco, Av. General Newton Cavalcanti, 1650, Tabatinga, Camaragibe, PE, Brazil
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Xu Z, Agbigbe O, Nigro N, Yakobi G, Shapiro J, Ginosar Y. Use of high-resolution thermography as a validation measure to confirm epidural anesthesia in mice: a cross-over study. Int J Obstet Anesth 2021; 46:102981. [PMID: 33906822 DOI: 10.1016/j.ijoa.2021.102981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/17/2021] [Accepted: 03/14/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Effective epidural anesthesia is confirmed in humans by sensory assessments but these tests are not feasible in mice. We hypothesized that, in mice, infrared thermography would demonstrate selective segmental warming of lower extremities following epidural anesthesia. METHODS We anesthetized 10 C57BL/6 mice with isoflurane and then inserted a PU-10 epidural catheter under direct surgical microscopy at T11-12. A thermal camera (thermal sensitivity ±0.05°C, pixel resolution 320x240 pixels, and spatial resolution 200 μm) recorded baseline temperature of front and rear paws, tail and ears. Thermography was assessed at baseline and 2, 5, 10, and 15 min after an epidural bolus dose of 50 μL bupivacaine 0.25% or 50 μL saline (control) using a cross-over design with dose order randomized and investigators blinded to study drug. Thermal images were recorded from video and analyzed using FLIR software. Effect over time and maximal effect (Emax) were assessed by repeated measures ANOVA and paired t-tests. Comparisons were between bupivacaine and control, and between lower vs upper extremities. RESULTS Epidural bupivacaine caused progressive warming of lower compared with upper extremities (P <0.001), typically returning to baseline by 15 min after administration. Mean (±SD) Emax was +3.73 (±1.56) °C for lower extremities compared with 0.56 (±0.68) °C (P=0.03) for upper extremities. Following epidural saline, there was no effect over time (Emax for lower extremities -0.88 (±0.28) °C compared with the upper extremities -0.88 (±0.19) °C (P >0.99). CONCLUSIONS Thermography is a useful tool to confirm epidural catheter placement in animals for which subjective, non-noxious, sensory measures are impossible.
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Affiliation(s)
- Z Xu
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA
| | - O Agbigbe
- Washington University School of Medicine, St Louis, MO, USA
| | - N Nigro
- Washington University School of Medicine, St Louis, MO, USA
| | - G Yakobi
- Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Hebrew University Medical Center, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - J Shapiro
- Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Hebrew University Medical Center, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Y Ginosar
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA; Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Hebrew University Medical Center, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Wohl Institute of Translational Medicine, Hadassah Hebrew University Medical Center, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
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Lammi MR, Ghonim MA, Johnson J, D'Aquin J, Zamjahn JB, Pellett A, Okpechi SC, Romaine C, Pyakurel K, Luu HH, Shellito JE, Boulares AH, deBoisblanc BP. Acute effect of inhaled iloprost on exercise dynamic hyperinflation in COPD patients: A randomized crossover study. Respir Med 2021; 180:106354. [PMID: 33721696 DOI: 10.1016/j.rmed.2021.106354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVE We tested whether the prostacyclin analog inhaled iloprost modulates dead space, dynamic hyperinflation (DH), and systemic inflammation/oxidative stress during maximal exercise in subjects with chronic obstructive pulmonary disease (COPD) who were not selected based on pulmonary hypertension (PH). METHODS Twenty-four COPD patients with moderate-severe obstruction (age 59 ± 7 years, FEV1 53 ± 13% predicted) participated in a randomized, double-blind, placebo-controlled crossover trial. Each subject received a single nebulized dose of 5.0 μg iloprost or placebo on non-consecutive days followed by maximal cardiopulmonary exercise tests. The primary outcome was DH quantified by end-expiratory lung volume/total lung capacity ratio (EELV/TLC) at metabolic isotime. RESULTS Inhaled iloprost was well-tolerated and reduced submaximal alveolar dead-space fraction but did not significantly reduce DH (0.70 ± 0.09 vs 0.69 ± 0.07 following placebo and iloprost, respectively, p = 0.38). Maximal exercise time (9.1 ± 2.3 vs 9.3 ± 2.2 min, p = 0.31) and peak oxygen uptake (17.4 ± 6.3 vs 17.9 ± 6.9 mL/kg/min, p = 0.30) were not significantly different following placebo versus iloprost. CONCLUSIONS A single dose of inhaled iloprost was safe and reduced alveolar dead space fraction; however, it was not efficacious in modulating DH or improving exercise capacity in COPD patients who were not selected for the presence of PH.
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Tsiormpatzis S. Is the N-of-1 method applicable in bodywork research? Lessons learned using a trial as a methodological pilot. J Integr Med 2021; 19:203-10. [PMID: 33583758 DOI: 10.1016/j.joim.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/08/2021] [Indexed: 11/20/2022]
Abstract
N-of-1 trial designs have rarely been used in bodywork research. Using a recent trial as a methodological pilot, critical issues related to the applicability of N-of-1 trials to bodywork are discussed. These include the issues of carry-over effects, bias-controlling approaches and statistical analysis. The discussion highlights the importance of mixed methods and draws some suggestions for a future research program. N-of-1 trials could be used to provide insights about some essential elements of bodywork modalities and their effectiveness.
