A Randomized Controlled Study of the Effectiveness of Electrophysiological Monitoring of Dexmedetomidine in Patients with Brain Damage of Various Origins

2020 ◽  
Vol 75 (5) ◽  
pp. 490-499
Author(s):  
Yuri Y. Kiryachkov ◽  
Marina V. Petrova ◽  
Bagautdin G. Muslimov ◽  
Sergey A. Bosenko ◽  
Mikhail M. Gorlachev

Background.At the same time, the main effect of the use of this drug is the elimination of the autonomic nervous system dysfunction and sympatholysis. It seems important to search for a method of indications and selection of a dose of dexmedetomidine in intensive care.Aims to improve the clinical effectiveness of the electrophysiological navigation of the prolonged use of dexmedetomidine in patients with brain pathology of various origins.Methods.The study included 83 patients 2050 days after the traumatic brain injury, anoxic damage; consequences of acute disorders of cerebral. 37 patients comprised the 1st intervention group with a clinical course of dexmedetomidine (male 28; female 9; average age 49.62.3 years) and 46 patients comprised the 2nd control group without pharmacological correction with dexmedetomidine (male 23; female 23, average age 512.5 years). Criteria for the inclusion of prolonged infusion of the drug dexmedetomidine (Orion Pharma, Finland) are based on heart rate variability (HRV) indicators characteristic of sympathetic hyperactivity, the target task of titration of doses of dexmedetomidine served as the parameters for achieving normal HRV indicators, the appearance of parasympathetic hyperactivity served as the basis for reducing the dosage of the drug or stopping it of application. HRV parameters were recorded before dexmetomedine infusion-initially, on 13; 45; 910; 1520 days of drug administration.Results.The starting dose of dexmedetomidine with sympathetic hyperactivity in patients was 0.12 to 0.24 g.kg1.hr1(average dose 0.160.01; total 200 mg/day). According to digital data from HRV, the effective dose of dexmedetomidine ED50 was 0.260.03 g.kg1.hr1(total daily 353.835.1 g) and was achieved on day 910 using dexmedetomidine.Conclusions.The protective role of dexmedetomidine with correction of sympathetic hyperactivity based on electrophysiological navigation according to the HRV is reliable in the following indicators: The improvement of consciousness; a significant decrease in the incidence of distress lung syndrome; septic shock; mortality.

2014 ◽  
Vol 104 (5) ◽  
pp. 444-450 ◽  
Author(s):  
Søren Kaalund ◽  
Pascal Madeleine

Background Playing soccer on artificial turf can provoke pain in young players. Using shock-absorbing insoles (SAIs) can result in decreased pain perception. We sought to investigate the pain and comfort intensity experienced during the switch from natural grass to third-generation artificial turf and with the use of SAIs on artificial turf during training in young soccer players. Methods In a prospective randomized controlled study, 75 players were included from the youth teams of U15, U17, and U19. Pain intensity and comfort were assessed after training on only grass turf for 3 months. Randomization stratified by team level and age was performed; the intervention group received SAIs, and the control group used their own insoles. Assessments were repeated after 3 weeks on artificial turf (baseline) and 3 more weeks (follow-up) on artificial turf with SAIs/usual insoles. Results Pain intensity increased and comfort decreased significantly after 3 weeks of training on artificial grass compared with natural grass (P < .05). The addition of SAIs resulted in significantly reduced pain intensity compared with the usual insoles (P < .05). Conclusions The switch to artificial turf is associated with less comfort and more pain during training in young soccer players. The use of SAIs led to lower pain intensity, highlighting a protective role of the insoles after 6 weeks of training on artificial turf.


2020 ◽  
Author(s):  
Tay Siew Cheng Sarah ◽  
Lim Jit Fan Christina ◽  
Tan Soo Chieng Daphne ◽  
Tan Seok Yee Maureen ◽  
Chen Jieying Cordelia ◽  
...  

BACKGROUND Diabetes is one of the most common medical conditions referred to medication review service run by pharmacists, OBJECTIVE This study aims to determine whether pharmacist-run MRS can be an effective intervention tool to improve patients’ participation in self-care of diabetes. METHODS This randomised controlled study was conducted in five public primary healthcare centres from December 2014 to October 2016. Participants were 40 to 80 years of age and had been diagnosed with type 2 diabetes. These participants were prescribed with five or more chronic medications, of which at least one was an antidiabetic medication, by the primary healthcare centres’ doctors. The participants were randomly recruited into the intervention or control arm. A self-developed questionnaire which incorporated the validated Diabetes Self-Management Questionnaire (DSMQ) was administered face-to-face by the study team to the participants prior to and after MRS. MRS was not administered to participants in the control group. RESULTS A total of 221 participants completed the follow up. There were 105 participants in the control arm and 116 in the intervention arm. The DSMQ Sum Scale score of the control group improved by 0.16 ± 1.11 (p= 0.136) while the intervention group improved by 0.40 ± 0.99 (p=0.000). Participants in the intervention group reported a better improvement in their self-care of diabetes, specifically in glucose management (0.38± 1.35, p=0.003), dietary control (0.26±1.66, p=0.096) and physical activity (0.67±2.36, p=0.003). CONCLUSIONS Pharmacist-run MRS is an effective intervention tool to improve participants’ self-care of diabetes, particularly in glucose management, dietary control and physical activity.


