scholarly journals A Randomized Comparison of Non-Channeled GlidescopeTM Titanium Versus Channeled KingVisionTM Videolaryngoscope for Orotracheal Intubation in Obese Patients with BMI > 35 kg·m−2

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1024
Author(s):  
Tomas Brozek ◽  
Jan Bruthans ◽  
Michal Porizka ◽  
Jan Blaha ◽  
Jitka Ulrichova ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Primary Outcome ◽  
Orotracheal Intubation ◽  
Obese Patients ◽  
Success Rates ◽  
Secondary Outcomes ◽  
Postoperative Complaints

Videolaryngoscopes may improve intubating conditions in obese patients. A total of 110 patients with a body mass index > 35 kg∙m−2 were prospectively randomized to tracheal intubation using non-channeled Glidescope Titanium or channeled King Vision videolaryngoscope. The primary outcome was the time to tracheal intubation. Secondary outcomes included: total success rate, number of attempts, the quality of visualization, peri-procedural and post-proceduralcomplications. Time to the first effective breath was shorter with the King Vision (median; 95% CI)—36; 34–39 s vs. 42; 40–50 in the Glidescope group (p = 0.007). The total success rate was higher in the Glidescope group—100% vs. 89.1% (p = 0.03). There was a higher incidence of moderate and difficult laryngoscopy in the King Vision group. No difference was recorded in first attempt success rates, total number of attempts, use of additional maneuvers, intraoperative trauma, or any significant decrease in SpO2 during intubation. No serious complications were noted and the incidence of postoperative complaints was without difference. Although tracheal intubation with King Vision showed shorter time to the first breath, total success was higher in the Glidescope group, and all but one patients where intubation failed with the KingVision were subsequently intubated with the Glidescope.

scholarly journals Maintaining musculoskeletal health using a behavioural therapy approach: a population-based randomised controlled trial (the MAmMOTH Study)

2021 ◽  
pp. annrheumdis-2020-219091 ◽  
Author(s):  
Gary J Macfarlane ◽  
Marcus Beasley ◽  
Neil Scott ◽  
Huey Chong ◽  
Paul McNamee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Primary Outcome ◽  
Population Based ◽  
Behavioural Therapy ◽  
Short Course ◽  
Life Years ◽  
Secondary Outcomes ◽  
Randomised Controlled

ObjectiveCognitive–behavioural therapy (CBT) has been shown to be effective in the management of chronic widespread pain (CWP); we now test whether it can prevent onset among adults at high risk.MethodsA population-based randomised controlled prevention trial, with recruitment through UK general practices. A mailed screening questionnaire identified adults at high risk of CWP. Participants received either usual care (UC) or a short course of telephone CBT (tCBT). The primary outcome was CWP onset at 12 months assessed by mailed questionnaire. There were seven secondary outcomes including quality of life (EuroQol Questionnaire-five dimensions-five levels/EQ-5D-5L) used as part of a health economic assessment.Results996 participants were randomised and included in the intention-to-treat analysis of which 825 provided primary outcome data. The median age of participants was 59 years; 59% were women. At 12 months there was no difference in the onset of CWP (tCBT: 18.0% vs UC: 17.5%; OR 1.05; 95% CI 0.75 to 1.48). Participants who received tCBT were more likely to report better quality of life (EQ-5D-5L utility score mean difference 0.024 (95% CI 0.009 to 0.040)); and had 0.023 (95% CI 0.007 to 0.039) more quality-adjusted life-years at an additional cost of £42.30 (95% CI −£451.19 to £597.90), yielding an incremental cost-effectiveness ratio of £1828. Most secondary outcomes showed significant benefit for the intervention.ConclusionsA short course of tCBT did not prevent onset of CWP in adults at high risk, but improved quality of life and was cost-effective. A low-cost, short-duration intervention benefits persons at risk of CWP.Trial registration numberClinicalTrials.gov Registry (NCT02668003).