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Kim CS, Kim M, Kim MJ, Jung H. Effects of sleep-inducing juice on sleep quality and heart rate variability in adults with disturbed sleep. Nutr Res Pract 2020; 14:606-620. [PMID: 33282123 PMCID: PMC7683203 DOI: 10.4162/nrp.2020.14.6.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/17/2020] [Accepted: 06/29/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES Although some juices affect subjective sleep quality, there is a lack of information on the effect of a specific juice on objective sleep quality and heart rate variability (HRV) during sleep; thus the present study investigated whether a blended juice made from natural extracts influenced sleep quality and HRV during sleep in adults with disturbed sleep. SUBJECTS/METHODS A randomized, crossover study was conducted on twenty-five adults (15/10, female/male) complaining of difficulty initiating or maintaining nighttime sleep (Pittsburgh sleep quality index [PSQI] ≥ 5). During feeding sessions (FS), subjects received sleep-inducing juice made of natural ingredients (250 mL/trial) twice a day for 8 weeks or non-FS (N-FS) for 8 weeks while maintaining normal activities. Sleep quality and parameters were recorded via wearable actigraph for 7 consecutive days, and PSQI scores were assessed before and after the intervention. HRV was also monitored at rest and during sleep. RESULTS After receiving the sleep-inducing juice intervention (FS), PSQI scores were significantly decreased (P < 0.001) and correlated with a significant decline in fatigue severity scale and visual analogue scale levels (P < 0.05; both). HRV indices of vagal activity were significantly improved during FS (P < 0.05), and no significant differences in N-FS were observed. Sleep efficiency and total sleep time increased significantly (P < 0.05) and sleep latency, total counts, sleep fragmentation index, and movement index, decreased significantly (P < 0.05, all 4) during FS, with no significant differences-observed during N-FS. CONCLUSIONS This study results demonstrated that an 8-week course of sleep-inducing juice has led to improve sleep quality, suggesting an enhanced cardiac vagal tone during sleep. Thus, it could be a well-tolerated option for adults with disturbed sleep.
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Affiliation(s)
- Choun-sub Kim
- Sports Medicine Lab, Department of Physical Education, Kyungpook National University, Daegu 41566, Korea
| | - Maengkyu Kim
- Sports Medicine Lab, Department of Physical Education, Kyungpook National University, Daegu 41566, Korea
| | - Min-ju Kim
- Bio-Food Research Center, Hurom Co., Ltd., Gimhae 50969, Korea
| | - Hyeyoung Jung
- Sports Medicine Lab, Department of Physical Education, Kyungpook National University, Daegu 41566, Korea
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Baretić M, Kušec V, Uroić V, Pavlić-Renar I, Altabas V. GLUCAGON-LIKE PEPTIDE-1 AFFECTS TASTE PERCEPTION DIFFERENTLY IN WOMEN: A RANDOMIZED, PLACEBO-CONTROLLED CROSSOVER STUDY. Acta Clin Croat 2019; 58:240-248. [PMID: 31819319 PMCID: PMC6884376 DOI: 10.20471/acc.2019.58.02.06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal tract is an important connector between food intake and body weight, it senses basic tastes in a similar manner as the tongue. The aim of the study was to find out how gut hormone glucagon-like peptide-1 (GLP-1) influences taste preference. Fourteen healthy participants (six male and eight female) were included in this double-blind, placebo-controlled crossover study. After overnight fast and salty fluid (oral sodium load), participants were randomized to receive placebo (500 mL of 0.9% saline) or GLP-1 infusion (1.5 pmol/kg/min) over a 3-hour period. At the end of infusion, participants chose food preferences from illustrations of food types representing 5 tastes. After 7 days, the protocol was repeated, this time those that had received placebo first got GLP-1 infusion, and those having received GLP-1 first got placebo. Change of taste preference after GLP-1 infusion but not after placebo was reported as response, and non-response was reported in case of taste persistence. A statistically significant difference in response type was found between genders, with women being more likely to change their taste preference after GLP-1 than men. The change of taste upon GLP-1 infusion observed in women might be ascribed to estrogen weight-lowering effects accomplished by receptor-mediated delivery.
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Affiliation(s)
| | - Vesna Kušec
- 1Division of Endocrinology, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; 2Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Nutrition and Dietetics, Zagreb University Hospital Centre, Zagreb, Croatia; 4Department of Endocrinology, Diabetes and Metabolic Diseases, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 5School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Valentina Uroić
- 1Division of Endocrinology, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; 2Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Nutrition and Dietetics, Zagreb University Hospital Centre, Zagreb, Croatia; 4Department of Endocrinology, Diabetes and Metabolic Diseases, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 5School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivana Pavlić-Renar
- 1Division of Endocrinology, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; 2Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Nutrition and Dietetics, Zagreb University Hospital Centre, Zagreb, Croatia; 4Department of Endocrinology, Diabetes and Metabolic Diseases, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 5School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Velimir Altabas
- 1Division of Endocrinology, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; 2Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital Centre, Zagreb, Croatia; 3Department of Nutrition and Dietetics, Zagreb University Hospital Centre, Zagreb, Croatia; 4Department of Endocrinology, Diabetes and Metabolic Diseases, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 5School of Medicine, University of Zagreb, Zagreb, Croatia
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Raisi Dehkordi Z, Rafieian-Kopaei M, Hosseini-Baharanchi FS. A double-blind controlled crossover study to investigate the efficacy of salix extract on primary dysmenorrhea. Complement Ther Med 2019; 44:102-109. [PMID: 31126541 DOI: 10.1016/j.ctim.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES Primary dysmenorrhea in the absence of pelvic pathology is a common gynecologic disorder affecting the quality of life of women of reproductive age. This study evaluates the effect of salix extract on primary dysmenorrhea. DESIGN This study was a randomized crossover clinical trial. SETTING The study population included 96 female students with level two or three of primary dysmenorrhea: 48 students in the treatment group (sequence I) followed by control (sequence II) and 48 students in control group (sequence I) followed by treatment (sequence II). INTERVENTIONS The intervention was salix capsule (400 mg daily) and the active control was mefenamic acid capsule (750 mg daily) as. MAIN OUTCOMES Pain intensity, measured by the visual analog scale (VAS), amount of bleeding, and severity of dysmenorrhea symptoms were outcomes. Generalized estimating equations were used for data analysis. RESULTS The demographic and menstrual characteristics of the students were homogenous between the groups. The results showed that the students in mefenamic acid group had a significantly higher level of VAS than the students in the salix group over time (1.61 ± 0.06, P < 0.001). The estimated odds of the bleeding level in the salix and mefenamic acid group were not significantly different (P = 0.31). In average, 77.39%±16.18 of the students in salix group showed no symptoms followed by 22.18%±14.08 of the students who experienced mild symptoms. Averagely, 44.58%±20.16 of the students in the mefenamic acid group had mild symptoms followed by moderate symptoms (28.12%±15.29). CONCLUSIONS Salix extract significantly decreased dysmenorrhea in comparison to mefenamic acid, as the standard treatment of dysmenorrhea.
