scholarly journals Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
René Rodríguez-Gutiérrez ◽  
Camilo González-Velázquez ◽  
Gerardo González-Saldívar ◽  
Jesús Zacarías Villarreal-Pérez ◽  
José Gerardo González-González
Keyword(s):  
Adrenal Insufficiency ◽  
Low Dose ◽  
Primary Hypothyroidism ◽  
Adrenocortical Function ◽  
Controlled Study ◽  
Control Group ◽  
Cortisol Response ◽  
Full Spectrum ◽  
Before And After ◽  
Prospective Longitudinal

Adrenal function might be impaired in patients with primary hypothyroidism. The objective was to evaluate adrenocortical function using the low-dose cosyntropin test in patients with primary hypothyroidism. Consequently a prospective, longitudinal, controlled study of sixty adult patients with primary hypothyroidism was carried out. Patientsnaïveto L-T4 treatment were compared with control participants. A low-dose cosyntropin test was done before and after L-T4 therapy. Thirty and sixty minutes after the low-dose cosyntropin, the mean cortisol values were lower in the cases group (612.6 ± 133.1 and 603.4 ± 153.7 nmol/L) when compared to the control group (677.0 ± 82.4 and 669.9 ± 83.7 nmol/L) (P=0.001and 0.003), respectively. After L-T4 therapy, this difference was lost. Four out of 60 cases (6.7%) taking a cortisol cutoff value of 500 mmol/L and 11 out of 60 (18.3%) having 550 mmol/L as the cutoff had adrenal insufficiency before L-T4 therapy. After L-T4 therapy, 50% and 81% of the cases had normal cortisol response. In conclusion, patients with different degrees of intensity of primary hypothyroidism had improved cortisol response after reaching euthyroidism. The incidence of adrenal insufficiency was 6.7–18.3% and more than 50% of the cases had a normal cortisol response after L-T4 therapy.

Comparison of Antileukotrienes and Antihistamines in the Treatment of Allergic Rhinitis

2007 ◽  
Vol 21 (4) ◽  
pp. 439-443 ◽  
Author(s):  
Ching-Yin Ho ◽  
Ching-Ting Tan
Keyword(s):  
Allergic Rhinitis ◽  
Low Dose ◽  
Treated Group ◽  
Nasal Symptom ◽  
Controlled Study ◽  
Control Group ◽  
High Dose ◽  
Nasal Resistance ◽  
Before And After ◽  
Nasal Secretions

Background The aim of this study was to compare the effect of antileukotriene (anti-LT), antihistamine, and a combination of anti-LT and antihistamine on the symptoms and nasal resistance in allergic rhinitis patients. Methods We performed a placebo-controlled study, with 120 persistent, moderate to severe allergic rhinitis patients randomly selected to receive the different treatments for 4 weeks: no treatment, 10 mg of cetirizine once per day, 20 mg of zafirlukast once per day, 20 mg of zafirlukast twice per day, a combination of 20 mg of zafirlukast and 10 mg of cetirizine once per day, or a combination of 20 mg of zafirlukast twice per day and 10 mg cetirizine once per day. The nasal secretion nitric oxide (NO) concentration, nasal symptom score, and nasal resistance were measured before and after treatment. Results Total symptom scores improved in each treated group compared with the control group (p < 0.05). Nasal obstruction significantly improved in the anti-LT-treated groups (p < 0.05). High-dose anti-LT or the combination of low-dose anti-LT and antihistamine significantly improved allergy symptoms compared with no treatment, low-dose anti-LT, or antihistamine alone (p < 0.05). Furthermore, anti-LT decreased NO concentration in nasal secretions (p < 0.05), regardless of the dose administered. Conclusion These results suggest that high-dose anti-LT alone or the combination of low-dose anti-LY and antihistamine can effectively treat allergic rhinitis.

Use of Propentofylline in Feline Bronchial Disease: Prospective, Randomized, Positive-Controlled Study

2010 ◽  
Vol 46 (5) ◽  
pp. 318-326 ◽  
Author(s):  
Ulrike Stursberg ◽  
Isabella Zenker ◽  
Silke Hecht ◽  
Katrin Hartmann ◽  
Bianka S. Schulz
Keyword(s):  
Combination Therapy ◽  
Low Dose ◽  
Respiratory Pattern ◽  
Controlled Study ◽  
Control Group ◽  
Bronchial Disease ◽  
Observation Period

Propentofylline is a methylxanthine derivative with bronchodilating actions similar to those of theophylline. Nineteen cats with bronchial disease were enrolled in this study. All cats received a low dose of prednisolone; 10 of the cats additionally received propentofylline. Propentofylline-treated cats significantly improved in their auscultation scores, respiratory pattern scores, and radiological bronchial markings score over the observation period, and they coughed less and slept less at the end of the study. No significant changes were noted in the control group. This study provides evidence that a combination therapy with prednisolone and propentofylline in cats with bronchial disease might be superior over monotherapy with prednisolone.

