scholarly journals Impact of ascorbic acid in reducing the incidence of vancomycin associated nephrotoxicity in critically ill patients: A preliminary randomized controlled trial

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 929
Author(s):  
Nouran Hesham El-Sherazy ◽  
Naglaa Samir Bazan ◽  
Sara Mahmoud Shaheen ◽  
Nagwa A. Sabri

Background Antioxidants show nephroprotective effect against vancomycin associated nephrotoxicity (VAN) in animals. This study aimed to assess the ascorbic acid nephro-protective role against VAN clinically. Methods Forty-one critically ill patients were randomly assigned to one of two groups: intervention group (vancomycin IV plus ascorbic acid, n=21) or control group (vancomycin IV only, n=20). Primary outcomes were the incidence of VAN and the absolute change in creatinine parameters, while mortality rate was the secondary outcome. Nephrotoxicity was defined as an increase in serum creatinine (S.cr) by at least 0.5 mg/dL or 50% of baseline for at least two successive measurements. This study is registered at Clinicaltrials.gov (NCT03921099), April 2019. Results Mean absolute S.cr increase was significant when compared between both groups, P-value = 0.036, where S.cr increased by 0.05(0.12) and 0.34(0.55) mg/dL in the intervention and control groups, respectively. Mean absolute Cr.cl decline was significant when compared between both groups, P-value = 0.04, where Cr.cl was decreased by 5.9(17.8) and 22.3(30.4) ml/min in the intervention and control groups, respectively. Incidence of VAN was 1/21(4.7%) versus 5/20(25%) in the intervention and control groups, respectively (RR: 0.19; CI: 0.024–1.49; P-value = 0.093). Mortality was higher in the control group; however, it was not statistically significant, P-value = 0.141. Conclusion Co-administration of ascorbic acid with vancomycin preserved renal function and reduced the absolute risk of VAN by 20.3%, however, the reduction in VAN incidence didn’t reach statistical significance level. Further large multicenter prospective trials are recommended.

2019 ◽  
Author(s):  
Yeshambel Agumas Ambelie ◽  
Getu Degu Alene ◽  
Damen Hailemariam Gebrekiros

AbstractObjectiveThe objective of this study is to examine, based on theory of change, whether integrated leading-managing-and-governing for results model is plausible cause of improved institutional delivery.MethodsA team-based quasi-experimental study was conducted. One-hundred-thirty-four health facility teams were enrolled in the study. Teams were allocated to intervention and control groups in a 1:1 ratio, non-randomly. End line institutional delivery was the dependent variable while the group (main predictor) and the baseline institutional delivery (covariate) were independent variables. The intervention that was given over six months was integrated leading-managing-and-governing for results model. The institutional deliveries were measured with percentages whilst the group was measured with exposure status (yes or no) to the intervention. Data, from both groups, were collected at baseline and end line. Data were analyzed using analysis of covariance. Statistical significance was determined at (p<.05). The main effect of the intervention was determined by 95% CI, presented in the contrast results.ResultsThe adjusted mean institutional deliveries with 95% CI were 47.4 (46.2, 48.6) and 33.4 (32.2, 34.6) in the intervention and control groups, respectively. Contrast results showed that having an intervention group, p = .000, 95% CI (12.2, 15.8), of integrated leading-managing-and governing for results model significantly increased mean institutional delivery compared to having a control group.ConclusionsThis study provides some guidance regarding the plausible causation of integrated leading-managing-and-governing for results model on institutional delivery. It would serve as a baseline in identifying true causation using a randomized design.


2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Gabriel Farhat ◽  
Camila Marinelli Martins ◽  
Ricardo Zanetti Gomes ◽  
Letícia Carollyne Galvão ◽  
Rodolfo Martins Kravutschke ◽  
...  

