Brain oximetry is not a good monitor on reducing neurological complications after cardiac surgery

Background Cerebral deoxygenation is related to several adverse systemic consequences. We aimed to assess the effect of noninvasive monitoring of cerebral oxygenation on reducing neurological complications after cardiac surgery. Methods In this randomized clinical trial, subjects were randomized into two groups: intervention group (111 subjects with monitoring of cerebral oximetry) and control group (112 subjects without any monitoring of cerebral oximetry). Monitoring of regional cerebral oxygen saturation (rScO2) was performed in the intervention group without any monitoring of cerebral oxygenation. The rScO2 was not recorded in the control group and no specific treatments were employed. Any neurological complications such as hallucinations, delirium, stroke, and length of stay in ICU after surgery were recorded. A p-value less than 0.05 was used as a cut-off for statistical significance. Results After surgery, in the intervention group one (1/111=0.09%) patient suffered from stroke and one patient had delirium, while in the control group three patients had stroke and three (3/112=2.6%) had delirium. There was no significant difference between the two groups regarding complications (p=0.527). The length of stay in ICU was 3.49 ± 0.96 days in the case group and 3.40 ± 0.80 days in the control group and there was no significant difference in the two groups (p=0.477). Conclusion Monitoring of rScO2 does not seem to be a good monitor for brain oxygenation. Further studies are needed to judge the usefulness of rScO2 for monitoring brain oxygenation.

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Office-Based Cholesterol Testing: Impact on Process-of-Care in Patients with Hypercholesterolemia a Pilot Study

Journal of Pharmacy Technology ◽

10.1177/875512259701300208 ◽

1997 ◽

Vol 13 (2) ◽

pp. 75-79 ◽

Cited By ~ 2

Author(s):

David M Ruffin ◽

James M McKenney

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Statistical Significance ◽

Intervention Group ◽

Office Visit ◽

Therapeutic Interventions ◽

Control Group ◽

Process Of Care ◽

Physician Office ◽

Significant Difference

Objective: To determine whether providing cholesterol results during a patient-physician office encounter would affect the process-of-care in patients with hypercholesterolemia. Methods: We used a randomized, parallel-group, control design to conduct the study. Thirty-five participants had a lipoprotein analysis performed using the L.D.X. cholesterol analyzer. Patients randomly assigned to the intervention group (n = 19) had their results provided to the physician during the office visit; the results of those in the control group (n = 16) were not made available to the physician. Each participant's medical record was reviewed to determine the physican's process-of-care with respect to cholesterol management. The indicators of the process-of-care for which we sought documentation included therapeutic interventions and the physician's assessment of risk for coronary heart disease. We used Fisher's exact test to determine statistical significance of the intervention. Descriptive analysis was also performed. Results: We were unable to detect a statistically significant difference in therapeutic interventions (p = 0.183). However, we did observe a statistically significant difference in the physician's assessment of risk for coronary heart disease (p = 0.0001). Conclusions: Our data suggest that providing a cholesterol test result during a patient-physician office encounter positively affects the process-of-care in patients with hypercholesterolemia. Future studies should include larger numbers of patients and longer follow-up periods.

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Development and Application of One Separation-Free Safety Tube on the Disposable Infusion Needle

Computational and Mathematical Methods in Medicine ◽

10.1155/2020/6896517 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Weifen Lu ◽

Qianli Pan ◽

Yinxin Zhou ◽

Wenyu Chen ◽

Hongyan Zhang ◽

...

Keyword(s):

