scholarly journals Effects of dexmedetomidine on renal function in patients with septic shock

2018 ◽  
Vol 16 ◽  
pp. 205873921879406
Author(s):  
Lvlin Chen ◽  
Ying Lan ◽  
Jun-Cheng Zhu ◽  
Yan He
Keyword(s):  
Septic Shock ◽  
Controlled Trial ◽  
Kidney Injury ◽  
Control Group ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Tnf Α ◽  
And Control ◽  
Experimental Group ◽  
Necrosis Factor

This study was to observe the effects of dexmedetomidine against acute kidney injury in patients with septic shock. A prospective randomized controlled trial (RCT) was conducted in which 80 patients with septic shock admitted in Department of Critical Care Medicine of the Affiliated Hospital of Chengdu University from June 2015 to January 2017 were divided into experimental group and control group. The patients in both groups received basic treatment for septic shock, and the patients in the experimental group were given intravenous injection of dexmedetomidine, maintained with 0.1–0.2 µg kg−1 h−1 for 5 days. In both groups, the changes in the levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, serum creatinine (SCr), cystatin C (Cys C), and β2-microglobulin (β2-MG) were determined before treatment and 1, 3, and 5 days after treatment. At 5 days after treatment, Cys C, β2-MG, and SCr were significantly decreased in both groups ( P < 0.05), and the degree of decrease in the experimental group was more obvious ( P < 0.05). At 1, 3, and 5 days after treatment, IL-6 and TNF-α were significantly decreased in both groups ( P < 0.05) and the degree of decrease in the experimental group was more obvious ( P < 0.05). Dexmedetomidine has certain renal protective effect in patients with septic shock, and its mechanism is possibly related to the regulation and improvement of uncontrolled inflammatory response.

scholarly journals Effects of Qingshen Granules on Immune Function in Patients with Comorbid Chronic Renal Failure and Damp-Heat Syndrome: A Multicenter, Randomized, Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Dong Wang ◽  
Yiping Wang ◽  
Chuanping Li ◽  
Shifu Liu ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Control Group ◽  
Control Groups ◽  
Randomized Controlled ◽  
Tnf Α ◽  
And Control ◽  
Heat Syndrome ◽  
Experimental Group ◽  
Necrosis Factor

Objective. The current study sought to compare the effects of the addition of Qingshen granules to conventional Western medicine on immune function in patients with comorbid chronic renal failure and damp-heat syndrome and to explore the possible mechanisms responsible for any differences observed. Methods. Through a multicenter, randomized, controlled study, a total of 282 eligible patients were divided into experimental (n = 136) and control groups (n = 146). All of the patients were treated with conventional Western medical therapy. The experimental group also received Qingshen granules three times daily for 12 weeks. Clinical efficacy was observed in the two groups. Peripheral blood levels of CD4+ T cells, CD8+ T cells, Th17 cells, nuclear factor-κB p65 (NF-κB p65) activity, serum interleukin-17 (IL-17), serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), tumor necrosis factor receptor-associated factor 6 (TRAF6), fibronectin (FN), and type IV collagen (Col-IV) were detected in both groups. Results. The total clinical curative effective rate was significantly higher p < 0.05 in the experimental group (79.41%) than in the control group (67.12%). Before treatment, there were no significant differences in CD4+/CD8+ T cell ratio, Th17 cell level, NF-κB p65 activity, serum IL-17, IL-6, TNF-α, TRAF6, FN, and Col-IV between the experimental and control groups p > 0.05 ; however, all of the measures were significantly higher than those observed in a healthy comparison group ( p < 0.05 or p < 0.01 ). After treatment, the above indexes in the experimental group were significantly lower than those before treatment ( p < 0.05 or p < 0.01 ). Similarly, NF-κB p65 activity, serum IL-17, TNF-α, TRAF6, FN, and Col-IV in the control group were significantly lower than the levels observed prior to treatment ( p < 0.05 or p < 0.01 ); however, while all of the other indexes were lower than those observed before treatment, the differences were not statistically significant p > 0.05 . Conclusion. Qingshen granules adjust immune dysfunction, improve immunity mediated inflammatory response, and attenuate renal fibrosis in patients with comorbid chronic renal failure and damp-heat syndrome.