scholarly journals Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
René Rodríguez-Gutiérrez ◽  
Jesús Zacarías Villarreal-Pérez ◽  
Felipe Arturo Morales-Martinez ◽  
René Rodríguez-Guajardo ◽  
Gloria González-Saldivar ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Strong Correlation ◽  
Hydatidiform Mole ◽  
Free Testosterone ◽  
Dehydroepiandrosterone Sulfate ◽  
Controlled Study ◽  
Control Group ◽  
The Difference ◽  
Prospective Longitudinal

Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered.Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM).Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P≤0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P=0.0001and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r=0.78;P≤0.001,r=0.74;  P≤0.001, andr=0.71;  P≤0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P=0.001) and free T and DHEA-S declined significantly (P=0.0002and 0.009).Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.

scholarly journals Controlled Study of the Impact of a Virtual Program to Reduce Stigma Among University Students Toward People With Mental Disorders

2021 ◽  
Vol 12 ◽  
Author(s):  
Matías E. Rodríguez-Rivas ◽  
Adolfo J. Cangas ◽  
Daniela Fuentes-Olavarría
Keyword(s):  
Mental Disorders ◽  
University Students ◽  
Intervention Group ◽  
Project Based Learning ◽  
Controlled Study ◽  
Control Group ◽  
Global Score ◽  
Stigma Reduction ◽  
Before And After ◽  
The Impact

Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p &lt; 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p &lt; 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.

Changes In Serum Leptin And Nesfatin-1 Levels Measured Before And After Acupuncture In Overweight/obese Patients: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Tevhid Aydin ◽  
Ruhusen Kutlu ◽  
Hayriye Alp ◽  
Ibrahim Kilinc
Keyword(s):  
Acupuncture Group ◽  
Controlled Study ◽  
Auricular Acupuncture ◽  
Control Group ◽  
Obese Patients ◽  
Health Crisis ◽  
Serum Leptin ◽  
Randomized Controlled ◽  
Control Serum ◽  
Before And After

Obesity has become a global epidemic and public health crisis in our country as well as all over the world.We aimed to investigate the changes in serum leptin and nesfatin-1 levels measured before and after acupuncture in overweight/obese patients. This randomized controlled study was carried out on 90 overweight/obese patients. Participants were divided into three groups: Group 1 (Acupuncture), Group 2 (Diet), and Group 3 (Control). Serum leptin and nesfatin-1 levels were measured before and after the intervention. The 30 days leptin values were significantly decreased in the acupuncture group (p=0.040) while they were significantly increased in the control group (p=0.039). It was detected that the nesfatin-1 values were significantly increased in both acupuncture (p=0.032) and diet groups (p=0.017). Also, body weights significantly decreased both in acupuncture (p=0.032) and diet groups (p<0.001). In the present study, auricular acupuncture was found to be more effective than body acupuncture in reducing body weight. Our results support the effects of acupuncture treatment on appetite hormones. Further research on the mechanisms of endogenous and exogenous actions of the recently discovered hormones leptin and nesfatin-1 isneeded.

Adrenal insufficiency in kidney transplant patients during low-dose prednisolone therapy: a cross-sectional case–control study

2019 ◽  
Vol 35 (12) ◽  
pp. 2191-2197 ◽  
Author(s):  
Amalie Valentin ◽  
Stina Willemoes Borresen ◽  
Marianne Rix ◽  
Thomas Elung-Jensen ◽  
Søren Schwartz Sørensen ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Low Dose ◽  
Case Control Study ◽  
Case Control ◽  
Adrenal Crisis ◽  
Control Group ◽  
Cross Sectional ◽  
Prednisolone Treatment ◽  
Synacthen Test ◽  
Control Study

Abstract Background Maintenance immunosuppressive regimens after renal transplantation (RTx) most often include prednisolone, which may induce secondary adrenal insufficiency, a potentially life-threatening side effect to glucocorticoid (GC) treatment due to the risk of acute adrenal crisis. We investigated the prevalence of prednisolone-induced adrenal insufficiency in RTx patients receiving long-term low-dose prednisolone treatment. Methods We performed a case–control study of patients on renal replacement therapy differing in terms of GC exposure. The study included 30 RTx patients transplanted &gt;11 months before enrolment in the study and treated with prednisolone (5 or 7.5 mg prednisolone/day for ≥6 months) and 30 dialysis patients not treated with prednisolone. Patients underwent testing for adrenal insufficiency by a 250-µg Synacthen test performed fasting in the morning after a 48-h prednisolone pause. Normal adrenal function was defined as P-cortisol ≥420 nmol/L 30 min after Synacthen injection. This cut-off is used routinely for the new Roche Elecsys Cortisol II assay and is validated locally based on the Synacthen test responses in 100 healthy individuals. Results Thirteen RTx patients {43% [95% confidence interval (CI) 27–61]} had an insufficient response to the Synacthen test compared with one patient in the control group [3% (95% CI 0.6–17)] (P = 0.0004). Insufficient responses were seen in 9/25 and 4/5 RTx patients treated with 5 and 7.5 mg prednisolone/day, respectively. Conclusions We found a high prevalence of adrenal insufficiency among RTx patients receiving low-dose prednisolone treatment. We therefore advocate for increased clinical alertness towards prednisolone-induced adrenal insufficiency in RTx patients and thus their potential need of rescue GC supplementation during stress.

