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Moosavimoghadam SF, Dehghani A, Akbar RE. The effect of 5A self-management program on medication adherence of epileptic patients during the COVID - 19 pandemic: A randomized controlled trial. Acta Neurol Taiwan 2024; 33(4):165-174. [PMID: 37994005] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
BACKGROUND Adherence to medication adherence plays a vital role in controlling the problems and complications of epilepsy. During the COVID - 19 pandemic and limitations of face-to-face education, the use of distance education can play an important role in providing education to patients. The aim of this study is the effect of model 5A self-management training on medication adherence in epileptic patients. METHODS In this single-blind randomized controlled trial, 56 epileptic patients referred to Shiraz Namazi Hospital were divided into intervention and control groups using random allocation. Thereafter, 5A self - management training sessions were virtually held in 5 sessions in WhatsApp application for intervention group. The data collection tool was MMAS-8 at two stages of before and two months after intervention. Data analysis was performed using SPSS 21 software. RESULTS The results of Wilcoxon test showed that in intervention group, the mean drug adherence in patients after intervention significantly increased compared to before intervention (p = 0.005). But in control group, this was not significant (p = 0.909). According to results of Mann-Whitney test, there was no significant difference between intervention and control groups before intervention (p = 0.632). However, by passing two months from intervention, a significant difference was found between intervention and control groups (p = 0.041). CONCLUSIONS Based on results, the implementation of model 5A can be effective on medication adherence in epileptic patients. This program can be considered as a suitable method in epileptic patients during COVID - 19 pandemic.
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Affiliation(s)
| | - Ali Dehghani
- Associate professor, Department of Community Health Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Rasool Eslami Akbar
- Assistant professor, Department of Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
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Rivas Neira S, Pasqual Marques A, Fernández Cervantes R, Seoane Pillado MT, Vivas Costa J. Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial. Physiotherapy 2024; 123:91-101. [PMID: 38447497 DOI: 10.1016/j.physio.2024.02.005] [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: 11/11/2022] [Revised: 12/28/2023] [Accepted: 02/14/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To determine the efficacy of two physiotherapeutic interventions - aquatic therapy (AT) and land-based therapy (LBT) - for reducing pain in women with fibromyalgia. DESIGN Single-blind, randomised controlled, equivalence trial. SETTING Fibromyalgia, Chronic Fatigue Syndrome and Multiple Chemical Sensitivity Association in A Coruña, Spain. PARTICIPANTS Forty women with fibromyalgia were assigned at random in a 1:1 manner to two groups: AT (n = 20) and LBT (n = 20). INTERVENTIONS Two therapeutic exercise programmes, with 60-min sessions, were undertaken three times per week for 12 weeks. Sessions were carried out in groups by a trained physiotherapist. OUTCOME The primary outcome was pain intensity (visual analogue scale). The secondary outcomes were pressure pain threshold (algometer), quality of life (Revised Fibromyalgia Impact Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory) and physical ability (6-Minute Walk Test). Patients were evaluated at baseline, 12 weeks (post-treatment) and 18 weeks (follow-up). The statistical analysis was per-protocol. P < 0.05 was considered to indicate significance. Effect size was calculated. RESULTS The mean age was 50 [standard deviation (SD) 9] years, with median body mass index of 27 [interquartile range (IQR) 25-30] kg/m2 and median symptom duration of 11 (IQR 6-15) years. No differences were observed between the groups post-treatment, but differences in favour of AT were found in pain intensity [2.7 (IQR 1.5-4.9) vs 5.5 (IQR 3.3-7.6); p= 0.023; large effect, Cohen's d= 0.8; 95% confidence interval (CI) 0.1-1.5] and sleep quality [12.0 (IQR 7.3-15.3) vs 15.0 (IQR 13.0-17.0); p= 0.030; large effect, Cohen's d= 0.8; 95% CI 0.1-1.5] at follow-up. CONCLUSIONS The results suggest that AT is better than LBT for reducing pain intensity and improving sleep quality after 6 weeks of follow-up. AT may be a good treatment option for women with fibromyalgia. CLINICAL TRIALS REGISTRATION NUMBER ClinicalTrials.gov NCT02695875 CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- S Rivas Neira
- Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidade da Coruña, A Coruña, Spain.
| | - A Pasqual Marques
- Department of Physiotherapy, Speech-Language Pathology and Audiology, and Occupational Therapy, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - R Fernández Cervantes
- Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidade da Coruña, A Coruña, Spain
| | - M T Seoane Pillado
- Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
| | - J Vivas Costa
- Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidade da Coruña, A Coruña, Spain
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Fung A, Howard D, Nichol H, Irvine MA, Zhang Q, Bone JN, Glackin S, Felgar E, Tatla S, Hursh BE. Coaching for parents of children with type 1 diabetes: A randomized controlled trial. Patient Educ Couns 2024; 123:108205. [PMID: 38422950 DOI: 10.1016/j.pec.2024.108205] [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] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To assess the effectiveness of a standardized bi-weekly six-month telephone coaching intervention for parents of children with type 1 diabetes. METHODS This single-blind randomized controlled trial followed participants for 12 months. The primary outcome was children's health-related quality of life. Secondary outcomes included treatment adherence, diabetes-related family conflict, and hemoglobin A1c. Data was collected using validated questionnaires and health records. We compared groups using a linear mixed effects model. RESULTS 102 families were randomized (control: n = 49; intervention: n = 53). Coaching had no impact on children's overall health-related quality of life or overall secondary outcomes; however, there were patterns in subsections that suggest the possible impact of coaching. Coaching was perceived as a positive addition to routine care by 80% of families and 82% would recommend working with a coach to another family. 58% of participants would continue coaching beyond the study. CONCLUSION Coaching did not impact overall quality of life or secondary outcomes; however, coaching was well received by families who perceived significant benefits. Patterns in subsections warrant further study. PRACTICE IMPLICATIONS Adding a health coach into diabetes multidisciplinary care supports families in a way that is unique from their routine clinical care.
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Affiliation(s)
- Alex Fung
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
| | - Dori Howard
- ensogroup Coaching & Consulting Inc., Salt Spring Island, British Columbia, Canada.
| | - Heather Nichol
- Department of Nursing, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
| | - Michael A Irvine
- Biostatistics, Clinical Research Support Unit, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - Qian Zhang
- Biostatistics, Clinical Research Support Unit, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - Jeffrey N Bone
- Biostatistics, Clinical Research Support Unit, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - Sinead Glackin
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
| | - Elena Felgar
- Department of New Knowledge and Innovation, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
| | - Sandy Tatla
- Department of New Knowledge and Innovation, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
| | - Brenden E Hursh
- Division of Endocrinology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
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Nekouei M, Tehrani FJ, Vasli P, Nasiri M. The effect of seven-step educational strategy on knowledge of diabetic foot ulcer prevention, critical thinking and self-efficacy of nursing students: A randomized controlled trial. Nurse Education Today 2024; 137:106164. [PMID: 38503249 DOI: 10.1016/j.nedt.2024.106164] [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] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Diabetic foot ulcer is a significant complication of diabetes that carries a high mortality risk and is associated with substantial financial costs. Choosing a suitable educational model for nursing students as future nurses is necessary to improve knowledge and manage issues related to caring for diabetic patients. OBJECTIVES To determine the effect of education based on the 7E learning cycle model on the knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy in nursing students. DESIGN A single-blind, randomized controlled trial with a parallel group. SETTINGS This study was conducted in a nursing school and hospitals covered by it in Iran. PARTICIPANTS 98 students studying in the fourth semester of the Bachelor of Nursing course. METHODS Students were divided into two distinct groups at random: an experimental group (class A, with 51 participants), and a control group (class B, with 47 participants). The participants of the experimental group were provided with an education based on the 7E learning cycle model, while the control group received conventional teaching method. Data collection methods included pre- and post-tests using research instruments (demographic questionnaire, Kaya Diabetic Foot Prevention Knowledge Questionnaire, Ricketts' Critical Thinking Disposition Questionnaire, and General Self-Efficacy Scale). The data were analyzed using descriptive statistics, non-parametric Mann-Whitney and Wilcoxon tests, parametric independent sample t-tests, ANCOVA, and paired sample t-tests. RESULTS The difference in mean scores of diabetic foot ulcer prevention knowledge (Z = -6.232, p < 0.001), critical thinking (t (50) = -4.382, p < 0.001), and self-efficacy (Z = -4.427, p < 0.001) in the experimental group were statistically significant between the time interval before the intervention and one month after its completion. CONCLUSIONS Compared to conventional method of teaching, education based on the 7E learning cycle model is a more effective method to improve nursing students' knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy.
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Affiliation(s)
- Mehrad Nekouei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereshteh Javaheri Tehrani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Trifi A, Tlili B, Kallel Sellami M, Feki M, Mehdi A, Seghir E, Messaoud L, Abdellatif S, Ben Lakhal S. Immunologic effect and clinical impact of erythromycin in septic patients: A randomized clinical trial. J Crit Care 2024; 81:154533. [PMID: 38359518 DOI: 10.1016/j.jcrc.2024.154533] [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: 11/11/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
To investigate the potential regulatory effect of erythromycin added to standard care in septic patients on sepsis biomarkers and clinical outcome. It was a single-blind randomized trial including critical septic patients. The primary endpoint was the change in the TNF/IL-10 ratio between days 0 and 6. Changes in other biomarkers, vasopressor use, and 28-day mortality were secondary endpoints. One hundred and ten patients were examined (erythromycin group, n = 55 versus placebo group, n = 55). Clinical features of the groups were well matched. Erythromycin addition had no beneficial effects on the TNF/IL-10 ratio or mortality (51% vs. 47%, p = 0.62). Both groups' serum TNF/IL-10 ratios did not significantly rise (from 0.48 [0.34-1.18] to 0.59 [0.21-1.10] vs. 0.65 [0.25-1.14] to 0.93 [0.24-1.88] in the erythromycin and placebo groups, respectively; p values = 0.86 and 0.12). Serum Procalcitonin (PCT) and CRP dropped considerably in the Erythromycin group, whereas only PCT showed a drop in the placebo group. On day 6, the non-survivors' serum TNF/IL-10 ratio was lower than that of the survivors (0.55 [0.17-1.04] vs 1.08 [0.4-2.28], p = 0.029). Neither the pro/anti-inflammatory imbalance nor the mortality were impacted by the addition of erythromycin to standard care in septic patients (ClinicalTrials.gov ID: NCT04665089 (11/12/2020)).
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Affiliation(s)
- Ahlem Trifi
- Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia.
| | - Badis Tlili
- Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia
| | | | - Moncef Feki
- Biochemistry Laboratory, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia
| | - Asma Mehdi
- Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia
| | - Eya Seghir
- Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia
| | - Lynda Messaoud
- Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia
| | - Sami Abdellatif
- Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia
| | - Salah Ben Lakhal
- Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia
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Ozturk CS, Katikol E. Effect of mHealth-based relaxation program on stress coping and anxiety levels in mothers of children with cancer: A randomized controlled study. Patient Educ Couns 2024; 123:108247. [PMID: 38471311 DOI: 10.1016/j.pec.2024.108247] [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] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE This study aimed to explore the effects of a mHealth-based relaxation program on anxiety and stress coping levels in mothers of children with cancer. METHODS This randomized controlled, single-blind, parallel-group trial was conducted in the pediatric hematology-oncology unit of a university hospital. The study was completed by 50 mothers (intervention group: n = 25; control group: n = 25). The mothers in the intervention group participated in a mHealth-based relaxation program for eight weeks (including progressive muscle relaxation, guided imagery, and the four-leaf clover of mindfulness). Videos of the relaxation program were sent to mothers' WhatsApp accounts. The mothers in the control group received routine care. The State-Trait Anxiety and Stress Coping Scales were administered during the first and eighth weeks. The registration number of this study on ClinicalTrials.gov is NCT05807295. RESULTS Mothers who participated in the relaxation program had lower anxiety levels and higher stress-coping scores than those in the control group (p < 0.05). CONCLUSION Progressive muscle relaxation exercises, guided imagery, and cognitive-based therapeutic approaches were effective in reducing mothers' anxiety and stress coping. PRACTICE IMPLICATIONS Pediatric oncology nurses can apply mHealth-based relaxation programs to support caregivers, particularly mothers. In this way, ensuring the continuity and integrity of care is easy.
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Affiliation(s)
- Cigdem Sari Ozturk
- Gazi University Nursing Faculty Pediatric Nursing Department, Emek, Ankara, Turkey.
| | - Emine Katikol
- Gazi University Health Research and Application Center, Pediatric Hematology and Oncology Service, Yenimahalle, Ankara, Turkey.
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Navas-Otero A, Calvache-Mateo A, Calles-Plata I, Valenza-Peña G, Hernández-Hernández S, Ortiz-Rubio A, Valenza MC. A lifestyle adjustments program in long COVID-19 improves symptomatic severity and quality of life. A randomized control trial. Patient Educ Couns 2024; 122:108180. [PMID: 38330704 DOI: 10.1016/j.pec.2024.108180] [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] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To evaluate the efficacy of a therapeutic intervention based on self-adjustment strategies for improving of symptomatic severity and quality of life. METHODS The study was a randomised single-blind clinical trial. Quality of life, disability, and functional impairment were collected. The control group received a leaflet with information on the main symptoms of Long-COVID-19 syndrome, in addition to standard medical treatment. The intervention group received treatment following a dual approach; on the one hand, monitoring and recognition of symptomatology and on the other hand, adaptation and functional improvement. RESULTS A total of 54 participants were included, 27 were included in the intervention group and 27 in the control group. At the beginning of the study, no significant differences were found between groups. After intervention, the quality of life variable showed significant differences between groups in the self-care and anxiety/depression dimensions. Significant between-groups differences were also found for the self-care subscale of the disability variable. The intervention group showed significant differences from baseline on some subscales of the quality of life, disability, and functional impairment variables. CONCLUSION Strategies based on lifestyle adjustments are adequate for the improvement of quality of life and symptom severity in the long COVID-19 population. PRACTICE IMPLICATION The findings suggest that applying an intervention focused in self-adjustment for long COVID patients can have positive effects.
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Affiliation(s)
- A Navas-Otero
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - A Calvache-Mateo
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - I Calles-Plata
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - G Valenza-Peña
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - S Hernández-Hernández
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - A Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - M C Valenza
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain.