scholarly journals Metabolic resuscitation therapy in critically Ill patients with sepsis and septic shock: A Prospective Randomized Controlled Trial

2021 ◽  
Author(s):  
Fang Feng ◽  
Huyong Yang ◽  
Weiwei Yang ◽  
Min Li ◽  
Yu Chen
Keyword(s):  
Septic Shock ◽  
Randomized Controlled Trial ◽  
Mortality Rate ◽  
Controlled Trial ◽  
Control Group ◽  
Icu Mortality ◽  
Randomized Controlled ◽  
Sepsis And Septic Shock ◽  
And Control ◽  
Experimental Group

Abstract ObjectiveTo further clarify the effectiveness and potential pathophysiological principles of metabolic resuscitation therapy in critically ill patients with sepsis and septic shock.MethodsProspective randomized controlled trial. Patients with sepsis and septic shock who were admitted to the ICU from Sep. 2019 to Mar. 2020 were prospectively enrolled. According to the computerized random sequence table, patients were randomly divided into the experimental group and the control group. All patients with sepsis were included in the research of cluster of initial therapy. The experimental group received metabolic resuscitation: vitamin C (1.5 g in an intravenous infusion q6h for 3 days), vitamin B1 (200 mg in an intramuscular injection q12h for 3 days), and hydrocortisone (50 mg in an intravenous infusion q6h for 7 days).ResultsOne hundred thirty-six patients with sepsis and septic shock were included in our study. Pneumonia was the main cause of sepsis and septic shock, including 33 (49%) and 41 (60%) patients in the experimental group and control group, respectively, and gram-negative bacilli were the main pathogenic bacteria (112/136, 82.4%). The ICU length of stay for the experimental group and the control group was 9 (7–12) and 11 (9–14) days, respectively, P = 0.002. The duration of vasoactive drugs (hours) was 20.8 ± 9.9 and 46.7 ± 12.8, respectively, P༜0.001. The 6-hour lactate clearance rate was 66.2% (55.5, 76.7) and 30.1% (15.6, 50) in the experimental group and control group, respectively, P = 0.000. The 72-hour PCT clearance rate was 70% (57.5, 80.3) and 40.7% (24.8, 52.2), respectively, P = 0.001. The ICU mortality rate was 8.8% (6/68) and 15% (15/68), respectively, P = 0.033.ConclusionsMetabolic resuscitation therapy is beneficial for patients with sepsis and septic shock, shortening the length of ICU stay, reducing the duration of vasopressor use, and reducing the ICU mortality rate of patients with sepsis and septic shock. However, large, multi-center, prospective randomized controlled trials are needed to further verify these results.Trial registrationChiCTR, ChiCTR1900026084. Registered 20 September 2019 - prospective registered, http://www.chictr.org.cn/edit.aspx?pid=40910&htm=4

scholarly journals The effectiveness of an interactive organ donation education intervention for Dutch lower-educated students: a cluster randomized controlled trial

2019 ◽  
Author(s):  
Esther Steenaart ◽  
Rik Crutzen ◽  
Math JJM Candel ◽  
Nanne K de Vries
Keyword(s):  
Randomized Controlled Trial ◽  
Organ Donation ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Post Test ◽  
Cluster Randomized ◽  
And Control ◽  
Experimental Group

