Sevoflurane versus  Halothane: Postoperative Maladaptive Behavioral Changes

2005 ◽  
Vol 102 (4) ◽  
pp. 720-726 ◽  
Author(s):  
Zeev N. Kain ◽  
Alison A. Caldwell-Andrews ◽  
Megan E. Weinberg ◽  
Linda C. Mayes ◽  
Shu-Ming Wang ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Sleep Disturbances ◽  
Controlled Trial ◽  
Postoperative Recovery ◽  
Behavioral Changes ◽  
Group Differences ◽  
Double Blind ◽  
Emergence Delirium ◽  
Group Assignment ◽  
Repeated Measures Analysis

Background The authors conducted a double-blind, randomized, controlled trial to determine whether the use of sevoflurane in children undergoing anesthesia and surgery results in a higher incidence of postoperative maladaptive behavioral changes as compared with halothane. Methods Children and their parents (n = 102) were randomly assigned to either a halothane group (n = 50) or a sevoflurane group (n = 52). The intraoperative anesthetic protocol was strictly controlled, and the postoperative analgesic consumption and pain levels were recorded. The effect of the group assignment on emergence status and maladaptive postoperative behavioral changes was assessed both by validated psychological measures and physiologic instruments (actigraphy) on postoperative days 1-7. Anxiety of the parent and child was also assessed, as was the child's postoperative recovery (Recovery Inventory). Results There were no group differences in preoperative state anxiety, postoperative analgesic requirements, postoperative pain, or the incidence of emergence delirium (P = not significant). Two-way repeated-measures analysis of variance showed no group differences in the incidence of postoperative maladaptive behaviors (F4,72 = 0.60, P = 0.701) or actigraphic variables such as percent sleep, number of night awakenings, and night awakenings that lasted for more than 5 min (P = not significant). Conclusion The authors found no increased incidence of emergence delirium, maladaptive postoperative behavior changes, or sleep disturbances in children undergoing anesthesia with sevoflurane as compared with halothane.

scholarly journals The Effect of Protein Supplementation versus Carbohydrate Supplementation on Muscle Damage Markers and Soreness Following a 15-km Road Race: A Double-Blind Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 858
Author(s):  
Dominique S. M. ten Haaf ◽  
Martin A. Flipsen ◽  
Astrid M. H. Horstman ◽  
Hans Timmerman ◽  
Monique A. H. Steegers ◽  
...  
Keyword(s):  
Placebo Group ◽  
Protein Intake ◽  
Muscle Soreness ◽  
Controlled Trial ◽  
Protein Supplementation ◽  
Group Differences ◽  
Double Blind ◽  
Carbohydrate Supplementation ◽  
Protein Group ◽  
Road Race

We assessed whether a protein supplementation protocol could attenuate running-induced muscle soreness and other muscle damage markers compared to iso-caloric placebo supplementation. A double-blind randomized controlled trial was performed among 323 recreational runners (age 44 ± 11 years, 56% men) participating in a 15-km road race. Participants received milk protein or carbohydrate supplementation, for three consecutive days post-race. Habitual protein intake was assessed using 24 h recalls. Race characteristics were determined and muscle soreness was assessed with the Brief Pain Inventory at baseline and 1–3 days post-race. In a subgroup (n = 149) muscle soreness was measured with a strain gauge algometer and creatine kinase (CK) and lactate dehydrogenase (LDH) concentrations were measured. At baseline, no group-differences were observed for habitual protein intake (protein group: 79.9 ± 26.5 g/d versus placebo group: 82.0 ± 26.8 g/d, p = 0.49) and muscle soreness (protein: 0.45 ± 1.08 versus placebo: 0.44 ± 1.14, p = 0.96). Subjects completed the race with a running speed of 12 ± 2 km/h. With the Intention-to-Treat analysis no between-group differences were observed in reported muscle soreness. With the per-protocol analysis, however, the protein group reported higher muscle soreness 24 h post-race compared to the placebo group (2.96 ± 2.27 versus 2.46 ± 2.38, p = 0.039) and a lower pressure muscle pain threshold in the protein group compared to the placebo group (71.8 ± 30.0 N versus 83.9 ± 27.9 N, p = 0.019). No differences were found in concentrations of CK and LDH post-race between groups. Post-exercise protein supplementation is not more preferable than carbohydrate supplementation to reduce muscle soreness or other damage markers in recreational athletes with mostly a sufficient baseline protein intake running a 15-km road race.

