Virtual Reality for Hypertension in Tooth Extraction: A Randomized Trial

2021 ◽  
pp. 002203452110493
Author(s):  
Z. Qin ◽  
C. Zhou ◽  
Y. Zhu ◽  
Y. Wang ◽  
H. Cao ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Standard Care ◽  
Tooth Extraction ◽  
Dental Anxiety ◽  
Care Group ◽  
Clinical Trial Registry ◽  
Anxiety Management ◽  
Intention To Treat ◽  
The Difference ◽  
And Gender

Tooth extraction is one of the most common causes of dental anxiety and pain, leading to the elevation of blood pressure (BP) and heart rate (HR). Such effects may be exaggerated and cause life-threatening accidents in patients with hypertension. Therefore, the pain and anxiety management of these patients is imperative. Virtual reality (VR) has been demonstrated to be a distraction method to relieve anxiety and pain in clinical operations. Thus, we hypothesized that VR can control the elevation of BP and HR in patients with hypertension. In this study, 96 eligible patients with controlled hypertension who needed tooth extraction were randomized to the VR or standard care group by stratified randomization of anxiety grade and gender. Their BP and HR were dynamically monitored. The corresponding systolic and diastolic BP and HR values were selected when systolic BP was at the highest point of the process. BP was converted into mean arterial pressure (MAP) for comparison per the following formula: MAP = (systolic BP + 2 × diastolic BP)/3. Statistical analyses were by intention to treat and conducted in SPSS. Nonparametric rank sum tests were used to compare the difference of ΔMAP and ΔHR between the VR and standard care groups. Multivariate linear regression was applied to evaluate the effect of VR on ΔMAP and ΔHR. The results showed that the VR technique significantly decreased the elevation of MAP ( P < 0.001) and HR ( P < 0.001), and this effect was found even after adjusting for baseline characteristics and additional surgical procedures (ΔMAP, P < 0.001, R2 = 0.276; ΔHR, P < 0.001, R2 = 0.152). VR did not increase the incidence of adverse events ( P = 0.677). In conclusion, the VR technique was effective in controlling BP and HR within an acceptable range and can help manage BP and HR during tooth extraction for patients with hypertension (Chinese Clinical Trial Registry: ChiCTR2100042132).

scholarly journals Tooth extraction: Pattern and etiology from extreme Northwestern Nigeria

2017 ◽  
Vol 11 (03) ◽  
pp. 335-339 ◽  
Author(s):  
Abdurrazaq Olanrewaju Taiwo ◽  
Adebayo Aremu Ibikunle ◽  
Ramat Oyebunmi Braimah ◽  
Omotayo Amidu Sulaiman ◽  
Olalekan Micah Gbotolorun
Keyword(s):  
Periodontal Disease ◽  
Tooth Extraction ◽  
Statistical Significance ◽  
Age Groups ◽  
Urban Region ◽  
Geographical Regions ◽  
Extraction Pattern ◽  
The Difference ◽  
And Gender ◽  
Age Range

ABSTRACT Objective: Tooth extraction is a commonly performed procedure in dental clinics. It has been shown that the reasons for and pattern of tooth extraction vary across geographical regions. Few reports on the pattern of extraction among a semi-urban populace exist. To the best of our knowledge, there is no study on the pattern and reasons for tooth mortality from Sokoto, Northwestern Nigeria, which is a semi-urban region. Materials and Methods: A review of the records of patients that had tooth extraction at our center between January 2009 and January 2016, was done. Data such as the age, gender, type of tooth extracted, and reasons for extraction were retrieved and analyzed. Cross tabulations for age and gender were also made. The level of statistical significance was set at P < 0.05. Results: A total of 1167 extractions were performed in 984 patients. An age range of 18–107 years with a mean (±standard deviation) of 34.8 (13.3) was observed. Most of the patients were in the 21–30 years age group accounting for 35.7% of cases. Dental caries and its sequelae (DCS) (631, 54.1%) were the most common reasons for extraction, followed by periodontal disease (192, 16.5%). The difference in proportions of reasons for tooth extraction between the gender was statistically significant (P = 0.02; df = 24). The difference in the reasons for extraction among the age groups was statistically significant (P < 0.001; df = 132). Conclusion: DCS along with periodontal disease were the major reasons for extractions. These are largely preventable causes of tooth extraction; therefore, there is a need for commencement of far-reaching preventative actions.

scholarly journals The VRIMM study: Virtual Reality for IMMunisation pain in young children—protocol for a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038354
Author(s):  
Kirrily Ellerton ◽  
Harishan Tharmarajah ◽  
Rimma Medres ◽  
Lona Brown ◽  
David Ringelblum ◽  
...  
Keyword(s):  
General Practice ◽  
Virtual Reality ◽  
Standard Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Pain Scale ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
The Difference ◽  
Randomised Controlled