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Tyrsin OY, Tyrsin DY, Nemenov DG, Ruzov AS, Odintsova VE, Koshechkin SI, D Amico L. Effect of Lactobacillus reuteri NCIMB 30351 drops on symptoms of infantile functional gastrointestinal disorders and gut microbiota in early infants: Results from a randomized, placebo-controlled clinical trial. Eur J Pediatr 2024; 183:2311-2324. [PMID: 38427038 DOI: 10.1007/s00431-024-05473-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
Infantile functional gastrointestinal disorders, such as colic, constipation, diarrhea, and gastroesophageal reflux (regurgitation), often occur in early infancy and, representing one of the causes of significant parental anxiety, lead to a significant strain on the healthcare resources. In this study, we aimed to evaluate the effects of Lactobacillus reuteri drops (L. reuteri NCIMB 30351) on the symptoms of infantile colic, constipation, diarrhea, and gastroesophageal reflux, as well as on the levels of intestinal microbiota in full-term newborns during the first months of life. A randomized, placebo-controlled, single-masked (blinded), post-marketing clinical study was conducted in two clinical units-Children's City Clinical Hospital of Moscow and Medical Center "St. Andrew's Hospitals-NEBOLIT" from March 2020 to May 2022 in 90 infants aged from 1 to 4 months (mean age (± SD) 12.3 ± 5.09 weeks; 53.3% females, 46.7% males). Patients with colic, regurgitation (single symptom or combination of several symptoms), and constipation or diarrhea were randomly allocated in two parallel arms to receive either 5 drops (2 × 108 colony forming unit) of L. reuteri NCIMB 30351 (n = 60) or masked placebo (n = 30) for 25 consecutive days. Two treatment arms had equal numbers of patients with constipation and diarrhea (n = 30 each). Daily crying times and their duration, evacuations, and regurgitations were recorded in a structured diary. The levels of gut microbiota were analyzed by deep sequencing of bacterial 16S rRNA gene. Infants with colic receiving supplementary L. reuteri NCIMB 30351 for 25 days had significant reduction in the numbers of colic (change from baseline - 6.3 (7.34) vs - 3.0 (7.29) in placebo, P < 0.05) and numbers of crying cases and mean duration of crying (decrease from baseline - 144 (70.7) minutes, lower in the diarrhea subgroup than in constipation infants, compared with - 80 (58.9) in placebo, P < 0.0001), as well as regurgitation numbers (decreased by - 4.8 (2.49) with L. reuteri vs - 3 (7.74) with placebo). We also observed increased numbers of evacuations in infants with constipation (L. reuteri 2.2 (2.4) vs 0.9 (1.06) in placebo, P < 0.05). There was a remarkable reduction of evacuations in infants with diarrhea, while not statistically significant. The analysis of bacterial 16S rRNA gene in the collected samples showed that L. reuteri positively influences the proportions of prevalent species, while it negatively affects both conditionally pathogenic and commensal microbes. Additional in vitro test for formation of Clostridium colonies in the presence of the probiotic demonstrated that L. reuteri effectively inhibits the growth of pathogenic Clostridium species. No adverse events were reported in this study. Conclusion: The uptake of L. reuteri NCIMB 30351 leads to a significant reduction in the number of regurgitations, feeding-induced constipations, and diarrhea as well as mean daily numbers of crying and crying duration in infants during the first months of life. Our results suggest that L. reuteri NCIMB 30351 represents a safe and effective treatment for colic in newborns. Trial registration: ClinicalTrials.gov : NCT04262648. What is Known: • Infantile functional gastrointestinal disorders, such as colic, constipation, diarrhea, and gastroesophageal reflux (regurgitation), often occur in early infancy and, represent one of the causes of significant parental anxiety. • A number of studies have shown that both the composition and diversity of the intestinal microbiota play important roles in the development and function of the gastrointestinal tract. What is New: • The uptake of L. reuteri NCIMB 30351 leads to a significant reduction in the number of regurgitations, feeding-induced constipations, and diarrhea as well as mean daily numbers of crying and crying duration in infants during the first months of life. • L. reuteri positively influences the proportions of prevalent species, while it negatively affects both conditionally pathogenic and commensal microbes in gut microbiota.
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Mehrzad M, Kang AS, Armstrong AW, Eisen DB. Comparing Cosmetic Outcomes of Straight-Line Versus W-Plasty Techniques for Linear Postauricular Wound Closure: A Randomized Evaluator Blind Split-Scar Trial. Dermatol Surg 2024; 50:423-427. [PMID: 38416811 DOI: 10.1097/dss.0000000000004113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
BACKGROUND Surgeons' opinions vary on the cosmetic outcome of straight-line (SL) versus broken-line (W-plasty) closure methods. To date, no studies have compared the 2 techniques in the split-scar design model that resolves the confounding individual patient factors that affects the scar outcome. OBJECTIVE Compare outcomes and wound cosmesis with SL versus W-plasty closure techniques. METHODS This clinical trial was conducted with 50 linear surgical wounds randomized to SL closure on half and W-plasty on the other half. At 3 months, patients and 2 masked observers evaluated each scar using the Patient and Observer Scar Assessment Scale (Patient Observer Scar Assessment Scale [POSAS]). RESULTS The mean (SD) sum of the POSAS observer component scores were 16.6 (6.18) for the SL side and 15.5 (6.37) for the W-plasty side ( p = .49). The mean (SD) sum of the POSAS patient scores were 14.4 (6.8) in SL and 15.1 (8.2) in W-plasty ( p = .59). The mean (SD) complications were 0.08 (0.06) for SL and 0.02 (0.14) for W-plasty ( p = .18). CONCLUSION No statistically significant difference in wound cosmesis or complications was noted between SL versus W-plasty closure techniques. Surgeons may want to consider whether the extra time involved in placing zigzag W-plasty lines is worthwhile.
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Affiliation(s)
- Mehrnaz Mehrzad
- School of Medicine, University of California, Davis, Sacramento, California
| | - Alison S Kang
- Department of Dermatology, Health Sciences Campus, University of Southern California, Los Angeles, California
| | - April W Armstrong
- Departments of Dermatology, University of California, Davis, Sacramento, California
| | - Daniel B Eisen
- Departments of Dermatology, University of California, Davis, Sacramento, California
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Othman SY, Elbiaa MA, Mansour ER, El-Menshawy AM, Elsayed SM. Effect of neuromuscular electrical stimulation and early physical activity on ICU-acquired weakness in mechanically ventilated patients: A randomized controlled trial. Nurs Crit Care 2024; 29:584-596. [PMID: 37984373 DOI: 10.1111/nicc.13010] [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: 05/07/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Intensive care unit-acquired weakness (ICU-AW) is common in critically ill patients and increases the duration of mechanical ventilation (MV) and weaning time. Early mobilization, range of motion (ROM) exercises, and neuromuscular electrical stimulation (NMES) can prevent ICU-AW by maintaining muscle mass. However, studies highlighting the effects of combining NMES with early physical activity in ICU patients are limited. AIM To evaluate the effect of NMES and early physical activity on ICU-AW in mechanically ventilated patients. STUDY DESIGN A single-blinded randomized controlled trial was conducted in Alexandria, Egypt. Patients were randomly assigned to one of four groups: NMES, ROM, combined therapy (ROM + NMES), or conventional care (control group). The Medical Research Council (MRC) scale was used to assess the ICU-AW for the study patients over a 7-day period. The duration of the patient's MV and ICU stays were recorded. RESULTS Of the 180 patients who were assessed for eligibility, 124 were randomly assigned to one of four groups: 32 patients in ROM exercises, 30 in NMES, 31 in combined therapy (ROM + NMES), and 31 in the control group. On day 7, ROM + NMES and NMES groups showed higher MRC scores than ROM and control groups (50.37 ± 2.34, 49.77 ± 2.19, 44.97 ± 3.61, and 41.10 ± 3.84, respectively). ANOVA test results indicated significant differences (p < .001) across the four groups. ICU-AW occurred in 0% of the ROM + NMES group, 60% of the ROM group, 13% of the NMES group, and 100% of the control group (p < .001). The MV duration (in days) in the ROM + NMES group was shorter (12.80 ± 3.800) than in the ROM, NMES, or control groups (21.80 ± 4.460, 18.73 ± 4.748, and 20.70 ± 3.932, respectively). ICU-LOS was shorter in the ROM + NMES group (17.43 ± 3.17 days) compared with the ROM group (22.53 ± 4.51 days), the NMES group (21.10 ± 5.0 days), and the control group (21.50 ± 4.42 days) with significant differences (p < .001) between the four groups. CONCLUSION Daily sessions of NMES and early physical activity were well tolerated, preserved muscle strength, prevented ICU-AW, and decreased the duration of the MV and ICU stay. RELEVANCE TO CLINICAL PRACTICE The findings of this study support the use of NMES and early physical exercises by critical care nurses as part of routine care for critically ill patients.
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Affiliation(s)
| | | | - Eman R Mansour
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Qu H, Zhang R, Xin W, Jing H, Wang G, Gao L. Investigator-blinded, controlled, and randomized comparative study on 1565 nm non-ablative fractional laser versus 5% minoxidil for treatment of androgenetic alopecia. J Cosmet Dermatol 2024; 23:1638-1644. [PMID: 38247260 DOI: 10.1111/jocd.16173] [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: 09/28/2023] [Revised: 12/19/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Characterized by progressive hair loss due to an excessive response to androgens, androgenetic alopecia (AGA) affects up to 50% of males and females. Minoxidil is one of approved medications for AGA but inadequate responses occur in many patients. AIMS To determine whether 1565 nm non-ablative fractional laser (NAFL) could yield better therapeutic benefits for patients with AGA as compared with 5% minoxidil. METHODS Thirty patients with AGA were enrolled; they were randomly assigned into the laser or minoxidil treatment groups. For the laser treatment group, patients were treated by 1565 nm NAFL at 10 mJ, 250 spots/cm2 with 2 weeks intervals for 4 sessions in total. For the minoxidil treatment group, 1-milliliter of topical 5% minoxidil solution was applied to hair loss area twice a day. RESULTS The primary outcomes were the changes in numerous hair growth indexes at the Week 10 as compared with the baselines. Both 1565 nm NAFL and 5% minoxidil led to significantly greater hair densities and diameters in patients at the Week 10 than the baselines (p < 0.01). As compared with 5% minoxidil, 1565 nm NAFL showed significantly greater improvements in total hair number, total hair density (hair/cm2), terminal hair number, terminal hair density (hair/cm2), number of hair follicle units, and average hair number/number of hair follicle units. CONCLUSIONS Our data demonstrate that 1565 nm NAFL exhibits superior clinical efficacy in some aspects of hair growth to the topical minoxidil. It is a safe and effective modality in treating AGA.
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Affiliation(s)
- Huanhuan Qu
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Rongli Zhang
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Wuyan Xin
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Huan Jing
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Lin Gao
- Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
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Kull C, Martin R, Rossel JB, Nguyen A, Albrecht E. Femoral vs sciatic nerve block to provide analgesia after medial open wedge high tibial osteotomy in the setting of multimodal analgesia: A randomized, controlled, single-blinded trial. J Clin Anesth 2024; 93:111355. [PMID: 38134484 DOI: 10.1016/j.jclinane.2023.111355] [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] [Revised: 10/14/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
STUDY OBJECTIVE Medial open wedge high tibial osteotomy (MOW HTO) is associated with moderate to severe postoperative pain. The proximal part of the tibia is innervated by branches from the femoral nerve anteriorly and the sciatic nerve posteriorly. There is a paucity of information regarding the optimal peripheral nerve block for postoperative analgesia with minimal impact on motor function. This study tested the hypothesis that a femoral nerve block provides superior analgesia to a sciatic nerve block after MOW HTO in the setting of multimodal analgesia. DESIGN Randomized controlled single-blind trial. SETTING Operating room, postoperative recovery area and ward, up to 6 postoperative months. PATIENTS Fifty patients undergoing MOW HTO. INTERVENTIONS Interventions were femoral or sciatic nerve block under ultrasound guidance. For each intervention, a total of 100 mg of ropivacaine was injected. Postoperative pain treatment followed a pre-defined protocol with intravenous patient-controlled analgesia of morphine, paracetamol, and ibuprofen. MEASUREMENTS The primary outcome was intravenous morphine consumption at 24 h postoperatively. Secondary outcomes included rest and dynamic pain scores (on a numeric rating scale out of 10) at 2, 24 and 48 h postoperatively. Functional outcomes included the Short Form-12, Knee injury and Osteoarthritis Outcome Score, and International Knee Documentation Committee (IKDC) scores measured at 6 months postoperatively. MAIN RESULTS Mean [95% confidence interval] i.v. morphine consumption at 24 postoperative hours were 24 mg [15 mg,33 mg] in the femoral nerve block group and 24 mg [16 mg,32 mg] in the sciatic nerve block group (p = 0.98). There were no significant differences in the secondary outcomes between groups. CONCLUSIONS This trial failed to demonstrate that a femoral nerve block provides superior analgesia to a sciatic nerve block after MOW HTO under general anesthesia in the setting of multimodal analgesia. There was no significant difference in quality of life and functional outcomes at 6 months postoperatively between groups. Trial registry number:Clinicaltrials.com - NCT05728294; Kofam.ch - SNCTP000003048 | BASEC2018-01774.
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Affiliation(s)
- Corey Kull
- Department of Anaesthesia, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Robin Martin
- Consultant, Department of Orthopedic surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Jean-Benoit Rossel
- Statistician, Centre for Primary Care and Public Health (Unisanté), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Alexandre Nguyen
- Research assistant, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Eric Albrecht
- Program director of Regional Anesthesia, Department of Anesthesia, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
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Penington E, Wild J, Warnock-Parkes E, Grey N, Murray H, Kerr A, Stott R, Rozental A, Andersson G, Clark DM, Tsiachristas A, Ehlers A. Cost-effectiveness of therapist-assisted internet-delivered psychological therapies for PTSD differing in trauma focus in England: an economic evaluation based on the STOP-PTSD trial. Lancet Psychiatry 2024; 11:339-347. [PMID: 38554731 DOI: 10.1016/s2215-0366(24)00055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Although there are effective psychological treatments for post-traumatic stress disorder (PTSD), they remain inaccessible for many people. Digitally enabled therapy is a way to overcome this problem; however, there is little evidence on which forms of these therapies are most cost effective in PTSD. We aimed to assess the cost-effectiveness of the STOP-PTSD trial, which evaluated two therapist-assisted, internet-delivered cognitive behavioural therapies: cognitive therapy for PTSD (iCT-PTSD) and a programme focusing on stress management (iStress-PTSD). METHODS In this health economic evaluation, we used data from the STOP-PTSD trial (n=217), a single-blind, randomised controlled trial, to compare iCT-PTSD and iStress-PTSD in terms of resource use and health outcomes. In the trial, participants (aged ≥18 years) who met DSM-5 criteria for PTSD were recruited from primary care therapy services in South East England. The interventions were delivered online with therapist support for the first 12 weeks, and three telephone calls over the next 3 months. Participants completed questionnaires on symptoms, wellbeing, quality of life, and resource use at baseline, 13 weeks, 26 weeks, and 39 weeks after randomisation. We used a cost-effectiveness analysis to assess cost per quality-adjusted life year (QALY) at 39 weeks post-randomisation, from the perspective of the English National Health Service (NHS) and personal social services and on the basis of intention-to-treat for complete cases. Treatment modules and the platform design were developed with extensive input from service users: service users also advised on the trial protocol and methods, including the health economic measures. This is a pre-planned analysis of the STOP-PTSD trial; the trial was registered prospectively on the ISRCTN Registry (ISRCTN16806208). FINDINGS NHS costs were similar across treatment groups, but clinical outcomes were superior for iCT-PTSD compared with iStress-PTSD. The incremental cost-effectiveness ratio for NHS costs and personal social services was estimated as £1921 per QALY. iCT-PTSD had an estimated 91·6% chance of being cost effective at the £20 000 per QALY threshold. From the societal perspective, iCT-PTSD was cost saving compared with iStress-PTSD. INTERPRETATION iCT-PTSD is a cost-effective form of therapist-assisted, internet-delivered psychological therapy relative to iStress-PTSD, and it could be considered for clinical implementation. FUNDING Wellcome Trust and National Institute of Health Research Oxford Health Biomedical Research Centre.