Abstract Background: Organ donation registration rates remain low, especially among people with lower educational levels. An interactive educational intervention was developed to prepare lower-educated students in the Netherlands for making a well-informed decision about organ donation. This article reports on the effects of this intervention on the intention to register (i.e. the primary outcome in the study at hand) and beliefs regarding organ donation. Methods: The effectiveness was investigated in a post-test only cluster randomized controlled trial, in which the intervention was offered to the experimental group and after measurement also to the control group. Randomization to the experimental and control groups took place at a class level. Teachers of schools for intermediate vocational education who taught a course on Citizenship delivered three intervention elements (i.e. video fragments and discussion, quizzes with tailored feedback and exercise filling out a registration form) to their students during two 50-minute lessons. Results: A total of 1170 students participated in the trial and filled out a questionnaire (45 experimental and 43 control classes). Compared to the control group, students in the experimental group had higher odds of having positive registration intentions (OR=1.81; 95%CI [1.10-2.96]), their perceived knowledge was higher (B=.62; 95%CI [.23-1.01]) and they had higher intentions to talk to family members (B=.68; 95%CI [.28-1.08]) and friends (B=.36; 95%CI [.07-.66]) about organ donation. There were no effects on the choice students intended to register (OR=1.08; 95%CI [.67-1.73]). Conclusions: Providing education in a classroom setting is an effective tool in increasing registration intentions. Despite uncertainties about the effects on actual registration behavior, a larger scale dissemination of this intervention is recommended. Providing clear information and opening the discussion about organ donation is an important and promising first step towards higher registration rates. Trial registration: The Dutch Trial Register, NTR6771. Registered on 24 October 2017. https://www.trialregister.nl/trial/6557

scholarly journals Contributions of auriculotherapy in smoking cessation: a pilot study

2014 ◽  
Vol 48 (5) ◽  
pp. 883-890
Author(s):  
Roberta de Paiva Silva ◽  
Erika de Cássia Lopes Chaves ◽  
Sandra Cristina Pillon ◽  
Andréia Maria Silva ◽  
Denis da Silva Moreira ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Pilot Study ◽  
Controlled Trial ◽  
Control Group ◽  
Double Blind ◽  
Future Studies ◽  
Randomized Controlled ◽  
And Control ◽  
Experimental Group

Objective To evaluate the contribution of auriculotherapy in smoking cessation. Method Double-blind randomized controlled trial, conducted with 30 smokers allocated into two groups: Experimental Group (21 participants received 10 sessions of auriculotherapy at specific points for smoking) and Control Group (nine participants received auriculotherapy in points that have no effect on the focus of research). Results Auriculotherapy contributed in reducing the number of cigarettes smoked in 61.9% of participants (p=0.002), in reducing the difficult to abstain from smoking in places where it is forbidden by 38% (p=0.050) and in not smoking when ill 23.8% (p=0.025). Conclusion Given the efficacy only in terms of reducing the number of cigarettes smoked and other parameters, we suggest that future studies consider the use of auriculotherapy combined with other treatment methods, in order to achieve better results in cessation/abstinence.

scholarly journals A Hospital based Randomized Controlled Trial to Evaluate the Effectiveness of Kegel's Exercise on Postpartum Perineal Laxity

2011 ◽  
Vol 3 (3) ◽  
pp. 157-159
Author(s):  
Sudha A Raddi ◽  
TT Sheeba ◽  
MB Ballad
Keyword(s):  
Vaginal Delivery ◽  
Postnatal Care ◽  
Controlled Trial ◽  
Control Group ◽  
Control Groups ◽  
Randomized Controlled ◽  
Postnatal Mothers ◽  
Perineal Muscle ◽  
And Control ◽  
Experimental Group

ABSTRACT Objectives The objectives of the study are to: (i) Assess the perineal muscle strength of postnatal mothers after vaginal delivery in the experimental and control groups before and after the intervention. (ii) Evaluate the effectiveness of Kegel's exercise on perineal laxity in the experimental group compared to control group. Methods This single blinded randomized controlled trial at a 1000 bedded tertiary care teaching hospital in India, enrolled 290 postnatal mothers between 20 and 40 years who had vaginal delivery with < 2 on modified Oxford grading scale as measured by per vaginal digital examination. The subjects were randomized into experimental and control groups. The experimental group received instructions to perform Kegel's exercises along with routine postnatal care while the control group received advice on routine postnatal care. Two follow-up assessments were done at 6 and 10 weeks. The primary outcome measure was increase in Oxford grading score. Results Major findings of the study were: The mean perineal muscle strength assessment scores noted before the intervention and during first and second postintervention assessments were 1.5 ± 0.52, 3.58 ± 0.51 and 4.28 ± 0.57 respectively for the experimental group and 1.56 ± 0.55, 2.41 ± 0.52 and 3 ± 0.51 respectively for the control group. Comparison of these scores between the groups by unpaired t-test yielded p-value of < 0.0001 suggesting high significant difference in favor of the experimental group. However, no additional benefit was observed after Kegel's exercise in the mothers who had episiotomy during vaginal delivery. Conclusion The Kegel's exercise is effective to reduce perineal laxity and hence should be included as a part of routine postnatal care.

