Clinical use of electrical stimulation with the Veinplicity®device and its effect on the first attempt success rate of peripheral intravenous cannulation: A non-randomized clinical trial

2019 ◽  
Vol 20 (6) ◽  
pp. 621-629 ◽  
Author(s):  
Fredericus HJ van Loon ◽  
Freek JP Willekens ◽  
Marc P Buise ◽  
Hendrikus HM Korsten ◽  
Arthur RA Bouwman ◽  
...  

Background:Peripheral intravenous cannulation is one of the most frequently performed medical procedures. Venodilation, which can be achieved with different techniques, is an important factor for first attempt success. The objective of this study was to compare the first attempt success rates upon peripheral intravenous cannulation after applying a tourniquet, with venous dilation by electrical stimulation using the Veinplicity®device, or a combination of both techniques, in participants at moderate risk of a difficult peripheral intravenous access.Methods:This non-randomized clinical trial was carried out in adult patients divided into three parallel study groups, consisting of cannulation with a tourniquet (control group), cannulation after electrical stimulation without using a tourniquet (intervention group 1), and cannulation after applying electrical stimulation followed by the application of a tourniquet on the selected upper extremity (intervention group 2). The primary outcome was the first attempt success rate of peripheral intravenous catheter placement.Results:In all, 141 participants were included in this study, with an overall success rate of 86%. Success rates of 78%, 88%, and 92% were observed in the control group, intervention group 1, and intervention group 2, respectively ( p = 0.25, χ2 = 2.771, df = 2). A higher first attempt success rate was detected in participants in intervention group 2, when compared to the control group ( p = 0.04, χ2 = 4.63, df = 1).Conclusion:Increase in first attempt success was clinically relevant when electrical stimulation with the Veinplicity®device was combined with the application of a tourniquet in participants at moderate risk of a difficult peripheral intravenous access.

2021 ◽  
Vol 6 (6-2) ◽  
pp. 82-91
Author(s):  
O. V. Bugun ◽  
A. V. Mashanskaya ◽  
A. V. Atalyan ◽  
V. I. Mikhnovich ◽  
T. A. Belogorova ◽  
...  

Until now, there is no radical method of treating children with cerebral palsy, which allows us to consider scientific research in this direction reasonable and promising.The aim of the research: to study the effect of exercises on the mini-simulator “Kinesioplatform-swing” with biofeedback on the indicators of motor skills in children with spastic cerebral palsy.Materials and methods. We conducted an open, non-randomized, prospective, comparative, controlled study in pairs (each participant in the main group corresponds to a participant in the control group). The study involved 53 patients aged 4–12 years with cerebral palsy: the intervention group (group 1: n = 27 (13 boys, 14 girls)) and the control group (group 2: n = 26 (11 boys, 15 girls)), comparable in terms of gender, age and severity of movement disorders. Characteristics of the medical intervention: group 1 – botulinum toxin type A (BTA, for exercising against the background of relative muscular normotonus) + exercise therapy + exercises on the mini-simulator “Kinesioplatform-swing” with biofeedback (BFB); group 2 – BTA + exercise therapy. Duration of the study: 2019–2020. The difference between groups in terms of motor skills on the day of hospitalization and after completion of the training program (10 sessions each) was determined. Motor skills were assessed according to the GMFM-66/88 (Gross Motor Function Measure) table using the “Scales for measuring global motor functions”.Results. The inclusion of additional exercises on the mini-simulator “Kinesioplatformswing” with biofeedback in the rehabilitation of patients with movement disorders with spastic cerebral palsy (BTA + exercise therapy) in comparison with the control group. However, the question of the long-term effects of such training remains open and requires further study.


2018 ◽  
Vol 06 (02) ◽  
pp. E131-E138 ◽  
Author(s):  
Tomazo Franzini ◽  
Renata Moura ◽  
Priscilla Bonifácio ◽  
Gustavo Luz ◽  
Thiago de Souza ◽  
...  