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Affiliation(s)
- Ed Penington
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Jennifer Wild
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK; Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, NSW, Australia
| | - Emma Warnock-Parkes
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK; Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings' College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Nick Grey
- Sussex Partnership NHS Foundation Trust, Worthing, UK; School of Psychology, University of Sussex, Brighton, UK
| | - Hannah Murray
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Alice Kerr
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings' College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Richard Stott
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings' College London, London, UK
| | - Alexander Rozental
- Department of Psychology, Uppsala University, Uppsala, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gerhard Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Behavioural Sciences and Learning and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - David M Clark
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Apostolos Tsiachristas
- Department of Psychiatry, University of Oxford, Oxford, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Anke Ehlers
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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Yabuwaki K, Shinohara K, Fujioka A, Inagaki S, Hirao K. Effectiveness of Comprehensive Environmental Support for Community-Dwelling Older Adults: A Single-Blind Randomized Controlled Trial. Am J Occup Ther 2024; 78:7803205070. [PMID: 38602705 DOI: 10.5014/ajot.2024.050431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
IMPORTANCE The importance of developing age-friendly environments is globally recognized. However, few clinical trials have comprehensively evaluated physical and social components of environments and examined the effects of offering support. OBJECTIVE To clarify the effectiveness of occupational therapy-based comprehensive environmental support for community-dwelling older adults. DESIGN A single-blind parallel-groups randomized controlled trial with blinded participants. SETTING Eight community-based settings under the long-term-care insurance system in regional towns and cities throughout Japan. PARTICIPANTS Sixty older adults age ≥65 yr who were new users of adult day care or adult day health care and allocated by stratified block randomization on the basis of age. INTERVENTION Comprehensive environmental support was provided to participants for 3 mo according to results on the Comprehensive Environmental Questionnaire for older adults (CEQ) to make improvements in environmental factors participants wanted to change to create a more satisfying life. OUTCOMES AND MEASURES The primary outcome measure was the Japanese Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) score at 3 mo postrandomization. Additionally, scores on the Short-Form Six-Dimension utility index were calculated. RESULTS The experimental group showed significant improvements in the SF-36's Role/Social Component Summary (p = .005) and Role-Physical (p = .02), Role-Emotional (p = .01), and Mental Health (p = .05) domains, with moderate effect sizes. The number needed to treat was 3.46, showing statistical significance. CONCLUSIONS AND RELEVANCE Occupational therapy-based comprehensive environmental support based on CEQ scores was effective, resulting in moderate improvements in health-related quality of life among community-dwelling older adults. Plain-Language Summary: Older adults experience a decline in physical and mental functions along with changes in social relationships. These problems make it challenging for older adults to perform valuable occupations, thus reducing their quality of life. This study demonstrated that occupational therapy based on the Comprehensive Environmental Questionnaire for older adults can improve health-related quality of life among community-dwelling older adults. Our findings pave the way for the development of an effective compensatory intervention model in occupational therapy practice.
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Affiliation(s)
- Kenji Yabuwaki
- Kenji Yabuwaki, PhD, OTR, is Professor, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan;
| | - Kazuya Shinohara
- Kazuya Shinohara, PhD, OTR, is Professor, Faculty of Health and Medical Sciences, Tokoha University, Hamamatsu, Japan
| | - Akira Fujioka
- Akira Fujioka, MS, OTR, is Association Certified Occupational Therapist, Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Okayama, Japan
| | - Shigeaki Inagaki
- Shigeaki Inagaki, MS, OTR, is Associate Professor, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan
| | - Kazuki Hirao
- Kazuki Hirao, PhD, OTR, is Associate Professor, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
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Jeong H, Kang T, Lee J, Im S. Comparison of SB17 and reference ustekinumab in healthy adults: A randomized, double-blind, single-dose, phase I study. Int J Clin Pharmacol Ther 2024; 62:231-240. [PMID: 38174886 PMCID: PMC11036876 DOI: 10.5414/cp204492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 04/09/2024] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE This study compared the pharmacokinetic (PK) characteristics of SB17 (Samsung Bioepis, Incheon, Republic of Korea), a proposed biosimilar of ustekinumab (UST) against reference UST (Stelara, Janssen Biotech, Horsham, PA, USA). MATERIALS AND METHODS This double-blind, three-arm, parallel-group, single-dose study randomized 201 healthy adult subjects 1 : 1 : 1 to receive 45 mg of SB17, European Union-sourced UST (EU-UST) or United States of America-sourced UST (US-UST) via subcutaneous (SC) injection. Primary endpoints were area under the concentration-time curve from time zero to infinity (AUCinf) and maximum serum concentration (Cmax). Safety, tolerability, and immunogenicity were investigated. RESULTS All 90% confidence intervals (CIs) for the ratios of AUCinf and Cmax between groups were within the predefined bioequivalence margin of 0.8 - 1.25. The geometric LSMeans ratios of AUCinf and Cmax were 0.99 and 0.90 for SB17/EU-UST, 1.01 and 0.94 for SB17/US-UST, and 1.02 and 1.05 for EU-UST/US-UST, respectively. The proportion of subjects with treatment-emergent adverse events (TEAEs) was comparable between SB17, EU-UST, and US-UST (68.7, 58.2, and 65.7%). No deaths, serious adverse events (SAEs), or severe TEAEs were reported. The incidence of subjects testing positive for post-dose anti-drug antibodies (ADAs) was 26.9%, 34.3%, and 34.3% in the SB17, EU-UST, and US-UST groups, respectively. Among the subjects with a positive ADA result at day 99/end of study, 53.8% (SB17 n = 5, EU-UST n = 12, and US-UST n = 11) were positive for neutralizing antibodies (NAbs). CONCLUSION This study demonstrated bioequivalence of SB17, EU-UST, and US-UST in terms of PK. Safety, tolerability, and immunogenicity were also comparable between all groups.
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16
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Pérez-González F, Sáez-Alcaide LM, Sánchez-Labrador L, Mateos-Moreno MV, Garcillán-Izquierdo MR, Salgado-Peralvo AO. Comparison of the effectiveness of two manual toothbrushes: Conventional design versus double-sided toothbrush design. A pilot study. Int J Dent Hyg 2024; 22:452-457. [PMID: 37753545 DOI: 10.1111/idh.12769] [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: 01/03/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES Dental hygiene is the most effective method in the prevention of oral diseases. However, most patients do not use the recommended teeth brushing techniques and/or time brushing is insufficient. With this objective, modifications in conventional toothbrushes have been developed to deal with these findings. The aim of this study was to compare plaque removal effectiveness of a manual toothbrush with a modified head (MTMH) with a wrap-around design versus a conventional manual toothbrush. METHODS This pilot prospective clinical study was designed according to STROBE guidelines. The patients suspended oral hygiene habits for 24 h (baseline). Subsequently, the teeth were brushed for 60 s. Both toothbrushes followed the same study procedure, separated by 1 month. Plaque-removing effectiveness was measured before and after tooth brushing using the modified O'Leary Plaque Index (PI). RESULTS Seven patients were included in this pilot study. The mean age was 37.66 ± 10.68 years. PI mean differences between baseline and after brushing were 51.99% ± 16.43 for MTMH and 27.93 ± 6.85, for conventional toothbrush (p = 0.0013). After brushing, mean PI values were 18.36% ± 6.95%, and 37.61% ± 10.57% respectively (p < 0.001). CONCLUSION Within the limitations of the present study, it can be concluded that the effectiveness of plaque removal by using MTMH is significantly higher than the conventional manual toothbrush.
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Affiliation(s)
- Fabián Pérez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Luis-Miguel Sáez-Alcaide
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Luis Sánchez-Labrador
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - María-Victoria Mateos-Moreno
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Angel-Orión Salgado-Peralvo
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
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Alajmi A, Niaz G, Chen C, Lee K. A 15% Trichloroacetic Acid + 3% Glycolic Acid Chemical Peel Series Improves Appearance of Hand Lentigines: An Evaluator-Blinded, Split-Hand Prospective Trial. Dermatol Surg 2024; 50:467-470. [PMID: 38460193 DOI: 10.1097/dss.0000000000004114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
BACKGROUND Improving the appearance of lentigines on the hands is a key component to hand rejuvenation. Soft tissue fillers revolumize hands, but do not address pigmentary changes. OBJECTIVE: This study investigated the effiacy of a 15% trichloroacetic acid (TCA) + 3% glycolic acid (GA) combination peel in improvement of appearance of hand lentigines. METHODS A prospective evaluator-blinded, split-hand study was performed using a 15% TCA + 3% GA peel to treat patients with hand lentigines. Subjects received a total of 3 treatments at 4-week intervals on 1 hand, with the other hand serving as an untreated control. Final photographs were taken 12 weeks after the last treatment. Two blinded board-certified dermatologists graded improvement in hand lentigines using a 5-point scale. RESULTS Eighteen of 20 patients completed the study (90%). The mean age was 64.4 years (SE 1.6, range 51-71). The mean pain scores were 3.8 (SE 0.4) on a 10-point scale (1 = no pain, 10 = extremely painful). Blinded evaluators correctly identified the after-treatment photographs in 16 patients (88%). Physician and patient-graded mean improvement of lentigines was significant for treated versus control hands ( p < .01). No adverse events were noted. CONCLUSION A series of three 15% TCA + 3% GA peels are effective and safe in the treatment of hand lentigines.
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Affiliation(s)
- Ali Alajmi
- Main Line Center for Laser Surgery, Ardmore, Pennsylvania
| | - Ghassan Niaz
- Main Line Center for Laser Surgery, Ardmore, Pennsylvania
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Christine Chen
- Department of Dermatology, Temple University, Philadelphia, Pennsylvania
| | - Kachiu Lee
- Main Line Center for Laser Surgery, Ardmore, Pennsylvania
- Department of Dermatology, Temple University, Philadelphia, Pennsylvania
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Davidovich E, Ccahuana-Vasquez RA, Grender J, Timm H, Gonen H, Zini A. A 4-week randomized controlled trial evaluating plaque and gingivitis effects of an electric toothbrush in a paediatric population. Int J Paediatr Dent 2024; 34:246-255. [PMID: 37864381 DOI: 10.1111/ipd.13130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 08/21/2023] [Accepted: 09/15/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Few extended studies have explored oscillating-rotating (O-R) toothbrush efficacy in young children. AIM To compare the efficacy between O-R and manual toothbrushes in reducing plaque and gingivitis after 4 weeks in children. DESIGN This was a randomized, parallel-group, examiner-blind, clinical trial. In two 50-subject cohorts (3-6 years, primary dentition, parental brushing; 7-10 years, mixed dentition, self-brushing), subjects used Oral-B Kids O-R toothbrush per manufacturer's instructions or Paro Junior manual toothbrush in a customary manner. Plaque and Modified Gingival Index (MGI; primary variable) scores were assessed at baseline and Week 4 for all subjects and within each age group. RESULTS Both toothbrushes significantly reduced whole mouth and posterior plaque and MGI versus baseline (p < .001). Combined groups: O-R showed greater plaque and MGI reductions versus manual for all measures (p ≤ .003). Three- to 6-year-olds: O-R demonstrated significantly (p < .032) greater whole-mouth (55.7%) and posterior (34.3%) plaque reductions at Week 4 versus manual. Seven- to 10-year-olds: O-R showed significantly (p < .001) greater whole-mouth (94.5%) and posterior (108.4%) plaque reductions and greater (p ≤ .016) whole-mouth (14.1%) and posterior (18.8%) MGI reductions versus manual. There were no adverse events. CONCLUSION The O-R toothbrush, used per manufacturer's instructions, reduced plaque and gingivitis better than a manual toothbrush used in a customary manner among children.
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Affiliation(s)
- Esti Davidovich
- Faculty of Dental Medicine, Hebrew University & Hadassah, Jerusalem, Israel
| | | | | | - Hans Timm
- Procter & Gamble Service GmbH, Kronberg, Germany
| | - Hila Gonen
- Faculty of Dental Medicine, Hebrew University & Hadassah, Jerusalem, Israel
| | - Avi Zini
- Faculty of Dental Medicine, Hebrew University & Hadassah, Jerusalem, Israel
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Yin XJ, Lin GP, Wu XY, Huang R, Xu CJ, Yao MY. Effects of lavender essential oil inhalation aromatherapy on depression and sleep quality in stroke patients: A single-blind randomized controlled trial. Complement Ther Clin Pract 2024; 55:101828. [PMID: 38241803 DOI: 10.1016/j.ctcp.2024.101828] [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: 06/03/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND AND PURPOSE Post-stroke depression (PSD) has major implications for rehabilitation, motor recovery, activities of daily living, social and interpersonal functioning, and mortality. In view of the side effects of antidepressants, aromatherapy, a widely used non-pharmacological therapy, has received growing attention in recent years for its benefits of reduced complications, accessibility, and effectiveness. This study was designed to assess the effects of inhalation aromatherapy with lavender essential oil on depression and sleep quality in patients with PSD. MATERIALS AND METHODS Forty patients with PSD were enrolled and randomized into experimental and placebo groups. Experimental-group patients inhaled microencapsulated lavender essential oil every night at bedtime over a period of 4 weeks. A nonwoven bag containing 2.3 g of microcapsules with about 1.5 g of lavender essential oil was placed on or under the patient's pillow, depending on the patient's scent sensitivity. Placebo-group patients used the empty nonwoven bags for the same period as the experimental group. The 17-item Hamilton Rating Scale for Depression (HAMD-17), the Zung Self-Rating Depression Scale (SDS), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure outcomes. RESULTS The HAMD-17 score, SDS score, and PSQI score showed statistically significant differences between both groups before and after intervention (P ≤ 0.01). The improvement in the experimental group was more marked than in the placebo group (P < 0.05). CONCLUSION Lavender essential oil inhalation aromatherapy may help reduce depression and improve sleep quality in patients with PSD.
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Affiliation(s)
- Xiao-Jun Yin
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China; Department of Nursing, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China
| | - Gao-Ping Lin
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China
| | - Xiao-Yan Wu
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China; Department of Nursing, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China
| | - Rui Huang
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China; Department of Nursing, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China
| | - Cun-Jin Xu
- College of Material, Chemistry and Chemical Engineering, Key Laboratory of Organosilicon Chemistry and Material Technology of Ministry of Education, Hangzhou Normal University, Hangzhou, 311121, China
| | - Mei-Yan Yao
- Department of Nursing, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China; Department of Outpatient Nursing, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310009, China.
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20
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Branagan A, Murphy C, O'Sullivan A, Bodnarova I, Feyereislova S, Berka I, Miletin J, Stranak Z. Influence of gastric residual assessment in preterm neonates on time to achieve enteral feeding (the GRASS trial)-Multi-centre, assessor-blinded randomised clinical trial. Eur J Pediatr 2024; 183:2325-2332. [PMID: 38427039 PMCID: PMC11035479 DOI: 10.1007/s00431-024-05483-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE Gastric residual measurement is routinely performed in premature infants prior to feeding despite a lack of evidence of benefit. We aimed to evaluate if the exclusion of routine gastric residual measurement and evaluation has an impact on the time taken to achieve full enteral feeding in preterm neonates. METHODS International multi-centre randomised controlled trial. Clinically stable, appropriate for gestational age infants between 26+0 and 30+6 weeks of gestation and less than 1.5 kg birth weight were eligible. Infants were randomised to the intervention arm (no monitoring of gastric aspirates) or control arm (routine care). Primary outcome was the achievement of enteral feeds of 100 ml/kg/day by day 5 of life. RESULTS Ninety-five infants were recruited with 88 included in an intention-to-treat analysis, 45 in the intervention arm and 43 in the control arm. There was no imbalance in baseline characteristics. Thirty-three (73.3%) infants in the intervention group and 32 infants (74.4%) in the control group reached full feeds by day 5 of life (p = 0.91) with no difference in median time to full feeds. There were no statistically significant differences in survival or the major morbidities of prematurity. CONCLUSION There was no difference in time to attainment of enteral feeds of 100 ml/kg/day in premature infants when gastric residuals were not monitored. In the absence of a clinical benefit to routine monitoring, it may be appropriate to discontinue this practice and only monitor residuals when clinical concern of feeding intolerance or gastrointestinal pathology arises in this group of patients. TRIAL REGISTRATION NCT03111329- https://clinicaltrials.gov/ . Registered 06/04/2017. WHAT IS KNOWN • Previous randomized trials have shown little benefit to the performance of routine assessment of gastric residuals in preterm infants. Despite this, they continue to be performed due to concerns from observational data regarding development of NEC. Meta-analysis to date has failed to answer the question regarding NEC. WHAT IS NEW • In very low birth weight infants who are fed using modern feeding practice of faster feed advancement, to minimize use of central access and parenteral nutrition, exclusion of routine checks of gastric residuals did not increase the proportion of infants reaching full enteral feeds by day 5. No harm was seen when residual checks were not performed. • In the absence of a clinical benefit to the routine performance of gastric residuals in very low birth weight infants, it may be appropriate to discontinue their use and instead check residuals when clinical concern of pathology arises.
