The Role of Probiotics in Inflammatory Responses of Critically-Ill Burn Patients (A Randomized Clinical Trial)

Objective. Although the role of oxidative stresses has been confirmed in the pathophysiology of allergic rhinitis and the protective effect of silymarin against oxidative stresses has been proven in different organs, no study has yet been conducted on the impact of silymarin on allergic rhinitis treatment. Study Design. A randomized clinical trial study. Setting. Two tertiary referral centers with otorhinolaryngology–head and neck surgery and allergy and immunology departments. Patients and Methods. In a randomized clinical trial, 94 patients with the signs and symptoms of allergic rhinitis and a positive skin prick test were selected and randomly divided into 2 groups. Their signs and symptoms, eosinophil percentage on nasal smear, serum IgE, and interleukin (IL-4, IL-5, interferon-γ) levels were recorded. The study group was treated with silymarin, whereas the control group received placebo, both for 1 month, along with routine antihistamine treatment. At the end of the treatment course, clinical and laboratory findings were statistically analyzed. Results. Sixty patients completed the trial. Based on the Sino-Nasal Outcome Test 20 (SNOT-20), a significant improvement in clinical symptom severity was observed in both groups (9.23 ± 5.14 vs 2.20 ± 2.69; P < .001), which was statistically significantly higher in the study group ( P < .001). Posttreatment percentage of nasal eosinophils and cytokine levels showed no significant difference ( P > .05). Rise in serum IgE level was seen after treatment with silymarin ( P = .003). Conclusion. Considering the statistically effective role of silymarin in alleviating the severity of allergic rhinitis symptoms, applying this herbal antioxidant along with other medications may result in better management.

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Trisodium citrate 4% versus heparin as a catheter lock for non-tunneled hemodialysis catheters in critically ill patients: a multicenter, randomized clinical trial

Annals of Intensive Care ◽

10.1186/s13613-019-0553-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 5

Author(s):

Jean-Pierre Quenot ◽

◽

Julie Helms ◽

Abderrahmane Bourredjem ◽

Auguste Dargent ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Critically Ill ◽

Critically Ill Patients ◽

Trisodium Citrate ◽

Catheter Lock

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Role of vitamin D in oxidative stress modulation in end‐stage renal disease patients: A double‐blind randomized clinical trial

Hemodialysis International ◽

10.1111/hdi.12849 ◽

2020 ◽

Vol 24 (3) ◽

pp. 367-373

Author(s):

Leila Malekmakan ◽

Zeinab Karimi ◽

Afshin Mansourian ◽

Maryam Pakfetrat ◽

Jamshid Roozbeh ◽

...

Keyword(s):

Oxidative Stress ◽

Clinical Trial ◽

Vitamin D ◽

Renal Disease ◽

Randomized Clinical Trial ◽

End Stage Renal Disease ◽

Double Blind ◽

Stage Renal Disease ◽

End Stage

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The host response to infection in the critically ill

10.1093/med/9780199600830.003.0303 ◽

2016 ◽

Author(s):

W. Joost Wiersinga ◽

Tom van der Poll

Keyword(s):

Critically Ill ◽

Host Response ◽

Inflammatory Responses ◽

Coagulation Cascade ◽

Microbial Infection ◽

Pathogen Invasion ◽

New Therapeutic Approaches ◽

Microbial Invasion ◽

Molecular Patterns

Infection continues to be a leading cause of intensive care unit death. The host response to infection can be seen as a pattern recognition receptor (PRR)-mediated dysregulation of the immune system following pathogen invasion in which a careful balance between inflammatory and anti-inflammatory responses is vital. A measured and rapid response to microbial invasion is essential to health. The same immunological and coagulation systems that protect against localized infection can act to our disadvantage when these systems are activated systemically during generalized microbial infection. Toll-like receptors (TLR), the inflammasomes and other PRRs initiate the host response after recognition of pathogen-associated-molecular-patterns (PAMPs) or endogenous danger-associated-molecular-patterns (DAMPs). The systemic host response to infection will result in activation of coagulation, downregulation of physiological anticoagulant mechanisms, and inhibition of fibrinolysis. Further dissection of the role of host–pathogen interactions, the cytokine response, the coagulation cascade and their multidirectional interactions in sepsis should lead towards the development of new therapeutic approaches in the critically ill who are faced with infection.

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The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial

Critical Care Research and Practice ◽

10.1155/2018/3712067 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Wesley Henrique Bueno de Camargo ◽

Rita de Cassia Pereira ◽

Marcos T. Tanita ◽

Lidiane Heko ◽

Isadora C Grion ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Critically Ill ◽

Critically Ill Patients ◽

Intervention Group ◽

Control Group ◽

Support Surface ◽

Intention To Treat ◽

Support Surfaces ◽

Effect Of Support

Purpose. To analyze whether a viscoelastic mattress support surface can reduce the incidence of stage 2 pressure injuries compared to a standard hospital mattress with pyramidal overlay in critically ill patients. Method. A randomized clinical trial with intention-to-treat analysis was carried out recruiting patients with Braden scale ≤14 on intensive care unit admission from April 2016 to April 2017. Patients were allocated into two groups: intervention group (viscoelastic mattress) and control group (standard mattress with pyramidal overlay). The level of significance adopted was 5%. Results. A total of 62 patients were included in the study. There was a predominance of males (53%) and the mean age was 67.9 (SD 18.8) years. There were no differences in clinical or severity characteristics between the patients in the control group and the intervention group. Pressure injuries occurred in 35 patients, with a median time of 7 days (ITQ 4–10) from admission. The frequency of pressure injuries was higher in the control group (80.6%) compared to the intervention group (32.2%; p<0.001). Conclusions. Viscoelastic support surfaces reduced the incidence of pressure injuries in moderate or higher risk critically ill patients when compared to pyramidal support surfaces.

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