The Study of Low Calcium Dialysate on Elderly Hemodialysis Patients with Secondary Hypoparathyroidism

2016 ◽  
Vol 42 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Jian-rao Lu ◽  
Yang Yi ◽  
Zhong-xiang Xiong ◽  
Xiu-feng Cheng ◽  
Jing Hu ◽  
...  

Objective: The study aimed to study the safety and efficacy of 1.25 mmol/l calcium dialysate on maintenance hemodialysis (MHD) in elderly patients who suffered from secondary hypoparathyroidism. Methods: Eighty-two elderly patients (ages ≥65) who had been in MHD with dialysate calcium at 1.5 mmol/l over 6 months and had 2 consecutive serum intact parathyroid hormone (iPTH) measurements at level below 100 pg/ml were selected and randomized into 2 groups: treatment group (41 patients, with dialysate calcium at 1.25 mmol/l) and control group (41 patients, still with dialysate calcium at 1.5 mmol/l). Both groups were studied for the duration of 12 months. The changes of serum iPTH, calcium, phosphorus, calcium and phosphorus product and other indicators as well as related adverse reactions were recorded at the following time points: before the study and 1, 3, 6 and 12 months into the study. In addition, the intimal media thickness (IMT) of carotid artery and abdominal aorta calcification score (AACS) were measured in the 0, 6 and 12 months during the study. Results: (1) In the treatment group, the levels of serum corrected calcium, phosphorus and calcium-phosphate product began to decline after 1 month and exhibited further decrease 3 months later. Serum iPTH level increased significantly after 1 month into the study and the trend continued. The above markers stabilized after month 6. Compared with pre-study markers, the changes of the above markers were significant after study (p < 0.05). (2) The average IMT and AACS were evidently decreased during the 6 and 12 months of study in the treatment group. There was statistical significance (p < 0.05) when compared with the above indexes of the pre-study and the control group. (3) In the control group, there were no significant differences in above laboratory markers over the 12-month study period. (4) There was no significant difference in the adverse events observed between the 2 groups. Conclusion: Safety of low calcium dialysate (dialysate calcium 1.25 mmol/l) in elderly MHD patients with iPTH <100 pg/ml is good, as well as improving carotid IMT, resistance index and AACS as indexes of vascular calcification in the small study group and warrants further investigation.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1751.1-1752
Author(s):  
S. Hecquet ◽  
F. Verhoeven ◽  
S. Aubry ◽  
C. Prati ◽  
D. Wendling

Background:Sacral fractures are a source of pain leading to loss of autonomy in elderly patients. Sacroplasty may be an effective alternative of conservative medical treatment.Objectives:To evaluate the short-term analgesic effect of sacroplasty compared to conservative treatment in patients with osteoporotic sacral fracturesMethods:This is a retrospective study of cases of osteoporotic sacral fractures treated with sacroplasty, compared with cases treated with conservative medical procedure over the same period. Outcome was evaluated by pain (Visual analogic scale) short-term (one month) evolution and side effects occurrence.Results:From January 2009 to June 2019, eleven patients were treated with sacroplasty for osteoporotic fractures at the Besançon University Hospital Centre. These were compared to 12 patients with osteoporotic sacral fracture with exclusive medical management, as a control group. The two groups were similar in age, gender and pain level at baseline. The median VAS was 7/10 in both groups at baseline, In the sacroplasty group, a significant decrease of pain was observed over the two first weeks, with a tendency remaining at day 30. There were no significant differences in the conservative treatment group at one week (p=0.2), fourteen days (p=0.6) and thirty days (p=0.7) compared to basal assessment.When comparing the sacroplasty group and the conservative treatment group, no differences were noted at baseline between the two groups, there was a significant difference between the two groups the following day (p=0.001), one week (p=0.003) and day 15 (p=0.01) after the intervention. However, there was no significant difference between the two groups at day 30, but only a trend (p=0.08).Regarding analgesic treatments, 30% of patients in the sacroplasty group could reduce their analgesics between the time they entered and left hospital. None of the patients in the control group were able to reduce their analgesic treatment over this period. In addition, half of the patients in the sacroplasty group were successful in returning home compared to only one-third of the patients in the conservative treatment group.Conclusion:In this study, sacroplasty was associated with an early and significant pain relief compared to conservative management in patients with osteoporotic sacral fracture. The procedure is well tolerated and may prevent loss of autonomy in these patients.Disclosure of Interests:None declared