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Affiliation(s)
- A Branagan
- The Coombe Women and Infants University Hospital, Dublin 8, Ireland.
| | - C Murphy
- The Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - A O'Sullivan
- The Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - I Bodnarova
- Institute for the Care of Mother and Child, Prague, Czech Republic
| | - S Feyereislova
- Institute for the Care of Mother and Child, Prague, Czech Republic
| | - I Berka
- Institute for the Care of Mother and Child, Prague, Czech Republic
- 3rd School of Medicine, Charles University, Prague, Czech Republic
| | - J Miletin
- The Coombe Women and Infants University Hospital, Dublin 8, Ireland
- Institute for the Care of Mother and Child, Prague, Czech Republic
- UCD School of Medicine, University College Dublin, Dublin, Ireland
- 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Z Stranak
- Institute for the Care of Mother and Child, Prague, Czech Republic
- 3rd School of Medicine, Charles University, Prague, Czech Republic
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Mohammad I, Stack T, Norris M, Kim S, Lamb M, Thorp BD, Klatt-Cromwell C, Ebert CS, Kimple AJ, Senior BA. The Surprising Effect of Priming on SNOT-22 Results. Am J Rhinol Allergy 2024; 38:153-158. [PMID: 38332587 PMCID: PMC11000435 DOI: 10.1177/19458924241229160] [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] [Indexed: 02/10/2024]
Abstract
BACKGROUND Priming is a psychological phenomenon where subconscious cues in the environment impact our behavioral responses in certain situations. Well studied in the worlds of business, marketing, and even politics, it is unclear how the priming phenomenon impacts patient perception of their own disease state nor how they report that perception using tools like the Sinonasal Outcomes Test (SNOT-22), used to measure that perception in chronic rhinosinusitis. OBJECTIVE To determine the impact of positive or negative priming on self-reported patient perception of their chronic rhinosinusitis disease using the SNOT-22 disease-specific quality of life instrument. METHODS Single-blind, randomized, prospective cohort pilot study of 206 consecutive adult patients with a clinical diagnosis of chronic rhinosinusitis presenting to a university rhinology clinic. Patients were randomized to receive "positive priming" (103) or "negative priming" (103) by reading a passage about the positive or negative aspects of chronic sinusitis and its treatment respectively. Patients were then asked to fill out the SNOT-22 and results between the two groups were compared. RESULTS The negative priming group had a higher median SNOT-22 score of 49 [IQR = 39] compared to the positive priming groups' score of 22 [IQR = 27], p < 0.0001), a difference of nearly three times the minimal clinical impactful difference (MCID). This effect was consistent regardless of age or sex of the patient. Subgroup analysis revealed a greater impact when priming was performed by the senior male attending regardless of patient age or sex (p < 0.001), while priming performed by the younger female research fellow had greater impact on older patients (>59 years, p = 0.001) and female patients (p = 0.003). CONCLUSIONS Priming impacts how patient's perceive their chronic rhinosinusitis as determined by the SNOT-22. It is imperative that the rhinologist understand this when using this instrument in research applications and in clinical decision-making for patients.
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Affiliation(s)
- Ibtisam Mohammad
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
- Department of Otolaryngology— Head & Neck Surgery at Gazi University, Ankara, Turkey
| | - Taylor Stack
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Meghan Norris
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Sulgi Kim
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Meredith Lamb
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Brian D. Thorp
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Christine Klatt-Cromwell
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Charles S. Ebert
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Adam J. Kimple
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Brent A. Senior
- Department of Otolaryngology—Head & Neck Surgery at the University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
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Han S, Kim B, Park H. Auricular Acupressure on Breast Pain Among Breastfeeding Mothers Receiving Gentle Hand Techniques: A Randomized, Single-Blind, Sham-Controlled Trial. J Hum Lact 2024; 40:248-258. [PMID: 38379313 DOI: 10.1177/08903344241228545] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Auricular acupressure influences pain reduction in patients with diseases. However, study results on its influence on breast pain, common among breastfeeding mothers, are insufficient. RESEARCH AIM This study aimed to explore the effectiveness of auricular acupressure on breast pain among breastfeeding mothers who also received a standard gentle hand technique. METHODS This was a placebo-controlled study wherein auricular acupressure was provided for 4 weeks to 52 breastfeeding mothers consulting a local breastfeeding clinic. In the intervention group, auricular acupressure was applied to specific acupoints, including Shenmen, central rim, breast, and endocrine, which are related to breast pain and postpartum lactation. For the placebo control group, auricular acupressure was applied to acupoints not related to breast pain. The degree of breast pain was assessed using a numeric rating scale and a pressure algometer. RESULTS After 4 weeks of auricular acupressure, numeric rating scale pain scores did not show a significant change. However, the pressure pain threshold for the upper left (Z = -2.202, p = .028) and upper right (t = 2.613, p = .012) areas of the right breast increased significantly in the intervention group. CONCLUSION This study employed subjective and objective measurements to evaluate the efficacy of auricular acupressure in alleviating breast pain. The intervention shows potential as a nursing measure. Further research is required to determine the optimal intervention duration and frequency, particularly for breastfeeding parents with severe pain, and to evaluate long-term outcomes.
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Affiliation(s)
- Shinae Han
- The Graduate School of Clinical and Public Health Convergence, Ewha Womans University, Seoul, South Korea
| | - Bomi Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Hyojung Park
- College of Nursing, Ewha Womans University, Seoul, South Korea
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Atan RM, Ersoy G, Çakıcı Ç. Effects of Hardaliye, a Fermented Grape Drink, on Oxidative Stress, Lipid Profile, and Blood Pressure in Young Soccer Players: A Randomized Controlled Trial. J Am Nutr Assoc 2024; 43:356-364. [PMID: 38112518 DOI: 10.1080/27697061.2023.2291789] [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] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Hardaliye, a traditional fermented grape juice, can prevent imbalances in the antioxidant defense systems of soccer players. Hardaliye is mainly produced through the fermentation of grapes, sour cherry leaves, and mustard seeds and is consumed as a drink. This study was aimed at investigating the effects of hardaliye consumption on oxidative stress parameters, lipid profile, and blood pressure in young elite soccer players. METHODS In this single-blind, randomized, placebo-controlled, parallel-design study, while the participants in one of the groups consumed 250 mL/d of hardaliye drink (Hardaliye Group), the participants in the other group consumed placebo drink (Placebo Group) for 28 days. Three-day food record and blood samples were taken from the soccer players and their blood pressure was measured. RESULTS Nutrient intakes in both groups were similar at the beginning and end of the study (p > 0.05). Dietary carbohydrates and vitamin A, E, and C intakes were below the recommended levels in both groups. Hardaliye consumption significantly increased the serum total antioxidant capacity level but significantly decreased serum total oxidation status, oxidative stress index, malondialdehyde, and nitric oxide levels compared to the Placebo Group (p < 0.05). Lipid parameters and diastolic blood pressure levels were not significantly different between the groups (p > 0.05). Hardaliye consumption significantly decreased systolic blood pressure compared to that in the Placebo Group (p < 0.05). CONCLUSION Hardaliye consumption in young elite soccer players showed antioxidative effects and decreased systolic blood pressure but did not affect their lipid profiles.
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Affiliation(s)
- Ramazan Mert Atan
- Department of Nutrition and Dietetics, Institute of Health Sciences, İstanbul Medipol University, İstanbul, Turkey
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bandirma Onyedi Eylül University, Balikesir, Turkey
| | - Gülgün Ersoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İstanbul Medipol University, İstanbul, Turkey
| | - Çağrı Çakıcı
- Department of Biochemistry, Faculty of Medicine, İstanbul Medipol University, İstanbul, Turkey
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Maher S, Elmeligy HA, Aboushousha T, Helal NS, Ossama Y, Rady M, Hassan AMA, Kamel M. Synergistic immunomodulatory effect of synbiotics pre- and postoperative resection of pancreatic ductal adenocarcinoma: a randomized controlled study. Cancer Immunol Immunother 2024; 73:109. [PMID: 38662232 DOI: 10.1007/s00262-024-03686-6] [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: 01/12/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a highly immunosuppressive microenvironment. This single-blind, randomized study aimed to evaluate the synergistic immunomodulatory effects of synbiotics (probiotics and inulin prebiotics), as well as their impact on postoperative complications and outcomes, compared to the use of probiotics alone. Ninety patients diagnosed with PDAC were enrolled and randomly assigned into three groups: the placebo group, the probiotics group (receiving a mixture of ten strains of Lactobacillus, Bifidobacterium, and Streptococcus bacteria at a dose of 25 billion CFUs), and the synbiotics group (the same probiotics along with inulin prebiotics). The interventions were administered for 14 days before the surgery and continued for one month postoperatively. Tumor tissue infiltration of CD8 + T cells and the expression of IFN γ were assessed by immunohistochemistry (IHC). Inflammatory cytokines concentrations, including Il 1 B, IL 6, and IL 10, were evaluated as well by ELISA at various time points pre- and postoperative. Furthermore, patients were followed up after the surgery to assess postoperative short-term outcomes. Our results showed a significant elevation of CD8 + T cell proportion and IFN γ expression in the synbiotics group compared to the probiotics group (p = 0.049, p = 0.013, respectively). Inflammatory cytokines showed a significant gradual decrease in the synbiotics group compared to placebo and probiotics-treated groups (p = 0.000 for both). Administration of synbiotics and probiotics significantly decreased the rate of postoperative complications including anastomotic leakage, diarrhea, and abdominal distension (p = 0.032, p = 0.044, p = 0.042, respectively), with a remarkable reduction in bacteremia in the synbiotics group. These results revealed that this synbiotics formulation potentially enhances the immune response and reduces complications associated with surgery.Clinical trial identification: NCT06199752 (27-12-2023).
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Affiliation(s)
- Sara Maher
- Lecturer of Immunology, Immunology Department, Theodor Bilharz Research Institute, Giza, Egypt.
| | - Hesham A Elmeligy
- Associate Professor of General Surgery, Surgery Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Tarek Aboushousha
- Professor of Pathology, Pathology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Noha Said Helal
- Associate Professor of Pathology, Pathology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Yousra Ossama
- Lecturer of Pathology, Pathology Department, October 6 University, Giza, Egypt
| | - Mahmoud Rady
- Lecturer of Surgery, Department of Surgery, Theodor Bilharz Research Institute, Giza, Egypt
| | - Ahmed Mohamed A Hassan
- Professor of Surgery, Surgery Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Manal Kamel
- Professor of Immunology, Immunology Department, Theodor Bilharz Research Institute, Giza, Egypt
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Abbasalizadeh M, Farsi Z, Sajadi SA, Atashi A, Fournier A. The effect of resilience training with mHealth application based on micro-learning method on the stress and anxiety of nurses working in intensive care units: a randomized controlled trial. BMC Med Educ 2024; 24:442. [PMID: 38658914 DOI: 10.1186/s12909-024-05427-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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Nurses in intensive care units (ICUs) face high stress and anxiety, impacting their well-being and productivity. Addressing this, this study evaluated the impact of resilience training via a mHealth application based on micro-learning on ICU nurses' stress and anxiety levels. MATERIALS AND METHODS This study, a single-blind randomized controlled trial conducted in 2022-23, involved sixty ICU nurses from two Tehran hospitals. Nurses were chosen through purposive sampling and divided into intervention and control groups by simple randomization. The intervention group was taught resilience via an educational mHealth application based on micro-learning, with data collected using the anxiety and stress subscales of DASS-21. RESULTS Before the intervention, there were no significant differences in stress and anxiety scores between the intervention and control groups (P > 0.05). Upon utilizing the mHealth application, the intervention group exhibited significant reductions in stress, from 10.77 ± 3.33 to 9.00 ± 1.66 (P = 0.001), and in anxiety, from 9.43 ± 3.35 to 7.93 ± 0.98 (P < 0.001). In contrast, the control group experienced a slight increase in stress levels, from 10.10 ± 2.19 to 10.73 ± 2.15 (P = 0.002), and in anxiety levels, from 9.10 ± 1.63 to 10.23 ± 1.65 (P < 0.0001). CONCLUSIONS The micro-learning-based mHealth application for resilience training significantly reduced ICU nurses' stress and anxiety, recommending its adoption as an innovative educational method. TRIAL REGISTRATION The study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).
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Affiliation(s)
- Maryam Abbasalizadeh
- Critical Care Nursing Department, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Zahra Farsi
- Medical-Surgical Nursing, Research and Ph.D. Nursing Departments, School of Nursing, Aja University of Medical Sciences, Kaj St., Shariati St., Tehran, Iran.
| | - Seyedeh Azam Sajadi
- Nursing Management Department, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Afsaneh Atashi
- Department of Psychology, Central Branch, Islamic Azad University, Tehran, Iran
- Faculty of Psychology, Bangalore University, Bangalore, India
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Lai D, Cheng S, Zhou S, Hao J, Chen H, Jia K, Liu H, Cui Y. 755-nm picosecond laser plus topical 20% azelaic acid compared to topical 20% azelaic acid alone for the treatment of melasma: a randomized, split-face and controlled trial. Lasers Med Sci 2024; 39:113. [PMID: 38656631 DOI: 10.1007/s10103-024-04052-9] [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: 11/09/2023] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Melasma remains a refractory skin condition that needs to be actively explored. Azelaic acid has been used for decades as a topical agent to improve melasma through multiple mechanisms, however, there is a lack of research on its combination with laser therapy. This study evaluated the effectiveness of isolated treatment with topical 20% azelaic acid and its combination with 755-nm picosecond laser in facial melasma patients. METHODS A randomized, evaluator-blinded, controlled study was conducted on 30 subjects with facial melasma in a single center from October 2021 to April 2022. All subjects received topical 20% azelaic acid cream (AA) for 24 weeks, and after 4 weeks, a hemiface was randomly assigned to receive 755-nm picosecond (PS) laser therapy once every 4 weeks for 3 treatments. Treatment efficacy was determined by mMASI score evaluations, dermoscopic assessment, reflectance confocal microscopy (RCM) assessments and patient's satisfaction assessments (PSA). RESULTS Treatment with 20% azelaic acid, with or without picosecond laser therapy, significantly reduced the hemi-mMASI score (P < 0.0001) and resulted in higher patient satisfaction. Improvements in dermoscopic and RCM assessments were observed in both sides of the face over time, with no difference between the two sides. RCM exhibited better dentritic cell improvement in the combined treatment side. No patients had serious adverse effects at the end of treatment or during the follow-up period. CONCLUSION The additional use of picosecond laser therapy showed no clinical difference except for subtle differences detected by RCM assessments.The study was registered in the Chinese Clinical Trial Registry (ChiCTR2100051294; 18 September 2021).
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Affiliation(s)
- Dihui Lai
- Department of Dermatology, China-Japan Friendship Hospital, Capital Medical University, NO.2 Yinghua East Road, Chaoyang District, Beijing, China
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Shaowei Cheng
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Shaona Zhou
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Jianchun Hao
- Department of Dermatology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China
| | - Hongguang Chen
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
| | - Kang Jia
- Department of Dermatology, MEIYAN Aesthetic Plastic Medical Clinic, Beijing, China
| | - Hongmei Liu
- Department of Dermatology, MEIYAN Aesthetic Plastic Medical Clinic, Beijing, China
| | - Yong Cui
- Department of Dermatology, China-Japan Friendship Hospital, Capital Medical University, NO.2 Yinghua East Road, Chaoyang District, Beijing, China.