IntroductionPain caused by routine immunisations is distressing to children, their parents and those administering injections. If poorly managed, it can lead to anxiety about future medical procedures, needle phobia and avoidance of future vaccinations and other medical treatment. Several strategies, such as distraction, are used to manage the distress associated with routine immunisations. Virtual reality (VR), a technology which transports users into an immersive ‘virtual world’, has been used to manage pain and distress in various settings such as burns dressing changes and dental treatments. In this study, we aim to compare the effectiveness of VR to standard care in a general practice setting as a distraction technique to reduce pain and distress in 4-year-old children receiving routine immunisations.Methods and analysisThe study is a randomised controlled clinical trial comparing VR with standard care in 100 children receiving routine 4-year-old vaccination. Children attending a single general practice in metropolitan Melbourne, Australia will be allocated using blocked randomisation to either VR or standard care. Children in the intervention group will receive VR intervention prior to vaccination in addition to standard care; the control group will receive standard care. The primary outcome is the difference in the child’s self-rated pain scores between the VR intervention and control groups measured using The Faces Pain Scale-Revised. Secondary outcomes include another measure of self-rated pain (the Poker Chip Tool), parent/guardian and healthcare provider ratings of pain (standard 100 mm visual analogue scales) and adverse effects.Ethics and disseminationEthics approval has been obtained in Australia from the Royal Australian College of General Practitioners National Research and Evaluation Ethics Committee (NREEC 18-010). Recruitment commenced in July 2019. We plan to submit study findings for publication in a peer-reviewed journal and presentation at relevant conferences.Trial registration numberACTRN12618001363279.

The Effect of Virtual Reality Game Preparation for Children scheduled for MRI (IMAGINE): a Randomized Controlled Trial Protocol (Preprint)

2021 ◽  
Author(s):  
Sylvie Le May ◽  
Christine Genest ◽  
Stéphane Guay ◽  
Nicole Hung ◽  
Maxime Francoeur
Keyword(s):  
Virtual Reality ◽  
Usual Care ◽  
Field Test ◽  
Controlled Trial ◽  
Muscle Tension ◽  
Test Phase ◽  
Therapeutic Modality ◽  
Care Group ◽  
Anxiety Management ◽  
Experimental Group

BACKGROUND Magnetic resonance imaging (MRI) has been known for almost forty years to generate fear and anxiety. Children may become restless during scanning, which results in movement artifacts requiring the MRI to be repeated and reschedule with sedation. Very few studies seemed to have looked at the effect of virtual reality (VR) on anxiety in children scheduled for an MRI and how this intervention could help identify which children are more responsive to VR. OBJECTIVE The aims of this study are three-fold: 1- to develop an algorithm of predictability based on biofeedback ; 2- to address feasibility and acceptability of a pre-procedural immersive VR (IVR) game preparation for anxiety management in children scheduled for an MRI (field test phase) and 3- to examine the efficacy of IVR game preparation compared to usual care for the management of procedural anxiety in children undergoing an MRI (RCT). METHODS This study will first consist of a field test phase with 10 participants, aged 7 to 17 years old, to initiate the development of a predictive algorithm for biofeedback solution requiring actual participants and to address the feasibility and acceptability of the VR intervention and research process. Following the field test, a randomized clinical trial will be completed using a parallel design with two groups: 1) experimental group (pre-procedural IVR game preparation), 2) usual care group (standard care as per radiology department’s protocol) in an equal ratio of 49 participants per group for a total of 98 participants. Recruitment will be done at CIUSSS de l’Est de l’Île de Montréal, Quebec, Canada. The experimental group will receive a pre-procedural IVR game preparation (IMAGINE) that offers an immersive and fun simulation of the MRI environment. Participants will complete a questionnaire to assess the acceptability, feasibility and incidence of side effects related to the intervention and the biofeedback device. Data collected will include socio-demographic and clinical characteristics and measures of procedure related-anxiety with the French-Canadian version of the State-Trait Anxiety Inventory for Children (STAIC-F) and the Child Fear Scale (CFS, 0-4). Physiological signs (heart rate, skin conductance, hand temperature and muscle tension) and levels of satisfaction of healthcare professionals, parents, and participants will also be collected. Analyses will be carried out according to the intention-to-treat principle, with a significance level (α) of 0.05. RESULTS Our study provides an alternative method for anxiety management to better prepare patients for an awake MRI. The biofeedback will help predict which children are more responsive to this type of intervention. CONCLUSIONS This study will guide future medical practice by providing evidence-based knowledge on a non-pharmacological therapeutic modality for anxiety management in children scheduled for MRI. CLINICALTRIAL NCT04988516

scholarly journals Virtual Reality for PEripheral Regional Anesthesia (VR-PERLA Study)