Impact of obesity on the clinical outcomes of patients undergoing pacemaker insertion during hospitalization: An analysis of the United States National Inpatient Sample

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Almani ◽  
M Usman ◽  
M Qudrat Ullah ◽  
N Fatima ◽  
M Yousuf ◽  
...  
Keyword(s):  
Heart Failure ◽  
Odds Ratio ◽  
Primary Outcome ◽  
Decompensated Heart Failure ◽  
Obesity Paradox ◽  
Obese Patients ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Secondary Outcomes ◽  
Pacemaker Insertion

Abstract Funding Acknowledgements Type of funding sources: None. 1. Introduction Obesity causes significant cardiovascular morbidity. Nonetheless, there is also evidence supporting obesity paradox particularly in heart failure patients. The impact of obesity on the outcomes of patients undergoing pacemaker insertion is not well studied. 2. Purpose The purpose of this study is to determine if obesity paradox exists for the patients who undergo pacemaker insertion. 3. Methods Data were extracted from the National Inpatient Sample (NIS) 2016 - 2018 Database. The NIS was searched for patients who underwent pacemaker insertion while hospitalized. The patients were divided into two groups based on presence or absence of obesity as secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used to for analysis. 4. Results Of 408,040 patients who underwent pacemaker insertion, 64185 (15.7%) were obese. The adjusted odds ratio for inpatient mortality for obese patient undergoing pacemaker insertion compared to non-obese patients was 0.65 (95% CI 0.516 – 0.821, p < 0.001). Secondary outcomes are listed in table 1. 5. Conclusion Obese patients who underwent pacemaker insertion had lower inpatient mortality compared to non-obese patients. Also, obese patients undergoing pacemaker insertion were less likely to have cardiac arrest but they were more likely to develop decompensated heart failure and acute renal failure compared to non-obese patients. Outcome Without Obesity, % With Obesity, % aOR (95% CI) p-value* Primary outcome In hospital mortality 10.8 7.0 0.65 (0.516 - 0.821) <0.001* Secondary outcomes Length of stay (days), mean 5.7 6.3 0.031 (-0.105 - 0.168) # 0.654 Total hospital charges (US$), mean 121250 134757 720 (-2307 - 3747) # 0.641 Decompensated heart failure 13.3 19.2 1.53 (1.451 - 1.629) <0.001* Cardiogenic shock 2.3 2.7 1.00 (0.883 - 1.141) 0.954 IABP placement 0.5 0.6 0.98 (0.746 - 1.294) 0.898 Cardiac arrest 4.27 4.30 0.83 (0.753 - 0.920) <0.001* Acute renal failure 20.7 25.4 1.17 (1.112 - 1.231) <0.001* Abbreviations: *; statistically significant, #; adjusted mean difference, aOR: adjusted odds ratio, CI: confidence interval, IABP: Intra-aortic balloon pump.Adjusting factors: Age, race, Charlson comorbidity index, primary insurance, median household income for patient’s zip code, location and teaching status of the admitting hospital, dyslipidemia, chronic obstructive pulmonary disease, hypertension, peripheral vascular disease, diabetes mellitus, chronic kidney disease, liver disease and smoking status. Table 1: Clinical outcomes of hospitalizations for pacemaker insertion based on presence or absence of obesity, analysis of United States National Inpatient Sample from 2016 through 2018.

scholarly journals Frailty and the Kidney Transplant Wait List: Protocol for a Multicenter Prospective Study

2020 ◽  
Vol 7 ◽  
pp. 205435812095743
Author(s):  
Karthik K. Tennankore ◽  
Lakshman Gunaratnam ◽  
Rita S. Suri ◽  
Seychelle Yohanna ◽  
Michael Walsh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Transplant ◽  
Repeated Measures ◽  
Primary Outcome ◽  
Frailty Index ◽  
Wait List ◽  
Relative Hazard ◽  
Risk Of Death ◽  
Secondary Outcomes

Background: Understanding how frailty affects patients listed for transplantation has been identified as a priority research need. Frailty may be associated with a high risk of death or wait-list withdrawal, but this has not been evaluated in a large multicenter cohort of Canadian wait-listed patients. Objective: The primary objective is to evaluate whether frailty is associated with death or permanent withdrawal from the transplant wait list. Secondary objectives include assessing whether frailty is associated with hospitalization, quality of life, and the probability of being accepted to the wait list. Design: Prospective cohort study. Setting: Seven sites with established renal transplant programs that evaluate patients for the kidney transplant wait list. Patients: Individuals who are being considered for the kidney transplant wait list. Measurements: We will assess frailty using the Fried Phenotype, a frailty index, the Short Physical Performance Battery, and the Clinical Frailty Scale at the time of listing for transplantation. We will also assess frailty at the time of referral to the wait list and annually after listing in a subgroup of patients. Methods: The primary outcome of the composite of time to death or permanent wait-list withdrawal will be compared between patients who are frail and those who are not frail and will account for the competing risks of deceased and live donor transplantation. Secondary outcomes will include number of hospitalizations and length of stay, and in a subset, changes in frailty severity over time, change in quality of life, and the probability of being listed. Recruitment of 1165 patients will provide >80% power to identify a relative hazard of ≥1.7 comparing patients who are frail to those who are not frail for the primary outcome (2-sided α = .05), whereas a more conservative recruitment target of 624 patients will provide >80% power to identify a relative hazard of ≥2.0. Results: Through December 2019, 665 assessments of frailty (inclusive of those for the primary outcome and all secondary outcomes including repeated measures) have been completed. Limitations: There may be variation across sites in the processes of referral and listing for transplantation that will require consideration in the analysis and results. Conclusions: This study will provide a detailed understanding of the association between frailty and outcomes for wait-listed patients. Understanding this association is necessary before routinely measuring frailty as part of the wait-list eligibility assessment and prior to ascertaining the need for interventions that may modify frailty. Trial Registration: Not applicable as this is a protocol for a prospective observational study.