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Baek JE, Hyeon SJ, Kim M, Cho HY, Hahm SC. Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial. BMC Geriatr 2024; 24:369. [PMID: 38658827 DOI: 10.1186/s12877-024-04942-1] [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: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Regular exercise is emphasized for the improvement of functional capacity and independence of older adults. This study aimed to compare the effects of a dual-task resistance exercise program and resistance exercise on cognition, mood, depression, physical function, and activities of daily living (ADL) in older adults with cognitive impairment. METHODS A total of 44 older adults participated in the study. Participants were randomly allocated to an experimental group (n = 22) performing a dual-task resistance exercise program for cognitive function improvement and a control group (n = 22) performing a resistance exercise program. Both groups performed the exercise for 40 min per session, three times a week, for 6 weeks (18 sessions). Cognition, mood, depression, functional fitness, and ADL were quantified before and after the intervention using the Mini-Mental State Examination (MMSE), profile of mood states (POMS), geriatric depression scale (GDS), senior fitness test (SFT), and Korean version of ADL, respectively. RESULTS There was a significant time and group interaction on the MMSE (p = 0.044). There were no significant time and group interactions in the POMS, GDS, SFT, or ADL. Cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after dual-task resistance exercise, and cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after resistance exercise. CONCLUSIONS Dual-task resistance exercise is more effective than resistance exercise in improving cognitive function in older adults with cognitive impairment. Both dual-task resistance exercise and resistance exercise improves mood, depression, functional fitness, and ADL after the intervention. We propose using dual-task resistance exercises for cognitive and physical health management in the older adults with cognitive impairment. TRIAL REGISTRATION This study was registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) (Registration ID, KCT0005389; Registration date, 09/09/2020).
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Affiliation(s)
- Ji-Eun Baek
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon
| | - Sang-Jun Hyeon
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea
| | - May Kim
- Department of Physical Education, College of Education, Korea University, Seoul, Republic of Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon.
| | - Suk-Chan Hahm
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea.
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Tsai CS, Li HT, Yang WL, Jhan YT. The effect of craniocervical flexion and neck endurance exercises plus pulmonary rehabilitation on pulmonary function in spinal cord injury: a pilot single-blinded randomised controlled trial. Spinal Cord Ser Cases 2024; 10:27. [PMID: 38654004 DOI: 10.1038/s41394-024-00637-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
STUDY DESIGN Randomised controlled trial with computerised allocation, assessor blinding and intention-to-treat analysis. OBJECTIVE This study wanted to prove that cervicocranial flexion exercise (CCFE) and superficial neck flexor endurance training combined with common pulmonary rehabilitation is feasible for improving spinal cord injury people's pulmonary function. SETTING Taoyuan General Hospital, Ministry of Health and Welfare: Department of Physiotherapy, Taiwan. METHOD Thirteen individuals who had sustained spinal cord injury for less than a year were recruited and randomised assigned into two groups. The experimental group was assigned CCFEs and neck flexor endurance training plus normal cardiopulmonary rehabilitation. The control group was assigned general neck stretching exercises plus cardiopulmonary rehabilitation. Lung function parameters such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow rate (PEFR), inspiratory capacity (IC), dyspnoea, pain, and neck stiffness were recorded once a week as short-term outcome measure. RESULT The experimental group showed significant time effects for FVC (pre-therapy: 80.4 ± 21.4, post-therapy: 86.9 ± 16.9, p = 0.021, 95% CI: 0.00-0.26) and PEFR (pre-therapy: 67.0 ± 33.4; post-therapy: 78.4 ± 26.9, p = 0.042, 95% CI: 0.00-0.22) after the therapy course. Furthermore, the experimental group showed significant time effects for BDI (experimental group: 6.3 ± 3.0; control group: 10.8 ± 1.6, p = 0.012, 95% CI: 0.00-0.21). CONCLUSION The exercise regime for the experimental group could efficiently increase lung function due to the following three reasons: first, respiratory accessory muscle endurance increases through training. Second, posture becomes less kyphosis resulting increasing lung volume. Third, the ratio between superficial and deep neck flexor is more synchronised. IRB TRIAL REGISTRATION TYGH108045. CLINICAL TRIAL REGISTRATION NCT04500223.
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Affiliation(s)
- Cheng Shin Tsai
- Department of Physiotherapy, TaoYuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
| | - Hsin-Tzu Li
- Department of Physiotherapy, TaoYuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Wan-Li Yang
- Department of Physiotherapy, TaoYuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yi-Ting Jhan
- Department of Physiotherapy, TaoYuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
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Wiesenberger R, Müller J, Kaufmann M, Weiß C, Ghezel-Ahmadi D, Hardt J, Reissfelder C, Herrle F. Influence of motivational interviewing on postoperative mobilization in the enhanced recovery after surgery (ERAS®) pathway in elective colorectal surgery - a randomized patient-blinded pilot study. Langenbecks Arch Surg 2024; 409:134. [PMID: 38644386 PMCID: PMC11033226 DOI: 10.1007/s00423-024-03321-z] [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: 11/21/2023] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE Early mobilization is an essential component of the Enhanced Recovery after Surgery (ERAS®)-pathway. However, a large percentage of patients fail to achieve the ERAS® recommended goal (360 min out of bed from post-operative day 1/POD1). Motivational Interviewing (MI) is an evidence-based type of patient-centered consultation to promote intrinsic motivation. This study aims to evaluate if MI can improve postoperative mobilization. METHODS This two-arm, patient-blinded pilot randomized controlled trial included ERAS®-patients undergoing elective bowel resections. Conversations were validated by MI Treatment Integrity. Two validated motion sensors (movisens) and self-assessments were used to measure mobilization (POD1-POD3: Time out of bed, time on feet and step count). RESULTS 97 patients were screened, 60 finally included and randomized. Cumulatively across POD1-3, the intervention group (IG) was longer out of bed than the control group (CG) (median: 685 vs. 420 min; p=0.022). The IG achieved the ERAS®-goal of 360 min/day more frequently across POD1-3 (27.4% vs. 10.61%; p=0.013). Time on feet was 131.5 min/day (median per POD) in IG vs. 95.8 min/day in the CG (p=0.212), step count was 1347 in IG vs. 754 steps/day in CG (p=0.298). CONCLUSION MI could be conducted low threshold and was well accepted by patients. MI can improve mobilization in the context of ERAS®. Despite better performance, it should be noted that only 27.4% of the IG reached the ERAS®-compliance goal of 360 min/day. The findings of this pilot study stipulate to further test the promising perioperative effects of MI within a multicenter superiority trial. REGISTRATION This study was registered prospectively in the German Clinical Trials Register on 25.02.2022. Trial registration number is "DRKS00027863".
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Affiliation(s)
- Rico Wiesenberger
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Julian Müller
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Mario Kaufmann
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Christel Weiß
- Institute for Medical Statistics, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - David Ghezel-Ahmadi
- Department of Anaesthesiology and Critical Care Medicine, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Julia Hardt
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Christoph Reissfelder
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | - Florian Herrle
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
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Marzban A, Mokhtari S, Tavakkolian P, Mansouri R, Jafari N, Maleki A. The impact of combined administration of surfactant and intratracheal budesonide compared to surfactant alone on bronchopulmonary dysplasia (BPD) and mortality rate in preterm infants with respiratory distress syndrome: a single-blind randomized clinical trial. BMC Pediatr 2024; 24:262. [PMID: 38643076 PMCID: PMC11031862 DOI: 10.1186/s12887-024-04736-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 04/02/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Respiratory distress syndrome (RDS) is one of the most important and common disorders among premature infants. OBJECTIVE This study aimed to compare the effect of the combination of surfactant and budesonide with surfactant alone on Bronchopulmonary dysplasia (BPD) and mortality rate among premature infants with RDS. METHOD An outcome assessor-blind randomized clinical trial was conducted on 134 premature infants with RDS who were born in Ayatollah Mousavi Hospital, Zanjan, Iran in 2021. The covariate adaptive randomization method was utilized to allocate participants into two groups (surfactant alone and a combination of surfactant and budesonide). The primary outcomes were BPD and Mortality rate from admission to hospital discharge. The data in this study were analyzed using SPSS software version 18. RESULTS Overall the comparison of mortality rate and BPD between the two groups did not show a significant difference(p > 0.05). The subgroup results showed that administering surfactant with budesonide to infants under 30 weeks of age significantly reduced the number of deaths compared to using surfactant alone (5 vs. 17). Similar positive effects were observed for the occurrence of Pulmonary Hemorrhage, the need for a second dose of surfactant, oxygen index, mean blood pressure and mean arterial pressure (MAP) in infants under 34 weeks of age compared to more than 34 weeks (p < 0.05). CONCLUSION These findings suggest that the combination therapy of surfactant and budesonide may be beneficial, particularly in preterm infants with less than 34 weeks gestational age and 1500 birth weight. However, further studies with larger sample sizes and longer follow-up periods are needed to confirm these results and assess long-term outcomes. TRIAL REGISTRATION The study was registered at the Iranian Registry of Clinical Trials website under the code IRCT20201222049802N1. https://en.irct.ir/user/trial/48117/view . REGISTRATION DATE 28/02/2021. PUBLIC REPOSITORY DATA SET: This research data set link is displayed on the Zanjan-Iran Medical Sciences website: https://repository.zums.ac.ir/cgi/users/login? target=https%3 A%2 F/repository.zums.ac.ir/id/eprint .
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Affiliation(s)
- Asghar Marzban
- Dept. of neonatology, School of Medicine, Musavi hospital, Zanjan university of medical sciences, Zanjan, Iran
| | - Samira Mokhtari
- Dept. of neonatology, School of Medicine, Musavi hospital, Zanjan university of medical sciences, Zanjan, Iran
| | - Pouria Tavakkolian
- Student Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Mansouri
- Department of Hematology & Medical Oncology, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nahid Jafari
- Dept. of neonatology, School of Medicine, Musavi hospital, Zanjan university of medical sciences, Zanjan, Iran
| | - Azam Maleki
- Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Azadi Square, Jomhori Eslami St, Zanjan, 4515613191, Iran.
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Bahçacı U, Atasavun Uysal S, Erdogan İyigün Z, Ordu Ç, Soybir GR, Ozmen V. Progressive relaxation training in patients with breast cancer receiving aromatase inhibitor therapy-randomized controlled trial. PLoS One 2024; 19:e0301020. [PMID: 38635763 PMCID: PMC11025930 DOI: 10.1371/journal.pone.0301020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/07/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Aromatase inhibitors have positive impacts on the disease-free life of patients with breast cancer. However, their side effects, especially arthralgia, may be experienced by many patients. This study sought to assess the efficacy of Progressive Relaxation Exercises on the prevalent side effects of Aromatase Inhibitors in patients with breast cancer. MATERIALS AND METHODS This clinical trial was conducted with single-blind randomization at a physiotherapy department in a local hospital. Patients who received Aromatase Inhibitor were assigned at random to either the study or control group. The study group (n = 22) performed a Progressive Relaxation Exercises program four days a week for six weeks, while the control group (n = 22) received advice on relaxation for daily life. Data was collected before the intervention and after six weeks. The study's primary endpoint was the Brief Pain Inventory, which was used to measure pain severity. Secondary endpoints included assessments of quality of life and emotional status, which were measured using the Functional Assessment of Chronic Illness Therapy and Hospital Anxiety and Depression scales, respectively. RESULTS The study group exhibited a significant reduction in Pain Severity (p = 0.001) and Pain Interference (p = 0.012) sub-scores. Reduction in Pain Severity (p<0.001) and Patient Pain Experience (p = 0.003) sub-scores was also noted between the groups. Quality of Life and Emotional Status showed no significant variation both within and between the groups (p>0.05). CONCLUSION The study demonstrated that Progressive Relaxation Exercises caused a significant reduction in pain scores among Breast Cancer patients receiving Aromatase Inhibitors. While a decrease in pain during the 6-week period is valuable data, it is necessary to monitor the long-term effects of relaxation techniques.
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Affiliation(s)
- Umut Bahçacı
- Graduate School of Health Sciences, Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | | | | | - Çetin Ordu
- Department of Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Gürsel Remzi Soybir
- Department of General Surgery, Memorial Etiler Health Center, Istanbul, Turkey
| | - Vahit Ozmen
- Breast Health Center, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
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Moujaes F, Ji JL, Rahmati M, Burt JB, Schleifer C, Adkinson BD, Savic A, Santamauro N, Tamayo Z, Diehl C, Kolobaric A, Flynn M, Rieser N, Fonteneau C, Camarro T, Xu J, Cho Y, Repovs G, Fineberg SK, Morgan PT, Seifritz E, Vollenweider FX, Krystal JH, Murray JD, Preller KH, Anticevic A. Ketamine induces multiple individually distinct whole-brain functional connectivity signatures. eLife 2024; 13:e84173. [PMID: 38629811 PMCID: PMC11023699 DOI: 10.7554/elife.84173] [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: 10/12/2022] [Accepted: 02/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Ketamine has emerged as one of the most promising therapies for treatment-resistant depression. However, inter-individual variability in response to ketamine is still not well understood and it is unclear how ketamine's molecular mechanisms connect to its neural and behavioral effects. Methods We conducted a single-blind placebo-controlled study, with participants blinded to their treatment condition. 40 healthy participants received acute ketamine (initial bolus 0.23 mg/kg, continuous infusion 0.58 mg/kg/hr). We quantified resting-state functional connectivity via data-driven global brain connectivity and related it to individual ketamine-induced symptom variation and cortical gene expression targets. Results We found that: (i) both the neural and behavioral effects of acute ketamine are multi-dimensional, reflecting robust inter-individual variability; (ii) ketamine's data-driven principal neural gradient effect matched somatostatin (SST) and parvalbumin (PVALB) cortical gene expression patterns in humans, while the mean effect did not; and (iii) behavioral data-driven individual symptom variation mapped onto distinct neural gradients of ketamine, which were resolvable at the single-subject level. Conclusions These results highlight the importance of considering individual behavioral and neural variation in response to ketamine. They also have implications for the development of individually precise pharmacological biomarkers for treatment selection in psychiatry. Funding This study was supported by NIH grants DP5OD012109-01 (A.A.), 1U01MH121766 (A.A.), R01MH112746 (J.D.M.), 5R01MH112189 (A.A.), 5R01MH108590 (A.A.), NIAAA grant 2P50AA012870-11 (A.A.); NSF NeuroNex grant 2015276 (J.D.M.); Brain and Behavior Research Foundation Young Investigator Award (A.A.); SFARI Pilot Award (J.D.M., A.A.); Heffter Research Institute (Grant No. 1-190420) (FXV, KHP); Swiss Neuromatrix Foundation (Grant No. 2016-0111) (FXV, KHP); Swiss National Science Foundation under the framework of Neuron Cofund (Grant No. 01EW1908) (KHP); Usona Institute (2015 - 2056) (FXV). Clinical trial number NCT03842800.
