scholarly journals The effect of dexmedetomidine on intraoperative blood glucose homeostasis: secondary analysis of a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chun-Jing Li ◽  
Bo-Jie Wang ◽  
Dong-Liang Mu ◽  
Dong-Xin Wang
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Glucose ◽  
Elderly Patients ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Secondary Analysis ◽  
Major Surgery ◽  
Control Group ◽  
Time Interval ◽  
Randomized Controlled

Abstract Purpose To investigate the effect of dexmedetomidine on intraoperative blood glucose hemostasis in elderly patients undergoing non-cardiac major surgery. Methods This was secondary analysis of a randomized controlled trial. Patients in dexmedetomidine group received a loading dose dexmedetomidine (0.6 μg/kg in 10 min before anaesthesia induction) followed by a continuous infusion (0.5 μg/kg/hr) till 1 h before the end of surgery. Patients in control group received volume-matched normal saline at the same time interval. Primary outcome was the incidence of intraoperative hyperglycemia (blood glucose higher than 10 mmol/L). Results 303 patients in dexmedetomidine group and 306 patients in control group were analysed. The incidence of intraoperative hyperglycemia showed no statistical significance between dexmedetomidine group and control group (27.4% vs. 22.5%, RR = 1.22, 95%CI 0.92–1.60, P = 0.167). Median value of glycemic variation in dexmedetomidine group (2.5, IQR 1.4–3.7, mmol) was slightly lower than that in control group (2.6, IQR 1.5–4.0, mmol), P = 0.034. In multivariable logistic analysis, history of diabetes (OR 3.007, 95%CI 1.826–4.950, P < 0.001), higher baseline blood glucose (OR 1.353, 95%CI 1.174–1.560, P < 0.001) and prolonged surgery time (OR 1.197, 95%CI 1.083–1.324, P < 0.001) were independent risk factors of hyperglycaemia. Conclusions Dexmedetomidine presented no effect on intraoperative hyperglycemia in elderly patients undergoing major non-cardiac surgery. Trial registration Present study was registered at Chinese Clinical Trial Registry on December 1, 2015 (www.chictr.org.cn, registration number ChiCTR-IPR-15007654).

scholarly journals High-Intensity Exercise Improves Fatigue, Sleep, and Mood in Patients With Axial Spondyloarthritis: Secondary Analysis of a Randomized Controlled Trial

2020 ◽  
Vol 100 (8) ◽  
pp. 1323-1332 ◽  
Author(s):  
Silje Halvorsen Sveaas ◽  
Hanne Dagfinrud ◽  
Inger Jorid Berg ◽  
Sella Arrestad Provan ◽  
Melissa Woll Johansen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Beneficial Effect ◽  
High Intensity ◽  
General Health ◽  
Axial Spondyloarthritis ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Exercise Group ◽  
Control Group ◽  
Randomized Controlled

Abstract Objective Although exercise is recommended in the treatment of axial spondyloarthritis (axSpa), the focus has been on flexibility, and the effect of high-intensity exercises is unknown. The purpose of this study was to investigate the effect of high-intensity exercises on fatigue, sleep, and mood in patients with axSpA. Methods In this secondary analysis of a randomized controlled trial, participants were recruited from outpatient clinics at 4 hospitals in Scandinavia. A total of 100 patients with axSpA were randomized to either an exercise group (n = 50) or a control group (n = 50). High-intensity exercise was provided 3 times per week for 3 months and supervised by a physical therapist. The controls received no intervention. Measurements were self-reported at baseline, 3 months, and 12 months: fatigue, using the Fatigue Severity Scale (range = 0–7, 7 = worst, ≥5 = severe); vitality, using the RAND 36-item short-form health survey (SF-36, range = 0–100, 100 = best); sleep, using the Pittsburgh Sleep Quality Index (range = 0–21, 21 = worst, &gt;5 = poor quality); mood, using the General Health Questionnaire 12 (range = 0–36, 36 = worst); and general health, using the EUROQoL (range = 0–100, 100 = best). Results A total of 38 participants (76%) in the exercise group followed ≥80% of the exercise protocol. At 3 months, there was a significant beneficial effect on fatigue (mean group differences = −0.4, 95% CI = −0.7 to −0.1), vitality (5.0, 95% CI = 1.1 to 10.5), mood (−2, 95% CI = −3.7 to −0.04), and general health (9.0, 95% CI = 3.3 to 14.7) but no effect on sleep (−1.1, 95% CI = −2.1 to 0.2). Compared with the control group, the exercise group had a reduced rate of severe fatigue and poor sleep. No differences were seen between the groups at 12 months. Conclusions A 3-month exercise program had a beneficial effect on fatigue, sleep, mood, and general health in patients with axSpA at the end of the intervention; however, no long-term effects were seen. Impact High-intensity cardiorespiratory and strength exercises should be considered as important in exercise programs for patients with axSpA.