2021 ◽  
pp. 1-4
Author(s):  
Xian-Rong Yu ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Zeng-Chun Wang ◽  
Hua Cao ◽  
...  

Abstract Objective: This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect. Methods: A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed. Results: There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group. Conclusion: The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.


2021 ◽  
Author(s):  
Umesh Shukla ◽  
Nitin Ujjaliya

Introduction: The characteristic clinical features of Covid-19 disease range between asymptomatic to mild-moderate symptoms. Studies suggest that a large population (80%) presents its asymptomatic or milder form. Remaining 20 percent, owing to severity of the diseases, need hospital-based care. Many treatment protocols and strategies have been promoted and recommended by authorities including WHO, but nothing has actually been finalized till date. The present study was planned to evaluate the effectiveness of an Ayurvedic formulation viz. Arogya Kashayam-20 in the hospitalized cases of Covid-19.Aim: To evaluate the effectiveness of Arogya Kashayam-20 in the cases of COVID-19 particularly the negative conversion of RTPCR in 10 days duration.Material and Methods: This was a randomized controlled trial conducted at COVID-19 Care Center, Pt. Khushilal Sharma Government Ayurveda College & Institute, Bhopal, Madhya Pradesh with a sample size of 112 participants, aged between 16 to 60 years of either sex. Participants were divided in two groups viz. group A and B. Both the groups received Hydroxychloroquine (HCQ), vitamin C and Zinc as per the prevailing ICMR guidelines and group 'A' received additionally Arogya Kashayam-20 for 10 days. Outcome measure of the study was to see the negative conversion RT-PCR test after intervention period of 10 days. CTRI Registration: CTRI/2020/06/026221. Results: Among the 60 cases registered in study group (group A), 51 cases (85.00%) were reported with negative RTPCR on 10th day. Out of 52 cases registered in control group (group B); 39 cases (75.00%) were tested negative RTPCR on 10th day. In both the groups all the cases were discharged asymptomatically on 10th day as per the prevailing ICMR guidelines. No ADR/AE observed during the intervention period.Conclusion: The study observes that the add on intervention group has a better outcome in terms of RT-PCR negative reports after 10 days comparing to the control group.


Author(s):  
Sevgi Peker ◽  
Özgür Çakmak ◽  
Talha Muezzinoglu ◽  
Guven Aslan ◽  
Hakan Baydur

Aim: This study was conducted to evaluate the effect of postoperative early mobilization in patients who underwent radical cystectomy (RC) and ileal conduit in terms of healing process and QOL. Methods: This multicenter prospective randomized controlled study was conducted with 40 patients who were randomly divided into two groups. The intervention group was mobilized within the first 16 hours postoperatively in accordance with the mobilization procedure which determined according to literature. Data were collected using the case report form, HADS and SF-36 QoL scale. Results: Postoperative hospitalization, duration of narcotic analgesic administration, first oral food intake, flatus, defecation and NG tube termination time were shorter in the intervention group. In the control group blood glucose and pulse values were higher after mobilization. SF-36 physical function, physical role difficulty and general perception of health were higher in intervention group at the postoperative first and third month (p <0.05). Conclusion: Our study showed that early mobilization contributed to the healing process positively and improved the quality of life in the patients who underwent radical cystectomy (RC) and ileal conduit surgery. Keywords: Early Mobilization, Radical Cystectomy, Ileal conduit, Quality of Life, Convalescence


2021 ◽  
Vol 12 ◽  
Author(s):  
Matías E. Rodríguez-Rivas ◽  
Adolfo J. Cangas ◽  
Daniela Fuentes-Olavarría

Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p &lt; 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p &lt; 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243086
Author(s):  
Lawrence Matthews ◽  
Krysta Contino ◽  
Charlotte Nussbaum ◽  
Krystal Hunter ◽  
Christa Schorr ◽  
...  