Abstract Background and study aims Endoscopic removal of biliary stones has high success rates, ranging between 85 % to 95 %. Nevertheless, some stones may be challenging and different endoscopic methods have evolved. Papillary large balloon dilation after sphincterotomy is a widely used technique with success rates ranging from 68 to 90 % for stones larger than 15 mm. Cholangioscopy allows performing lithotripsy under direct biliary visualization, either by laser or electrohydraulic waves, which have similar success rate (80 % – 90 %). However, there is no study comparing these 2 techniques. Patients and methods From April 2014 to June 2016, 100 patients were enrolled and randomized in 2 groups, using a non-inferiority hypothesis: cholangioscopy + electrohydraulic lithotripsy (group 1) and endoscopic papillary large balloon dilation (group 2). The main outcome was complete stone removal. Adverse events were documented. Mechanical lithotripsy was not performed. Failure cases had a second session with crossover of the methods. Results The mean age was 56 years. 74 (75.5 %) patients were female. The initial overall complete stone removal rate was 74.5 % (77.1 % in group 1 and 72 % in group 2, P > 0.05). After second session the overall success rate achieved 90.1 %. Procedure time was significantly lower in group 2, – 25.2 min (CI95 % – 12.48 to – 37.91). There were no significant differences regarding technical success rate, radiologic exposure and adverse events. Conclusion Single-operator cholangioscopy-guided lithotripsy and papillary large balloon dilation are effective and safe approaches for removing complex biliary stones.


2021 ◽  
Author(s):  
Volkan Dericioğlu ◽  
Mehmet Orkun Sevik ◽  
Sena Sümmen Saçu ◽  
Muhsin Eraslan ◽  
Eren Cerman

Abstract Purpose: To compare the success rates of balloon dacryocystoplasty (BDP) and probing as a primary procedure in congenital nasolacrimal duct obstruction (CNLDO) and investigate the effect of age on both procedures.Methods: A total of 135 patients (171 eyes) with simple or incomplete complex CNLDO were included in this retrospective study; complete complex CNLDO cases were excluded. The success rates for primary BDP (118 eyes) and for probing (53 eyes) were compared as overall and among the age groups; Group 1 (12–24 months old), Group 2 (25–36 months old), and Group 3 (> 36 months old).Results: Mean age of the patients was 41.5±27.2 months for primary BDP, and 21.8±10.8 months for probing (p<0.001). Overall success rates for primary BDP and probing were 81.1% (43/53) and 76.3% (90/118), respectively (p=0.481). Success rates for BDP and probing among age groups were, 93.8% and 85.3% in Group 1 (p=0.306), 93.3% and 50.0% in Group 2 (p=0.012), and 63.6% and 27.3% in Group 3 (p=0.052), respectively. Cox regression analysis showed that the median ages were 18 months for probing and 36 months for primary BDP. Poisson regression model showed that, for every one-month increase in patients’ age, the success rate of probing decreased by 9.7%.Conclusion: Probing success decreased to a point where different treatment options such as primary BDP can be discussed with the patient’s parents after 18 months of age. The success of BDP decreased after 36 months, while it maintained a high success rate between 24-36 months as primary treatment.


