Efficacy of epinephrine and diphenhydramine rinses in decreasing local reactions to subcutaneous aeroallergen immunotherapy

2020 ◽  
Vol 41 (1) ◽  
pp. 52-58
Author(s):  
S. Shahzad Mustafa ◽  
Karthik Vadamalai ◽  
Theresa Bingemann ◽  
Allison Ramsey
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Subcutaneous Immunotherapy ◽  
Effective Strategy ◽  
Dosing Schedule ◽  
Patients Âgés ◽  
Oral Antihistamine ◽  
Local Reactions ◽  
Single Blind

Background: Although local reactions (LR) to subcutaneous immunotherapy (SCIT) occur in 26‐86% of patients, there are no well-studied strategies to manage LRs. Objective: To complete a prospective, randomized, single-blind, controlled trial that compared pre-rinsing SCIT syringes with diphenhydramine, epinephrine, or placebo in patients who were receiving aeroallergen SCIT and experiencing LRs despite pretreatment with an antihistamine. Methods: Patients ages ≥5 years who were receiving aeroallergen SCIT per a conventional dosing schedule and who were experiencing LRs despite premedicating with an oral antihistamine were randomized to diphenhydramine, epinephrine, or placebo rinse, and were followed up for three subsequent visits. At each visit, the patients were asked (yes or no) if LRs improved. Results: A total of 490 patients were enrolled in the study. Seventy-four of the 490 patients (15.1%) experienced an LR despite pretreatment with an oral antihistamine and were randomized into an intervention group. At visit 1, an epinephrine rinse was strongly associated with decreasing LR compared with both diphenhydramine rinse and placebo (p < 0.001). There was no difference among the intervention groups at visits 2 and 3. In patients who reported a consistent outcome at all three visits, the epinephrine rinse was significantly associated with a decrease in LR compared with both diphenhydramine rinse and placebo rinse (p = 0.05). Conclusion: In patients who received aeroallergen SCIT per a conventional dosing schedule, an epinephrine rinse significantly decreased LR at the first visit, and also within a population that reported a consistent outcome at all three study visits. In patients already premedicating with an oral antihistamine, adding an epinephrine rinse is a safe and effective strategy to decrease LRs to aeroallergen SCIT.

scholarly journals DREAMS-START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives) for people with dementia and sleep disturbances: a single-blind feasibility and acceptability randomized controlled trial

2018 ◽  
Vol 31 (2) ◽  
pp. 251-265 ◽  
Author(s):  
Gill Livingston ◽  
Julie A. Barber ◽  
Kirsi M. Kinnunen ◽  
Lucy Webster ◽  
Simon D. Kyle ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Light Exposure ◽  
Controlled Trial ◽  
Intervention Group ◽  
Pharmacological Therapy ◽  
Post Intervention ◽  
Night Time ◽  
People With Dementia ◽  
Single Blind

ABSTRACTBackground:40% of people with dementia have disturbed sleep but there are currently no known effective treatments. Studies of sleep hygiene and light therapy have not been powered to indicate feasibility and acceptability and have shown 40–50% retention. We tested the feasibility and acceptability of a six-session manualized evidence-based non-pharmacological therapy; Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS-START) for sleep disturbance in people with dementia.Methods:We conducted a parallel, two-armed, single-blind randomized trial and randomized 2:1 to intervention: Treatment as Usual. Eligible participants had dementia and sleep disturbances (scoring ≥4 on one Sleep Disorders Inventory item) and a family carer and were recruited from two London memory services and Join Dementia Research. Participants wore an actiwatch for two weeks pre-randomization. Trained, clinically supervised psychology graduates delivered DREAMS-START to carers randomized to intervention; covering Understanding sleep and dementia; Making a plan (incorporating actiwatch information, light exposure using a light box); Daytime activity and routine; Difficult night-time behaviors; Taking care of your own (carer's) sleep; and What works? Strategies for the future. Carers kept their manual, light box, and relaxation recordings post-intervention. Outcome assessment was masked to allocation. The co-primary outcomes were feasibility (≥50% eligible people consenting to the study) and acceptability (≥75% of intervention group attending ≥4 intervention sessions).Results:In total, 63out of 95 (66%; 95% CI: 56–76%) eligible referrals consented between 04/08/2016 and 24/03/2017; 62 (65%; 95% CI: 55–75%) were randomized, and 37 out of 42 (88%; 95% CI: 75–96%) adhered to the intervention.Conclusions:DREAM-START for sleep disorders in dementia is feasible and acceptable.