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Affiliation(s)
- Flora Moujaes
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Masih Rahmati
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Joshua B Burt
- Department of Physics, Yale UniversityBostonUnited States
| | - Charles Schleifer
- David Geffen School of Medicine, University of California, Los AngelesLos AngelesUnited States
| | - Brendan D Adkinson
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
| | | | - Nicole Santamauro
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Caroline Diehl
- Department of Psychology, University of California, Los AngelesLos AngelesUnited States
| | | | - Morgan Flynn
- Department of Psychiatry, Vanderbilt University Medical CenterNashvilleUnited States
| | - Nathalie Rieser
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Terry Camarro
- Magnetic Resonance Research Center, Yale University School of MedicineNew HavenUnited States
| | - Junqian Xu
- Department of Radiology and Psychiatry, Baylor College of MedicineHoustonUnited States
| | - Youngsun Cho
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Child Study Center, Yale University School of MedicineNew HavenUnited States
| | - Grega Repovs
- Department of Psychology, University of LjubljanaLjubljanaSlovenia
| | - Sarah K Fineberg
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Peter T Morgan
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Bridgeport HospitalBridgeportUnited States
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - John H Krystal
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - John D Murray
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Physics, Yale UniversityBostonUnited States
- Department of Psychology, Yale UniversityNew HavenUnited States
| | - Katrin H Preller
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
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Ozlu O, Atilgan E. The effect of high-intensity laser therapy on pain and lower extremity function in patellofemoral pain syndrome: a single-blind randomized controlled trial. Lasers Med Sci 2024; 39:103. [PMID: 38630331 PMCID: PMC11024020 DOI: 10.1007/s10103-024-04017-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: 04/25/2023] [Accepted: 02/07/2024] [Indexed: 04/19/2024]
Abstract
Patellofemoral pain syndrome (PFPS) is a set of symptoms that negatively affect the daily life activities of the individual, leading to functional disability and significant loss of labor, especially in young adults. PFPS is usually due to weakness of the vastus medialis obliquus (VMO) resulting in abnormal patellar tracking and pain. Our study aims to compare the efficacy of high-intensity laser therapy (HILT) on pain and lower extremity function in the treatment of PFPS with different electrophysical agents (EPAs). The study was designed as a single-blind randomized controlled trial. Forty-five people with PFPS (aged 25-45 years) were included in the study. The patients were randomly divided into three groups and a total of ten sessions of treatment were administered to all three groups for 2 weeks, 5 days a week. High-intensity laser (HILT) and exercise program were applied to group 1. Ultrasound (US), transcutaneous electrical nerve stimulation (TENS), and exercise program were applied to group 2. In group 3, US, interferential current (IFC), and exercise program were applied. Both groups underwent three evaluations: pre-treatment, post-treatment, and 12 weeks after treatment. Outcome measures included the visual analog scale for pain severity (VAS), knee flexion range of motion (FROM), Q angle, pain threshold, muscle strength of quadriceps and hamstring, Kujala patellofemoral scoring, lower extremity functional scale (LEFS), and Timed Up and Go Test (TUG). The ANOVA was used for comparing the data of the groups, and two-way repeated measure ANOVA was used to compare at the pre-post and post-intervention 3rd month. The LSD and Bonferroni post hoc tests were also used to identify the between-group differences. Groups 2 and 3 were statistically effective in pain and functionality (p < 0.05). Group 1 was found to be statistically more effective than other groups in reducing pain (95% confidence interval (CI), 0.000/0.000; p = 0.000), increasing knee flexion angle (95% CI, 127.524/135.809; p = 0.000), and increasing lower extremity function (95% CI, 75.970/79.362; p = 0.000). This study indicated that high-intensity laser therapy was found to be a more effective method in the treatment of patellofemoral pain syndrome after 3 months of follow-up compared to US-TENS combination and US-interferential current combination treatments. Also, HILT can be used as an effective method in combination with an appropriate exercise program including vastus medialis strengthening to reduce pain and increase functionality in the patients with PFPS.
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Affiliation(s)
- Ozge Ozlu
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Istanbul Medipol University, 34815, Istanbul, Turkey.
| | - Esra Atilgan
- Department of Orthotics and Prosthetic, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Gibbons CH, Levine T, Adler C, Bellaire B, Wang N, Stohl J, Agarwal P, Aldridge GM, Barboi A, Evidente VGH, Galasko D, Geschwind MD, Gonzalez-Duarte A, Gil R, Gudesblatt M, Isaacson SH, Kaufmann H, Khemani P, Kumar R, Lamotte G, Liu AJ, McFarland NR, Miglis M, Reynolds A, Sahagian GA, Saint-Hillaire MH, Schwartzbard JB, Singer W, Soileau MJ, Vernino S, Yerstein O, Freeman R. Skin Biopsy Detection of Phosphorylated α-Synuclein in Patients With Synucleinopathies. JAMA 2024; 331:1298-1306. [PMID: 38506839 PMCID: PMC10955354 DOI: 10.1001/jama.2024.0792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 03/21/2024]
Abstract
Importance Finding a reliable diagnostic biomarker for the disorders collectively known as synucleinopathies (Parkinson disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA], and pure autonomic failure [PAF]) is an urgent unmet need. Immunohistochemical detection of cutaneous phosphorylated α-synuclein may be a sensitive and specific clinical test for the diagnosis of synucleinopathies. Objective To evaluate the positivity rate of cutaneous α-synuclein deposition in patients with PD, DLB, MSA, and PAF. Design, Setting, and Participants This blinded, 30-site, cross-sectional study of academic and community-based neurology practices conducted from February 2021 through March 2023 included patients aged 40 to 99 years with a clinical diagnosis of PD, DLB, MSA, or PAF based on clinical consensus criteria and confirmed by an expert review panel and control participants aged 40 to 99 years with no history of examination findings or symptoms suggestive of a synucleinopathy or neurodegenerative disease. All participants completed detailed neurologic examinations and disease-specific questionnaires and underwent skin biopsy for detection of phosphorylated α-synuclein. An expert review panel blinded to pathologic data determined the final participant diagnosis. Exposure Skin biopsy for detection of phosphorylated α-synuclein. Main Outcomes Rates of detection of cutaneous α-synuclein in patients with PD, MSA, DLB, and PAF and controls without synucleinopathy. Results Of 428 enrolled participants, 343 were included in the primary analysis (mean [SD] age, 69.5 [9.1] years; 175 [51.0%] male); 223 met the consensus criteria for a synucleinopathy and 120 met criteria as controls after expert panel review. The proportions of individuals with cutaneous phosphorylated α-synuclein detected by skin biopsy were 92.7% (89 of 96) with PD, 98.2% (54 of 55) with MSA, 96.0% (48 of 50) with DLB, and 100% (22 of 22) with PAF; 3.3% (4 of 120) of controls had cutaneous phosphorylated α-synuclein detected. Conclusions and Relevance In this cross-sectional study, a high proportion of individuals meeting clinical consensus criteria for PD, DLB, MSA, and PAF had phosphorylated α-synuclein detected by skin biopsy. Further research is needed in unselected clinical populations to externally validate the findings and fully characterize the potential role of skin biopsy detection of phosphorylated α-synuclein in clinical care.
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Affiliation(s)
- Christopher H. Gibbons
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Todd Levine
- HonorHealth Neurology, Scottsdale, Arizona
- CND Life Sciences, Scottsdale, Arizona
| | - Charles Adler
- Department of Neurology, Mayo Clinic College of Medicine, Scottsdale, Arizona
| | | | - Ningshan Wang
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | | | | | - Georgina M. Aldridge
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City
| | - Alexandru Barboi
- Department of Neurology, Northshore University Health System, Glenview, Illinois
| | | | - Douglas Galasko
- Department of Neurology, University of California, San Diego
| | | | | | - Ramon Gil
- Parkinson’s Disease Treatment Center of Southwest Florida, Port Charlotte
| | - Mark Gudesblatt
- Department of Neurology, New York University Grossman Long Island School of Medicine, New York
| | - Stuart H. Isaacson
- Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, Florida
| | - Horacio Kaufmann
- Department of Neurology, New York University Grossman School of Medicine, New York
| | - Pravin Khemani
- Department of Neurology, Swedish Medical Center, Seattle, Washington
| | - Rajeev Kumar
- Rocky Mountain Movement Disorders Center, Englewood, Colorado
| | | | - Andy J. Liu
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | | | - Mitchell Miglis
- Department of Neurology, Stanford University Medical Center, Palo Alto, California
| | | | | | | | | | - Wolfgang Singer
- Department of Neurology, Mayo Clinic Rochester, Rochester, New York
| | | | - Steven Vernino
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas
| | - Oleg Yerstein
- Department of Neurology, Lahey Clinic, Burlington, Massachusetts
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Huang B, Li NP, Tan GK, Liang N. Effectiveness and safety of remimazolam combined with alfentanil in hysteroscopic examination: A prospective, randomized, single-blind trial. Medicine (Baltimore) 2024; 103:e37627. [PMID: 38608088 PMCID: PMC11018237 DOI: 10.1097/md.0000000000037627] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 02/26/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Remimazolam is a novel, ultrashort-acting benzodiazepine. This study aimed to compare the efficacy and safety of remimazolam and propofol for hysteroscopic examination, to determine the optimal dose of remimazolam combined with alfentanil for painless hysteroscopy, and to calculate its median effective dose (ED50). METHODS Step 1: A total of 208 patients undergoing hysteroscopic examination were prospectively included in this study. Patients were randomized into 4 groups: 0.2 mg/kg remimazolam (group A), 0.25 mg/kg remimazolam besylate (group B), 0.3 mg/kg remimazolam (group C), and 2 mg/kg propofol (group D), with 52 patients in each group. One minute after losing consciousness, patients received an intravenous injection of alfentanil at 5 µg/kg, followed by a continuous infusion of alfentanil at 0.5 µg/kg/min. If patients showed frowning, movement, or MOAA/S > 1, sedatives were added: 0.05 mg/kg/dose of remimazolam for groups A, B, and C, and 0.5 mg/kg/dose of propofol for group D. Step 2: Dixon's up-and-down method was used to calculate the ED50 of remimazolam combined with alfentanil during hysteroscopic examination. MAIN RESULTS The sedation success rates of the remimazolam groups were 88.46%, 94.23%, and 98.08%, respectively, compared to 96.15% in the propofol group, with no significant difference (P = .175). MAP in groups A and B was higher than in group D (P < .05), and significantly higher in group C than in group D (P = .0016). SpO2 values in groups A, B, and C were higher than in group D at T2 to T3 (P < .001). HR in groups A, B, and C was significantly higher than in group D (P < .001). The ED50 of remimazolam combined with alfentanil in hysteroscopy was 0.244 mg/kg, 95%CI (0.195-0.22) and ED95 was 0.282 mg/kg, 95%CI (0.261-1.619). CONCLUSION In hysteroscopy, the sedative effect of remimazolam is like that of propofol, with 0.25 mg/kg remimazolam showing better safety and efficacy, and less impact on the respiratory and circulatory systems. Additionally, under the influence of alfentanil, the ED50 of remimazolam in hysteroscopy is 0.244 mg/kg, with no severe adverse reactions observed.
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Affiliation(s)
- Bei Huang
- The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The Affiliated Nanhua Hospital, Department of Anesthesiology, Hengyang Medical School, University of Suth China, Hengyang, Hunan, China
| | - Nan-Ping Li
- The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The Affiliated Nanhua Hospital, Department of Anesthesiology, Hengyang Medical School, University of Suth China, Hengyang, Hunan, China
| | - Gang-Kai Tan
- The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The Affiliated Nanhua Hospital, Department of Anesthesiology, Hengyang Medical School, University of Suth China, Hengyang, Hunan, China
| | - Na Liang
- The Affiliated Nanhua Hospital, Department of Anesthesiology, Hengyang Medical School, University of Suth China, Hengyang, Hunan, China
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Wang Y, Chen Y, Song Y, Chen H, Guo X, Ma L, Liu H. The Impact of mHealth-Based Continuous Care on Disease Knowledge, Treatment Compliance, and Serum Uric Acid Levels in Chinese Patients With Gout: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e47012. [PMID: 38623741 PMCID: PMC11034422 DOI: 10.2196/47012] [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: 03/06/2023] [Revised: 12/23/2023] [Accepted: 01/23/2024] [Indexed: 04/17/2024] Open
Abstract
Background In patients with gout, suboptimal management refers to a lack of disease knowledge, low treatment compliance, and inadequate control of serum uric acid (SUA) levels. Several studies have shown that continuous care is recommended for disease management in patients with gout. However, in China, the continuous care model commonly used for patients with gout requires significant labor and time costs, and its efficiency and coverage remain low. Mobile health (mHealth) may be able to address these issues. Objective This study aimed to explore the impact of mHealth-based continuous care on improving gout knowledge and treatment compliance and reducing SUA levels. Methods This study was a single-center, single-blind, and parallel-group randomized controlled trial. Participants were recruited at the West China Hospital of Sichuan University in Chengdu, China, between February 2021 and July 2021 and were randomly assigned to the intervention and control groups. The intervention group received continuous care via an mHealth app, which includes modules for health records, 24 weeks of gout-related health education materials, and interactive support. The control group received routine continuous care, including face-to-face health education, paper-based health education materials consistent with the content for the intervention group, and telephone consultations initiated by the patient. Follow-up was conducted at 6 months. Participants' gout knowledge levels and treatment compliance were measured at baseline and the 12th and 24th weeks, and participants' SUA levels were measured at baseline and the 24th week. The intention-to-treat principle and a generalized estimating equation model were used to test the effect of the intervention. Results Overall, 258 potential participants underwent eligibility assessments, and 120 were recruited and randomized into the intervention (n=60, 50%) and control (n=60, 50%) groups. Of the 120 participants, 93 (77.5%) completed the 24-week study. The 2 groups had no significant differences in sociodemographic or clinical characteristics, and the baseline measurements were comparable (all P>.05). Compared with the control group, the intervention group exhibited a significant improvement in gout knowledge levels over time (β=0.617, 95% CI 0.104-1.129; P=.02 and β=1.300, 95% CI 0.669-1.931; P<.001 at the 12th and 24th weeks, respectively). There was no significant difference in treatment adherence between the 2 groups at the 12th week (β=1.667, 95% CI -3.283 to 6.617; P=.51), while a statistical difference was observed at the 24th week (β=6.287, 95% CI 1.357-11.216; P=.01). At the 24th week, SUA levels in both the intervention and control groups were below baseline, but there was no significant difference in SUA changes between the 2 groups (P=.43). Conclusions Continuous care based on the mHealth app improved knowledge levels and treatment compliance among patients with gout. We suggest incorporating this intervention modality into standard continuous care for patients with gout.
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Affiliation(s)
- Ying Wang
- Department of Rheumatology and Immunology, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yanling Chen
- Department of Rheumatology and Immunology, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yuqing Song
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hong Chen
- West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xin Guo
- Department of Rheumatology and Immunology, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Ling Ma
- Department of Rheumatology and Immunology, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Huan Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Chutoprapat R, Witarat J, Jongpanyangarm P, Mang Sung Thluai L, Khankaew P, Wah Chan L. Development of solid lipid microparticles (SLMs) containing asiatic acid for topical treatment of acne: Characterization, stability, in vitro and in vivo anti-acne assessment. Int J Pharm 2024; 654:123980. [PMID: 38460769 DOI: 10.1016/j.ijpharm.2024.123980] [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: 09/03/2023] [Revised: 02/18/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
Solid lipid microparticles (SLMs) represent a promising approach for drug delivery in anti-acne applications. In this study, asiatic acid-loaded SLMs (AASLMs) were prepared by melt emulsification method in conjunction with freeze-drying. Comprehensive evaluations comprised particle size, %entrapment efficiency (%EE), %labeled amount (%LA), surface morphology, stability, %release, %skin permeation, and anti-acne activity. The AASLMs exhibited an average particle size ranging from 7.46 to 38.86 µm, with %EE and %LA falling within the range of 31.56 to 100.00 and 90.43 to 95.38, respectively. The AASLMs demonstrated a spherical shape under scanning electron microscopy, and maintained stability over a 3-month period. Notably, formulations with 10 % and 15 % cetyl alcohol stabilized with poloxamer-188 (specifically F6 and F12) displayed a minimum inhibitory concentration (MIC) value of 75 mg/ml against Cutibacterium acnes. Furthermore, F12 exhibited a higher %release and %skin permeation compared to F6 over 24 h. In a single-blind clinical trial involving fifteen participants with mild-to-moderate acne, F12 showcased its potential not only in reducing porphyrin intensity and enhancing skin barriers but also in significantly improving skin hydration and brightness. However, further investigations with larger subject cohorts encompassing diverse age groups and genders are necessary to thoroughly establish the performance of the developed AASLMs.