Author(s):  
Orlagh Farmer ◽  
Kevin Cahill ◽  
Wesley O’Brien

Girls are less active than boys throughout childhood and adolescence, with limited research focusing on female community sports-based programs. This study aims to assess the effectiveness of a multi-component, community sports-based intervention for increasing girl’s physical activity (PA) levels, fundamental movement skill (FMS) proficiency, and psychological wellbeing, as relative to a second treatment group (the traditionally delivered national comparative program), and a third control group. One hundred and twenty female-only participants (mean age = 10.75 ± 1.44 years), aged 8 to 12 years old from three Ladies Gaelic Football (LGF) community sports clubs (rural and suburban) were allocated to one of three conditions: (1) Intervention Group 1 (n = 43) received a novel, specifically tailored, research-informed Gaelic4Girls (G4G) intervention; (2) Intervention Group 2 (n = 44) used the traditionally delivered, national G4G program, as run by the Ladies Gaelic Football (LGF) Association of Ireland; and (3) Control Group 3 (n = 33) received no G4G intervention (group 1 or 2) conditions and were expected to carry out their usual LGF community sports activities. Primary outcome measurements (at both pre- and 10-week follow up) examining the effectiveness of the G4G intervention included (1) PA, (2) FMS and (3) Psychological correlates (enjoyment levels, self-efficacy, peer and parental support). Following a two (pre to post) by three (intervention group 1, intervention group 2, and control group 3) mixed-model ANOVA, it was highlighted that intervention group 1 significantly increased in PA (p = 0.003), FMS proficiency (p = 0.005) and several psychological correlates of PA (p ≤ 0.005). The findings demonstrate that the 10-week, specifically tailored, research-informed G4G intervention is a feasible and efficacious program, leading to a positive effect on the physical and psychological wellbeing of pre-adolescent Irish girls, relative to the traditionally delivered national G4G comparative program and control group conditions.


Author(s):  
Sven Rinke ◽  
Tanja Zuck ◽  
Tim Hausdörfer ◽  
Andreas Leha ◽  
Torsten Wassmann ◽  
...  

Abstract Objectives A university-based randomized clinical study evaluated the 5-year performance of chairside-fabricated zirconia-reinforced lithium silicate (ZLS)-ceramic partial crowns. Material and methods Forty-five patients were restored with 61 chairside-fabricated ZLS-restorations (Cerec SW 4.2, Dentsply Sirona, Germany; Vita Suprinity, Vita Zahnfabrik, Germany). Deviating from the manufacturers’ recommendations, restorations with reduced minimum material thicknesses (MMT) were fabricated: group 1, MMT = 0.5–0.74 mm (n = 31); group 2, MMT = 0.75–1.0 mm (n = 30). For luting, a self-adhesive cement (SAC) or a total-etch technique with a composite cement (TEC) was applied. Statistical evaluation was performed by time-to-event analysis (Kaplan–Meier). Possible covariates of the survival (SVR) and success rates (SCR), evaluated in a Cox regression model, were MMT, restoration position (premolar/molar), and cementation technique (SAC vs. TEC). Results Forty patients (54 restorations, premolars, n = 23; molars, n = 31) participated in the 5-year follow-up. Five losses due to ceramic fractures occurred in group 1 (n = 28) (SVR: 83.0% [95% confidence interval (CI): 0.71–0.96]). Group 2 (n = 26) showed no losses (SVR: 100%). The success rate for partial crowns placed on premolars was 100% and 69% (95% CI: 0.54–0.84) for molar restorations. Recementation was required in 4 restorations with SAC (SCR: 86% [95% CI: 0.73–0.99]; SCR-DC: 100%). Restorations in group 2 showed a significantly reduced risk of material fracture hazard ratio (HR) = 0.09, p = 0.0292) compared with the restorations in group 1. Molar partial crowns showed an increased risk for a clinical intervention (HR = 5.26, p = 0.0222) compared to premolar restorations. Conclusions Material thickness and position of the restoration are risk factors influencing the survival and success rate of ZLS-ceramic partial crowns. Clinical relevance Observation of an MMT of at least 0.75–1.0 mm for ZLS-ceramics is essential to avoid material-related fractures. Clinical trial registration: German Clinical Trails Register (trial number: DRKS00005611)


2020 ◽  
Vol 97 (3) ◽  
pp. 160-166
Author(s):  
E.V. Makarova ◽  
L.A. Marchenkova ◽  
M.A. Eremushkin ◽  
E.M. Styazhkina ◽  
D.V. Razvalyaeva