2020 ◽  
Vol 9 (1) ◽  
pp. 215 ◽  
Author(s):  
Camille Alaterre ◽  
Baptiste Duceau ◽  
Eileen Sung Tsai ◽  
Siham Zriouel ◽  
Francis Bonnet ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Patient Satisfaction ◽  
Regional Anesthesia ◽  
Standard Care ◽  
Satisfaction Score ◽  
Anxiety Reduction ◽  
Care Group ◽  
Hemodynamic Changes ◽  
Upper Limb Surgery ◽  
Patient Reported

When used as an add-on to regional anesthesia, virtual reality (VR) has been reported to provide anxiety-reducing benefits and sedation-sparing effects. However, its impact on patient satisfaction is still a matter of controversy. We investigated the feasibility and benefits of implementing intraoperative VR distraction in a French University Hospital (Hôpital Saint-Antoine, AP-HP). This monocentric observational before–after study included 100 patients who underwent ambulatory upper limb surgery under peripheral nerve block in January 2019, 50 before and 50 after implementation of an intraoperative VR distraction protocol. Primary outcome was patient self-rated satisfaction score evaluated right after surgery. Secondary outcomes included 2-month patient-reported satisfaction score, perioperative self-rated anxiety and intraoperative hemodynamic changes. Compared to former standard care, VR distraction was associated with significantly higher postoperative satisfaction scores (10 [IQR 9; 10] vs. 9 [8; 10], p < 0.001) still reported two months after surgery (10 [10;10] vs. 10 [8.5;10], p = 0.06). Patient median intraoperative anxiety score was lower in the VR group, compared to Standard Care group (0 [0; 2] vs. 3 [0.25; 7], p < 0.001), and occurrence of intraoperative hemodynamic changes was also lessened in the VR group (2% vs. 16%, 0R = 0.11[95% CI 0.002–0.87], p = 0.031). The present findings suggest that VR distraction program in the operating room could effectively improve patient satisfaction with anxiety-reduction and hemodynamic benefits.

Evaluation of the Degree of Dental Anxiety in a Lot of Patients Altered in Young Adults

2019 ◽  
Vol 70 (2) ◽  
pp. 689-692
Author(s):  
Gheorghe Raftu ◽  
Elena-Claudia Sin ◽  
Aureliana Caraiane ◽  
Steliana Gabriela Bustiuc ◽  
Raluca Briceag
Keyword(s):  
Young Adults ◽  
Oral Cavity ◽  
Dental Treatment ◽  
Economic Status ◽  
Dental Anxiety ◽  
Background Level ◽  
Anxiety Scale ◽  
Statistical Relationships ◽  
And Gender ◽  
Age Range

The study aims at identifying and highlighting dental anxiety in a group of young adults, analyzing patients� concerns about the main dental treatment procedures, and establishing statistical relationships between anxiety and gender, the background, level of education, socio-economic status and knowledge of habits of care and hygiene of oral cavity characteristic of the studied group. The study group consists of 150 female (50%) and male (50%) patients , aged between 20 and 40 years. The inclusion criteria in the batch were those related to the age range of 20 to 40 years.Two respondents (Corah�s Dental Anxiety Scale, Revised (DAS-R)) were given two questionnaires ( Corah�s Dental Anxiety Scale, DAS-R), and the second questionnaire contained 7 questions about the habits dental care). Most patients� concerns about the main procedures of dental treatment / other concerns are: dental extraction, material expenses, possibility of treatments and shame she felt oppressed health of the oral cavity. Regardless of the level of dental anxiety, the oral cavity hygiene habits are not properly performed by patients, with an increased tendency for them to be disregarded by patients with severe dental anxiety.