2021 ◽  
Vol 12 ◽  
Author(s):  
Fazheng Zhao ◽  
Xin Tong ◽  
Changqing Wang

Objective: We aimed to analyze the characteristics and psychological mechanism of depressive symptoms in elderly patients with alcohol dependence under the COVID-19 epidemic and to observe the effect of acupuncture combined with emotional therapy of Chinese medicine treatment on depressive symptoms in elderly patients with alcohol dependence.Methods: Sixty patients were randomly divided into two groups. One group was treated by a set of emotional therapy of Chinese medicine treatment for 12 weeks (control group). One group was treated by a set of acupuncture combined with emotional therapy of Chinese medicine treatment for 12 weeks (treatment group). We compared the curative effect between the control group and the treatment group, the mean alcohol consumption, the SF-36 scores before and after treatment, and the scores of Hamilton Depression Scale before and after treatment of 3, 6, and 9 weeks.Results: Based on the cognitive behavior model, the characteristics and psychological mechanism of depression in elderly patients with alcohol dependence under the COVID-19 epidemic situation were summarized. The total effective rate of the control group was 60%, and that of the treatment group was 100% (p &lt; 0.05). The alcohol consumption of the patients in each group decreased significantly after treatment (p &lt; 0.05), and there was no significant difference in alcohol consumption between the treatment group and the control group (p &gt; 0.05). After 12 weeks of treatment, there were significant differences in PF, RF, physical pain, general health status, energy, and mental health between the treatment group and the control group (p &lt; 0.05). Before and after treatment, there were significant differences in PF, RF, physical pain, general health, energy, emotional function, and mental health (p &lt; 0.05) of the treatment group. The PF, energy, and mental health of the control group were significantly different before and after treatment (p &lt; 0.05). There was no significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale before treatment. There was significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale at 3, 6, and 9 weeks after treatment.Conclusion: Attention, cognition, emotion, behavior, and physical response reinforce each other, creating a vicious cycle that reinforces and sustains the depressive symptoms of elderly alcohol dependence under the COVID-19 epidemic, and acupuncture combined with emotional therapy of Chinese medicine treatment for improving the depressive symptoms of elderly alcohol dependence during the epidemic period of COVID-19 has a brilliant therapeutic effect.


2011 ◽  
Vol 39 (10) ◽  
pp. 1431-1439 ◽  
Author(s):  
Selcuk Karaman

The effects of audience response systems (ARS) on students' academic success and their perceptions of ARS were examined in this study. Participants, comprising 44 undergraduate students, were randomly assigned to a control or treatment group. The course design was the same for both groups and the instructor prepared the multiple-choice questions in advance; students in the control group responded to these questions verbally whereas the treatment group used ARS. Two paper-based examinations were used to measure the learning of concepts and skills that were taught. Students' perceptions of ARS were collected via a questionnaire. Results showed that ARS usage has a significant learning achievement effect in the first 4 weeks but not at the end of the second 4 weeks. There was no significant difference in retention between either group. Students perceived the ARS tool positively, finding it very enjoyable and useful.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Houben ◽  
J.A Snoek ◽  
E Prescott ◽  
N Mikkelsen ◽  
A.E Van Der Velde ◽  
...  