The FIFA 11+ Shoulder Injury Prevention Program Was Effective in Reducing Upper Extremity Injuries Among Soccer Goalkeepers: A Randomized Controlled Trial

2021 ◽  
pp. 036354652110218
Author(s):  
Wesam Saleh A. Al Attar ◽  
Oliver Faude ◽  
Mario Bizzini ◽  
Saud Alarifi ◽  
Hosam Alzahrani ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Controlled Trial ◽  
Control Group ◽  
Shoulder Injury ◽  
Warm Up ◽  
Randomized Controlled ◽  
Injury Prevention Program ◽  
Extremity Injuries ◽  
And Control ◽  
Experimental Group

Background: Soccer is one of the most popular sports worldwide. Goalkeepers are more likely to injure their upper limbs, particularly their shoulders, than outfield players. To reduce upper extremity injuries, the FIFA 11+ Shoulder Injury Prevention Program (FIFA 11+S) was developed. Purpose: The purpose of this study was to assess the effectiveness of the FIFA 11+S program in reducing the incidence of upper extremity injuries among amateur soccer goalkeepers. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 726 goalkeepers, who were blinded to study intent, were randomly assigned to the experimental group (n = 360) or control group (n = 366). The experimental group was instructed to perform the FIFA 11+S program before all training sessions for 1 season (6 months). The control group was instructed to continue performing their usual routine warm-up program before training sessions for 1 season. Primary outcomes included the incidence of upper extremity injury and incidence of mechanism, type, and severity of injury measured using injury risk ratios (IRR); compliance with the experimental and control interventions was also recorded. Results: A total of 50 injuries (0.62 injuries per 1000 exposure-hours) were reported in the experimental group, and 122 injuries (1.94 injuries/1000 hours) were reported in the control group. The FIFA 11+S program reduced the total number of upper extremity injuries by 68% (IRR = 0.32 [95% CI, 0.27-0.34]) compared with the usual warm-up. The FIFA 11+S program reduced the incidence of contact injury (IRR = 0.30 [95% CI, 0.25-0.31]), noncontact injury (IRR = 0.40 [95% CI, 0.35-0.43]), initial injury (IRR = 0.34 [95% CI, 0.29-0.36]), recurrent injury (IRR = 0.20 [95% CI, 0.17-0.21]), and overuse injury (IRR = 0.40 [95% CI, 0.35-0.43]). Participants in the experimental group demonstrated a significant decrease in injuries of minor (IRR = 0.32 [95% CI, 0.27-0.34]) and moderate severity (IRR = 0.33 [95% CI, 0.29-0.35]) compared with the control group. We noted no difference in compliance between the experimental and control groups (80% vs 73%, respectively; P = .92). Conclusion: The FIFA 11+S program resulted in 50% fewer upper extremity injuries among soccer goalkeepers, compared with a regular warm-up. Registration: ACTRN12618001080213 (Australian New Zealand Clinical Trials Registry).

scholarly journals A Randomized Controlled Trial of Thermo-Sensitive Sol–Gel Anti-Adhesion Agent after Gynecologic Surgery

2020 ◽  
Vol 9 (7) ◽  
pp. 2261
Author(s):  
Young Im Kim ◽  
Maria Lee ◽  
Se Ik Kim ◽  
Aeran Seol ◽  
Eun Ji Lee ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Sol Gel ◽  
Adhesion Formation ◽  
Gynecologic Surgery ◽  
Control Group ◽  
Abdominal Adhesions ◽  
Randomized Controlled ◽  
Slide Test ◽  
And Control ◽  
Experimental Group