Discouraging soft drink consumption reduces blood glucose and cholesterol of Brazilian elementary students: Secondary analysis of a randomized controlled trial

2017 ◽  
Vol 100 ◽  
pp. 223-228 ◽  
Author(s):  
Milena Miranda de Moraes ◽  
Mauro Felippe Felix Mediano ◽  
Rita Adriana Gomes de Souza ◽  
Anibal Sanchez Moura ◽  
Gloria Valeria da Veiga ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Glucose ◽  
Elementary Students ◽  
Soft Drink ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Soft Drink Consumption ◽  
Randomized Controlled

scholarly journals Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial

2018 ◽  
Vol 33 (1) ◽  
pp. 64-73 ◽  
Author(s):  
Monica Berggren ◽  
Åsa Karlsson ◽  
Nina Lindelöf ◽  
Undis Englund ◽  
Birgitta Olofsson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hip Fracture ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Geriatric Care ◽  
Control Group ◽  
Older Individuals ◽  
Randomized Controlled ◽  
Significant Difference

Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation. Design: Randomized controlled trial. Setting: Geriatric department, participants’ residential care facilities, and ordinary housing. Subjects: Individuals aged ⩾70 years with acute hip fracture ( n = 205) were included. Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge. Main measures: Complications, readmissions, and days spent in hospital were registered from patients’ digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits. Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group ( n = 106) and control group ( n = 93), 57 (53.8%) and 44 (47.3%) had complications ( P = 0.443), 46 (43.4%) and 38 (40.9%) fell ( P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital ( P = 0.383); the median total days spent in hospital were 11.5 and 11.0 ( P = 0.353), respectively. Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

scholarly journals Effectiveness of brief suicide management training programme for medical residents in Japan: a cluster randomized controlled trial

2013 ◽  
Vol 23 (2) ◽  
pp. 167-176 ◽  
Author(s):  
Y. Suzuki ◽  
T. A. Kato ◽  
R. Sato ◽  
D. Fujisawa ◽  
K. Aoyama-Uehara ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Management Training ◽  
Training Programme ◽  
Medical Residents ◽  
Control Group ◽  
Individual Level ◽  
Randomized Controlled

Aims.To evaluate the effectiveness of a brief suicide management training programme for Japanese medical residents compared with the usual lecture on suicidality.Methods.In this multi-center, clustered randomized controlled trial, the intervention group attended a structured suicide management programme and the control group, the usual lecture on depression and suicidality. The primary outcome was the difference in residents' cumulative competency score to manage suicidal persons from baseline (T0) to 1 month after the intervention (T2), determined using the Suicide Intervention Response Inventory (SIRI-1) score, at individual level.Results.Analysis of 114 residents (intervention group n = 65, control group n = 49) assigned to two clusters in each group revealed no change in SIRI-1 score from T0 to T2 or immediately after the intervention (T1) between the two groups. As a secondary analysis, discrepancy in judgement between the participants and Japanese suicidologists was examined immediately after the intervention in the adjusted model, with a mean difference in score of 9.98 (95% confidence interval: 4.39–15.56; p = 0.001).Conclusions.The structured programme was not proven to improve competency in suicide management when measured by the SIRI-1 score. Further elaboration of the programme and valid measurement of its outcome would be needed to show the program's effectiveness.