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Affiliation(s)
- Romchat Chutoprapat
- Cosmetic Science Program, Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University Bangkok, 10330, Thailand.
| | - Jatuporn Witarat
- Cosmetic Science Program, Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University Bangkok, 10330, Thailand
| | - Panalee Jongpanyangarm
- Cosmetic Science Program, Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University Bangkok, 10330, Thailand
| | - Lucy Mang Sung Thluai
- Cosmetic Science Program, Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University Bangkok, 10330, Thailand
| | - Pichanon Khankaew
- Cosmetic Science Program, Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University Bangkok, 10330, Thailand
| | - Lai Wah Chan
- Department of Pharmacy, National University of Singapore, Singapore.
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Sun XL, Dai AN, Xu SY, Huang JP, Ding PH. [Healing effect of photodynamic therapy on extraction sockets of periodontally compromised teeth: a randomized, controlled, superiority clinical trial]. Zhonghua Kou Qiang Yi Xue Za Zhi 2024; 59:326-335. [PMID: 38548589 DOI: 10.3760/cma.j.cn112144-20231127-00271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Objective: To evaluate the effects of photodynamic therapy (PDT) in extraction sockets of periodontally compromised molars on soft tissue healing, postoperative pain, bone density and bone height changes. Methods: This study is a single-center, single-blind, randomized controlled superiority clinical trial. Thirty-eight periodontally compromised molars requiring extraction in patients attending the Department of Periodontology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, from December 2022 to September 2023 were included, and randomly assigned to PDT group and control group. The control group received routine debridement after extraction, while PDT group received routine debridement followed by PDT. The bucco-lingual and mesio-distal wound distances at 7 and 14 d after extraction were measured, and then the wound closure rates were calculated. Evaluating the soft tissue healing indexes at 7 and 14 d after extraction. The visual analogue scale was used to assess the pain level at 6 h, 1 d, 2 d, and 3 d after tooth extraction. Apical radiographs were taken immediately and 2 months after extraction in order to compare the changes of the bone density and height. Results: The wound closure rate at 1 week was (78.08±5.45)% in PDT group and (71.03±6.82)% in control group, with significant differences (P<0.01). The wound closure rate at 2 weeks in PDT group [(85.88±3.84) %] was significantly higher than that in the control group [(81.66±3.79) %] (P<0.01), but did not reach the superiority value of the superiority test (superiority value=10%, 95%CI at 1 week: 3.00%-11.12%, 95%CI at 2 weeks: 1.71%-6.73%). The soft tissue healing index of PDT group at 1 week was significantly better than the control group (P<0.05), but there was no significant difference between the two groups at 2 weeks (P>0.05). There was no significant difference between the two groups in terms of postoperative pain at 6 h, 1 d, 2 d and 3 d as well as in bone density and height changes at 2 months after tooth extraction (P>0.05). Conclusions: PDT could promote soft tissues healing to some extent, but did not provide additional assistance in the healing of extraction sockets of periodontally compromised teeth. PDT did not show benefits on postoperative pain, changes of the bone density and bone height after tooth extraction.
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Affiliation(s)
- X L Sun
- Department of Periodontology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine & Clinical Research Center for Oral Diseases of Zhejiang Province & Key Laboratory of Oral Biomedical Research of Zhejiang Province & Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - A N Dai
- Department of Periodontology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine & Clinical Research Center for Oral Diseases of Zhejiang Province & Key Laboratory of Oral Biomedical Research of Zhejiang Province & Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - S Y Xu
- Department of Periodontology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine & Clinical Research Center for Oral Diseases of Zhejiang Province & Key Laboratory of Oral Biomedical Research of Zhejiang Province & Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - J P Huang
- Department of Periodontology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine & Clinical Research Center for Oral Diseases of Zhejiang Province & Key Laboratory of Oral Biomedical Research of Zhejiang Province & Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - P H Ding
- Department of Periodontology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine & Clinical Research Center for Oral Diseases of Zhejiang Province & Key Laboratory of Oral Biomedical Research of Zhejiang Province & Cancer Center of Zhejiang University, Hangzhou 310006, China
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Savran F, Bayram F. Comparison of the Efficacies of Vicryl Rapide and Prolene Sutures in Transcolumellar Incision. Otolaryngol Pol 2024; 78:23-28. [PMID: 38623859 DOI: 10.5604/01.3001.0053.9314] [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] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
<b><br>Introduction:</b> Septorhinoplasty aims to enhance nasal function and appearance. This common but complex procedure has demonstrated advancements with both open and endonasal approaches. The selection of sutures can impact patient comfort and scar outcomes, presenting both advantages and disadvantages.</br> <b><br>Aim:</b> This study was conducted to compare the cosmetic outcomes of the use of absorbable polyglactin 910 (PG) (Vicryl Rapide 5/0; Ethicon Inc.) and nonabsorbable polypropylene (PP) (Prolene 5/0; Ethicon Inc.) in open septorhinoplasty in terms of surgical scarring.</br> <b><br>Methods:</b> The sample of this prospective, randomized, single-blind study consisted of 42 patients who underwent open septorhinoplasty. The patients were randomized into the vicryl rapide (n = 16) and prolene (n = 26) suture groups. The groups were comparatively evaluated by two surgeons in terms of surgical scarring, pigmentation, level difference, indentation, and general appearance based on patient photographs taken in the 2nd week, 6th weeks and 12th week post-op.</br> <b><br>Results:</b> The mean age of the vicryl rapide and prolene groups was 26.9 5.7 years and 24.6 3.9 years, respectively. There was no significant difference between the groups in any of the parameters investigated within the scope of the study in postoperative week 2, 6, and 12 (P > 0.05). On the other hand, intragroup analyses revealed that suture scar significantly decreased in the vicryl rapide group in the 6th and 12th weeks compared to the 2nd week (P < 0.05), while no significant difference was observed in the prolene group in the suture scars in week 6 and 12 compared to week 2 (P > 0.05).</br> <b><br>Conclusions:</b> Inverted V trans-columellar incisions sutured with rapidly absorbable suture material resulted in significantly less suture discomfort and did not significantly increase the risk of postoperative infection compared to nonabsorbable suture material. However, there was no significant difference between the two suture materials in terms of scar appearance.</br>.
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Affiliation(s)
- Fatih Savran
- Department of Otolaryngology, Istanbul Private Sancaktepe Bolge Hospital, Istanbul, Turkey
| | - Furkan Bayram
- Department of Otolaryngology, Umraniye Training and Research Hospital, Istanbul, Turkey
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Algyar MF, Abdelsamee KS. Laparoscopic assisted versus ultrasound guided transversus abdominis plane block in laparoscopic bariatric surgery: a randomized controlled trial. BMC Anesthesiol 2024; 24:133. [PMID: 38582852 PMCID: PMC10998407 DOI: 10.1186/s12871-024-02498-6] [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: 07/15/2023] [Accepted: 03/14/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Transversus abdominis plane block (TAPB) guided by laparoscopy and ultrasound showed promise in enhancing the multimodal analgesic approach following several abdominal procedures. This study aimed to compare the efficacy and safety between Laparoscopic (LAP) TAP block (LTAP) and ultrasound-guided TAP block (UTAP) block in patients undergoing LAP bariatric surgery. PATIENTS AND METHODS This non-inferiority randomized controlled single-blind study was conducted on 120 patients with obesity scheduled for LAP bariatric surgeries. Patients were allocated into two equal groups: LTAP and UTAP, administered with 20 mL of 0.25% bupivacaine on each side. RESULTS There was no statistically significant difference in the total morphine consumption, Visual Analogue Scale (VAS) score at all times of measurements, and time to the first rescue analgesia (p > .05) between both groups. The duration of anesthesia and duration of block performance were significantly shorter in the LTAP group than in the UTAP group (p < .001). Both groups had comparable post-operative heart rate, mean arterial pressure, adverse effects, and patient satisfaction. CONCLUSIONS In LAP bariatric surgery, the analgesic effect of LTAP is non-inferior to UTAP, as evidenced by comparable time to first rescue analgesia and total morphine consumption with similar safety blocking through the low incidence of post-operative complications and patient satisfaction. TRIAL REGISTRATION The study was registered in Pan African Clinical Trials Registry (PACTR) (ID: PACTR202206871825386) on June 29, 2022.
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Affiliation(s)
- Mohammad Fouad Algyar
- Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Kafr ElSheikh University, Kafr ElSheikh, 33516, Egypt.
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Yu S, Jia H, Ding S, Zhang M, Li F, Xu P, Tian Y, Ma L, Gong L, Feng J, Sun Z, Qian F, Li H. Efficacy and safety of intracoronary pro-urokinase combined with low-pressure balloon pre-dilatation during percutaneous coronary intervention in patients with anterior ST-segment elevation myocardial infarction. J Cardiothorac Surg 2024; 19:180. [PMID: 38580976 PMCID: PMC10996115 DOI: 10.1186/s13019-024-02699-7] [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: 09/17/2023] [Accepted: 03/27/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The efficacy and safety of low-pressure balloon pre-dilatation before intracoronary pro-urokinase (pro-UK) in preventing no-reflow during percutaneous coronary intervention (PCI) remains unknown. This study aimed to evaluate the clinical outcomes of intracoronary pro-UK combined with low-pressure balloon pre-dilatation in patients with anterior ST-segment-elevation myocardial infarction (STEMI). METHODS This was a randomized, single-blind, investigator-initiated trial that included 179 patients diagnosed with acute anterior STEMI. All patients were eligible for PCI and were randomized into two groups: intracoronary pro-UK combined with (ICPpD group, n = 90) or without (ICP group, n = 89) low-pressure balloon pre-dilatation. The main efficacy endpoint was complete epicardial and myocardial reperfusion. The safety endpoints were major adverse cardiovascular events (MACEs), which were analyzed at 12 months follow-up. RESULTS Patients in the ICPpD group presented significantly higher TIMI myocardial perfusion grade 3 (TMPG3) compared to those in the ICP group (77.78% versus 68.54%, P = 0.013), and STR ≥ 70% after PCI 30 min (34.44% versus 26.97%, P = 0.047) or after PCI 90 min (40.0% versus 31.46%, P = 0.044). MACEs occurred in 23 patients (25.56%) in the ICPpD group and in 32 patients (35.96%) in the ICP group. There was no difference in hemorrhagic complications during hospitalization between the groups. CONCLUSION Patients with acute anterior STEMI presented more complete epicardial and myocardial reperfusion with adjunctive low-pressure balloon pre-dilatation before intracoronary pro-UK during PCI. TRIAL REGISTRATION 2019xkj213.
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Affiliation(s)
- Shicheng Yu
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China.
| | - Haoxuan Jia
- Graduate School of Bengbu Medical College, Bengbu, Anhui, 233004, People's Republic of China
| | - Shengkai Ding
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Mengda Zhang
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Fengyun Li
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Pan Xu
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Yuan Tian
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Lingling Ma
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Lijie Gong
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Jun Feng
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Zhaojin Sun
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Fudong Qian
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
| | - Hui Li
- Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237000, People's Republic of China
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Christopher M, Bowen S, Witkiewitz K, Grupe D, Goerling R, Hunsinger M, Oken B, Korecki T, Rosenbaum N. A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers. BMC Complement Med Ther 2024; 24:142. [PMID: 38575888 PMCID: PMC10993469 DOI: 10.1186/s12906-024-04452-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: 08/26/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs. METHODS This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes. RESULTS We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures. CONCLUSIONS Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve. TRIAL REGISTRATION ClinicalTrials.gov, NCT03784846 . Registered on December 24th, 2018.
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Affiliation(s)
- Michael Christopher
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA.
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, 2001 Redondo S Dr, Albuquerque, NM, 87106, USA
| | - Daniel Grupe
- Center for Healthy Minds, University of Wisconsin Madison, 625 West Washington Ave, Madison, WI, 53703, USA
| | - Richard Goerling
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Matthew Hunsinger
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Barry Oken
- Department of Neurology, Oregon Center for Complementary and Alternative Medicine in Neurological Disorders, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Tyrus Korecki
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA
| | - Nils Rosenbaum
- Behavioral Sciences Department, Albuquerque Police Department, 400 Rome, NW, Albuquerque, NM, 87102, USA
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Falcone V, Catic A, Heinzl F, Steinbauer P, Wagner M, Mikula F, Dorittke T, Roessler B, Farr A. Impact of a virtual reality-based simulation training for shoulder dystocia on human and technical skills among caregivers: a randomized-controlled trial. Sci Rep 2024; 14:7898. [PMID: 38570525 PMCID: PMC10991516 DOI: 10.1038/s41598-024-57785-6] [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: 07/11/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
This study analyzed the adherence to the modified Advanced Life Support in Obstetrics (ALSO) algorithm (HELP-RER) for handling shoulder dystocia (SD) using a virtual reality (VR) training modality. Secondary outcomes were improvements in the post-training diagnosis-to-delivery time, human skills factors (HuFSHI), and perceived task-load index (TLX). Prospective, case-control, single-blind, 1:1 randomized crossover study. Participants were shown a 360° VR video of SD management. The control group was briefed theoretically. Both groups underwent HuFSHI and HELP-RER score assessments at baseline and after the manikin-based training. The TLX questionnaire was then administered. After a washout phase of 12 weeks, we performed a crossover, and groups were switched. There were similar outcomes between groups during the first training session. However, after crossover, the control group yielded significantly higher HELP-RER scores [7 vs. 6.5; (p = 0.01)], with lower diagnosis-to-delivery-time [85.5 vs. 99 s; (p = 0.02)], and TLX scores [57 vs. 68; (p = 0.04)]. In the multivariable linear regression analysis, VR training was independently associated with improved HELP-RER scores (p = 0.003). The HuFSHI scores were comparable between groups. Our data demonstrated the feasibility of a VR simulation training of SD management for caregivers. Considering the drawbacks of common high-fidelity trainings, VR-based simulations offer new perspectives.
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Affiliation(s)
- Veronica Falcone
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Anja Catic
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Florian Heinzl
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Philipp Steinbauer
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Michael Wagner
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Fanny Mikula
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Tim Dorittke
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Bernhard Roessler
- Medical Simulation and Emergency Management Research Group, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Wang LF, Feng HX, Shi YH, Li Y, Zheng MT, Bu T, Zhang ZR. Protocol for a randomised controlled trial: optimisation of perioperative analgesia protocol for uniportal video-assisted thoracoscopic surgery. BMJ Open 2024; 14:e079434. [PMID: 38569709 PMCID: PMC10989176 DOI: 10.1136/bmjopen-2023-079434] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Postoperative pain after thoracic surgery impairs patients' quality of life and increases the incidence of respiratory complications. Optimised analgesia strategies include minimally invasive incisions, regional analgesia and early chest tube removal. However, little is known about the optimal analgesic regimen for uniportal video-assisted thoracoscopic surgery (uVATS). METHODS AND ANALYSIS We will conduct a single-centre, prospective, single-blind, randomised trial. The effects of postoperative analgesia will be tested using thoracic paravertebral block (PVB) in combination with patient-controlled intravenous analgesia (PVB+PCIA), erector spinae plane block (ESPB) in combination with patient-controlled intravenous analgesia (ESPB+PCIA) or PCIA alone; 102 patients undergoing uVATS will be enrolled in this study. Patients will be randomly assigned to the PVB group (30 mL of 0.33% ropivacaine with dexamethasone), ESPB group (40 mL of 0.25% ropivacaine with dexamethasone) or control groups. PCIA with sufentanil will be administered to all patients after surgery. The primary outcome will be total opioid consumption after surgery. Secondary outcomes include postoperative pain score; postoperative chronic pain at rest and during coughing; sensations of touch and pain in the chest wall, non-opioid analgesic consumption; length of stay; ambulation time, the total cost of hospitalisation and long-term postoperative analgesia. Adverse reactions to analgesics and adverse events related to the regional blocks will also be recorded. The statisticians will be blinded to the group allocation. Comparison of the continuous data among the three groups will be performed using a one-way analysis of variance to assess differences among the means. ETHICS AND DISSEMINATION The results will be published in patient education courses, academic conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT06016777.
