Early Lactate-Guided Resuscitation of Elderly Septic Patients

2021 ◽  
pp. 088506662110233
Author(s):  
Hui Chen ◽  
Jiangqing Xu ◽  
Xia Wang ◽  
Yaxuan Wang ◽  
Fei Tong
Keyword(s):  
Septic Shock ◽  
Control Group ◽  
Surviving Sepsis Campaign ◽  
Treatment Control ◽  
Icu Mortality ◽  
Regular Treatment ◽  
Asian Patients ◽  
Medical University ◽  
To Receive ◽  
Treatment Control Group

Background: Early lactate-guided resuscitation was endorsed in the guidelines of the Surviving Sepsis Campaign as a key strategy to decrease the mortality of patients admitted to the ICU department with septic shock. However, its effectiveness in elderly Asian patients is uncertain. Method: We conducted a single-center trial to test the effectiveness of the early lactate-guided resuscitation of older Asian patients at the Second Hospital of Hebei Medical University. Eligible septic shock patients who consented to participation in the study were randomly assigned to receive early lactate-guided treatment or regular treatment as controls. Result: A total of 82 patients met the hyperlactatemia criteria and participated in the trial. Forty-two patients received early lactate-guided treatment (lactate group) and 40 received regular treatment (control group). The lactate group received more fluids at initial 6 hours (3.3 ± 1.4 vs 2.4 ± 1.7 L, P = 0.01), but similar proportions of patients in both groups required the use of vasopressors and vasodilators. Patients in the lactate group showed significantly reduced ICU needs compared to the control group, which were weaned from mechanical ventilation more quickly (median 7, IQR 4 to 14 vs median 9, IQR 4.3 to 17.8, P = 0.02) and transferred out of the ICU earlier (median 4.5, IQR 2.8 to 7.3 vs median 6, IQR 3.2 to 8, P = 0.01). However, the hospital mortality (35.7% vs 42.5%, P = 0.35) and ICU mortality (31.0% vs 37.5%, P = 0.38) for both groups were not reduced. Conclusion: For critically ill patients (elderly Asian patients) admitted to the ICU department with hyperlactatemia, early lactate-guided treatment reduced ICU needs but did not reduce mortality.

Protective effects of histamine on Gq-mediated relaxation in regenerated endothelium

2014 ◽  
Vol 306 (2) ◽  
pp. H286-H290 ◽  
Author(s):  
Calvin K. Chan ◽  
Song Yan Liao ◽  
Yue Lin Zhang ◽  
Aimin Xu ◽  
Hung Fat Tse ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Treated Group ◽  
Control Group ◽  
Protective Effects ◽  
Treatment Control ◽  
Porcine Coronary Artery ◽  
Endogenous Histamine ◽  
Coronary Endothelium ◽  
Treatment Control Group

In the porcine coronary artery, regenerated endothelium is dysfunctional as regards the responses to endothelium-dependent agonists. The current study aimed to determine the possible involvement of histamine in such dysfunction. Pigs were treated chronically with pyrilamine (H1 receptor inhibitor, 2 mg·kg−1·day−1) with part of their coronary endothelium and allowed to regenerate for 28 days after balloon denudation. The results showed a reduction in relaxation to bradykinin (Gq protein dependent) only in the pyrilamine-treated group (area under the curve, 269.7 ± 13.4 vs. 142.0 ± 31.0, native endothelium vs. regenerated endothelium) but not in the control group (253.0 ± 22.1 vs. 231.9 ± 29.5, native endothelium vs. regenerated endothelium). The differences in the relaxation to serotonin (Gi protein dependent) between native and regenerated endothelium were not affected by the pyrilamine treatment (control group, 106.3 ± 17.0 vs. 55.61 ± 12.7; and pyrilamine group, 106.0 ± 8.20 vs. 49.30 ± 6.31, native endothelium vs. regenerated endothelium). These findings indicate that during regeneration of the endothelium, the activation of H1 receptors by endogenous histamine may be required to maintain the endothelium-dependent Gq protein-mediated relaxation to bradykinin, suggesting a beneficial role of the monoamine in the process of endothelial regeneration.