Postoperative abdominal adhesions can lead to several adverse consequences such as pelvic pain, bowel obstruction, and infertility. We aimed to explore the anti-adhesion efficacy and safety of a thermo-sensitive sol–gel agent in patients who receive abdominopelvic surgery for benign gynecologic disease. This study was a randomized, controlled, single-blind clinical trial of women undergoing benign gynecologic surgery between January 2017 and December 2017. The patients were randomly assigned to three groups with a 1:1:1 ratio: experimental group (received the thermo-sensitive sol–gel agent), control group (untreated), and comparator group (received 4% icodextrin). Patients were followed for 4 weeks postoperatively, and efficacy was evaluated by performing the visceral slide test to identify adhesion formation. In total, 183 patients were enrolled in the study, and 178 (97.3%) completed the trial. The incidence rate of abdominal adhesion formation was significantly lower in the experimental group than in the control group (7.9% vs. 21.1%, p = 0.040); however, it was similar between the experimental and comparator groups (7.9% vs. 13.8%. p = 0.299). At 4 weeks, no differences in adhesion-related symptoms were observed between the experimental and control groups. Adverse events were mostly mild and did not differ significantly among the three groups (p = 0.375). In conclusion, use of a thermo-sensitive sol–gel agent was safe and effective to prevent abdominal adhesions after benign gynecologic surgeries.

scholarly journals The effectiveness of an interactive organ donation education intervention for Dutch lower-educated students: a cluster randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Esther Steenaart ◽  
Rik Crutzen ◽  
Math J. J. M. Candel ◽  
Nanne K. de Vries
Keyword(s):  
Randomized Controlled Trial ◽  
Organ Donation ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Post Test ◽  
Cluster Randomized ◽  
And Control ◽  
Experimental Group

Abstract Background Organ donation registration rates remain low, especially among people with lower educational levels. An interactive educational intervention was developed to prepare lower-educated students in the Netherlands for making a well-informed decision about organ donation. This article reports on the effects of this intervention on the intention to register (i.e., the primary outcome in the study at hand) and beliefs regarding organ donation. Materials and methods The effectiveness was investigated in a post-test-only cluster randomized controlled trial, in which the intervention was offered to the experimental group and after measurement also to the control group. Randomization to the experimental and control groups took place at a class level. Teachers of schools for Intermediate Vocational Education who taught a course on Citizenship delivered three intervention elements (i.e., video fragments and discussion, quizzes with tailored feedback and exercise filling out a registration form) to their students during two 50-min lessons. Results A total of 1170 students participated in the trial and filled out a questionnaire (45 experimental and 43 control classes). Compared to the control group, students in the experimental group had higher odds of having positive registration intentions (OR = 1.81; 95%CI [1.10–2.96]), their perceived knowledge was higher (B = 0.62; 95%CI [0.23–1.01]) and they had higher intentions to talk to family members (B = 0.68; 95%CI [0.28–1.08]) and friends (B = 0.36; 95%CI [0.07–0.66]) about organ donation. There were no effects on the choice students intended to register (OR = 1.08; 95%CI [0.67–1.73]). Conclusions Providing education in a classroom setting is an effective tool in increasing registration intentions. Despite uncertainties about the effects on actual registration behavior, a larger-scale dissemination of this intervention is recommended. Providing clear information and opening the discussion about organ donation is an important and promising first step towards higher registration rates. Trial registration The Dutch Trial Register, ID: NTR6771. Registered on 24 October 2017. https://www.trialregister.nl/trial/6557

scholarly journals Changes in the cortisol and oxytocin levels of first-time pregnant women during interaction with an infant: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nozomi Sonoda ◽  
Kaori Takahata ◽  
Wataru Tarumi ◽  
Kazuyuki Shinohara ◽  
Shigeko Horiuchi
Keyword(s):  
Randomized Controlled Trial ◽  
Pregnant Women ◽  
Salivary Cortisol ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Salivary Cortisol Level ◽  
And Control ◽  
First Time ◽  
Experimental Group