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Affiliation(s)
- Z Raisi Dehkordi
- Department of Midwifery, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - M Rafieian-Kopaei
- Medical Plants Research Center, Shahrekord University of Medical Science, Shahrekord, Iran.
| | - F S Hosseini-Baharanchi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Ji EL, Seung-Yeon C, Seong-Uk P, Woo-Sang J, Sang-Kwan M, Jung-Mi P, Chang-Nam K, Ki-Ho C, Seungwon K. Effect of the herbal medicine Danggui Sini plus Wuzhuyu Shengjiang Tang on erythrocyte deformability in normal subjects: a cross-over trial. J TRADIT CHIN MED 2018; 38:769-772. [PMID: 32185995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To show whether Danggui Sini plus Wuzhuyu Shengjiang Tang (DSWST) has any transient effect on erythrocyte deformability in normal subjects. METHODS A total of 25 subjects [mean age (27.8 ¡À 1.8) years] was enrolled in this study. The study was designed as a cross-over trial in which the subjects took part for 2 d. On the first day, blood samples were collected at baseline and 1-2 h after administration of water, whereas, on the second day, instead of water, the subjects were administered DSWST after the baseline blood sampling. The blood samples collected at baseline and after the administration water or DSWST, were examined for erythrocyte deformability. RESULTS The elongation index increased significantly after 2 h (P = 0.009) compared to the baseline after DSWST intake. However, after water intake, there was no significant difference observed. When comparing the percent change of erythrocyte deformability between DSWST and water, we found that after 2 h of administration, DSWST improved erythrocyte deformability significantly compared to water (P < 0.001). CONCLUSION DSWST has a transient effect on erythrocyte deformability in normal subjects.
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Affiliation(s)
- Eun Lee Ji
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Cho Seung-Yeon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Park Seong-Uk
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Jung Woo-Sang
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Moon Sang-Kwan
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Park Jung-Mi
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Ko Chang-Nam
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Cho Ki-Ho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Kwon Seungwon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
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de Souza RF, Bedos C, Esfandiari S, Makhoul NM, Dagdeviren D, Abi Nader S, Jabbar AA, Feine JS. Single-implant overdentures retained by the Novaloc attachment system: study protocol for a mixed-methods randomized cross-over trial. Trials 2018; 19:243. [PMID: 29685161 PMCID: PMC5913792 DOI: 10.1186/s13063-018-2606-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overdentures retained by a single implant in the midline have arisen as a minimal implant treatment for edentulous mandibles. The success of this treatment depends on the performance of a single stud attachment that is susceptible to wear-related retention loss. Recently developed biomaterials used in attachments may result in better performance of the overdentures, offering minimal retention loss and greater patient satisfaction. These biomaterials include resistant polymeric matrixes and amorphous diamond-like carbon applied on metallic components. The objective of this explanatory mixed-methods study is to compare Novaloc, a novel attachment system with such characteristics, to a traditional alternative for single implants in the mandible of edentate elderly patients. METHODS/DESIGN We will carry out a randomized cross-over clinical trial comparing Novaloc attachments to Locators for single-implant mandibular overdentures in edentate elderly individuals. Participants will be followed for three months with each attachment type; patient-based, clinical, and economic outcomes will be gathered. A sample of 26 participants is estimated to be required to detect clinically relevant differences in terms of the primary outcome (patient ratings of general satisfaction). Participants will choose which attachment they wish to keep, then be interviewed about their experiences and preferences with a single implant prosthesis and with the two attachments. Data from the quantitative and qualitative assessments will be integrated through a mixed-methods explanatory strategy. A last quantitative assessment will take place after 12 months with the preferred attachment; this latter assessment will enable measurement of the attachments' long-term wear and maintenance requirements. DISCUSSION Our results will lead to evidence-based recommendations regarding these systems, guiding providers and patients when making decisions on which attachment systems and implant numbers will be most appropriate for individual cases. The recommendation of a specific attachment for elderly edentulous patients may combine positive outcomes from patient perspectives with low cost, good maintenance, and minimal invasiveness. TRIAL REGISTRATION ClinicalTrials.gov, NCT03126942 . Registered on 13 April 2017.