scholarly journals Kangaroo Mother Care versus Incubator in Transporting Stable Preterm Neonates: A Randomized Controlled Trial

2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Renelyn P. Ignacio ◽  
Maria Esterlita T. Villanueva-Uy
Keyword(s):  
Heart Rate ◽  
Randomized Controlled Trial ◽  
Blood Glucose ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Controlled Trial ◽  
Kangaroo Mother Care ◽  
Preterm Neonates ◽  
Control Group ◽  
Randomized Controlled

Background. Transporting preterm neonates soon after birth entails risks. Only one study among many about the beneficial effects of Kangaroo Mother Care (KMC) had cited it as a safe and effective alternative to transport incubators. Objective. To determine if KMC transport could be an alternative to transport incubators by comparing the physiological outcomes of the two transport methods. Methods. This is a parallel non-blinded randomized-controlled trial funded by KMC Foundation, Philippines, Inc, of physiologically stable preterm neonates weighing ≤ 2200 grams delivered at a tertiary government hospital from September 10, 2011, to April 18, 2012. After obtaining written consent from their mothers, participants were randomly assigned to either the intervention or control group. The intervention groups were transported from the delivery room to the NICU while on skin-to-skin contact with the caregiver. In contrast, those in the control group were placed in a transport incubator. Vital signs, oxygen saturation, and blood glucose were measured before transport and upon NICU arrival. Adverse effects were monitored. Data were recorded using a standard database. Results. Ninety-two participants were recruited, forty-six in each arm. Two dropped out. The mean change in heart rate in the KMC transport decreased by 1.6 beats per minute; respiratory rate decreased by 0.18 breaths per minute, the temperature increased by 0.01°C, oxygen saturation decreased by 0.07%, blood glucose decreased by 5.07 mg/dL. The measured physiological parameters were not statistically significant between the two groups. In the KMC transport, there was a decreasing trend in the incidence of hypothermia, hypoglycemia, tachypnea, and tachycardia. Conclusion. There are no significant differences in the heart rate, respiratory rate, temperature, oxygen saturation, and blood glucose levels among preterm neonates on KMC transport compared with preterm neonates on transport incubators, which is the current standard of care. The study showed that KMC transport is equally effective as a transport incubator. Hence, in low-resource settings, KMC transport may be used as a safe and effective neonatal transport.

Post-surgical physical activity enhancing program for elderly patients after hip fracture: a randomized controlled trial

2014 ◽  
Vol 8 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Sunee Suwanpasu ◽  
Yupin Aungsuroch ◽  
Chanokporn Jitapanya
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Independent Living ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Post Surgery

AbstractBackground: Hip fracture seriously influences an elderly person’s life and mobility, independent living, and causes earlier mortality. Although surgery is generally successful, many of the elderly suffer from decreased physical ability after surgery for hip fracture.Objectives: To determine the effects of a physical activity enhancing program (PEP) on the level of physical activity of elderly patients after surgical treatment of hip fracture.Methods: A randomized controlled trial of 46 elderly patients was conducted at King Chulalongkorn Memorial Hospital from January 2012 to February 2013 to evaluate the effectiveness of the Resnick self-efficacy model (2009) compared with standard care in improving physical activity. The participants were enrolled on a criteria basis and were block randomized into two groups. The intervention group attended four phases of physical training and efficacy based intervention comprising assessment, preparation, practicing, and evaluation phases with face-to-face contact and five telephone calls during seven weeks post-surgery.Results: Six weeks after discharge, the physical activity of the intervention group increased by significantly more than the control group (F1,43= 9.63, P < 0.01), with an effect size of 0.18 after controlling for preoperative physical activity. The ratio of the effect on physical activity induced by the PEP was higher than that induced by usual care (65.2% vs. 47.8%).Conclusion: PEP is effective at improving physical activity. Efforts to follow up for longer periods and with studies using larger populations are recommended.

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