Effects of Electroacupuncture on Stress-Related Symptoms in Medical Students: A Randomised Placebo-Controlled Study

2014 ◽  
Vol 32 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Marcio Dias ◽  
Guillermo Coca Vellarde ◽  
Beni Olej ◽  
Ana Emília Teófilo Salgado ◽  
Ighor de Barros Rezende
Keyword(s):  
Medical Students ◽  
Sleep Quality ◽  
Maslach Burnout Inventory ◽  
Controlled Study ◽  
Control Group ◽  
Life Questionnaire ◽  
Student Survey ◽  
Before And After ◽  
Mental Symptoms ◽  
Continuous Frequency

Objective To assess the effects of electroacupuncture (EA) on relieving stress-related symptoms—sleep disorders, anxiety, depression and burnout—in medical students. Methods Eighty-two students were randomised into an EA treatment group (n=30), a sham TENS group (n=18) and an untreated control group (n=34). EA was applied at a continuous frequency of 2 Hz to the limbs, face, ears and scalp for 20 min once a week, over 6–8 weeks. Sham transcutaneous electrical nerve stimulation (TENS) was performed on similar sites for the same number of times in each session and for the same length of time. Outcome measurements included a comparison of the indices obtained by different self-applied questionnaires before and after treatment. The surveys used were the Mini-Sleep Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the Beck Depression and Anxiety Inventories (BDI and BAI) and the Maslach Burnout Inventory—Student Survey (MBI-SS), in addition to the Quality of Life Questionnaire—abbreviated version (WHOQOL-bref). Results EA significantly improved scores on the MSQ, PSQI, BDI and the cynicism and academic efficacy (AE) dimensions of the MBI-SS in relation to the control. Sleep quality (MSQ) improved from 36.9 (SD 7.6) to 25.0 (5.7) with EA, 37.6 (6.0) to 32.1 (6.9) with sham TENS, and 36.5 (5.9) to 33.6 (6.7) in the controls (p=0.0000). Compared with the sham TENS group, EA significantly reduced scores on the PSQI. Score improvements in the sham TENS group in relation to control group were significant in the MSQ, BDI and AE. In the EA group, the number of students with better scores after intervention was significantly higher for the MSQ, PSQI, ESS and BAI. This only occurred for the MSQ in the sham TENS group and for the MSQ and ESS in the control group. Conclusions EA significantly reduced stress-related mental symptoms. The improvement obtained by sham TENS compared with the control group confirmed the presence of a placebo effect resulting from the treatment ritual.

Impact of Enhanced Recovery Program after Surgery in Patients Undergoing Pancreatectomy on Postoperative Outcomes: A Controlled before and after Study

2019 ◽  
Vol 37 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Julie Perinel ◽  
Antoine Duclos ◽  
Cecile Payet ◽  
Yves Bouffard ◽  
Jean Christophe Lifante ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Compliance Rate ◽  
Postoperative Outcomes ◽  
Controlled Study ◽  
Control Group ◽  
Difference In Differences ◽  
Control Hospital ◽  
Before And After ◽  
Implementation Period ◽  
The Impact

Background: Implementation of enhanced recovery after surgery (ERAS) program after pancreatic surgery was associated with decreased length of stay (LOS). However, there were only retrospective uncontrolled before-after study, and care protocols were heterogeneous. We aimed to evaluate the impact of ERAS program on postoperative outcomes after pancreatectomy through a prospective controlled study. Methods: A before/after study with a contemporary control group was undertaken in patients undergoing pancreatectomy. We compared 2 groups: the intervention hospital that implemented ERAS program and the control hospital that performed traditional care; and 2 periods: the preimplementation and the post-implementation period. A difference-in-differences approach was used to evaluate whether implementation of ERAS program was associated with improved LOS and postoperative morbidity. Results: About 97 and 75 patients were included in intervention and control hospital. In multivariate analysis, implementation of ERAS was associated with a significantly shorten LOS (hazard ratio 1.61; 95% CI 1.07–2.44) and higher compliance rate (OR 1.34; 95% CI 1.18–1.53). Difference-in-differences analysis revealed that LOS, morbidity, and readmission did not differ after ERAS implementation. Conclusion: Implementation of ERAS program was safe and effective after pancreatectomy with high compliance rate. LOS was significantly reduced without compromising morbidity

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