Reducing Children’s Preoperative Fear with an Educational Pop-up Book: A Randomized Controlled Trial

2021 ◽  
pp. 019459982110531
Author(s):  
Holly Cordray ◽  
Chhaya Patel ◽  
Kara K. Prickett
Keyword(s):  
Randomized Controlled Trial ◽  
Coping Strategies ◽  
Outpatient Surgery ◽  
Controlled Trial ◽  
Intervention Group ◽  
Anesthesia Induction ◽  
Patients Âgés ◽  
Randomized Controlled ◽  
Positive Coping ◽  
And Coping

Objective Preoperative education empowers children to approach surgery with positive expectations, and providers need efficient, child-focused resources. This study aimed to evaluate an interactive pop-up book as a tool for explaining surgery, managing preoperative anxiety, and strengthening coping strategies. Study Design Prospective randomized controlled trial. Setting Pediatric outpatient surgery center. Methods Patients ages 5 to 12 undergoing outpatient surgery read a pop-up book about anesthesia (intervention) or received standard care (control). Patients self-reported their preoperative fear, pain expectations, views of the procedure and preoperative explanations, and coping strategies. Outcomes also included observer-rated behavioral anxiety and caregiver satisfaction. Results In total, 148 patients completed the study. The pop-up book had a significant, large effect in reducing patients’ fear of anesthesia induction (Cohen’s d effect size = 0.94; P < .001). Intervention patients also expected less pain than control patients from the anesthesia mask and during surgery ( d = 0.60-0.80; P < .001). The book encouraged more positive views of the procedure and preoperative explanations ( P < .005). Furthermore, the book prepared patients to cope adaptively: intervention patients were significantly more likely to generate positive active coping strategies, distraction strategies, and support-seeking strategies ( P < .001). Observer-rated behavioral anxiety at anesthesia induction did not differ between groups ( P = .75). Caregivers in the intervention group were significantly more satisfied with each aspect of the surgical experience ( P≤ .02). Conclusion The educational pop-up book offers a child-focused resource that helps alleviate children’s preoperative fears, encourages positive coping, and improves caregivers’ perceptions of the experience. This study was registered at ClinicalTrials.gov (NCT04796077).

Meridian Cuffing Exercises Improved Functional Fitness and Cardiopulmonary Functioning of Community Older Adults

2018 ◽  
Vol 29 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hsiao-Ting Tung ◽  
Chi-Chieh Lai ◽  
Kuei-Min Chen ◽  
Han-Ya Tsai
Keyword(s):  
Older Adults ◽  
Community Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Functional Fitness ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
Study Intervention ◽  
Single Blind

This study was aimed to test the effects of a meridian cuffing exercise, the Healthy Beat Acupunch (HBA) regimen, on the functional fitness and cardiopulmonary functioning of community older adults. A single-blind, cluster randomized controlled trial was conducted. We randomly allocated eight community care centers to the intervention or control group and recruited 228 participants who completed the study (intervention: four centers, n = 111; control: four centers, n = 117). The intervention group underwent a 40-min session of HBA regimen 3 times per week for 6 months. Functional fitness and cardiopulmonary functioning were assessed at baseline, 3 months, and 6 months of the intervention. The intervention group demonstrated significantly greater improvements in functional fitness and cardiopulmonary functioning than the control group between baseline and either 3 months or 6 months. We suggest that activities designed to promote health among community older adults include acupunch exercises.

Effect of acupressure on post tonsillectomy pain in adolescents: a randomized, single-blind, placebo-controlled trial study

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Somaye Pouy ◽  
Abolfazl Etebarian Khorasgani ◽  
Ali Azizi-Qadikolaee ◽  
Yasaman Yaghobi
Keyword(s):  
Pain Control ◽  
Controlled Trial ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
Significant Difference ◽  
The World ◽  
Before And After ◽  
Positive Effect ◽  
Single Blind

Abstract Introduction Tonsillectomy is one of the most common pediatric surgeries in the world and pain control following tonsillectomy is very important. Objective The aim of this study is to investigate the effect of acupressure on the amount of pain following tonsillectomy in children. Method One hundred and forty-four children aged 5–12 years old were assigned into one of three groups: interventions, control and placebo. In the intervention group, acupressure was applied at three acupoints and in the placebo group, sham acupressure was applied. In the control group routine care only was applied. Results There was a significant difference between an average of changes in pain score before and after the intervention during the 3 time periods after the tonsillectomy operation in the acupressure group (p = 0.002). Conclusion The results showed that acupressure had a positive effect on pain reduction after tonsillectomy in children in the intervention group.