Abstract Background During pregnancy, physiological, psychological, and social changes affect pregnant women’s childcare anxiety and childrearing behavior. However, there are scarce reports on hormonal evaluation related to such anxiety and behavior. Herein, we evaluated changes in salivary cortisol (primary outcome) and oxytocin (secondary outcome) levels of first-time pregnant women when interacting with an infant and discussed the relation of these changes to the women’s stress level. Methods This was a two-arm randomized controlled trial. Participants were randomly assigned using a web-based randomization system. The experimental group involved interaction with an infant for 30 min. The control group involved watching a DVD movie of an infant for 30 min. Saliva samples were collected at preintervention and postintervention. Saliva samples were assayed, and all data were compared between and within the groups using independent t-test and paired t-test with a two-sided 5% significance level. This study was approved by the Research Ethics Committee of St. Luke’s International University. Results A total of 102 women were randomly assigned to the experimental (n = 51) and control (n = 51) groups. Finally, 38 women in the experimental group and 42 women in the control group were analyzed. The salivary cortisol level significantly decreased after the interventions in both groups (t = 4.57, p = 0.00; t = 5.01, p = 0.00). However, there were no significant differences in the salivary cortisol (t = 0.349, p = 0.73) and oxytocin (t = − 1.945, p = 0.58) levels between the two groups. Conclusions The salivary cortisol level of first-time pregnant women significantly decreased in the experimental and control groups postintervention, although no significant difference was found between the two groups. Such decrease indicates stress reduction and release among these women. The absence of a significant increase in salivary oxytocin level in both groups may be related to the limitations of an insufficient number of samples that could be analyzed owing to the small saliva volume in some samples and the lack of adequate tactile stimulation of the intervention protocol. These results and procedural limitations provide useful insights into approaching subsequent studies aiming at continuously optimizing detection procedures. Trial registration UMIN000028471 (Clinical Trials Registry of University Hospital Information Network. July 31, 2017- Retrospectively registered.

scholarly journals Seminar-case learning model improves clinical teaching: a prospective randomized controlled trial

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11487
Author(s):  
Peiyuan Li ◽  
Bin Zeng ◽  
Xuanmin Chen ◽  
Zhifeng Liu ◽  
Jing Yang
Keyword(s):  
Controlled Trial ◽  
Case Analysis ◽  
Learning Model ◽  
Control Group ◽  
First Year ◽  
Traditional Lecture ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Theoretical Test ◽  
Experimental Group

Purpose The purpose of this research was to assess whether the efficacy of the seminar-case learning model is superior to the traditional lecture-based learning model in the gastroenterology curriculum for first-year graduate students. Materials & Methods This research was a prospective randomized controlled trial that enrolled 92 first-year postgraduate students with a rotation internship in the gastroenterology department. The students were randomly divided into 2 groups and then subjected to an identical version of the curriculum for 8 weeks. The experimental group (n = 50) used the seminar-case learning model, while the control group (n = 42) used the traditional lecture-based learning model. Examinations consisted of a theoretical test and a case analysis test, and anonymous questionnaires were used to assess teaching quality. Results All participants completed the examinations and questionnaires. The average theoretical test score of the experimental group was no statistical significance with that of the control group (P = 0.17). The average case analysis test score of the experimental group was significantly higher than that of the control group (P < 0.05). The indicators of the experimental group’s feedback were better than those of the control group, such that there were significantly higher learning interest and motivation, a better understanding of diseases and knowledge, improvements in clinical thinking and summary ability, and an active classroom atmosphere in the experimental group (P < 0.05). However, students in the experimental group felt more burdensome. Conclusion Compared to the traditional method, the seminar-case learning model showed a higher efficacy. The seminar-case learning model effectively improved students’ outcomes and satisfaction, which helped students narrow the gap between theoretical knowledge and clinical practical application.

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