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Affiliation(s)
- Raphael F de Souza
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada.
| | - Christophe Bedos
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
| | - Shahrokh Esfandiari
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
| | - Nicholas M Makhoul
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Didem Dagdeviren
- Division of Oral Diagnostic Sciences, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Samer Abi Nader
- Division of Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Areej A Jabbar
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
| | - Jocelyne S Feine
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
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Tew GA, Shalan A, Jordan AR, Cook L, Coleman ES, Fairhurst C, Hewitt C, Hutchins SW, Thompson A. Unloading shoes for intermittent claudication: a randomised crossover trial. BMC Cardiovasc Disord 2017; 17:283. [PMID: 29179693 PMCID: PMC5704386 DOI: 10.1186/s12872-017-0716-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 11/19/2017] [Indexed: 11/19/2022] Open
Abstract
Background The purpose of this study was to assess the functional effects and acceptability of rocker-soled shoes that were designed to relatively “unload” the calf muscles during walking in people with calf claudication due to peripheral arterial disease. Methods In this randomised AB/BA crossover trial, participants completed two assessment visits up to two weeks apart. At each visit, participants completed walking tests whilst wearing the unloading shoes or visually-similar control shoes. At the end of the second visit, participants were given either the unloading or control shoes to use in their home environment for 2 weeks, with the instruction to wear them for at least 4 h every day. The primary outcome was 6-min walk distance. We also assessed pain-free walking distance and gait biomechanical variables during usual-pace walking, adverse events, and participants’ opinions about the shoes. Data for continuous outcomes are presented as mean difference between conditions with corresponding 95% confidence interval. Results Thirty-four participants (27 males, mean age 68 years, mean ankle-brachial index 0.54) completed both assessment visits. On average, the 6-min walk distance was 11 m greater when participants wore the control shoes (95% CI -5 to 26), whereas mean pain-free walking distance was 7 m greater in the unloading shoes (95% CI -17 to 32). Neither of these differences were statistically significant (p = 0.18 and p = 0.55, respectively). This was despite the unloading shoes reducing peak ankle plantarflexion moment (mean difference 0.2 Nm/kg, 95% CI 0.0 to 0.3) and peak ankle power generation (mean difference 0.6 W/kg, 95% CI 0.2 to 1.0) during pain-free walking. The survey and interview data was mixed, with no clear differences between the unloading and control shoes. Conclusions Shoes with modified soles to relatively unload the calf muscles during walking conferred no substantial acute functional benefit over control shoes. Trial registration Clinicaltrials.gov, Trial Registration Number: NCT02505503, First registered 22 July 2015. Electronic supplementary material The online version of this article (10.1186/s12872-017-0716-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Garry A Tew
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Northumberland Road, Newcastle upon Tyne, NE1 8ST, UK.
| | - Ahmed Shalan
- General Surgery Department, York Hospital, Wigginton Road, York, YO31 8HE, UK
| | - Alastair R Jordan
- School of Sport, York St John University, Lord Mayor's Walk, York, YO31 7EX, UK
| | - Liz Cook
- York Trials Unit, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Elizabeth S Coleman
- York Trials Unit, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Stephen W Hutchins
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Pilestredet 44, PB4 St.Olavs plass, N-0130, Oslo, Norway.,Directorate of Prosthetics and Orthotics and Podiatry, School of Health Sciences, University of Salford, Frederick Road, Salford, M6 6PU, UK
| | - Andrew Thompson
- General Surgery Department, York Hospital, Wigginton Road, York, YO31 8HE, UK
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Bayer O, Brémová T, Strupp M, Hüfner K. A randomized double-blind, placebo-controlled, cross-over trial (Vestparoxy) of the treatment of vestibular paroxysmia with oxcarbazepine. J Neurol 2017; 265:291-298. [PMID: 29204964 PMCID: PMC5808055 DOI: 10.1007/s00415-017-8682-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/09/2017] [Accepted: 11/14/2017] [Indexed: 11/25/2022]
Abstract
Objective Vestibular paroxysmia (VP) is characterized by short, often oligosymptomatic attacks of vertigo which occur spontaneously or are sometimes provoked by turning the head. Despite the description of the disease almost 40 years ago (first termed “disabling positional vertigo”), no controlled treatment trial has been published to date. The Vestparoxy trial was designed as a randomized, placebo-controlled, double-blind cross-over trial to examine the therapeutic effect of oxcarbazepine (OXA) in patients with definite or probable VP. Methods Patients were recruited from August 2005 to December 2011 in the outpatient Dizziness Unit of the Department of Neurology of the Munich University Hospital, and randomized to receive OXA (first week: 300 mg once per day, second week: 300 mg b.i.d., third week: 300 mg t.i.d. until the end of the third month), followed by placebo or vice versa with a 1-month wash-out period in between. The primary endpoint was the number of days with one or more attacks. Secondary endpoints were the number of attacks during the observed days, and the median (for each day) duration of attacks. All these endpoints were assessed using standardized diaries collected at the end of each treatment phase. Results Forty-three patients were randomized, 18 patients provided usable data (2525 patient days) for at least one treatment phase and were included in the main (intention-to-treat) analysis. The most common reasons for discontinuation documented were adverse events. The risk of experiencing a day with at least one attack was 0.41 under OXA, and 0.62 under placebo treatment, yielding a relative risk of 0.67 (95% CI 0.47–0.95, p = 0.025). The number of attacks during the observed days ratio was 0.53 (95% CI 0.42–0.68, p < 0.001) under OXA compared to placebo. Median attack duration was 4 s (Q25: 2 s, Q75: 120 s) under OXA, and 3 s (Q25: 2 s, Q75: 60 s) under placebo treatment. When days with no attacks, i.e., duration = 0, were included in the analysis, these figures changed to 0 (Q25: 0, Q75: 3 s), and 2 (Q25: 0, Q75: 6 s). No serious adverse events or new safety findings were identified during the trial. Conclusions The Vestparoxy trial showed a significant reduction of VP attacks under OXA compared to placebo treatment, confirming the known and revealing no new side effects.