A Treatment/Control Group Study of Growth Hormone Treatment

2000 ◽  
Vol 10 (Supplement 1) ◽  
pp. 31S-37S ◽  
Author(s):  
Barbara Y. Whitman ◽  
Susan Myers ◽  
Aaron Carrel ◽  
David Allen
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Treatment ◽  
Hormone Treatment ◽  
Control Group ◽  
Treatment Control ◽  
Treatment Control Group

The effect of midodrine on lactate clearance in patients with septic shock: a pilot study

2021 ◽  
Author(s):  
Effat Davoudi-Monfared ◽  
Mostafa Mohammadi ◽  
Meysam Khoshavi ◽  
Hossein Khalili
Keyword(s):  
Septic Shock ◽  
Pilot Study ◽  
Effect Size ◽  
Critically Ill Patients ◽  
Lactate Clearance ◽  
Control Group ◽  
Large Effect Size ◽  
Group 13 ◽  
Registration Number ◽  
To Receive

Background: The effect of midodrine on lactate clearance has not been assessed in critically ill patients yet. Objective: The goal of this study was to assess the effect of adjunctive midodrine therapy on lactate clearance in patients with septic shock. Materials & methods: Patients with septic shock were assigned to receive either adjunctive midodrine 10 mg three-times a day for 5 days (midodrine group = 15 patients) or not (control group = 13 patients). Results: The lactate clearance was significantly faster in the midodrine group than the control group (p = 0.049) with a large effect size ([Formula: see text] = 0.141). Conclusion: When midodrine was added to intravenous vasopressors, it significantly accelerated lactate clearance in patients with septic shock. Trial registration number: IRCT20100228003449N25 (Clinicaltrials.gov).

Can placebos prevent intrusive memories?

2022 ◽  
Author(s):  
Tobias Kube ◽  
Irving Kirsch ◽  
Julia Glombiewski ◽  
Philipp Herzog
Keyword(s):  
Psychological Trauma ◽  
Traumatic Experiences ◽  
Control Group ◽  
Treatment Control ◽  
Open Label ◽  
Intrusive Memories ◽  
Experimental Psychopathology ◽  
Negative Appraisal ◽  
Treatment Control Group ◽  
Healthy Participants

After traumatic experiences, intrusive memories can flash back and evoke significant distress. Here, we investigated whether the occurrence of intrusions can be prevented by placebo. After the exposure to an experimental psychopathology model of psychological trauma, healthy participants (N=112) were randomised to deceptive placebo (DP), open-label placebo (OLP), or a no-treatment control group. The results show that one week later, the groups did not differ in the frequency of intrusive memories. However, participants receiving OLP reported the lowest intensity of intrusions. Participants receiving DP reported the lowest burden of intrusions. Across groups, the expectation that intrusions will be intense and hardly controllable was associated with a higher frequency of intrusions, higher distress, higher burden, and more negative appraisal. The results suggest that expectations play a crucial role in the emergence of intrusive memories and that at least some of the disabling aspects of intrusive memories can be reduced by placebo.

scholarly journals Identifying Key MicroRNAs Targeted by Narenmandula in a Rodent Nephropathy Model

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Xiulan Wang ◽  
Chun Chang ◽  
Wenjie Jin ◽  
Arun Arun ◽  
Sudunabuqi Sudunabuqi ◽  
...  
Keyword(s):  
Renal Function ◽  
Differential Expression ◽  
Target Genes ◽  
Enrichment Analysis ◽  
Control Group ◽  
Doxorubicin Hydrochloride ◽  
Treatment Control ◽  
Number Of Genes ◽  
Version 2.0 ◽  
Treatment Control Group

Background. Untreated nephropathy can progress to renal failure. The traditional Mongolian remedy Narenmandula regulates the kidney “yang.” This study aimed to identify key microRNAs (miRNAs) targeted by Narenmandula in a rat model of nephropathy. Methods. Fifteen rats exhibiting normal renal function were randomized to three study arms. Nephropathy was induced in n = 10 rats using doxorubicin hydrochloride, followed by either Narenmandula treatment (treatment group) or no treatment (control group). In n = 5 rats, no doxorubicin was given and renal function remained unchanged (healthy group). Microarray analysis identified miRNAs which were differentially expressed (DE-miRNAs) between groups. Target genes of DE-miRNAs were predicted using miRWalk version 2.0, followed by enrichment analysis using DAVID, and construction of the miRNA coregulatory network using Cytoscape. Results. Nephropathy was successfully induced, with doxorubicin resulting in differential expression of 3645 miRNAs (1324 upregulated and 2321 downregulated). Narenmandula treatment induced differential expression of a total of 159 miRNAs (102 upregulated and 57 downregulated). Upregulated DE-miRNAs (e.g., miR-497-5p, miR-195-5p, miR-181a-5p, miR-181c-5p, and miR-30e-5p) and downregulated DE-miRNAs (e.g., miR-330-3p and miR-214-3p) regulated a high number of target genes. Moreover, the miRNA pairs (e.g., miR-195-5p—miR-497-5p, miR-181a-5p—miR-181c-5p, and miR-30e-5p—miR-30a-5p) coregulated a high number of genes. Enrichment analysis indicated functional synergy between miR-30e-5p—miR-30a-3p, miR-34a-5p—miR-30e-5p, miR-30e-5p—miR-195-3p, and miR-30a-3p—miR-195-3p pairs. Conclusion. Narenmandula may modulate doxorubicin-induced nephropathy via targeting miR-497-5p, miR-195-5p, miR-181a-5p, miR-181c-5p, miR-30e-5p, miR-330-3p, miR-214-3p, miR-34a-5p, miR-30a-3p, and miR-30a-5p.