The aim of the study: Evaluate the impact of physical rehabilitation complex on balance function in patients with osteoporosis (OP) and vertebral compression fractures (VCFs). Materials and methods: A prospective controlled study of 40-80 years old men and women with OP and VCFs was conducted. Patients were divided into two groups by simple randomization. The intervention group (1) received an intensive rehabilitation course. The control group (2) received therapeutic exercise using the Gorinevska-Dreving method. Before rehabilitation all patients were tested: 1) stabilometry; 2) Tests: single leg stand, Fukuda test). Re-examination after rehabilitation and one month after the course. Results:The study enrolled 90 people (65.4±9.1 years). In group №1 after the course of rehabilitation there was a significant improvement in indicators: balance function coefficient (BFC) with open and closed eyes (84.1±8.6%, p=0.01 and 73.8±9.6%, p=0.01); frontal shifts (FS) (1.9 [0.7; 2,4], p=0,01), the area of statokinesiogram (ASKG) (131,9±210,4 mm2, p=0,04); center of pressure velocity (CPV) (12,2±10,1 mm/sec, p=0,001); in the Fukuda test the displacement in degrees has decreased (32.8±14.5, p=0.03), in the test «Single leg stand» the time for right and left leg with open eyes has improved (17.8±31.8 sec, p=0.001, 17.1±30.1 respectively). In group №2 there was an improvement in CPV (2.1 [1.9;5.2], p=0.001); FS movement rate (10.1±3.9 mm/sec, p=0.05). After a month in group №1 the positive dynamics by parameters was preserved: BFC with open and closed eyes, FS, CPV movement speed, SKG area, displacement in meters and degrees in the Fukuda test, standing time on the right and left legs with open and closed eyes. Conclusions: A physical rehabilitation complex aimed at training back muscles and coordination has improved balance function in patients who have experienced OP and VCFs. Pathological shift of CPV forward in frontal area was corrected and stability was improved. Stabilometry and coordination tests served as reliable methods to evaluate balance function in this group of patients.


2003 ◽  
Vol 83 (7) ◽  
pp. 608-616 ◽  
Author(s):  
Peter AA Struijs ◽  
Pieter-Jan Damen ◽  
Eric WP Bakker ◽  
Leendert Blankevoort ◽  
Willem JJ Assendelft ◽  
...  

Abstract Background and Purpose. Lateral epicondylitis (“tennis elbow”) is a common entity. Several nonoperative interventions, with varying success rates, have been described. The aim of this study was to compare the effectiveness of 2 protocols for the management of lateral epicondylitis: (1) manipulation of the wrist and (2) ultrasound, friction massage, and muscle stretching and strengthening exercises. Subjects and Methods. Thirty-one subjects with a history and examination results consistent with lateral epicondylitis participated in the study. The subjects were randomly assigned to either a group that received manipulation of the wrist (group 1) or a group that received ultrasound, friction massage, and muscle stretching and strengthening exercises (group 2). Three subjects were lost to follow-up, leaving 28 subjects for analysis. Follow-up was at 3 and 6 weeks. The primary outcome measure was a global measure of improvement, as assessed on a 6-point scale. Analysis was performed using independent t tests, Mann-Whitney U tests, and Fisher exact tests. Results. Differences were found for 2 outcome measures: success rate at 3 weeks and decrease in pain at 6 weeks. Both findings indicated manipulation was more effective than the other protocol. After 3 weeks of intervention, the success rate in group 1 was 62%, as compared with 20% in group 2. After 6 weeks of intervention, improvement in pain as measured on an 11-point numeric scale was 5.2 (SD=2.4) in group 1, as compared with 3.2 (SD=2.1) in group 2. Discussion and Conclusion. Manipulation of the wrist appeared to be more effective than ultrasound, friction massage, and muscle stretching and strengthening exercises for the management of lateral epicondylitis when there was a short-term follow-up. However, replication of our results is needed in a large-scale randomized clinical trial with a control group and a longer-term follow-up.