Effect of Rosuvastatin in Preventing Chemotherapy-Induced Cardiotoxicity in Women With Breast Cancer: A Randomized, Single-Blind, Placebo-Controlled Trial

2019 ◽  
Vol 24 (3) ◽  
pp. 233-241 ◽  
Author(s):  
Maryam Nabati ◽  
Ghasem Janbabai ◽  
Jamil Esmailian ◽  
Jamshid Yazdani
Keyword(s):  
Breast Cancer ◽  
Placebo Group ◽  
Controlled Trial ◽  
Intervention Group ◽  
Tissue Doppler ◽  
Chemotherapeutic Agents ◽  
Left Ventricular ◽  
Significant Difference ◽  
To Receive ◽  
Single Blind

Objective: Chemotherapy-induced cardiotoxicity is a major and leading cause of death in breast cancer survivors. It can present decades after chemotherapy and can manifest in different ways; some chemotherapeutic agents have a powerful dose-dependent relationship with cardiotoxicity. The aim of this study was to investigate the effect of rosuvastatin on preventing chemotherapy-induced cardiotoxicity in patients with breast cancer. Methods: Our study was a randomized, single-blind, placebo-controlled trial that involved 89 women with newly diagnosed breast cancer who were scheduled to receive chemotherapy. Patients were randomly assigned to receive rosuvastatin or a placebo in a 1:1 ratio for 6 months. Echocardiography, using 2-dimensional (2D) Doppler, tissue Doppler, and speckle-tracking methods, was used to determine the absolute changes in the left ventricular systolic ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial (LA) diameter, transmitral Doppler early diastolic velocity (E wave), tissue Doppler early diastolic (e′) and peak systolic (s′) mitral annular velocities, E/e′ ratio, and global longitudinal systolic strain. Results: The LVEF was significantly reduced in the placebo group at the end of the study when compared with the baseline value. However, there was no significant difference in the LVEF in the intervention group (intergroup P = .012). Furthermore, compared with the intervention group at the end of the study, there was a significant increase in the 4- and 2-chamber LVESV, LA diameter, and E/e′ ratio in the placebo group (intergroup P = .019, P = .024, P < .001, and P = .021, respectively) and a significant decrease in the e′ and s′ velocities in the placebo group (intergroup P < .001 and P < .006, respectively). Conclusions: The present study showed that the prophylactic use of rosuvastatin may prevent the development of chemotherapy-induced cardiotoxicity.

scholarly journals After Partial Knee Replacement, Patients Can Kneel, But They Need to Be Taught to Do So: A Single-Blind Randomized Controlled Trial

2008 ◽  
Vol 88 (9) ◽  
pp. 1012-1021 ◽  
Author(s):  
Cathy Jenkins ◽  
Karen L Barker ◽  
Hemant Pandit ◽  
Christopher AF Dodd ◽  
David W Murray
Keyword(s):  
Randomized Controlled Trial ◽  
Physical Therapy ◽  
Knee Replacement ◽  
Controlled Trial ◽  
Intervention Group ◽  
Oxford Knee Score ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Partial Knee Replacement ◽  
Single Blind

Background and Purpose Kneeling is an important functional activity frequently not performed after knee replacement, thus affecting a patient's ability to carry out basic daily tasks. Despite no clinical reason preventing kneeling, many patients fail to resume this activity. The purpose of this study was to determine whether a single physical therapy intervention would improve patient-reported kneeling ability following partial knee replacement (PKR). Subjects Sixty adults with medial compartment osteoarthritis, suitable for a PKR, participated. Methods This was a single-blind, prospective randomized controlled trial. Six weeks after PKR, participants randomly received either kneeling advice and education or routine care where no specific kneeling advice was given. Reassessment was at 1 year postoperatively. The primary outcome measure was patient-reported kneeling ability, as assessed by question 7 of the Oxford Knee Score. Other factors associated with kneeling ability were recorded. These factors were scar position, numbness, range of flexion, involvement of other joints, and pain. Statistical analysis included nonparametric tests and binary logistic regression. Results A significant improvement in patient-reported kneeling ability was found at 1 year postoperatively in those participants who received the kneeling intervention. Group allocation was the only factor determining an improvement in patient-reported kneeling ability at 1 year postoperatively. Discussion and Conclusion The single factor that predicted patient-reported kneeling ability at 1 year postoperatively was the physical therapy kneeling intervention given at 6 weeks after PKR. The results of this study suggest that advice and instruction in kneeling should form part of a postoperative rehabilitation program after PKR. The results can be applied only to patients following PKR.