Abstract Background and purpose Although participation in cardiac rehabilitation (CR) improves quality of life (QoL), participation in CR, especially among elderly, is limited. We conducted this study to assess whether mobile home-based CR (mCR) increases QoL in elderly (≥65 years old) patients with coronary artery disease (CAD) or a valvular intervention who decline participation in conventional CR. Methods It is designed as a randomised multi-centre study with two parallel arms. Randomisation assigned patients either to mCR or a control group. mCR Consisted of six months of home-based CR with telemonitoring and coaching. Control-group patients did not receive any form of CR throughout the study period. Quality of life was measured with the SF-36v2 questionnaire at 0, 6 and 12 months. Results A total of 179 patients were included in this study (90 control, 89 mCR). A flowchart of the trial is presented in Figure 1. Patients were predominantly male (81.1%). Baseline characteristics can be found in Table 1. Patients using mCR improved on physical QoL after 6 (p=0.026) and 12 (p=0.008) months. There was no difference on mental QoL for both groups (mCR 6 months p=0.563, 12 months p=0.945; control 6 months p=0.589, 12 months p=0.542). No difference existed in QoL between the mCR and control group (physical: 6 months p=0.070, 12 months p=0.150; mental: 6 months p=0.355, 12 months p=0.625). Conclusion Although there is no significant difference in QoL between the control and mCR group, mCR increases physical QoL after 6 and 12 months in elderly patients who decline participation in conventional CR. Therefore E-Health tools should be considered as an alternative for conventional CR when (elderly) patients decline to participate in conventional CR. Figure 1. Flow chart of all eligible patients Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme


Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 34
Author(s):  
Cheuk Kei Lao ◽  
Bing Long Wang ◽  
Richard S. Wang ◽  
Hsiao Yun Chang

Background and objectives: Faced with the serious problem of an aging population, exercise is one of the most effective ways to maintain the health of the elderly. In recent years, with the popularization of smartphones, the elderly have increasingly accepted technological products that incorporate artificial intelligence (AI). However, there is not much research on using artificial intelligence bracelets to enhance elders’ motivation and participation in exercise. Therefore, the purpose of this study is to evaluate the effectiveness of the combination of sports smart bracelets and multi-sport training programs on the motivation of the elderly in Macau. Materials and Methods: The study was conducted with a randomized trial design in a 12 week multi-sport exercise training intervention. According to the evaluation, a total of sixty elders’ pre- and post-test data were included in this study. Results: After 12 weeks of multi-sport exercise training, the evaluation scores on the exercise motivation scale (EMS) increased significantly in the group wearing exercise bracelets and those taking part in the multi-component exercise program, and the degree of progress reached a statistically significant level, but the control group did not show any statistically significant difference. The influence of the combination of sports smart bracelets and multi-sport training programs on elders’ motivation is clearer. Conclusions: The use of sports smart bracelets by elderly people in conjunction with diverse exercise training can effectively enhance elders’ motivation and increase their participation in regular exercise. The combination of sports smart bracelets and multi-sport training programs is worth promoting in the elderly population.


Author(s):  
Muhammad Kashif ◽  
Nosheen Manzoor ◽  
Rimsha Safdar ◽  
Hafsa Khan ◽  
Maryam Farooq ◽  
...  

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.