The Use of Varying High-Confusion versus Low-Confusion Sequences to Teach Letter Discrimination

1976 ◽  
Vol 8 (2) ◽  
pp. 161-171
Author(s):  
Rosemery O. Nelson ◽  
Kenneth S. Wein
Keyword(s):  
Preschool Children ◽  
Discrimination Training ◽  
Matching To Sample ◽  
Control Group ◽  
Treatment Control ◽  
Distinctive Features ◽  
Training Groups ◽  
Different Types ◽  
Treatment Control Group

Within Gibson's framework of teaching children to discriminate the distinctive features of letters, 28 preschool children were trained in letter discrimination using three different types of matching-to-sample alternatives: (1) high-confusion alternatives; (2) low-confusion alternatives; or (3) a sequence of low-, middle-, and high-confusion alternatives. On posttest 1, given after a criterion of two consecutive errorless training days, only the high-confusion and sequence groups significantly improved over their pretest scores as compared with the no-treatment control group. On posttest 2, however, given after a standard number of 20 training days, the performance of all three training groups, including low-confusion, was superior to the control group; no differences were found among the three training groups. The implications of these and other findings for letter discrimination training were discussed.

Increasing Verbalization of Chronic Mental Patients with Operant Techniques: Partial Replication

1973 ◽  
Vol 37 (1) ◽  
pp. 205-206
Author(s):  
Robert E. Pawlicki ◽  
Gary H. Miller ◽  
Graham A. Haley
Keyword(s):  
Behavior Modification ◽  
Attention Control ◽  
Control Group ◽  
Partial Replication ◽  
Treatment Control ◽  
Research Attention ◽  
Mental Patients ◽  
Simple Motor ◽  
Treatment Control Group ◽  
Modification Treatment

The present study replicated previous results showing the effectiveness of behavior-modification techniques in reinstating verbalization in mute psychotics. Those patients experiencing behavior-modification treatment increased their verbalization level significantly more than patients in either an attention-control or a no-treatment control group. Commencing behavior-modification at a simple motor level offers important practical advantages and deserves research attention.

Prevention of Depressive Symptoms in Schoolchildren: Two-Year Follow-Up

1995 ◽  
Vol 6 (6) ◽  
pp. 343-351 ◽  
Author(s):  
Jane E. Gillham ◽  
Karen J. Reivich ◽  
Lisa H. Jaycox ◽  
Martin E.P. Seligman
Keyword(s):  
Depressive Symptoms ◽  
Problem Solving ◽  
Social Problem ◽  
Sixth Grade ◽  
Social Problem Solving ◽  
Control Group ◽  
Children At Risk ◽  
Treatment Control ◽  
Treatment Control Group

After teaching cognitive and social-problem-solving techniques designed to prevent depressive symptoms, we followed 69 fifth- and sixth-grade children at risk for depression for 2 years We compared these children with 49 children in a matched no-treatment control group The prevention group reported fewer depressive symptoms through the 2-year followup, and moderate to severe symptoms were reduced by half Surprisingly, the effects of the prevention program grew larger after the program was over We suggest that psychological immunization against depression can occur by teaching cognitive and social skills to children as they enter puberty

scholarly journals Effect of Glucose-Insulin-Potassium Infusion on Hemodynamics in Patients with Septic Shock