Background Implementation of a point of care ultrasound curricula is valuable, but optimal integration for internal medicine residency is unclear. The purpose of this study was to evaluate if a structured ultrasound curriculum vs. structured ultrasound curriculum plus supervised thoracic ultrasounds would improve internal medicine residents’ skill and retention 6 and 12 months from baseline. Methods We conducted a randomized controlled study evaluating internal medical residents’ skill retention of thoracic ultrasound using a structured curriculum (control, n = 14) vs. structured curriculum plus 20 supervised bedside thoracic ultrasounds (intervention, n = 14). We used a stratified randomization based on program year. All subjects attended a half-day course that included 5 lectures and hands-on sessions at baseline. Assessments included written and practical exams at baseline, immediately post-course and at 6 and 12 months. Scores are reported as a percentage for the number of correct responses/number of questions (range 0–100%). The Mann Whitney U and the Friedman tests were used for analyses. Results Twenty-eight residents were enrolled. Two subjects withdrew prior to the 6-month exams. Written exam scores for all subjects improved, baseline median (IQR) 60 (46.47 to 66.67) post-course 80 (65 to 86.67), 6-month 80 (66.67 to 86.67) and 12-month 86.67 (80 to 88.34), p = <0.001. All subjects practical exam scores median (IQR) significantly improved, baseline 18.18 (7.95 to 32.95), post-course 59.09 (45.45 to 70.45), 6 month 71.74 (60.87 to 82.61) and 12-month 76.09 (65.22 to 88.05), p = <0.001. Comparing the control group to the intervention group, there were statistically significant higher scores, median (IQR), in the intervention group on the practical exam at 6 months 63.05 (48.92 to 69.57) vs. 82.61(72.83 to89.13), p = <0.001. Conclusion In this cohort, internal medicine residents participating in a structured thoracic ultrasound course plus 20-supervised ultrasounds achieved higher practical exam scores long-term compared to controls.


2021 ◽  
pp. 1-9
Author(s):  
Nazlı Baltacı ◽  
Mürüvvet Başer

<b><i>Background:</i></b> Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. <b><i>Materials and Methods:</i></b> This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. <b><i>Results:</i></b> Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl –1.18 to 8.64], <i>p</i> = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference –9.40 [95% Cl –13.91 to –4.88], <i>p</i> &#x3c; 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl –3.18 to 7.51], <i>p</i> = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], <i>p</i> &#x3c; 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (<i>p</i> &#x3c; 0.01), but not in the control group (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.


2021 ◽  
Author(s):  
Jose Maria Montero-Moraga ◽  
Margarita Posso ◽  
Marta Román ◽  
Andrea Burón ◽  
Maria Sala ◽  
...  

Abstract Objective: To evaluate the impact of an information leaflet about the risk-benefit balance of breast cancer screening on women’s participation.Methods: This randomized controlled study was conducted within a population-based breast cancer screening program and included women from the catchment areas of two hospitals in Barcelona, Spain. We evaluated women aged 50-69 years invited to screening between September 2019 and January 2020. One hospital attended a population with a lower socioeconomic status than the other. The intervention group received an information leaflet on the benefits and harms of mammography screening. The control group received the usual invitation letter. We compared the participation rate between groups, stratified by hospital and by per-protocol and intention-to-treat analyses. Results: We included 11,119 women in the study: 5,416 in the intervention group and 5,703 in the control group. A total of 36.4% (1,964/5,393) of the women in the intervention group and 37.5% (2,135/5,694) of those in the control group attended screening, respectively. Overall, we found no differences in participation among groups (difference in participation -1.1%; 95% CI; -2.9% to 0.7%, p-value=0.240). In the hospital attending a population with a low socioeconomic status, attendance was lower in the intervention group (-1.4%, 95% CI: -5.7% to -0.03%, p-value=0.029). In the per-protocol analysis, participation was lower in the intervention group (-2.6%, 95% CI: -4.6% to -0.5%, p-value=0.015). Conclusions: Overall participation in our program was unaffected by a new information leaflet on the risk-benefit balance of breast cancer screening. However, participation was lower in certain populations with lower socioeconomic status.


2020 ◽  
Author(s):  
Kazuhiro Shimo ◽  
Mami Hasegawa ◽  
Seiko Mizutani ◽  
Tomomi Hasegawa ◽  
Takahiro Ushida

Abstract Background Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear if workplace PA interventions can improve LBP. This study aimed to investigate the effects of workplace interview intervention on increasing PA and improving LBP among office workers. Methods We recruited 37 workers of a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention group (n=20) or control group (n=17). We affixed waist-worn accelerometers to monitor PA in all participants, and provided face-to-face counseling with a physical therapist or nurse once a week for 12 weeks as workplace PA program to reassurance and encourage participants to keep high levels of PA. PA and LBP severity were assessed at baseline, 3 and 6 months. Results Baseline characteristics were similar in both groups, but PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, was PA significantly increased at 3 and 6 months from baseline and LBP severity improved significantly at 6 months from baseline. We calculated the effect size of the interview intervention, and found that workplace interview intervention had a medium to large effect on PA and LBP severity. Conclusions Our data suggests that workplace PA intervention can increase PA and improve LBP among office workers. Trial registration UMIN-CTR Clinical Trial UMIN000038864 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044321). Registered 12 December 2019, retrospectively registered.


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