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Affiliation(s)
- Otmar Bayer
- German Center for Vertigo and Balance Disorders, Campus Großhadern, Munich University Hospital, Marchioninistrasse 15, 81377 Munich, Germany
- Department of Neurology, Munich University Hospital, Munich, Germany
| | - Tatiana Brémová
- German Center for Vertigo and Balance Disorders, Campus Großhadern, Munich University Hospital, Marchioninistrasse 15, 81377 Munich, Germany
- Department of Neurology, Munich University Hospital, Munich, Germany
| | - Michael Strupp
- German Center for Vertigo and Balance Disorders, Campus Großhadern, Munich University Hospital, Marchioninistrasse 15, 81377 Munich, Germany
- Department of Neurology, Munich University Hospital, Munich, Germany
| | - Katharina Hüfner
- German Center for Vertigo and Balance Disorders, Campus Großhadern, Munich University Hospital, Marchioninistrasse 15, 81377 Munich, Germany
- Department of Neurology, Munich University Hospital, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
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MacSween A, Lorrimer S, van Schaik P, Holmes M, van Wersch A. A randomised crossover trial comparing Thai and Swedish massage for fatigue and depleted energy. J Bodyw Mov Ther 2017; 22:817-828. [PMID: 30100318 DOI: 10.1016/j.jbmt.2017.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND The aim of this study was to compare the efficacy and social constructions of Thai massage (TM) and Swedish massage (SM) for patients experiencing fatigue or depleted energy. METHOD Twenty participants were randomised to receive three once-weekly TM treatments and three once-weekly SM treatments, with crossover after three massages. Symptom checklists were administered at three time points and included Activation-Deactivation Adjective Check List and VAS Scale. Qualitative data were collected through semi-structured interviews and participants' diary entries. RESULTS Both massage types enhanced physical, emotional and mental wellbeing through improved sleep, relaxation, relief of stress and relief of muscular tension. TM alone showed specific energising and psychological stimulation results, along with carry-over effect and longer lasting benefits. Ninety-five percent of participants found relief from their initial reason presenting symptoms. CONCLUSION TM or SM can relieve symptoms of fatigue or low energy by releasing stress, promoting relaxation, relieving muscular aches and pains and improving energy. SM results in a larger effect in relaxation and improved sleep whereas TM results in a larger effect in energising, rejuvenating and mentally stimulating effects.
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Affiliation(s)
- Alasdair MacSween
- School of Health and Social Care, Teesside University, Middlesbrough, UK.
| | - Susan Lorrimer
- Teesside University, Student Services Department, Middlesbrough, UK
| | - Paul van Schaik
- School of Social Science, Business and Law, Teesside University, Middlesbrough, UK
| | - Marie Holmes
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Anna van Wersch
- School of Social Science, Business and Law, Teesside University, Middlesbrough, UK
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Ottestad I, Nordvi B, Vogt G, Holck M, Halvorsen B, Brønner KW, Retterstøl K, Holven KB, Nilsson A, Ulven SM. Bioavailability of n-3 fatty acids from n-3-enriched foods and fish oil with different oxidative quality in healthy human subjects: a randomised single-meal cross-over study. J Nutr Sci 2016; 5:e43. [PMID: 28620470 DOI: 10.1017/jns.2016.34] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/12/2016] [Accepted: 08/16/2016] [Indexed: 01/23/2023] Open
Abstract
Regular consumption of long-chain n-3 fatty acids (LC n-3 FA) reduces postprandial triacylglycerolaemia. Functional foods and supplements are alternative sources of LC n-3 FA; however, emulsification technologies, food matrices and altered lipid oxidation levels affect their bioavailability. Moreover, which functional foods are optimal LC n-3 FA carriers is unknown. The aim of the study was to determine the bioavailability of LC n-3 FA and the postprandial TAG response after the intake of oxidised or non-oxidised cod liver oil and after the intake of emulsified or non-emulsified LC n-3 FA using novel functional food items as LC n-3 FA carriers in a randomised cross-over acute study. A total of twenty-four healthy subjects completed the study in which subjects consumed one of four different test meals containing 1·5 g LC n-3 FA, or a control meal with no LC n-3 FA. Postprandial TAG-rich lipoproteins were isolated and their fatty acid composition was measured. The LC n-3 FA from emulsified foods were more rapidly incorporated into TAG-rich lipoproteins compared with non-emulsified foods. The incorporation of LC n-3 FA was similar for oils emulsified in yogurt or juice and was unaffected by the oxidative status of the oil. Postprandial TAG levels did not differ among the various test meals. In conclusion, emulsification increases the bioavailability of LC n-3 FA through a more rapid incorporation into TAG-rich lipoproteins, and juice and yogurt are equally suited as LC n-3 FA carriers. The acute intake of oxidised cod liver oil does not influence the incorporation of LC n-3 FA into TAG-rich lipoproteins.