scholarly journals A Field Vegetable Transplanter for Use in Both Tilled and No-Till Soils

2019 ◽  
Vol 62 (3) ◽  
pp. 593-602 ◽  
Author(s):  
Christian Frasconi ◽  
Luisa Martelloni ◽  
Michele Raffaelli ◽  
Marco Fontanelli ◽  
Lara Abou Chehade ◽  
...  
Keyword(s):  
Success Rate ◽  
Conservation Tillage ◽  
Soil Conditions ◽  
Technical Solution ◽  
Vegetable Crops ◽  
Success Rates ◽  
No Till ◽  
Draft Force ◽  
Actual Field

Abstract. A commercial, manually fed vegetable transplanter was modified and adapted to work in no-till soils. Details of the modifications are described in this article. The aim of this research was to evaluate the performance of this transplanter under actual field conditions in both tilled and no-till soils. The draft force in the no-till soil was measured for different working tools mounted for tilling or loosening a narrow band of soil before passing with the furrower. The combination of a ripper shank opener with a straight nose point resulted in the lowest draft force values per unit of working depth. The transplanter accuracy and transplant success rate were evaluated in different vegetable crops. The accuracy parameters (multiple index, miss index, quality of feed index, and precision) were estimated and in general were similar in the tilled and no-till soils, indicating that the transplanter was able to operate in both soil conditions with the same accuracy. The transplant success rates were also similar in both soil conditions. The transplanter thus offers a satisfactory technical solution for transplanting vegetables in both tilled and no-till soils. Keywords: Conservation tillage, draft force, organic farming, transplanter accuracy, transplant success rate.

scholarly journals Restarting antiplatelet therapy after spontaneous intracerebral hemorrhage

Neurology ◽  
2018 ◽  
Vol 91 (1) ◽  
pp. e26-e36 ◽  
Author(s):  
Ching-Jen Chen ◽  
Dale Ding ◽  
Thomas J. Buell ◽  
Fernando D. Testai ◽  
Sebastian Koch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intracerebral Hemorrhage ◽  
Functional Outcomes ◽  
Primary Outcome ◽  
Modified Rankin Scale ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Secondary Outcomes

ObjectiveTo compare the functional outcomes and health-related quality of life metrics of restarting vs not restarting antiplatelet therapy (APT) in patients presenting with intracerebral hemorrhage (ICH) in the ERICH (Ethnic/Racial Variations of Intracerebral Hemorrhage) study.MethodsAdult patients aged 18 years and older who were on APT before ICH and were alive at hospital discharge were included. Patients were dichotomized based on whether or not APT was restarted after hospital discharge. The primary outcome was a modified Rankin Scale score of 0–2 at 90 days. Secondary outcomes were excellent outcome (modified Rankin Scale score 0–1), mortality, Barthel Index, and health status (EuroQol–5 dimensions [EQ-5D] and EQ-5D visual analog scale scores) at 90 days.ResultsThe APT and no APT cohorts comprised 127 and 732 patients, respectively. Restarting APT was associated with lower rates of good functional outcome (36.5% vs 40.8%; p = 0.021) and lower Barthel Index scores at 90 days (p = 0.041). The 2 cohorts were then matched in a 1:1 ratio, and the matched cohorts each comprised 107 patients. No difference in primary outcome was observed between restarting vs not restarting APT (35.5% vs 43.9%; p = 0.105). There were also no differences between the secondary outcomes of the 2 cohorts.ConclusionRestarting APT in patients with ICH of mild to moderate severity after acute hospitalization is not associated with worse functional outcomes or health-related quality of life at 90 days. In patients with significant cardiovascular risk factors who experience an ICH, restarting APT remains the decision of the treating practitioner.

scholarly journals PROFAST: A Randomized Trial Assessing the Effects of Intermittent Fasting and Lacticaseibacillus rhamnosus Probiotic among People with Prediabetes