Relief of pain and trismus in patients treated with naproxen or acetylsalicylic acid after tonsillectomy

1988 ◽  
Vol 102 (1) ◽  
pp. 39-42 ◽  
Author(s):  
S. Kristensen ◽  
K. Tveteraas ◽  
P. Hein ◽  
H. B. Poulsen ◽  
K. E. Outzen
Keyword(s):  
Clinical Trial ◽  
Acetylsalicylic Acid ◽  
Pain Intensity ◽  
Sleep Disturbances ◽  
Significant Positive Correlation ◽  
Controlled Trial ◽  
Double Blind ◽  
Treatment Groups ◽  
Significant Difference ◽  
Therapeutic Gain

AbstractThe pain-relieving efficacy of naproxen and acetylsalicylic acid (ASA) in tonsillectomized patients was compared in a double blind parallel clinical trial comprising 83 patients, among whom 42 were treated with naproxen and 41 with ASA. The patients were treated post-operatively for two days with either naproxen suppositories 500 mg. twice, or ASA effervescent tablets 1000 mg. three times, daily.The therapeutic gain was evaluated by recording the intensity of pain, reduced ability to open the mouth (trismus), consumption of supplementary analgesic (parcetamol), and pain-related sleep disturbances.The statistical analysis of the results revealed no differences in pain intensity, consumption of additional analgesics or pain-related sleep disturbances in the two treatment groups. A considerable degree of trismus was demonstrated in most of the tonsillectomized patients. This reduced ability to open the mouth was gradually overcome in the naproxen group while it remained unchanged in the ASA group, however, no statistical significant difference could be demonstrated. Additionally, no significant positive correlation between pain intensity and trismus was proven. The pain-relieving effect, however, was unsatisfactory in both the naproxen and the ASA group, and clinical controlled trial studies of alternative analgetics in tonsillectomized patients are still to be encouraged.

scholarly journals Tinospora cordifolia Enhances Vyadhikshamatwa (immunity) in Children

2015 ◽  
Vol 4 (4) ◽  
pp. 227-230
Author(s):  
Devasya Narayana Sharma ◽  
◽  
Ajitha Sharma ◽  
◽  
Keyword(s):  
Repeated Measures ◽  
Controlled Trial ◽  
Study Drug ◽  
Absolute Lymphocyte Count ◽  
Tinospora Cordifolia ◽  
Total Leucocyte Count ◽  
Traditional Medicines ◽  
Repeated Measures Analysis ◽  
Increased Risk

Background: The immune system in children is constantly developing and they are at an increased risk of infections. It is vital to help enhance immunity by vaccination but more people are turning towards traditional medicines today. The vast flora of the world offers newer options to this effect and is worth exploring. Tinospora cordifolia (Guduchi) is one such plant which has been traditionally used for various health conditions and is also proven to be an immunomodulator. Objective: To evaluate the role of Tinospora cordifolia in status of Vyadhikshamatwa (immunity) in children. Materials and Methods: An open-labelled, placebo-controlled, randomized controlled trial was conducted in 400 children aged 1-15 years, with 200 each in control and test groups. Study drug and placebo were administered orally at a dose of 100 mg/kg body weight twice daily with honey for 2 months. Response was assessed by total leucocyte count (TLC), lymphocyte percentage and absolute lymphocyte count (ALC). Results were analysed statistically using repeated measures Analysis of Variance (ANOVA) for intra-group comparisons and unpaired t-test for intergroup comparisons using Statistical Packages for Social Sciences (SPSS) software version 20.0. Results: The test drug showed statistically significant increase in TLC (P<0.001), ALC (P<0.001) and lymphocyte percentage (P<0.001) as compared to placebo. Also the rate of infections in the trial group were significantly lesser during the study period (P<0.001). Conclusion: Tinospora cordifolia significantly improves immunity in children and can be used as an adjuvant to vaccination.