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Maleki A, Soltanian AR, Zeraati F, Sheikh V, Poorolajal J. The flavor and acceptability of six different potassium-enriched (sodium reduced) iodized salts: a single-blind, randomized, crossover design. Clin Hypertens 2016; 22:18. [PMID: 28031983 PMCID: PMC5178985 DOI: 10.1186/s40885-016-0054-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/13/2016] [Indexed: 11/16/2022] Open
Abstract
Background Hypertension is a serious public health problem. Potassium-enriched salt is suggested as a tool for lowering blood pressure. However, its flavor and taste acceptability is essential for population-based salt reduction strategy and needs to be well-understood. This trial assessed the flavor and taste acceptability of six different potassium-enriched iodized salts in the general population. Methods We conducted this crossover trial from May to June 2016, enrolling 100 normal volunteer subjects aged 11 to 64 years. We compared regular sodium chloride salt (placebo) with six different potassium-enriched (sodium reduced) iodized salt (experiment), including 0 %, 5 %, 10 %, 15 %, 20 %, 25 %, and 30 %. The participants served as their own control and received a placebo and a sequence of the experiments. They tasted the two salts sequentially and stated their preference and acceptance. Each subject received all salts. Results More than 80 % of participants who either did not distinguish between the two salts even in high potassium-enriched salts or preferred potassium-enriched salt (P < 0.001). The number of participants who preferred the flavor of potassium-enriched salt was greater than the number of subjects who preferred the flavor of regular sodium chloride. Conclusion Our findings indicated that the six different potassium-enriched salts had a public acceptability of at least 80 % among normal subjects from the general population. Although the acceptability of the potassium-enriched salts by a more general population group would require to be confirmed, universal use of this salt may help us achieve the target of 30 % relative reduction in mean population intake of sodium by 2025.
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Affiliation(s)
- Akram Maleki
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Soltanian
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran ; Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Zeraati
- Department of Pharmacology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Vida Sheikh
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran ; Research Center for Health Sciences, Hamadan University of Medical Sciences, 65157838695 Hamadan, Iran
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Claret PG, Asencio R, Rogier D, Roger C, Fournier P, Tran TA, Sebbane M, Bobbia X, Emmanuel de La Coussaye J. Comparison of Miller and Airtraq laryngoscopes for orotracheal intubation by physicians wearing CBRN protective equipment during infant resuscitation: a randomized crossover simulation study. Scand J Trauma Resusc Emerg Med 2016; 24:35. [PMID: 27004945 PMCID: PMC4804507 DOI: 10.1186/s13049-016-0228-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the performance of orotracheal intubation with the Miller laryngoscope compared with the Airtraq laryngoscope by emergency and pediatric physicians wearing CBRN-PPE type III on infant manikins with conventional airway. We hypothesized that in this situation, the orotracheal intubation with the Airtraq laryngoscope would be faster and more effective than with the Miller laryngoscope. METHODS This was a prospective, randomized, crossover, single-center study who recruited emergency department physicians on a voluntary basis. Each physician performed a total of 20 intubation trials while in CBRN-PPE with the two intubation techniques, Miller and Airtraq. Intubations by each airway device were tested over ten consecutive runs. The order of use of one or the other devices was randomized with a ratio of 1:1. The primary endpoint was overall orotracheal intubation success. RESULTS Fifty-five emergency and pediatric physicians were assessed for eligibility. Forty-one physicians were included in this study and 820 orotracheal intubation attempts were performed. The orotracheal intubation success rate with the Airtraq laryngoscope was higher than with the Miller (99% vs. 92%; p-adjusted <.001). The orotracheal intubation and glottis visualization times decreased with the number of attempts (p <.001). The median orotracheal intubation time with the Airtraq laryngoscope was lower than with the Miller laryngoscope (15 s vs. 20 s; p-adjusted <.001). The median glottis visualization time with the Airtraq laryngoscope and with the Miller laryngoscope were not different (6.0 s vs. 7.5 s; p-adjusted =.237). Thirty-four (83 %) physicians preferred the Airtraq laryngoscope versus 6 (15 %) for the Miller (p-adjusted <.001). DISCUSSION For tracheal intubation by physicians wearing CBRN-PPE during infant resuscitation simulation, we showed that the orotracheal intubation success rate with the Airtraq laryngoscope was higher than with the Miller laryngoscope and that orotracheal intubation time with the Airtraq laryngoscope was lower than with the Miller laryngoscope. CONCLUSIONS It seems useful to train the physicians in emergency departments in the use of pediatric Airtraq and for the management of CBRN risks.
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Affiliation(s)
- Pierre-Géraud Claret
- Department of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France. .,EA 2415, Clinical Research University Institute, Montpellier University, 641 Avenue du Doyen Gaston Giraud, Montpellier, 34093, France.
| | - Renaud Asencio
- Department of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
| | - Damien Rogier
- Department of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
| | - Claire Roger
- Department of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
| | - Philippe Fournier
- Department of Pediatrics, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
| | - Tu-Anh Tran
- Department of Pediatrics, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
| | - Mustapha Sebbane
- Department of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
| | - Xavier Bobbia
- Department of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
| | - Jean Emmanuel de La Coussaye
- Department of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, 1 place du Professeur Robert Debré, Nîmes, 30029, France
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Schmid A, Petry N, Walther B, Bütikofer U, Luginbühl W, Gille D, Chollet M, McTernan PG, Gijs MAM, Vionnet N, Pralong FP, Laederach K, Vergères G. Inflammatory and metabolic responses to high-fat meals with and without dairy products in men. Br J Nutr 2015; 113:1853-61. [PMID: 25990454 PMCID: PMC4498462 DOI: 10.1017/s0007114515000677] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/19/2015] [Accepted: 02/09/2015] [Indexed: 12/17/2022]
Abstract
Postprandial inflammation is an important factor for human health since chronic low-grade inflammation is associated with chronic diseases. Dairy products have a weak but significant anti-inflammatory effect on postprandial inflammation. The objective of the present study was to compare the effect of a high-fat dairy meal (HFD meal), a high-fat non-dairy meal supplemented with milk (HFM meal) and a high-fat non-dairy control meal (HFC meal) on postprandial inflammatory and metabolic responses in healthy men. A cross-over study was conducted in nineteen male subjects. Blood samples were collected before and 1, 2, 4 and 6 h after consumption of the test meals. Plasma concentrations of insulin, glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, TAG and C-reactive protein (CRP) were measured at each time point. IL-6, TNF-α and endotoxin concentrations were assessed at baseline and endpoint (6 h). Time-dependent curves of these metabolic parameters were plotted, and the net incremental AUC were found to be significantly higher for TAG and lower for CRP after consumption of the HFM meal compared with the HFD meal; however, the HFM and HFD meals were not different from the HFC meal. Alterations in IL-6, TNF-α and endotoxin concentrations were not significantly different between the test meals. The results suggest that full-fat milk and dairy products (cheese and butter) have no significant impact on the inflammatory response to a high-fat meal.