Experimental Investigation into Driver Behavior along Curved and Parallel Diverging Terminals of Exit Interchange Ramps

2021 ◽  
pp. 036119812199742
Author(s):  
Alberto Portera ◽  
Marco Bassani
Keyword(s):  
Design Stage ◽  
Lane Change ◽  
Age And Gender ◽  
Traffic Conditions ◽  
Current Design ◽  
The Difference ◽  
Safety Countermeasures ◽  
And Gender ◽  
Set Up ◽  
Curve Radius

Current design manuals provide guidance on how to design exit ramps to facilitate driving operations and minimize the incidence of crashes. They also suggest that interchanges should be built along straight roadway sections. These criteria may prove ineffective in situations where there is no alternative to terminals being located along curved motorway segments. The paper investigates driving behavior along parallel deceleration curved terminals, with attention paid to the difference in impact between terminals having a curvature which is the same sign as the motorway segment (i.e., continue design), and those having an opposite curvature (i.e., reverse design). A driving simulation study was set up to collect longitudinal and transversal driver behavioral data in response to experimental factor variations. Forty-eight drivers were stratified on the basis of age and gender, and asked to drive along three randomly assigned circuits with off-ramps obtained by combining experimental factors such as motorway mainline curve radius (2 values), terminal length (3), curve direction (2), and traffic conditions (2). The motorway radius was found to be significant for drivers’ preferred speed when approaching the terminal. Terminal length and traffic volume do not have a significant impact on either longitudinal or transversal driver outputs. However, the effect of curve direction was found to be significant, notably for reverse terminals which do not compel drivers to select appropriate speeds and lane change positions. This terminal type can give rise to critical driving situations that should be considered at the design stage to facilitate the adoption of appropriate safety countermeasures.

scholarly journals Behaviour and Anxiety Management of Paediatric Dental Patients through Virtual Reality: A Randomised Clinical Trial

2021 ◽  
Vol 10 (14) ◽  
pp. 3019
Author(s):  
Cristina Gómez-Polo ◽  
Ana-Aida Vilches ◽  
David Ribas ◽  
Antonio Castaño-Séiquer ◽  
Javier Montero
Keyword(s):  
Virtual Reality ◽  
Dental Treatment ◽  
Randomised Clinical Trial ◽  
Control Group ◽  
Chi Square ◽  
Anxiety Management ◽  
Dental Patients ◽  
Paediatric Patients ◽  
Chi Square Test ◽  
Scale Test

Clinicians should appreciate the effectiveness of virtual reality (VR) headsets for managing both the anxiety and the behaviour of non-cooperative paediatric patients who require treatment over several dental appointments. The aim of this study was to assess the effectiveness of using a VR headset as a distraction for managing the anxiety and behaviour of paediatric patients during their dental treatment. Eighty patients, aged between five and ten years old and who required dental treatment over three or more appointments, were randomly allocated into two groups. One group used a VR headset during all their appointments, and the other one did not use any distraction technique. The patients were asked to take a Facial Image Scale Test during their first and last appointments to assess their level of anxiety. Additionally, the dentist completed the Frankl Test to quantify the child’s behaviour at the beginning and the end of their treatment. The results obtained, both from the group using the VR headset and from the control group, were compared using the chi-square test. The use of a VR headset during dental treatment significantly reduced anxiety (95% of the children were happy) and improved behaviour (100% positive behaviour) as compared with the control group (40% and 57.5%, respectively). A VR headset can effectively distract a paediatric patient, helping to reduce anxiety and manage behaviour during dental treatment

scholarly journals The bowel and beyond: extracolonic findings from CT colonography

2021 ◽  
Author(s):  
Gerard Lambe ◽  
Peter Hughes ◽  
Louise Rice ◽  
Caoimhe McDonnell ◽  
Mark Murphy ◽  
...  
Keyword(s):  
Ct Colonography ◽  
Surgical Intervention ◽  
Potential Significance ◽  
Age And Gender ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Extracolonic Findings ◽  
The Difference ◽  
Clinically Significant ◽  
And Gender

AbstractCT colonography has emerged as the investigation of choice for suspected colorectal cancer in patients when a colonoscopy in incomplete, is deemed high risk or is declined because of patient preference. Unlike a traditional colonoscopy, it frequently reveals extracolonic as well as colonic findings. Our study aimed to determine the prevalence, characteristics and potential significance of extracolonic findings on CT colonography within our own institution. A retrospective review was performed of 502 patients who underwent CT colonography in our institution between January 1, 2010 and January 4, 2015. Of 502 patients, 60.63% had at least one extracolonic finding. This was close to other similar-sized studies (Kumar et al. Radiology 236(2):519–526, 2005). However, our rate of E4 findings was significantly higher than that reported in larger studies at 5.3%(Pooler et al. AJR 206:313–318, 2016). The difference may be explained by our combination of symptomatic/screening patients or by the age and gender distribution of our population. Our study lends support to the hypothesis that CT colonography may be particularly useful in identifying clinically significant extracolonic findings in symptomatic patients. CT colonography may allow early identification of extracolonic malignancies and life-threatening conditions such as an abdominal aortic aneurysm at a preclinical stage when they are amenable to medical or surgical intervention. However, extracolonic findings may also result in unnecessary investigations for subsequently benign findings.