Exposure Time ◽

Statistical Significance ◽

Intervention Group ◽

Operation Time ◽

Control Group ◽

Needle Stick ◽

Significant Difference ◽

New Type ◽

Needle Stick Injuries ◽

The Difference

Objective. To develop a new type infusion set and apply it to the clinic, as well as explore its effectiveness in the prevention from needle stick injuries. Methods. A total of 200 inpatients who were in need of intravenous infusion with a disposable infusion needle were included and randomly divided into two groups: intervention group and control group. Disposable infusion needles with a separation-free safety tube were used in the intervention group, whereas conventional ones were used in the control group. Then, effects of the two types of infusion sets were observed and compared. Results. As for the operation time for infusion, it was (82.19±1.80) seconds in the intervention group and (83.02±1.83) seconds in the control group, with the difference statistically significant (P<0.05). Besides, the exposure time of the needles after infusion in the intervention group was (3.36±0.17) seconds while (18.85±1.18) seconds in the control group; the difference between which was statistically significant (P<0.05). In terms of the time for needle disposal, (18.60±0.84) seconds was required in the intervention group, while for the control group, it took (18.85±1.18) seconds, and the difference between two groups was of statistical significance as well (P<0.05). Nevertheless, there was no statistically significant difference in the accidental slip rate of the needles as that turned out 0% in both groups (P>0.05). It was worth noting that the block rate of the disposed needles in the intervention group was 100%. Conclusion. The separation-free safety tube on the disposable infusion needle could instantly block the sharp needle after infusion, which reduces the needle exposure time and lowers the risk of needle stick injuries. In the meantime, the safety tube is convenient to use, and its application can shorten the time for infusion and needle disposal, consequently improving the working efficiency of nurses. As the new type safety tube has above advantages and would not raise the risk of needle slippage, it is worthy of clinical promotion.

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Effect of injection site pre-cooling on pain perception in patients attending a dental camp at Life Line Express: A split mouth interventional study

Medicine and Pharmacy Reports ◽

10.15386/cjmed-694 ◽

2017 ◽

Vol 90 (2) ◽

pp. 220-225 ◽

Cited By ~ 1

Author(s):

Upendra Singh Bhadauria ◽

Pralhad L Dasar ◽

Sandesh N ◽

Prashant Mishra ◽

Shaijal Godha

Keyword(s):

Injection Site ◽

Pain Perception ◽

Statistical Significance ◽

Intervention Group ◽

Control Group ◽

Median Score ◽

Interventional Study ◽

Topical Lidocaine ◽

Significant Difference ◽

Group A

Background and aim. To determine the effect of pre-cooling injection site on pain perception in patients attending a dental camp at lifeline express, Habibganj.Methods. A split mouth interventional study assessed the effect of pre cooling the injection site in patients (n=33) requiring bilateral buccal infiltration prior to extraction. One side of the patient’s mouth received the intervention after the injection site was pre cooled with ice for 3 minutes along with topical Lidocaine, while the other mouth side of the same patient received only topical Lidocaine and served as control group. A structured proforma assessed the demographic characteristics and risk factors that influence pain perception in patients. Mann-Whitney U tests and Wicoxon rank sum test were used for statistical analysis. Statistical significance was defined at P<0.05.Results. The results revealed a significant difference in pain perception between control and intervention group as assessed using both Heft-Parker Visual Analog Scale (median score 3.0 and 1.0) and Sound Eye Motor scale (median score=1.0 and 0.0) (P<0.01). For both the scales the assessed and self reported variables Gender, Location, Chief Complaint, Region and Arch were found to be statistically significant.Conclusion. Pre cooling injection site reduced pain perception in patients.

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Effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren - a randomized controlled trial

Fisioterapia em Movimento ◽

10.1590/1980-5918.032.ao08 ◽

2019 ◽

Vol 32 ◽

Cited By ~ 1

Author(s):

Mariana Vieira Batistão ◽

Letícia Carnaz ◽

Roberta de Fátima Carreira Moreira ◽

Tatiana de Oliveira Sato

Keyword(s):