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Affiliation(s)
- Alexandra Schmid
- Agroscope, Institute for Food Sciences (IFS),
Schwarzenburgstrasse 161, 3003Bern, Switzerland
| | - Nicolai Petry
- Agroscope, Institute for Food Sciences (IFS),
Schwarzenburgstrasse 161, 3003Bern, Switzerland
- Groundwork LLC, Crans-près-Céligny,
Switzerland
| | - Barbara Walther
- Agroscope, Institute for Food Sciences (IFS),
Schwarzenburgstrasse 161, 3003Bern, Switzerland
| | - Ueli Bütikofer
- Agroscope, Institute for Food Sciences (IFS),
Schwarzenburgstrasse 161, 3003Bern, Switzerland
| | | | - Doreen Gille
- Agroscope, Institute for Food Sciences (IFS),
Schwarzenburgstrasse 161, 3003Bern, Switzerland
| | - Magali Chollet
- Agroscope, Institute for Food Sciences (IFS),
Schwarzenburgstrasse 161, 3003Bern, Switzerland
| | - Philip G. McTernan
- Division of Translational and Systems Medicine, University of
Warwick, Coventry, UK
| | - Martin A. M. Gijs
- Laboratory of Microsystems 2, Ecole Polytechnique Fédérale de
Lausanne, Lausanne, Switzerland
| | - Nathalie Vionnet
- Service of Endocrinology, Diabetes and Metabolism, University Hospital
CHUV, Lausanne, Switzerland
| | - François P. Pralong
- Service of Endocrinology, Diabetes and Metabolism, University Hospital
CHUV, Lausanne, Switzerland
| | - Kurt Laederach
- Department of Visceral Surgery and Medicine, University
Hospital Inselspital, Bern,
Switzerland
| | - Guy Vergères
- Agroscope, Institute for Food Sciences (IFS),
Schwarzenburgstrasse 161, 3003Bern, Switzerland
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Finnbjornsdottir RG, Oudin A, Elvarsson BT, Gislason T, Rafnsson V. Hydrogen sulfide and traffic-related air pollutants in association with increased mortality: a case-crossover study in Reykjavik, Iceland. BMJ Open 2015; 5:e007272. [PMID: 25854971 PMCID: PMC4390682 DOI: 10.1136/bmjopen-2014-007272] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To study the association between daily mortality and short-term increases in air pollutants, both traffic-related and the geothermal source-specific hydrogen sulfide (H₂S). DESIGN Population-based, time stratified case-crossover. A lag time to 4 days was considered. Seasonal, gender and age stratification were calculated. Also, the best-fit lag when introducing H₂S >7 µg/m(3) was selected by the Akaike Information Criterion (AIC). SETTING The population of the greater Reykjavik area (n=181,558) during 2003-2009. PARTICIPANTS Cases were defined as individuals living in the Reykjavik capital area, 18 years or older (N=138,657), who died due to all natural causes (ICD-10 codes A00-R99) other than injury, poisoning and certain other consequences of external causes, or cardiovascular disease (ICD-10 codes I00-I99) during the study period. MAIN OUTCOME MEASURE Percentage increases in risk of death (IR%) following an interquartile range increase in pollutants. RESULTS The total number of deaths due to all natural causes was 7679 and due to cardiovascular diseases was 3033. The interquartile range increased concentrations of H₂S (2.6 µg/m(3)) were associated with daily all natural cause mortality in the Reykjavik capital area. The IR% was statistically significant during the summer season (lag 1: IR%=5.05, 95% CI 0.61 to 9.68; lag 2: IR%=5.09, 95% CI 0.44 to 9.97), among males (lag 0: IR%=2.26, 95% CI 0.23 to 4.44), and among the elderly (lag 0: IR%=1.94, 95% CI 0.12 to 1.04; lag 1: IR%=1.99, 95% CI 0.21 to 1.04), when adjusted for traffic-related pollutants and meteorological variables. The traffic-related pollutants were generally not associated with statistical significant IR%s. CONCLUSIONS The results suggest that ambient H₂S air pollution may increase mortality in Reykjavik, Iceland. To the best of our knowledge, ambient H₂S exposure has not previously been associated with increased mortality in population-based studies and therefore the results should be interpreted with caution. Further studies are warranted to confirm or refute whether H₂S exposure induces premature deaths.