OBJECTIVE: To evaluate the influence of customized insoles in the plantar pressure of diabetes patients with neuropathy in comparison to the sham group. METHODS:  The work method, duly registered at the Registro Brasileiro de Ensaios Clínicos – REBEC (Clinical Trial Brazilian Register) (http://www.ensaiosclinicos.gov.br/) RBR-5NQK4K, includes a randomized, controlled, prospective, double-blinded clinical trial, with a sample of 46 volunteers that will be randomly randomized in a 1: 1 ratio to be referred to intervention and control groups. The intervention group will receive customized insoles, with a retrocapital bar and an ethyl vinyl acetate plaque (EVA) in the same shape as the retrocapital bar, in order to reduce the pressure on the forefoot. In the control group, flat insoles will be prepared without any therapeutic objective. This project was developed according to the standard protocol for randomized clinical trials (SPIRIT). Along with the clinical evaluation, demographic data of the sample will be collected to identify and confirm the presence of peripheral neuropathy, next, the pedobarographic will be evaluated, and finally, the patients will answer the FAAM questionnaire to assess foot functionality. The primary outcome will be analyzing pressure points in KiloPascal (kPa) in the patients’ feet through pedobarographic of the patients in the intervention and control groups. The secondary outcome will be the foot functionality in activities of daily living through the FAAM (Foot and Ankle Ability Measure), considering the volunteers in the initial evaluation, third and sixth months.  FINAL CONSIDERATIONS: Mainly, results of this study will show whether there is a structural alteration in the analysis of the plantar pressure due to the continuous use of insoles and present the evaluation of whether the use of therapeutic insoles improves the foot functionality of the same users when compared to sham insoles.


Author(s):  
Matthew S. Chrisman ◽  
Robert Wright ◽  
William Purdy

Standing desks may reduce sedentary behaviors in college students. Students at one mid-size urban university in the Midwestern United States were randomized into intervention (n = 21) and control groups (n = 27) to assess standing time when given access to standing desks. The intervention group received visual and oral instructor prompts to stand, while the control received no prompts during a 50 min lecture. All students were provided with adjustable tabletop standing desks. ActivPAL accelerometers measured sitting and standing time. A brief survey assessed student preferences, including facilitators and barriers to standing. Mean standing time was greater in the intervention vs. control group (26 vs. 17 min, p = 0.023). Students tended to stand in the corners and edges of the room. Main facilitators for standing included to break up sitting, reduce back pain, and increase attention and focus; main barriers were not wanting to distract others or be the only one standing. In total, 87.5% of intervention group participants found five prompts to stand were adequate. Students increased standing time in class when provided with standing desks and instructor prompts to stand. Findings can inform the layout of classrooms and when and how to promote standing desks during lectures.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yukari Isaka ◽  
Ai Hori ◽  
Rie Tanaka ◽  
Masao Ichikawa

Abstract Background The method of communicating a positive cancer screening result should seek to alleviate psychological distress associated with a positive result. We evaluated whether the provision of information through a leaflet would help reduce psychological distress in a randomized controlled trial. Methods The participants were women aged 20–69 years who were about to undergo cervical cancer screening at health centers. Before the screening, they received hypothetical screening results, with a leaflet (intervention group, n = 493) or without it (control group, n = 479), randomly. Their psychological distress and intention to undergo further examination were then compared between the intervention and control groups. Results After the intervention (providing a leaflet with hypothetical screening results), psychological distress appeared to be higher in the control group than in the intervention group among those who received a hypothetical positive screening result (odds ratio: 2.57, 95% confidence interval: 1.87–3.54), while 95% and 97% of those in the intervention and control groups, respectively, reported that they would undergo further examination. Conclusions Information provision might help reduce psychological distress but not hinder further examination among women who screen positive for cervical cancer. Trial registration: UMIN Clinical Trials Registry UMIN000029894. Date of Registration: November 2017.


Author(s):  
Cynthia Uchechukwu Ejike ◽  
Akinola Stephen Oluwole ◽  
Olaitan Olamide Omitola ◽  
Adedotun Ayodeji Bayegun ◽  
Islamiat Yetunde Shoneye ◽  
...  