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Affiliation(s)
- Li Fang Wang
- Anesthesiology, China-Japan Friendship Hospital, Beijing, China
| | - Hong Xiang Feng
- Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Yu Hui Shi
- Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Yan Li
- Anesthesiology, China-Japan Friendship Hospital, Beijing, China
- China-Japan Friendship Hospital, Beijing, China
| | - Meng Tao Zheng
- Anesthesiology, China-Japan Friendship Hospital, Beijing, China
| | - Tegeleqi Bu
- Department of Anesthesiology, Peking University First Hospital, Beijing, Xicheng District, China
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Rahlin M, Haney NB, Barnett J. Perception-Action Approach Versus Standard Care for Infants With Congenital Muscular Torticollis: A Pilot Single-Blind Randomized Controlled Trial. Phys Ther 2024; 104:pzae038. [PMID: 38484092 DOI: 10.1093/ptj/pzae038] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/22/2023] [Accepted: 03/12/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE The purposes of this pilot study were to compare short-term outcomes of the Perception-Action Approach (P-AA) and standard care based on 5 components of first-choice interventions listed in the congenital muscular torticollis (CMT) clinical practice guideline. Changes in postural alignment, symmetrical use of both sides of the body during movement and play, gross motor development, and behavior observed during therapy were considered. METHODS Thirty-two participants were enrolled in a 2-group (P-AA and standard care) randomized, single-blind trial with pre-posttest measures. Participants were infants with CMT, age range 5 to 35 weeks at enrollment. Outcome measures administered at initial and final evaluations included still photography, arthrodial goniometry, Muscle Function Scale, Alberta Infant Motor Scale, and Functional Symmetry Observation Scale. Participants in both groups attended 3 intervention sessions. Their behavior exhibited during therapy was compared using the Therapy Behavior Scale Version 2.2. RESULTS Data collection was interrupted by the COVID-19 pandemic lockdown. Twenty-four infants completed the study (10 in P-AA and 14 in the standard care group). There were no significant differences between the groups in performance at initial and final evaluations. Both groups improved on most outcome measures. The P-AA group made greater gains on the Functional Symmetry Observation Scale, and the Therapy Behavior Scale Version 2.2 scores were higher in the P-AA group; however, these results did not reach significance. CONCLUSION Results suggest that similar short-term outcomes may be obtained in infants with CMT undergoing P-AA and standard care interventions. Definitive conclusions regarding the efficacy of the P-AA in infants with CMT cannot be made at this time. Nevertheless, the pilot findings provide valuable preliminary data for a future efficacy trial, which will require funding. IMPACT This was the first randomized controlled trial to provide evidence for use of P-AA intervention in infants with CMT. LAY SUMMARY Compared to standard treatment, the Perception-Action Approach (P-AA) provided similar short-term benefits to infants with congenital muscular torticollis. The P-AA group participants demonstrated higher symmetry and behavior scores, which needs to be confirmed in a larger future study.
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Affiliation(s)
- Mary Rahlin
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Nancy B Haney
- Formerly of Department of Physical Therapy, Rady Children's Hospital, San Diego, California, USA
| | - Joyce Barnett
- Formerly of Ability Occupational Therapy Services, LLC, Anchorage, Alaska, USA
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Karakuş Z, Özer Z. The effect of a fatigue self-management program based on individual and family self-management theory in cancer patients: A single-blinded randomized controlled trial. Eur J Oncol Nurs 2024; 69:102483. [PMID: 38417400 DOI: 10.1016/j.ejon.2023.102483] [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: 01/06/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 03/01/2024]
Abstract
PURPOSE This study was conducted to investigate the effect of the Fatigue Self-Management Program based on the Individual and Family Self-Management Theory on fatigue, daily living activities, and well-being in cancer patients. METHODS This randomized controlled single-blind experimental study was carried out between November 2020 and April 2022. A total of 94 patients with advanced cancer, 47 in each group, were included in the study, and 57 participants completed the study. Data were collected using the Brief Fatigue Inventory, Katz Index of Independence in Activities of Daily Living, and Well-Being Questionnaire-22. The Fatigue Self-Management Program based on Individual and Family Self-Management Theory was delivered to the intervention group with two face-to-face and two tele-monitoring sessions. No intervention was applied to the control group, who received only routine care. RESULTS The mean score of fatigue in the intervention group compared to the control group decreased, and the difference was statistically significant (p < .05); daily living activities mean scores were higher than the control group, but there was no statistically significant difference (p > .05). The mean scores of depression and anxiety in the intervention group were lower than those in the control group; energy, positive well-being, and general well-being mean scores were found to be higher than those in the control group, and the difference was statistically significant (p < .05). CONCLUSIONS The Fatigue Self-Management Program effectively reduces the fatigue experienced by cancer patients and increases their well-being but it does not increase their independence in daily living activities. CLINICAL TRIAL REGISTRY NCT04822220.
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Affiliation(s)
- Zeynep Karakuş
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Huang YH, Kuo YC, Hsieh LF, Tsai CM, Liu YF, Hsieh TL. Efficacy of Combination Therapy (Hydrodilatation and Subdeltoid Bursa Injection With Corticosteroid, Mobilization, and Physical Therapy) vs Physical Therapy Alone for Treating Frozen Shoulder: A Randomized Single-Blind Controlled Trial, Phase I. Arch Phys Med Rehabil 2024; 105:631-638. [PMID: 38092231 DOI: 10.1016/j.apmr.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/20/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE To compare the efficacy of combination therapy (hydrodilatation and subdeltoid bursa injection with corticosteroid, mobilization, and physical therapy [PT]) with that of PT alone for treating frozen shoulder. DESIGN A prospective, 2-arm parallel, single-blinded, randomized controlled trial. SETTING Rehabilitation clinic of a private academic hospital. PARTICIPANTS Patients (n=70) with frozen shoulder (freezing stage). INTERVENTIONS Participants (n=35) in the combination group underwent hydrodilatation and subdeltoid bursa injection with corticosteroid twice, mobilization, and usual-care PT for 8 weeks; participants (n=35) in the PT group received only the usual-care PT for 8 weeks. MAIN OUTCOME MEASURES The Shoulder Pain and Disability Index (SPADI) was the primary outcome measure. The secondary outcome measures were pain scores on a visual analog scale, range of motion (ROM), the Shoulder Disability Questionnaire (SDQ), quality of life (evaluated using the 36-item Short-Form Health Survey [SF-36]), and self-assessment of the treatment effect. RESULTS Compared with the PT group, the combination group had significantly better pain (during activity), SPADI, SDQ, active and passive ROM, and self-assessment scores (all P<.001) as well as scores on some parts of the SF-36 (physical function and bodily pain, P<.05). Between-group differences were significant at the 1-, 2-, 4-, and 6-month follow-ups. CONCLUSIONS A combination of hydrodilatation (with corticosteroid), bursal corticosteroid injection, and joint mobilization with PT was superior to PT alone for treating frozen shoulder, and the effects persisted for at least 6 months.
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Affiliation(s)
- Yu-Hao Huang
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ying-Chen Kuo
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Lin-Fen Hsieh
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Chun-Mei Tsai
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ya-Fang Liu
- Administration Division, Research Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Tien-Lee Hsieh
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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Yuan M, Ling T, Su Q, Wan X, Lai Y, Zhou Z. Safety and Effectiveness of Robotic-Arm Assisted Total Knee Arthroplasty. Orthop Surg 2024; 16:882-893. [PMID: 38404194 PMCID: PMC10984807 DOI: 10.1111/os.14008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVE We investigated the advantages of robotic arm-assisted total knee arthroplasty (raTKA) over conventional manual TKA (cmTKA) by comprehensively comparing patients who received raTKA and cmTKA in terms of postoperative pain, function, imaging assessment, and trauma to the body. This study investigated the efficacy and safety of raTKA in patients using the YUANHUA-TKA system. METHODS In a prospective, randomized single-blind trial, 60 patients undergoing primary unilateral TKA from October 2020 to December 2020 were randomly assigned to either raTKA or cmTKA. Clinical evaluation, including the time of osteotomy and prosthesis model testing, the total operation time, the visual analogue scale at rest, VAS in motion, opioid consumption, white blood cell count, neutrophil ratio, erythrocyte sedimentation rate, C-reactive protein (CRP), passive and active range of motion (pROM, aROM), Western Ontario and McMaster Universities Arthritis Index (WOMAC [stiffness, pain, and function]) score, gait analysis, keen society score (KSS), adverse events, and blood loss were collected by the project nurse, as well as the imaging evaluation, including the lateral tibia component angle (LTC), frontal femoral component angle, frontal tibia component angle (FTC), lateral femoral component angl, and hip-knee-ankle angle (HKA). The student t-test (or the Wilcoxon signed-rank test) and the χ2-test (or the Fisher exact test) were used to determine differences in categorical variables. RESULTS No significant difference was found between the two groups in pain throughout the whole follow-up period. On the third day postoperatively, the erythrocyte sedimentation rate in the cmTKA group was significantly higher (p = 0.02), as well as the CRP (p = 0.04). No significant difference was found in the WOMAC stiffnes score or pROM. However, the aROM and the flexion range when walking (FRW) were significantly better in the raTKA group throughout the trial (p < 0.05). The KSS at the 1-month follow-up and the WOMAC function score at the 1-year follow-up were both significantly better in the raTKA group (p < 0.05). The HKA and the LTC in the raTKA group closer to the ideal angle, and the difference between the groups was significant (p < 0.05). The total operation time of the raTKA group was significantly longer (p = 0.001). The intraoperative blood loss had no significant difference in the two groups. CONCLUSION Compared with cmTKA, raTKA with the YUANHUA robot not only avoids extra pain and trauma in patients but promises better functional recovery and improves the accuracy of the prosthesis position and axial alignment reconstruction.
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Affiliation(s)
- Mingcheng Yuan
- Department of Orthopedics, West China Hospital of Sichuan University/West China School of Medicine, Sichuan University, Chengdu, China
| | - Tingxian Ling
- Department of Orthopedics, West China Hospital of Sichuan University/West China School of Medicine, Sichuan University, Chengdu, China
| | - Qiang Su
- Department of Orthopedics, West China Hospital of Sichuan University/West China School of Medicine, Sichuan University, Chengdu, China
| | - Xufeng Wan
- Department of Orthopedics, West China Hospital of Sichuan University/West China School of Medicine, Sichuan University, Chengdu, China
| | - Yahao Lai
- Department of Orthopedics, West China Hospital of Sichuan University/West China School of Medicine, Sichuan University, Chengdu, China
| | - Zongke Zhou
- Department of Orthopedics, West China Hospital of Sichuan University/West China School of Medicine, Sichuan University, Chengdu, China
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Cho RJ, Kadowaki K, Seelig D, Glumac DE, Kent LA, Hunter RC, MacIver RH, Peterson GK, Pandey V, Tanahashi K. To Compare the Effects of a Standard Versus Hydrophilic Polymer Coated Airway Stent in a Porcine Model: A Randomized, Single-Blinded Study. J Bronchology Interv Pulmonol 2024; 31:132-138. [PMID: 37332107 DOI: 10.1097/lbr.0000000000000934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/25/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Stent encrustation with debris and mucostasis is a significant cause of airway injury and comorbidity, leading to ~25% of stent exchanges (1-3). Previous work from our group has shown that the experimental coating can reduce mucous adhesion in bench testing and demonstrated a signal for reducing airway injury and mucostasis in a feasibility study. OBJECTIVES The aim of this study is to continue our inquiry in a randomized, single-blinded multi-animal trial to investigate the degree of airway injury and mucostasis using silicone stents with and without this specialized coating. METHODS We modified commercially available silicone stents with a hydrophilic polymer from Toray Industries. We conducted an in vivo survival study in 6 mainstem airways (3 coated and 3 uncoated) of 3 pigs to compare the degree of airway injury and mucostasis between coated versus noncoated stented airways. Both stents were randomized to either left or right mainstem bronchus. The pathologist was blinded to the stent type. RESULTS We implanted a total of six 14×15 mm silicone stents (1 per mainstem bronchi) into 3 pigs. All animals survived to termination at 4 weeks. All stents were intact; however, 1 uncoated stent migrated out. On average, all the coated stents demonstrated reduced pathology and tissue injury scores (75 vs. 68.3, respectively). The average total dried mucous weight was slightly higher in the coated stents (0.07 g vs. 0.05 g; respectively). CONCLUSION Coated stents had lower airway injury compared with uncoated stents in this study. Of all the stents, 1 uncoated stent migrated out and was not included in the dried mucous weight totals. This could explain the slightly higher mucous weight in the coated stents. Nevertheless, this current study demonstrates promising results in lowering airway injury in stents incorporated with the hydrophilic coating, and future studies, including a larger number of subjects, would be needed to corroborate our findings.
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Affiliation(s)
- Roy Joseph Cho
- Interventional Pulmonary, Department of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis MN
| | - Koji Kadowaki
- Advanced Materials Research Laboratories, Toray Industries, Inc, Tokyo, Japan
| | - Davis Seelig
- Department of Veterinary Clinical Sciences, University of Minnesota, MN
| | | | - Leslie A Kent
- Department of Microbiology & Immunology, University of Minnesota Medical School, Minneapolis MN
| | - Ryan C Hunter
- Department of Microbiology & Immunology, University of Minnesota Medical School, Minneapolis MN
| | - Robroy H MacIver
- Children's Heart Clinic, Children's Hospitals and Clinics of Minnesota
| | | | - Vidhu Pandey
- Department of Internal Medicine and Pediatrics, University of Minnesota, Minneapolis MN
| | - Kazuhiro Tanahashi
- Advanced Materials Research Laboratories, Toray Industries, Inc., Tokyo, Japan
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Özlü A, Üstündağ S, Bulut Özkaya D, Menekşeoğlu AK. Effect of Exergame on Pain, Function, and Quality of Life in Shoulder Impingement Syndrome: A Prospective Randomized Controlled Study. Games Health J 2024; 13:109-119. [PMID: 38394299 DOI: 10.1089/g4h.2023.0108] [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] [Indexed: 02/25/2024] Open
Abstract
Objective: This study aimed to investigate the effect of a virtual reality (VR)-mediated gamified rehabilitation program added to a home exercise program on pain, functionality, and quality of life in shoulder impingement syndrome. Methods: Forty-eight participants with shoulder impingement syndrome were included in this prospective, randomized, single-blind study between January and July 2022. The participants were randomized into two groups: the VR group (n = 24) and the control group (n = 24). All participants were given a home exercise program for 3 weeks, with five sessions per week. The participants in the VR group received 15 sessions (45 minutes each session) of a gamified shoulder exercise program with an immersive VR headset, while those in the control group received 15 sessions (45 minutes each session) of supervised therapeutic exercises. The participants were evaluated and compared before and after treatment using the 36-item Short Form Survey (SF-36), range-of-motion (ROM) measurements, the Visual Analog Scale (VAS), and the Shoulder Pain and Disability Scale (SPADI). Results: At the baseline assessment, the two groups were homogenous regarding demographic and clinical parameters. The post-treatment shoulder extension and adduction ROM was significantly greater in the VR group and the post-treatment pain subscales for SPADI and SF-36 were significantly lower in the VR group. Conclusion: In individuals with shoulder impingement syndrome, a VR-mediated gamified exercise program added to a home exercise program increased shoulder ROM and reduced pain scores. Further clinical studies are needed to prove the long-term efficacy of the addition of VR-mediated gamified exercises to the treatment of this condition in clinical settings.
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Affiliation(s)
- Aysun Özlü
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Sema Üstündağ
- Department of Internal Medicine, Faculty of Nursing, Kutahya Health Sciences University, Kutahya, Turkey
| | - Dilan Bulut Özkaya
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Ahmet Kıvanç Menekşeoğlu
- Department of Physical Medicine and Rehabilitation, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
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