scholarly journals Acute Arginine Supplementation Is Associated with Increased Growth Hormone in Younger Healthy Males: A Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 609-609
Author(s):  
John Apolzan ◽  
Jennifer Rood ◽  
Robbie Beyl ◽  
Shengping Yang ◽  
Frank Greenway ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Sex Hormone Binding Globulin ◽  
Double Blind ◽  
Time Points ◽  
Arginine Supplementation ◽  
Time Point

Abstract Objectives Assess the effects of the amino acid arginine on growth hormone (GH), other metabolites, and mood. Arginine is reported to increase GH, but the mechanism is not known. It was hypothesized prolactin mediated this effect since it is similar in structure to GH and, like GH, is secreted by the pituitary gland. Methods Thirty physically active healthy young males (18–39 y; 18.5–25 kg/m2) were enrolled in a randomized, double-blind, placebo-controlled, crossover trial. Two days prior and 1 day following each treatment a standardized diet was provided that maintained arginine at 3–5 g/d. Arginine or placebo treatments in the form of a beverage were consumed after an overnight fast. Treatment conditions were separated by at least a one week washout period. The beverages contained either 10 g of arginine or 0 g (placebo). Blood was collected at baseline and 1.5, 3.0, and 24 hr post treatment. Plasma GH, prolactin, amino acids, glucose, insulin, triacylglycerols, thyroid hormones, sex hormone binding globulin (SHBG), testosterone, cortisol, and dehydroepiandrosterone (DHEA) were assessed. The Profile of Mood States (POMS) was administered at the same time as blood draws. Repeated measures ANOVAs were used to estimate treatment effects at each time point. Results Arginine increased plasma arginine at 1.5, 3.0, and 24 hr (P ≤ 0.001) and GH at 24 hr (P ˂ 0.05) but not other time points. Arginine increased glucose and insulin at the 1.5 and 3.0 hr (P ˂ 0.05) but not 24 hr. Arginine did not affect any other dependent measure (P &gt; 0.05) including prolactin. When only individuals with detectable levels of GH (responders; n = 16) were analyzed separately, arginine increased GH at the 1.5 (P ˂ 0.05) but not the 3.0 or 24 hr time points. Among the responders, arginine also increased thyroid stimulating hormone (TSH) at the 24 hr time point (P ˂ 0.05) but not the 1.5 and 3.0 hr time points. Conclusions Arginine supplementation modestly increased growth hormone. Despite their similar structures, prolactin secretion was not elevated following arginine supplementation, thus another mechanism is responsible for growth hormone secretion. Funding Sources DoD and NIH P30DK072476. Views expressed are those of the authors and do not reflect official policy of the Army, DoD, or US Government.

Progress of negative symptoms over the initial 5 years of a first episode of psychosis

2018 ◽  
Vol 49 (1) ◽  
pp. 66-74 ◽  
Author(s):  
Danyael Lutgens ◽  
Ridha Joober ◽  
Srividya Iyer ◽  
Martin Lepage ◽  
Ross Norman ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Additional Benefit ◽  
First Episode ◽  
Systematic Assessment ◽  
Randomized Controlled ◽  
Regular Care ◽  
Repeated Measures Analysis ◽  
Extension Period

AbstractBackgroundSpecialized early intervention (EI) following a first episode of psychosis (FEP) are effective at reducing negative symptoms, although its trajectory warrants systematic assessment. However, findings are equivocal as to whether extended gains are made post 2 years of EI and whether there is additional benefit of extending EI for an additional 3 years.MethodsData on 178 FEP patients, from a randomized controlled trial of a 3-year extension of EI service v. transfer to regular care following 2 years of EI service, were used for this report. Repeated measures analysis of variance were conducted separately for the initial 2 years of treatment in an EI service, and for the 3-year post-randomization to examine trajectories of negative symptoms over the two periods in the two arms of the study.ResultsThere were significant improvements in total negative symptoms over the first 2 years of EI F(4.612, 797.905) = 25.263, p < 0.001 and in domains of ‘expressivity’ and ‘motivation’. In the following 3 years, there were further significant improvements in negative symptoms F(4.318, 759.908) = 4.182, p = 0.002 with no difference between groups F(4.318, 759.908) = 1.073, p = 0.371. Changes in negative symptoms over the extension period were driven by expressivity F(4.01, 674.73) = 7.19, p < 0.01, but not motivation F(6.58, 1112.18) = 0.95, p = 0.46.ConclusionNegative symptoms improve significantly over the first 2 years of EI. Subsequent amelioration was largely the result of expressivity. Motivation deficits remained stable. Extended EI offered no advantage over regular care post-randomization.