Abstract Background We redesigned the Schisto and Ladders health educational board game and evaluated its potential to encourage compliance to school-based mass drug administration with praziquantel. Methods Two hundred and seventy-five children from six schools who rejected praziquantel treatment were divided into intervention and control groups. Before the intervention, preassessment interviews were conducted on their knowledge about praziquantel treatment and schistosomiasis. The Schisto and Ladders version 2 game as an intervention, and the Snakes and Ladders game as a control, were played for 6 mo. Postassessment interviews, including focus group discussions, were conducted. Results At preassessment, 0/98 (0.0%) children in the intervention group had heard of praziquantel compared with 2/177 (1.1%) in the control group. Similarly, 0/98 (0.0%) children in the intervention group did not know that praziquantel does not kill compared with 4/177 (2.3%) in the control group. The postassessment showed that 53/78 (67.9%) in the intervention group were aware of praziquantel compared with 2/177 (1.1%) in the control group (p=0.000). Similarly, 53 (69.7%) in the intervention group knew about the safety of praziquantel compared with 0/177 (0.0%) in the control group (p=0.000). Sixty-four children (65.3%) from the intervention group sought praziquantel treatment after the trial. Conclusions Schisto and Ladders version 2 is a useful sensitisation tool with which to encourage compliance to praziquantel treatment in schools.


2021 ◽  
Vol 1 (2) ◽  
pp. 55-67
Author(s):  
Werna Nontji ◽  
Dwi Kartika Sari ◽  
Sitti Maria Ulfa ◽  
Syafruddin Syarif ◽  
Inez Vravty Lestari ◽  
...  

Background: Educating mothers during their postpartum period could potentially help them to overcome some important phases after giving birth. The process of education is evaluated based on the mothers’ knowledge about their independent self-care. Independency is an activity that is started individually and is done based on self-capability. The independency in the postpartum care is not only important to decrease the mother’s mortality and morbidity rate, but it is also crucial to strengthen and improve the post-partum mother’s healthy behavior during the perineal care. Providing education using Android-based application called BUBI Care could be potential to facilitate a more dynamic transfer of knowledge to the postpartum mothers.Aims: To analyze the knowledge, skills, and independence of primipara postpartum mothers in independent perineal care before and after accessing BUBI Care app. Research Method: employing quasi experimental research with pre-test and post-test design with control group design. The sample for this research were 19 pregnant mothers TM III (pregnancy age of ? 38 weeks) on each group. The treatment group was educated using BUBI Care Android app that was conducted at one of Public Health Center. The control group was educated without BUBI Care that was conducted at a Midwife Practice Clinic. The research was conducted on September to October 2020. Study Result: According to the Wilcoxon test, there was a difference in the pre-test knowledge of the treatment and control groups with the similar median of 53 and p-value of 0.666, the treatment group showed their scores improved to 80 on the post-test while the control group stayed at 53 with the p-value of 0.000. It means that BUBI Care app education influences the post-test. On the other hand, the perineal care skill saw a difference between the intervention and control groups. The intervention group had a mean of 70.05 and 56.68 for the control group with the p-value of 0.002 which means that there was an influence from the BUBI Care app education. Additionally, Mann Whitney test showed that the intervention group had a mean score of 78.95, but the control group only had 49.26, the total difference between the two are 29.69 with the p-value of 0.000. It can be concluded that there is a significance in difference in the independency rate from the provision of BUBI Care Android app education.Conclusion:  there is a significance effect on the intervention group in terms of Android based usage.


2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Yannan Sun

 Objective: Investigate the effectiveness of nursing risk management in the care of critically ill patients in the respiratory unit. Methods: Among the critically ill respiratory patients admitted to our hospital between May 2019 and April 2020, 78 patients were randomly selected and divided into an observation group and a control group, each consisting of 39 patients. In the observation group, a nursing risk management model was implemented, i.e., patients' clinical symptoms were observed at any time to monitor their treatment satisfaction and the effectiveness of their care and routine care was implemented for the control group. Results: The heart rate, respiratory rate, and pH of patients in the observation group were more stable than those in the control group, and their respiratory status was better, with differences in data. There was also significant statistical significance (P<0.05). The incidence of patient-provider disputes, unplanned extubation, and unplanned events were lower in the observation group compared to the control group, and their data difference was statistically significant (P<0.05). The treatment satisfaction as well as the total effective rate of patients in the observation group was also much higher than that of the control group, and there was also a statistically significant difference in the data (P<0.05). Conclusion: The nursing risk management model has a significant therapeutic effect in the care of critically ill respiratory patients. Therefore, it is worth popularizing to use in the clinical nursing of respiratory critical patients.