Author(s):  
Changying Yi ◽  
Jie Zhang ◽  
Meili Fan

<B>Objective:</B> Functional fecal incontinence in children (FFIC), also known as functional fecal disorder in children, is a type of childhood diseases characterized by excretory dysfunction. In the study, we observed the clinical effect of Changqiang acupoint injection on functional fecal incontinence in children (FFIC) by randomized controlled clinical trials. <BR><B>Materials and methods:</B> 140 children with functional fecal incontinence who met the screening criteria were respectively assigned into the treatment group (100 cases) and the control group (40 cases) according to the completely randomized controlled design. In the treatment group, Chuankezhi injection was administrated at the Changqiang acupoint once a week for three weeks (one course of treatment). In contrast, the subjects in the control group was instructed to receive sphincter exercise and defecation training, followed by an assessment on the therapeutic efficacy after one course of treatment. <BR><B>Results:</B> The overall response rate of the two groups was 93.00% (93/100) and 57.50% (23/40), respectively, with a statistically significant difference (P<0.01). The treatment group showed a performance superior to the control group based on the Cleveland Clinic Florida Fecal Incontinence Score System (CCF-FI)—dry stool incontinence, liquid incontinence, gas incontinence, lifestyle change, necessity of using pads or antidiarrheals, the ability to delay defecation, and the total score. The inter-group comparison revealed a statistically significant difference (P<0.01). <BR><B>Conclusion:</B>Changqiang acupoint injection has significant curative effect on FFIC as demonstrated by significant relief in the symptoms associated with fecal incontinence, and thus is considered as a useful approach to be widely applied in clinical practice.


Author(s):  
Suélem B. de Lorena ◽  
Angela L.B.P. Duarte ◽  
Markus Bredemeier ◽  
Vanessa M. Fernandes ◽  
Eduardo A.S. Pimentel ◽  
...  

BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n= 23) or to a control group (n= 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, -13.64, 95% CI, -21.78 to -5.49, P= 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P= 0.001) than the CONTROL group, but no significant difference in pain VAS (-1.41, -3.04 to 0.22, P= 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.


2020 ◽  
Vol 12 (8) ◽  
pp. 1030-1037
Author(s):  
Hailing Yang ◽  
Xiaolin Zhang ◽  
Weijun Chen ◽  
Libo Shang ◽  
Bin Chen ◽  
...  

Multiple organ dysfunction syndrome (MODS) is a key factor that leads to death in elderly patients with sepsis. Therefore, early prevention and treatment of gastrointestinal dysfunction (GIDF) in elderly patients with sepsis is an important measure to prevent MODS occurrence. This research explores the correlation between intestinal microflora and GIDF in elderly patients with sepsis and provides ideas for the prevention and treatment of GIDF in elderly patients with sepsis. In this study, 152 patients with sepsis (122 patients with sepsis and GIDF) treated in the Third Affiliated Hospital of Yunnan University of Chinese Medicine from January to September 2019 were selected as the sepsis group and 100 elderly who had normal physical examination results were selected as the control group. The common intestinal microflora of the two groups was compared. Patients with sepsis and GIDF were treated as the GIDF group and the other patients with sepsis were treated as the non-GIDF group. The common intestinal microflora, gastrointestinal indicators, serum inflammatory factors, and immune function indices were compared between the two groups. Correlation analysis of the observed indices with statistical significance was carried out. The results showed 152 patients with sepsis and 122 patients with sepsis and GIDF; thus, the incidence of sepsis with GIDF was 80.26%. The total average score of sepsis with GIDF was 3.61±0.09. There was no statistically significant difference in GIDF scores of patients ages 65–75 and > 75 years old. The number of Bifidobacterium and Lactobacillus in elderly patients with sepsis was lower and the number of Escherichia coli was higher than in the control group. In elderly patients with sepsis, the number of Bifidobacterium and Lactobacillus in the GIDF group was lower and the number of E. coli was higher than in the non-GIDF group. White blood cell (WBC) count, procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), gastrin (GAS), and diamine oxidase (DAO) in GIDF patients were higher and motilin (MOT), CIT (CIT), CD4+, and CD8+ were lower than in the non-GIDF group. WBC count, PCT, CRP, TNF-α, GAS, and DAO were negatively correlated with the number of Bifidobacterium and Lactobacillus but positively correlated with E. coli. MOT, CIT, CD4+, and CD8+ were positively correlated with the number of Bifidobacterium and Lactobacillus but negatively correlated with E. coli. There was a negative correlation between Bifidobacterium and Lactobacillus and GIDF score and a positive correlation between E. coli and GIDF score. Therefore, the change in the intestinal microflora in elderly patients with sepsis is related to GIDF.


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