scholarly journals A Phase 3, Randomized, Double-Blind Study Comparing Tedizolid Phosphate and Linezolid for Treatment of Ventilated Gram-Positive Hospital-Acquired or Ventilator-Associated Bacterial Pneumonia

2021 ◽  
Author(s):  
Richard G Wunderink ◽  
Antoine Roquilly ◽  
Martin Croce ◽  
Daniel Rodriguez Gonzalez ◽  
Satoshi Fujimi ◽  
...  
Keyword(s):  
Clinical Response ◽  
Bacterial Pneumonia ◽  
Double Blind Study ◽  
Phase 3 ◽  
Gram Positive ◽  
Double Blind ◽  
Intention To Treat ◽  
The Difference ◽  
Hospital Acquired ◽  
Noninferiority Margin

Abstract Background Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) are associated with high mortality rates. We evaluated the efficacy and safety of tedizolid (administered as tedizolid phosphate) for treatment of gram-positive ventilated HABP/VABP. Methods In this randomized, noninferiority, double-blind, double-dummy, global phase 3 trial, patients were randomized 1:1 to receive intravenous tedizolid phosphate 200 mg once daily for 7 days or intravenous linezolid 600 mg every 12 hours for 10 days. Treatment was 14 days in patients with concurrent gram-positive bacteremia. The primary efficacy end points were day 28 all-cause mortality (ACM; noninferiority margin, 10%) and investigator-assessed clinical response at test of cure (TOC; noninferiority margin, 12.5%) in the intention-to-treat population. Results Overall, 726 patients were randomized (tedizolid, n = 366; linezolid, n = 360). Baseline characteristics, including incidence of methicillin-resistant Staphylococcus aureus (31.3% overall), were well balanced. Tedizolid was noninferior to linezolid for day 28 ACM rate: 28.1% and 26.4%, respectively (difference, –1.8%; 95% confidence interval [CI]: –8.2 to 4.7). Noninferiority of tedizolid was not demonstrated for investigator-assessed clinical cure at TOC (tedizolid, 56.3% vs linezolid, 63.9%; difference, –7.6%; 97.5% CI: –15.7 to 0.5). In post hoc analyses, no single factor accounted for the difference in clinical response between treatment groups. Drug-related adverse events occurred in 8.1% and 11.9% of patients who received tedizolid and linezolid, respectively. Conclusions Tedizolid was noninferior to linezolid for day 28 ACM in the treatment of gram-positive ventilated HABP/VABP. Noninferiority of tedizolid for investigator-assessed clinical response at TOC was not demonstrated. Both drugs were well tolerated. Clinical Trials Registration NCT02019420.

EXPRESS: Serum Carbohydrate Antigen72-4 levels decrease with age in females but not males in Beijing, China

2021 ◽  
pp. 000456322110269
Author(s):  
Tongmei Duan ◽  
Xun Chen ◽  
Jing Wu ◽  
Ronghai Li ◽  
Huijuan Guo ◽  
...  
Keyword(s):  
Age Groups ◽  
Reference Interval ◽  
Carbohydrate Antigen ◽  
Female Group ◽  
Healthy Population ◽  
Age Difference ◽  
Significant Difference ◽  
The Difference ◽  
And Gender ◽  
Beijing China

Objective: Carbohydrate antigen 72-4 (CA72-4) is widely used in the diagnosis and monitoring of many cancers. However, there are few studies on the differences of CA72-4 levels in terms of age and gender. Methods: 10957 healthy subjects were divided into two groups according to gender and three age groups. The serum CA72-4 were detected. Statistical analysis was performed by SPSS. Results: The CA72-4 level in female group was significantly higher than that in male group. The level of CA72-4 gradually decreased with age. Compared with the age >60 group, the CA72-4 levels were increased in the age 46-60 group and 16-45 group (P >0.05, respectively). To better observe the age difference, the age 16-45 and 46–60 group were combined into the age 16-60 group. In comparison to the age >60 group, the CA72-4 level of age 16-60 group was significantly increased (P =0.000). In the age >60 group, there was no difference between genders. Nevertheless, the difference between the sexes in the age 16-60 group was significant (P =0.023). Conclusions: The reference interval of CA72-4 for local healthy population was established. CA72-4 levels gradually decreased with the increase of age, and CA72-4 level in females aged 16-60 years (0-18.0 U/mL) was higher than in males (0-14.5 U/mL), however there was no gender difference in the age group above 60 years old (0-14.5 U/mL). Moreover, male CA72-4 was no significant difference among all age groups, while the potential mechanism of female changes with age needed further study.

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