scholarly journals Randomized Double-Blind Controlled Trial on the Effect of Proteins with Different Tryptophan/Large Neutral Amino Acid Ratios on Sleep in Adolescents: The PROTMORPHEUS Study

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1885 ◽  
Author(s):  
Oussama Saidi ◽  
Emmanuelle Rochette ◽  
Éric Doré ◽  
Freddy Maso ◽  
Julien Raoux ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Dietary Intake ◽  
Sleep Disturbances ◽  
Controlled Trial ◽  
Internal Clock ◽  
Sleep Efficiency ◽  
Large Neutral Amino Acid ◽  
Double Blind ◽  
Circadian Phase ◽  
Two Samples

Disturbed sleep is common in adolescents. Ingested nutrients help regulate the internal clock and influence sleep quality. The purpose of this clinical trial is to assess the effect of protein tryptophan (Trp)/large neutral amino acids (LNAAs) ratio on sleep and circadian rhythm. Ingested Trp is involved in the regulation of the sleep/wake cycle and improvement of sleep quality. Since Trp transport through the blood–brain barrier is competing with LNAAs, protein with higher Trp/LNAAs were expected to increase sleep efficiency. This randomized double-blind controlled trial will enroll two samples of male adolescents predisposed to sleep disturbances: elite rugby players (n = 24) and youths with obesity (n = 24). They will take part randomly in three sessions each held over a week. They will undergo a washout period, when dietary intake will be calibrated (three days), followed by an intervention period (three days), when their diet will be supplemented with three proteins with different Trp/LNAAs ratios. Physical, cognitive, dietary intake, appetite, and sleepiness evaluations will be made on the last day of each session. The primary outcome is sleep efficiency measured through in-home electroencephalogram recordings. Secondary outcomes include sleep staging, circadian phase, and sleep-, food intake-, metabolism-, and inflammation-related biochemical markers. A fuller understanding of the effect of protein Trp/LNAAs ratio on sleep could help in developing nutritional strategies addressing sleep disturbances.

scholarly journals Ultra-Marathon-Induced Increase in Serum Levels of Vitamin D Metabolites: A Double-Blind Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3629 ◽  
Author(s):  
Jan Mieszkowski ◽  
Błażej Stankiewicz ◽  
Andrzej Kochanowicz ◽  
Bartłomiej Niespodziński ◽  
Tomasz Kowalik ◽  
...  
Keyword(s):  
Vitamin D ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Serum Levels ◽  
Vitamin D Metabolites ◽  
Double Blind ◽  
Vitamin D Metabolism ◽  
Repeated Measures Design ◽  
Randomized Controlled ◽  
Type Of Exercise

Purpose: While an increasing number of studies demonstrate the importance of vitamin D for athletic performance, the effects of any type of exercise on vitamin D metabolism are poorly characterized. We aimed to identify the responses of some vitamin D metabolites to ultra-marathon runs. Methods: A repeated-measures design was implemented, in which 27 amateur runners were assigned into two groups: those who received a single dose of vitamin D3 (150,000 IU) 24 h before the start of the marathon (n = 13) and those (n = 14) who received a placebo. Blood samples were collected 24 h before, immediately after, and 24 h after the run. Results: In both groups of runners, serum 25(OH)D3, 24,25(OH)2D3, and 3-epi-25(OH)D3 levels significantly increased by 83%, 63%, and 182% after the ultra-marathon, respectively. The increase was most pronounced in the vitamin D group. Body mass and fat mass significantly decreased after the run in both groups. Conclusions: Ultra-marathon induces the mobilization of vitamin D into the blood. Furthermore, the 24,25(OH)2D3 and 3-epi-25(OH)D3 increases imply that the exercise stimulates vitamin D metabolism.

scholarly journals Dental arch effects after early and later timed cervical headgear treatment—a randomized controlled trial