Effectiveness of Wet Cupping on Patients with Facial Acne Vulgaris: A 12-Week, Randomized, Single-Blind, Intervention-Sham-Controlled Trial

2021 ◽  
pp. 1-8
Author(s):  
Fatemeh Tabatabaei ◽  
Mehdi Pasalar ◽  
Haleh Tajadini ◽  
Mohadese Kamali ◽  
Thomas Rampp
Keyword(s):  
Quality Of Life ◽  
Antibiotic Therapy ◽  
Controlled Trial ◽  
Acne Vulgaris ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Single Blind ◽  
Facial Acne

<b><i>Introduction:</i></b> Acne vulgaris is a widespread skin disorder. The aim of this study was to assess the effectiveness of wet cupping in the treatment of moderate to severe facial acne vulgaris. <b><i>Methods:</i></b> Between August 2018 and January 2020, eligible patients with moderate to severe facial acne were recruited in this single-blind, intervention-sham-controlled clinical trial in Iran. The intervention group received wet cupping twice and likewise the control group received sham cupping. Also, both groups received 500 mg azithromycin 3 times/week for 12 weeks. Acne grades were assessed 6 weeks and 12 weeks after beginning of the treatment by the dermatologist uninformed of group allocation and participant self-assessment. Quality of life was assessed with valid questionnaire before and after the treatment. <b><i>Result:</i></b> Totally, 103 patients completed the trial. The patients in the intervention group had better improvement and grade of acne compared to the control group at the end of the trial. Patients showed a shorter time to removing facial lesions in the intervention group in contrast with the control group (<i>p</i> &#x3c; 0.001). Quality of life significantly increased in the intervention group compared with the control group (<i>p</i> = 0.004). <b><i>Conclusion:</i></b> Wet cupping plus antibiotic therapy seems to be more effective than antibiotic therapy per se in patients with facial acne vulgaris.

scholarly journals Evaluation of an Ultrasound-Guided Palpation Intervention for Palpation Skill Training: A Single-Blind, Parallel Group, Randomised Controlled Trial

2021 ◽  
Author(s):  
Takashi Kitagawa ◽  
Yuma Aoki ◽  
Hotaka Sugimoto ◽  
Natsumi Ozaki
Keyword(s):  
Medical Students ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Parallel Group ◽  
Randomised Controlled ◽  
Single Blind

Abstract Although there are increasing reports on the usefulness of sonopalpation with ultrasound imaging, many previous studies have reported interventions without a control group. This single-blind, parallel group randomised controlled trial aimed to determine whether educational instruction with sonopalpation for medical students has a superior effect on skill improvement than traditional instruction without ultrasonography. Twenty-nine medical students participated in the study and were randomised using block randomisation into an ultrasound imaging group (n = 15) and a control group (n = 14). Then, they underwent three training sessions focusing on the shoulder joint. Participants underwent a scoring assessment of their palpation skills at pre-intervention, post-intervention, and follow-up 3 months after training. The raters were blinded to the subjects’ group. The Friedman and Mann–Whitney U tests were used for data analysis. The intervention group showed a significant increase in scores at post-intervention and at the 3-month follow-up when compared with the pre-intervention group (p < 0.05); the effect sizes were large (0.849 and 0.849, respectively). A comparison of the scores at different time points after the intervention at the 3-month follow-up revealed that there was no significant difference between the groups. Education using ultrasound images may improve the sonopalpation skills of medical students.

scholarly journals Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial

2014 ◽  
Vol 204 (6) ◽  
pp. 454-461 ◽  
Author(s):  
Martin Orrell ◽  
Elisa Aguirre ◽  
Aimee Spector ◽  
Zoe Hoare ◽  
Robert T. Woods ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cognitive Stimulation ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Randomised Controlled ◽  
Single Blind ◽  
Pragmatic Randomised Controlled Trial

BackgroundThere is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects.AimsTo evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs).MethodThe participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067).ResultsFor the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer's Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03).ConclusionsContinuing CST improves quality of life; and improves cognition for those taking AChEIs.

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