Musculoskeletal Pain ◽

Controlled Trial ◽

Statistical Significance ◽

Intervention Group ◽

Exercise Program ◽

Control Group ◽

School Based ◽

Postural Changes ◽

Significant Difference ◽

Strengthening Exercises

Abstract Introduction: The exercise benefits for the most prevalent postural changes require proper investigation, with large samples, control group, and concealed allocation. Objective: To assess the effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren. Method: Three hundred students from three schools in Brazil were evaluated. Stretching and strengthening exercises, twice a week, for eight weeks in group sessions were provided by one physiotherapist. The control group did not undergo any intervention. Head, back and shoulder posture were qualitatively evaluated. Head and trunk alignment were evaluated using the Posture Assessment Software. Cervical, thoracic, low back and upper limb pain were assessed for the last seven days. The trunk mobility was recorded through the flexibility of the posterior chain. Posture, pain and trunk mobility were recorded at baseline and after the intervention. Groups were compared using χ2 test, two-way MANOVA, and two-way ANOVA, with α set at 5%. Results: Shoulder posture showed significant results (P = 0.04), the intervention group showed the lower worsening rate. In the quantitative evaluation, a statistically significant difference was observed between assessments (P < 0.01 for head and trunk; ES = 0.53) but not between groups. The intervention group had a higher percentage of improvement in the overall musculoskeletal pain (P = 0.04; ES = 0.54). Mobility decreased an average of 1.8° in the control group and increased 5.0° in the intervention group, without statistical significance. Conclusion: The program was effective in reducing pain level and shoulder misalignment at the intervention group.

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Effect of the Addition of Human Milk Fortifier to Breast Milk on the Early Recovery of Infants After Congenital Cardiac Surgery

Frontiers in Pediatrics ◽

10.3389/fped.2021.661927 ◽

2021 ◽

Vol 9 ◽

Author(s):

Xian-Rong Yu ◽

Wen-Peng Xie ◽

Jian-Feng Liu ◽

Li-Wen Wang ◽

Hua Cao ◽

...

Keyword(s):

Cardiac Surgery ◽

Breast Milk ◽

Human Milk ◽

Intervention Group ◽

Postoperative Recovery ◽

Control Group ◽

Early Recovery ◽

Congenital Cardiac Surgery ◽

Significant Difference ◽

Human Milk Fortifier

Objective: This article studied the effect of breast milk supplemented with human milk fortifier (HMF) on the early recovery of infants after congenital cardiac surgery.Methods: Infants undergoing congenital cardiac surgery were randomly divided into an intervention group (n = 27) and a control group (n = 27). Infants in the intervention group received HMF, and those in the control group were exclusively breastfed. The nutritional indicators at discharge, the postoperative recovery status, and nutritional-related complications were recorded.Results: Compared with the control group at the time of discharge, the weight and albumin and prealbumin levels of the intervention group were significantly increased (P < 0.05). The length of hospital stay of the intervention group was significantly reduced compared with that of the control group (P < 0.05). Although the length of ICU stay for the intervention group was shorter than that of the control group, the difference was not significant (P > 0.05). No significant difference in the incidence of postoperative nutrition-related complications was noted between the two groups (P > 0.05).Conclusion: Compared with breastfeeding alone, with HMF can improve postoperative weight gains, reduce the length of stay, and promote infants' early recovery after congenital cardiac surgery.

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The Effect of Aerobic Walking on Sleep Quality, Stress and Life Satisfaction: A Longitudinal Analysis a Randomized Control Trial

10.21203/rs.3.rs-39694/v1 ◽

2020 ◽

Author(s):

Feifei Wang

Keyword(s):

Life Satisfaction ◽

Sleep Quality ◽

Longitudinal Analysis ◽

Repeated Measures ◽

Randomized Control Trial ◽

Statistical Significance ◽

Intervention Group ◽

Control Group ◽

Significant Difference ◽

Randomized Control

Abstract BackgroundThis study aimed to evaluate the longitudinal effects of a randomized control trial about a goal-setting aerobic walking intervention conducted among sedentary young adults.MethodsA 4-week daily aerobic walking (a. continually walking for at least 10 minutes; b. walk at least 60 steps per minute.) intervention was conducted to examine its effectiveness on sleep quality, stress and life satisfaction. Fifty-four participants aged 19–36 years old were assigned into two groups randomly (i.e. intervention group, control group). Sleep quality, stress and life satisfaction were assessed at baseline, post intervention and four weeks after the intervention by a battery of questionnaires. Omron HJ-112 pedometer and daily diary were used to facilitate the intervention process.ResultsThe comparison between intervention group and control group did not show significant difference in terms of sleep quality, stress and life satisfaction after intervention. Repeated measures ANOVA showed significant longitudinal effect with regard to stress (p = 0.03). Sleep quality was improved close to statistical significance (p = 0.06). Longitudinal analysis reported that the aerobic walking effect pertaining to life satisfaction rather than stress and sleep quality (p = 0.05).ConclusionsAerobic walking is an effective exercise for stress and sleep. Further studies are suggested to explore feasible intervention strategies that could bring long-term effectiveness to health.Trial registrationClinicalTrials.gov, NCT04427696. Registered 11June 2020- retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04427696?cntry=HU&city=Budapest&draw=2&rank=1

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Long-term outcomes of metallic endobronchial stents in lung transplant recipients are not affected by bacterial colonization

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivaa221 ◽

2020 ◽

Vol 32 (1) ◽

pp. 47-54

Author(s):

Shimon Izhakian ◽

Walter G Wasser ◽

Baruch Vainshelboim ◽

Barak Pertzov ◽

Oleg Gorelik ◽

...