2019 ◽  
Vol 41 (6) ◽  
pp. 622-630
Author(s):  
Johanna Julku ◽  
Matti Hannula ◽  
Kirsi Pirilä-Parkkinen ◽  
Mimmi Tolvanen ◽  
Pertti Pirttiniemi
Keyword(s):  
Repeated Measures ◽  
Controlled Trial ◽  
Class Ii ◽  
Dental Arch ◽  
Maxillary Molars ◽  
Parallel Group ◽  
Repeated Measures Analysis ◽  
Size Groups ◽  
T1 And T2

Summary Background Cervical headgear (CH) is a commonly used orthodontic appliance and its dentoalveolar changes are known. However, the effects related to gender and timing have gained less attention. Objectives To examine dimensions of dental arches among children with Class II occlusion without posterior mandibular rotation according to timing of Kloehn-type CH treatment. Trial design Prospective, randomized, parallel-group controlled trial. Methods Sixty-seven seven-year-old children with a Class II occlusion were included in the study. The children were randomized into two equal-size groups in 1:1 ratio by sealed-envelope randomization. The early group (EG, n = 33) was treated between T0 and T1 (26 months), right after eruption of the first maxillary molars. The late group (LG, n = 34) was treated between T1 and T2 (24 months). The children were treated with CH until normal Class I occlusion on first molars was achieved. Impressions for dental casts were taken from all participants at T0, T1, and T2. Blinding was applicable for outcome assessors. Changes in dental cast measurements were compared between the groups and genders using t-test, Mann-Whitney U-test, and repeated measures analysis of variance. Results Of the children, 56 completed the study. The maxillary arch length and the transversal changes between the upper canines and upper first molars were significantly increased in EG at T0−T1 (P < 0.001). At T2, the transversal dimension between the upper first molars was larger (P < 0.05), and in the lower arch the mandibular arch length (P < 0.05) and the transversal dimension between the lower first molars (P < 0.01) were increased in EG males compared to LG males. No harms were encountered. Conclusions The male gender benefits most from early timing of the CH treatment, showing larger dimensions at the end of the follow-up. The results clearly indicated a wider and longer upper dental arch and spontaneous expansion of the lower dental arch after treatment. Clinical Registration NCT02010346.

scholarly journals Vitamin C to pregnant smokers persistently improves infant airway function to 12 months of age: a randomised trial

2020 ◽  
Vol 56 (6) ◽  
pp. 1902208 ◽  
Author(s):  
Cindy T. McEvoy ◽  
Lyndsey E. Shorey-Kendrick ◽  
Kristin Milner ◽  
Diane Schilling ◽  
Christina Tiller ◽  
...  
Keyword(s):  
Vitamin C ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Analysis Of Covariance ◽  
Secondary Outcome ◽  
Double Blind ◽  
Smoking Cessation Counselling ◽  
Airway Function ◽  
Pregnant Smokers

BackgroundVitamin C (500 mg·day−1) supplementation for pregnant smokers has been reported to increase newborn pulmonary function and infant forced expiratory flows (FEFs) at 3 months of age. Its effect on airway function through 12 months of age has not been reported.ObjectiveTo assess whether vitamin C supplementation to pregnant smokers is associated with a sustained increased airway function in their infants through 12 months of age.MethodsThis is a pre-specified secondary outcome of a randomised, double-blind, placebo-controlled trial that randomised 251 pregnant smokers between 13 and 23 weeks of gestation: 125 to 500 mg·day−1 vitamin C and 126 to placebo. Smoking cessation counselling was provided. FEFs performed at 3 and 12 months of age were analysed by repeated-measures analysis of covariance.ResultsFEFs were performed in 222 infants at 3 months and 202 infants at 12 months of age. The infants allocated to vitamin C had significantly increased FEFs over the first year of life compared to those allocated to placebo. The overall increased flows were 40.2 mL·s−1 for at FEF75 (75% of forced vital capacity (FVC)) (adjusted 95% CI for difference 6.6–73.8; p=0.025); 58.3 mL·s−1 for FEF50 (10.9–105.8; p=0.0081); and 55.1 mL·s−1 for FEF25–75 (9.7–100.5; p=0.013).ConclusionsIn offspring of pregnant smokers randomised to vitamin C versus placebo, vitamin C during pregnancy was associated with a small but significantly increased airway function at 3 and 12 months of age, suggesting a potential shift to a higher airway function trajectory curve. Continued follow-up is underway.

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