Author(s):  
Sepehr Eslami ◽  
Mina Shakeri

Background: Some studies have shown that vitamin C has a positive effect on reducing headaches after spinal anesthesia, but studies in this field are inadequate. The aim of this study was to determine the effect of vitamin C infusion on the decrease of headache after spinal anesthesia in cesarean section. Methods: This clinical trial study was performed on 160 patients undergoing cesarean section referred to Kowsar Hospital of Yazd in 2017. The patients were randomly divided into two groups including group 1, 2 gr of vitamin C in 500 cc normal saline, and group 2, 500 cc of normal saline was injected preoperatively. The two groups were compared for headache incidence. Results: At the time of recovery, 2 hours later, the frequency of headache in the intervention group was significantly lower than the control group (P <0.05). But there was no significant difference between the two groups regarding headache at 4, 6, 12, 24, and 48 hours postoperatively (P>0.05). Conclusion: Considering the patient's condition, and according to the anesthesiologist and surgeon, vitamin C can be used to reduce pain in patients undergoing cesarean section with spinal anesthesia.


2019 ◽  
Vol 12 (1) ◽  
pp. 188-196
Author(s):  
Taufik Taufik ◽  
Suwarsi Suminto ◽  
Rahimah Ibrahim ◽  
Haslinda Abdullah

Objective: This study examined the role of a joyful phonetic method to improve reading skills of pre-school children in Indonesia. Materials and Methods: Forty-seven pre-school children of age 4-5 years are involved in the study. Two criteria were used to select the participants of the study. Criteria included “they could not read” and “had never read”. The Solomon three groups design was used to test the effectiveness of the treatment. There were one intervention group and two control groups. One of the control groups received the treatment and another one did not. Treatment included joyful learning so that participants did not realise that they were actually learning. Results: According to data analysis, (1) joyful phonetic improved the reading skills of the experimental group more than the control group 1 and (2) the joyful phonetic improved the reading skills of the control group 2 more than the control group 1. Moreover, it was found that the phonetic, which had been given in the joyful condition, affects the improvement of the reading skills of pre-school children. Conclusion: The implication of the study is that the pre-school children would be more focused on the learning if the method has been conducted in a playing nature. Furthermore, pre-school children should be taught to read as they tend to begin their schooling.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
P H Malky ◽  
A M Emam ◽  
H S Shaker

Abstract Background Alpha blockers decrease peristalsis above and below the stone, which increases the urine bolus and intraureteral pressure above it and lowers intraureteral pressure below it in association with the decrease in basal and micturition pressure, even at the bladder neck; thus, it increases the chance of stone expulsion.We aim to evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance. Since our aim in ureteroscopic treatment of upper ureteric stones is laser dusting rather than stone retrieval, its possible that alpha blockers can improve the access to upper ureter and clearance of fragmented stones. Objective To evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance. Patients and Methods This prospective, randomized, multicenter study included 60 patients and carried out between March 2018 and December 2018 in Police hospital Nasr City and Ain Shams University Hospitals included adult patients (at least 15 years) with proximal ureteral stones (≥ 5mm) scheduled for URS lithotripsy. Results In this study, the overall failure rate was 18.3%. In most cases 8/11(72.7%), failure of the procedure was due to the difficulty experienced in advancing the ureteroscope. We should mention that this technical problem was reported only in 2 (6.7%) patients receiving pre-URS tamsulosin but in 6 (20%) patients of the control group. The mean operative time in this series was significantly shorter operative time in Group 2(51.8min) compared to Group 1(58.8 min).At follow-up 4 weeks after URS, SFR was (86.7% for Group 2 and 66.7% for Group 1). Conclusion Adjunctive tamsulosin therapy prior to laser-assisted semi-rigid URS for the management of proximal ureteral stones improves ureteroscopic access, reduces the operative time and improves the SFR with an acceptable complication rate. Further research should be conducted on a larger scale to evaluate the various predictors of the outcome of URS and analyze the results with different pre-URS tamsulosin time periods in order to consolidate the results and to confirm the conclusion.


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