Keyword(s):

Lung Transplant ◽

Bacterial Colonization ◽

Statistical Significance ◽

Intervention Group ◽

Control Group ◽

Stent Insertion ◽

Transplant Recipients ◽

Significant Difference ◽

Lung Transplant Recipients

Abstract OBJECTIVES We evaluated associations of endobronchial stenting with airway bacterial colonization, the antimicrobial resistance profile, hospitalizations for pneumonia and survival in lung transplant recipients. METHODS This is a retrospective single-centre study of 582 recipients of lung transplant during 2002–2018. We compared outcomes of 57 patients (9.7%) who received endobronchial stents (intervention group) to a control group of 57 patients without stents who were matched one to one for age, sex, year of transplantation, unilateral/bilateral transplantation and underlying disease. RESULTS For the intervention compared to the control group, airway colonization was more common for Pseudomonas (86% vs 35%, P < 0.001), Acinetobacter (21% vs 7%, P = 0.05), Klebsiella (21% vs 5%, P = 0.02) and Staphylococcus species (11% vs 0%, P = 0.02). The respective proportions of patients with positive bronchoalveolar lavage cultures on the third post-transplantation day, the day of stent insertion and 6-month post-stent insertion were 47.4%, 50.9% and 65.4% for Pseudomonas sp.; 15.8%, 12.3% and 3.8% for Klebsiella sp.; and 8.8%, 5.3% and 5.8% for Acinetobacter sp. The mean number of hospitalizations for pneumonia per patient was higher, without statistical significance, in the intervention than the control group (1.5 ± 1.7 vs 0.9 ± 1.5, P = 0.1). Kaplan–Meier survival curves did not show a statistically significant difference between the intervention group and the entire group without endobronchial stents (n = 525) (P = 0.4). CONCLUSIONS Lung transplant recipients with endobronchial stents were more likely to be colonized with pathologic bacteria and having pneumonia; however, stent placement was not associated with increased long-term mortality with appropriate stent maintenance.

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Effect of nursing telemonitoring on the knowledge of obese women: clinical trial

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0500 ◽

2019 ◽

Vol 72 (suppl 3) ◽

pp. 212-219

Author(s):

Fernanda Carneiro Mussi ◽

Catia Suely Palmeira ◽

Carlos Antonio de Souza Teles Santos ◽

Armenio Costa Guimarães ◽

Maria de Lourdes Lima ◽

...

Keyword(s):

Clinical Trial ◽

Eating Habits ◽

Statistical Significance ◽

Intervention Group ◽

Control Group ◽

Obese Women ◽

Overweight Women ◽

Intergroup Comparison ◽

Significant Difference

ABSTRACT Objective: To assess the effectiveness of remote monitoring in the knowledge of overweight women. Method: Randomized clinical trial with 101 women, randomly assigned to the control group (CG=50) and to the intervention group (IG=51). The IG received educational intervention over the telephone, during three months and routine follow-up in the service, while the CG only received conventional follow-up. The knowledge was assessed by a specific questionnaire. Data were analyzed by the Robust Linear Regression Model, adopting a statistical significance of 5%. Results: In the intragroup assessment, an increase in the correct answers with a statistically significant difference was observed only for the IG in the domains: “Concept and causes of overweight,” “Complications of overweight” and “Eating habits.” In the intergroup comparison, an increase in the average knowledge was verified in the same domains for the IG (p≤0.005). Conclusion: nursing telemonitoring contributed positively to the improvement of women’s knowledge.