2021 ◽  
Vol 9 (B) ◽  
pp. 1517-1524
Author(s):  
Hassan Effat ◽  
Ramy Khaled ◽  
Ahmed Battah ◽  
Mohamed Shehata ◽  
Waleed Farouk
Keyword(s):  
Septic Shock ◽  
Myocardial Dysfunction ◽  
Statistical Significance ◽  
Lactate Clearance ◽  
University Hospital ◽  
Control Group ◽  
Surviving Sepsis Campaign ◽  
Significant Difference ◽  
Successful Weaning ◽  
Infusion Protocol

BACKGROUND: Glucose-insulin-potassium (GIK) demonstrates a cardioprotective effect by providing metabolic support and anti-inflammatory action, and may be useful in septic myocardial depression. AIM: The aim of this study was to assess role of GIK infusion in improving hemodynamics in patients with septic shock in addition to its role in myocardial protection and preventing occurrence of sepsis-induced myocardial dysfunction and sepsis-induced arrhythmias. METHODS: This study was conducted on 75 patients admitted to the Critical Care Department in Cairo University Hospital with the diagnosis of septic shock during the period from January 2019 to December 2019. Patients were divided into two groups; first group was managed according to the last guidelines of surviving sepsis campaign and was subjected to the GIK infusion protocol while second group was managed following the last guidelines of surviving sepsis campaign only without adding GIK infusion. RESULTS: Patients in the GIK group showed better lactate clearance (50% vs. 46.7%) and less time needed for successful weaning of vasopressors than the control group (3.57±1.16 vs. 3.6±1.45 days) thought not reaching statistical significance. There was no statistically significant difference between both groups regarding development of septic-induced cardiomyopathy (16.7% in the control group vs. 13.3% in the GIK group); however, patients with hypodynamic septic shock showed better improvement in hemodynamic profile in the GIK group. Sepsis-induced arrhythmias occurred more in patients of the control group than in patients of the GIK group with no statistically significant difference between both groups (33.3% vs. 20%, p = 0.243). Few side effects were developed as a result of using GIK infusion protocol. CONCLUSIONS: GIK may help in improving hemodynamics and weaning of vasopressors in patients with refractory septic shock and those with septic induced cardiomyopathy. The use of GIK was well tolerated with minimal adverse reactions.

scholarly journals Treatment with Molgramostim (Recombinant Human Granulocyte-Macrophage Colony Stimulating Factor, Rhugm-Csf, Mielogen) and Lenograstim (Granulocyte-Colony Stimulating Factor) Improves Experimental Colitis in Rats

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Apostolos E. Papalois ◽  
Calypso Barbatis ◽  
Dimosthenis Chrysikos ◽  
Maria Korontzi ◽  
Michail Sideris ◽  
...  
Keyword(s):  
Experimental Colitis ◽  
Control Group ◽  
Colony Stimulating Factor ◽  
Treatment Control ◽  
Group 4 ◽  
Histological Score ◽  
Group 3 ◽  
Group 5 ◽  
Treatment Control Group ◽  
Stimulating Factor

Background/Aim. Treatment with growth factors could be beneficial in both inflammatory bowel disease and experimental colitis. The aim of this study was to investigate the effect of Colony Stimulating Factor (CSF), and Recombinant Human (rHu) Granulocyte Stimulating Factor (GSF) in experimental colitis in rats. Methods. Experimental colitis was induced in 62 male Wistar rats, divided into 9 groups, using 2,4,6-trinitrobenzensulfonic acid (TNBS). Group 1: Ten rats with colitis without treatment (control group). Euthanasia after 15 days. Group 2: Ten animals with colitis without treatment (control group). Euthanasia after 30 days. Group 3: Six animals with colitis. Immediate treatment with CSF. Euthanasia after 19 days. Group 4: Six animals with colitis. Treatment started 7 days after the induction of colitis. Animals were kept for 19 days. Group 5: Six animals with colitis. Treatment started 2 weeks after the induction of colitis. Group 6: Six animals with colitis, the same as in group 3. Treatment with GSF. Group 7: Six animals with colitis, the same as in group 4. Treatment with GSF. Group 8. Six animals with colitis, the same as in group 5. Treatment with GSF. Group 9: Six animals with colitis. Immediate treatment with prednisolone. Euthanasia after 15 days. Results. CSF and GSF administration significantly improved the histological score (P<0.05) and reduced malondialdehyde contents (P<0.05), compared to control groups in all animals. CSF was superior to GSF and to prednisolone. Conclusion. Administration of both CSF and GSF could significantly improve the histological score and oxidative stress in experimental colitis in rats.

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