2021 ◽  
pp. 026921552110411
Author(s):  
Hiromichi Takeda ◽  
Katsuhiko Takatori

Objective To assess the preliminary effects of a buddy-style intervention to improve exercise adherence. Design A parallel-group, open-label, pilot randomized controlled trial. Setting Adult day-care centers. Participants Sixty-five disabled older adults. Interventions All participants underwent a 12-week home exercise program, and the intervention group received a 5–10 min buddy-style intervention between older adults in the intervention group once weekly at an adult day-care center. Main measures Based on the exercise log calendar, the number of days of exercise was assessed for each of the three phases: 1–4 weeks, 5–8 weeks, and 9–12 weeks. Short physical performance battery was measured at baseline and after 12 weeks. Results Of the 590 screened older adults, 65 were recruited and 33 were assigned to the intervention group. One participant in each group withdrew before the program began, and four and five patients in the intervention and control groups, respectively, dropped out by the 12-week assessment. Analysis of covariance of the 28 and 26 patients in the intervention and control groups, respectively, for whom exercise log calendars could be retrieved, showed that the intervention group (24.4/28 days) exercised significantly more days than the control group (20.6/28 days) at 9–12 weeks ( P = 0.009). In the between-group effect of the intention-to-treat analysis of short physical performance battery, walking and standing test ( P = 0.790, P = 0.829) were not significantly different, and balance test ( P = 0.049) was significantly better in the control group. Conclusions There was a preliminary effect of the buddy-style intervention to improve exercise adherence.


2016 ◽  
Vol 50 (5) ◽  
pp. 823-830 ◽  
Author(s):  
Patrícia de Oliveira Salgado ◽  
Ludmila Christiane Rosa da Silva ◽  
Priscila Marinho Aleixo Silva ◽  
Tânia Couto Machado Chianca

Abstract OBJECTIVE To evaluate the effects of physical methods of reducing body temperature (ice pack and warm compression) in critically ill patients with fever. METHOD A randomized clinical trial involving 102 adult patients with tympanic temperature ≥ 38.3°C of an infectious focus, and randomized into three groups: Intervention I - ice pack associated with antipyretic; Intervention II - warm compress associated with antipyretic; and Control - antipyretic. Tympanic temperature was measured at 15 minute intervals for 3 hours. The effect of the interventions was evaluated through the Mann-Whitney test and Survival Analysis. "Effect size" calculation was carried out. RESULTS Patients in the intervention groups I and II presented greater reduction in body temperature. The group of patients receiving intervention I presented tympanic temperature below 38.3°C at 45 minutes of monitoring, while the value for control group was lower than 38.3°C starting at 60 minutes, and those who received intervention II had values lower than 38.3°C at 75 minutes of monitoring. CONCLUSION No statistically significant difference was found between the interventions, but with the intervention group I patients showed greater reduction in tympanic temperature compared to the other groups. Brazilian Registry of Clinical Trials: RBR-2k3kbq


Author(s):  
Mansoor Keshavarz ◽  
Maryam Kashanian ◽  
Soodabeh Bioos ◽  
Yasaman Vazani

Abstract Background Traditional Persian Medicine (TPM) is an ancient medical system that provides suggestions to improve the health of mothers and children during pregnancy and labor. Persian physicians believed that these instructions made labor easier, safer, and less painful. Methods The present randomized clinical trial was conducted among women at 33–38 weeks of pregnancy in Tehran, Iran. TPM instructions consisted of diet, bathing, and application of oil from the 38th week of pregnancy to the onset of labor. The primary outcome was the duration of the active phase of labor. Results The mean duration of the active phase was 331.60 ± 151.48 min for the intervention group and 344.40 ± 271.46 min for the control groups, but it was not statistically significant. The active phase was significantly shorter in women who had better compliance (p=0.03). The need for oxytocin augmentation was 53.3% in the control group and 38.5% in the intervention group (p=0.17). The rate of perineal infection was 13% in the control group and 0% in the intervention group (p=0.11). Conclusions The active phase was not different in the intervention and control groups, but it was shorter in compliant women. It is possible that prolonged use of these recommendations in combination with a sitz baths and a larger sample size could result in more significant outcomes.


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