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Use of polypeptide neuroprotection for prevention of postoperative cognitive dysfunction after cardiac surgery: a pilot prospective randomized placebo-controlled clinical study

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2017-4-69-78 ◽

2017 ◽

Vol 21 (4) ◽

pp. 69

Author(s):

M. A. Putanov ◽

M. A. Sokolova ◽

P. I. Lenkin ◽

V. Yu. Slastilin ◽

I. G. Baskakova ◽

...

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Cognitive Dysfunction ◽

Study Design ◽

Cerebral Oxygenation ◽

Plasma Concentrations ◽

Postoperative Cognitive Dysfunction ◽

Cerebral Oximetry ◽

S100b Protein ◽

Control Group

Aim. The study was designed to evaluate the efficacy of polypeptide neuroprotection using brain protein “Cellex” for prevention of postoperative cognitive dysfunction after cardiac surgery. Methods. Our study included 60 patients undergoing elective cardiosurgical operations, who were randomized into two groups. In the “Cellex” group, the patients received 1.0 ml of “Cellex” subcutaneously daily during 8 days, beginning from the preoperative day, while the control group patients were given a saline placebo. The cognitive function was assessed using a Montreal cognitive assessment (MoCA) test on the day before surgery and also at Days 3 and 7 postoperatively. The plasma concentrations of S100b protein were measured before surgery, and at Days 3 and 7. The patients’ gas exchange, hemodynamics and cerebral oxygenation were monitored. In addition, the efficacy of “Cellex” and the severity of cognitive dysfunction were evaluated intraoperatively under cardiopulmonary bypass. Results. The duration of intervention and mechanical ventilation, as well as hemodynamics and cerebral oximetry data did not differ significantly between the groups. There was a transient decline of cognitive functions and an increase in plasma concentration of S100b at Day 3 after surgery in both groups (p<0.05). At Day 7, the MoCA score was still decreased in the control group (p<0.003), but returned to the baseline in the “Cellex” group. These effects became more pronounced after cardiopulmonary bypass. The intraoperative PaCO2 correlated with cerebral oxygenation surgery by the beginning and at the end of surgery (rho = 0.305, p = 0.033 and rho = 0.533; p<0.001). Conclusion. The perioperative use of “Cellex” can attenuate cognitive dysfunction after cardiac surgery, especially when following interventions under cardiopulmonary bypass.Received 25 May 2017. Revised 9 November 2017. Accepted 13 November 2017.Funding: The study was carried out with support of the “Farm-Sintez” company’s grant. The money was spent for purchase of the preparation, the authors’ honoraria and purchase of a kit for determining S100b protein concentration. The sponsors’ support had no impact on the study design and data acquisition, analysis and interpretation. The “Farm-Sintez” company’s representatives were not participating in the preparation and publication of the article.Conflict of interest: The study was carried out with support of the “Farm-Sintez” company’s grant.Author contributions Conception and study design: M.A. Putanov, M.M. Sokolova, P.I. Lenkin, M.Yu. Kirov Data collection and analysis: M.A. Putanov, M.M. Sokolova, P.I. Lenkin, I.G. Baskakova, A.N. Kiriluk, D.N. Kazarinov, K.M. Checkaya, T.S. Isakova, M.A. Rumyanceva, V.Yu. Slastilin Statistical data analysis: M.M. Sokolova Drafting the article: M.A. Putanov, M.M. Sokolova Critical revision of the article: M.Yu. Kirov Final approval of the version to be published: M.A. Putanov, M.M. Sokolova, P.I. Lenkin, V.Yu. Slastilin, I.G. Baskakova, A.N. Kiriluk, D.N. Kazarinov, K.M. Checkaya, T.S. Isakova, M.A. Rumyanceva, M.Yu. Kirov

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Breastfeeding Training through Role-Play and Effects on Mother-infant Attachment Behaviours: A Randomised Controlled Trial

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/6232 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Farokh Saljughi ◽

Mitra Savabi-Esfahani ◽

Shahnaz Kohan ◽

Soheila Ehsanpour

Keyword(s):

Pregnant Women ◽

Maternal Employment ◽

Controlled Trial ◽

Role Play ◽

Intervention Group ◽

Control Group ◽

Maternal Behaviour ◽

Infant Attachment ◽

Significant Difference ◽

History Of

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.

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