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Affiliation(s)
| | - Anna Oudin
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland Department of Allergy and Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Vilhjalmur Rafnsson
- Department of Preventive Medicine, University of Iceland, Reykjavik, Iceland
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Valentini M, Scardapane M, Bondanini F, Bossi A, Colatrella A, Girelli A, Ciucci A, Leotta S, Minotti E, Pasotti F, Pesenti A, Rocca L, Sciangula L, Vavassori E, Nicolucci A. Efficacy, safety and acceptability of the new pen needle 33G × 4 mm. AGO 01 study. Curr Med Res Opin 2015; 31:487-92. [PMID: 25469829 DOI: 10.1185/03007995.2014.993025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Adherence to insulin therapy can be threatened by pain and needle fear. This cross-over randomized non-inferiority trial evaluated a new Pic Insupen 33G × 4 mm needle vs. a 32G × 4 mm needle in terms of metabolic control, safety and acceptability in patients with diabetes treated with insulin. RESEARCH DESIGN AND METHODS We used a centralized, permuted block randomization, stratified by center and maximum insulin dose per single injection. Subjects used the two needles in two 3 week treatment periods. The primary endpoint was the absolute percentage variation of the blood fructosamine between the two treatments (% |ΔFru|). Additional endpoints were: glycemic variability, total insulin doses, body weight, severe hypoglycemic episodes, leakage at injection sites and pain measured by visual analogue scale. Equivalent glycemic control was defined a priori as % |ΔFru| (including 95% CI) within 20%. RESULTS Of 87 subjects randomized, 77 completed the study (median age 53.1 [IR 42.3-61.2], median BMI 24.3 Kg/m(2) [IR 21.3-28.5], median duration of insulin therapy [in months] 141.4 (IR 56.3-256.9), median baseline HbA1c 7.9% [IR 7.2-8.8]). The % |ΔFru| was 7.93% (95% CI 6.23-9.63), meeting the non-inferiority criterion. The fasting blood glucose standard deviation was 46.2 (mean 154.6) with the 33G needle and 42.8 (mean 157.3) with the 32G needle (p=0.42). Insulin daily dose and patients' weight did not show any statistically significant variation. We observed 95 episodes of symptomatic hypoglycemia with the 33G needle and 96 with the 32G needle. One episode of severe hypoglycemia was documented in the latter group. As for insulin leakage we observed 37.55 episodes per 100 patient-days with the 33G needle and 32.21 episodes per 100 patient-days with the 32G needle (p=0.31). Patients reported less pain with the 33G × 4 mm needle (p=0.05). STUDY LIMITATIONS Study sample was mainly composed of adults with type 1 diabetes and study was not blinded. CONCLUSIONS The 33G needle is not inferior to the 32G needle in terms of efficacy and safety, with reduced pain and no difference in insulin leakage. CLINICAL TRIAL REGISTRATION NCT01745549.
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Affiliation(s)
- M Valentini
- Fondazione Mario Negri Sud , S. Maria Imbaro , Italy
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Martin D, Friesen E, De Pau A. Three heads are better than one: a mixed methods study examining collaborative versus traditional test-taking with nursing students. Nurse Educ Today 2014; 34:971-977. [PMID: 24484780 DOI: 10.1016/j.nedt.2014.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/22/2013] [Accepted: 01/08/2014] [Indexed: 06/03/2023]
Abstract
Patient care requires a collaborative teamwork approach; therefore, nursing programs must provide students with ample opportunities to hone teamwork skills. Although collaborative testing (CT) has been utilized in higher education for decades, its uptake in nursing education has only recently surfaced. The purpose of this mixed methods study was to examine CT versus traditional test-taking with undergraduate nursing students in a Western Canadian university. Using a cross-over design, surveys, and focus groups, nursing students' experiences of learning, retention of course content, and teamwork were explored. A convenience sample of 70 students was recruited. In this paper, we present the results along with recommendations for future research. The treatment effect was highly significant with CT scores being an average of 7.99 units higher than traditional test-taking scores when the test was allocated a total score of 100. However, the two formative tests were weighted minimally resulting in participating students' overall grades being increased by an average of 1.2 out of 100. Of practical significance, students perceived that CT helped them understand the course material better and they appreciated the opportunity to practice effective communication within a group to prepare for future practice.
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Affiliation(s)
- Donna Martin
- Faculty of Nursing, University of Manitoba, Winnipeg, Canada.
| | - Eunice Friesen
- Centre for Advancement in Teaching/Learning, University of Manitoba, Winnipeg, Canada
| | - Antonina De Pau
- Faculty of Nursing, University of Manitoba, Winnipeg, Canada
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Ji YJ, Jeong JS. [Comparison of antimicrobial effect of alcohol gel according to the amount and drying time in health personnel hand hygiene]. J Korean Acad Nurs 2013; 43:305-11. [PMID: 23893220 DOI: 10.4040/jkan.2013.43.3.305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to compare the effect of alcohol gel according to the amount and drying time in health personnel hand hygiene and to promote in their practice adequate and effective hand hygiene. METHODS The cross-over experimental study was performed with 14 volunteers. Hands were artificially contaminated with 5 mL of 10⁸ CFU/mL of Serratia marcescens (ATCC 14756) and four different alcohol gel hand hygiene methods varying by the amount of alcohol gel (2 mL vs. 1 mL) and drying time (complete vs. incomplete) were compared. Samples were collected by glove juice sampling procedures. RESULTS Mean log reduction values of the four different hand hygiene methods were 2.22±0.36, 1.26±0.53, 1.49±0.60, 0.89±0.47 respectively for the 4 groups: adequate amount (2mL) and complete dry (30 seconds rubbing followed by 2 min air-dry), inadequate amount (1 mL) and complete dry, adequate amount and incomplete dry (15 seconds rubbing and no air-dry), and inadequate amount and incomplete dry. The difference was statistically significant in the adequate amount and complete dry group compared to other three groups (p<.001). CONCLUSION Only alcohol gel hand hygiene with adequate amount and complete drying was satisfactory by U.S. FDA-TFM efficacy requirements for antiseptic hand hygiene products.
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Affiliation(s)
- Yoon Jung Ji
- The Graduate School of Industrial Technology University of Ulsan, Seoul, Korea
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