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3530
Author(s):  
Audrey Tay ◽  
Hannah Pringle ◽  
Elise Penning ◽  
Lindsay D. Plank ◽  
Rinki Murphy
Keyword(s):  
Weight Loss ◽  
Primary Outcome ◽  
Synergistic Effects ◽  
Gut Hormones ◽  
Group Differences ◽  
Intermittent Fasting ◽  
Psychological Benefits ◽  
Secondary Outcomes ◽  
Double Blinded

Both intermittent fasting and specific probiotics have shown promise in improving glucose tolerance with a potential for synergistic effects through alterations to gut microbiota. In this randomized, double-blinded, two-arm feasibility study, we investigated whether intermittent fasting, supplemented with Lacticaseibacillus rhamnosus HN001 probiotic, reduces HbA1c in individuals with prediabetes. All participants with HbA1c 40–50 mmol/mol commenced intermittent fasting (2 days per week of calorie restriction to 600–650 kcal/day) and were randomized 1:1 to either daily probiotic (Lacticaseibacillus rhamnosus HN001) or placebo for 12 weeks. The primary outcome was a change in HbA1c. Secondary outcomes included changes in anthropometry, body composition, glucoregulatory markers, lipids, hunger hormones, liver enzymes, inflammatory markers, gut hormones, calorie and macronutrient intake, quality of life, hunger, mood and eating behavior. Of 33 participants who commenced the trial, 26 participants (mean age 52 years, body mass index (BMI) 34.7 kg/m2) completed the intervention (n = 11 placebo, n = 15 probiotic). HbA1c decreased from 43 ± 2.7 mmol/mol to 41 ± 2.3 mmol/mol, p < 0.001, with average of 5% weight loss. No significant between-group differences were seen in primary or secondary outcomes except for social functioning (p = 0.050) and mental health (p = 0.007) scores as improvements were seen in the probiotic group, but not in the placebo group. This study shows additional psychological benefits of probiotic supplementation during intermittent fasting to achieve weight loss and glycemic improvement in prediabetes.

scholarly journals Effect of acupuncture on lung cancer-related fatigue: study protocol for a multi-center randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhaoqin Wang ◽  
Shanshan Li ◽  
Luyi Wu ◽  
Qin Qi ◽  
Huirong Liu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Primary Outcome ◽  
Acupuncture Treatment ◽  
Acupuncture Group ◽  
Randomized Controlled ◽  
Link Type ◽  
Cancer Related Fatigue ◽  
Secondary Outcomes

Abstract Background Fatigue is one of the primary symptoms in lung cancer, with a prevalence of 88.0% in survivors of cancer, and an even higher prevalence post resection surgery. Effective fatigue control after lung cancer surgery is important for patient recovery and quality of life. Some studies have shown that acupuncture might be effective in treating cancer-related fatigue; however, randomized controlled trials (RCTs) of suitable sample size are limited. Method/design This is a multi-center, patient-blinded RCT. A total of 320 eligible patients will be recruited in four centers and randomly assigned to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Treatment will be given twice per week for 12 sessions. Treatment will be given at acupoints GV20, GV29, CV12, CV6, CV4, and bilateral LI4, LR3, SP6, ST36. The primary outcome will be assessed using the Chinese version of The Brief Fatigue Inventory. The secondary outcomes will be measured using The European Organization for Research and The Treatment of Cancer Quality of Life Questionnaire, and the Hamilton Rating Scale for Depression. The primary outcome will be assessed at all main points (baseline, the 3rd week, the 6th week, and at follow up time points) and the secondary outcomes will be assessed at baseline and the 6th week. Intention-to-treat analysis will be used in this RCT. Discussion This trial protocol provides an example of the clinical application acupuncture treatment in the management of lung cancer-related fatigue. If the acupuncture treatment protocol confirms that acupuncture is an effective and safe option for lung cancer-related fatigue, it can be adopted as a standardized treatment. Trial registration Chinese Clinical Trial Registry, ChiCTR1900022831. Registered on 27 April 2019. URL: http://www.chictr.org.cn/showproj.aspx?proj=37823

scholarly journals A Randomized Comparison of Bougie-Assisted and TracheoQuick Plus Cricothyrotomies on a Live Porcine Model

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Tomas Henlin ◽  
Pavel Michalek ◽  
Tomas Tyll ◽  
Ondrej Ryska
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Success Rate ◽  
Primary Outcome ◽  
Porcine Model ◽  
Live Animal ◽  
Group Oxygen ◽  
Secondary Outcomes ◽  
Rescue Procedure ◽  
Posterior Tracheal Wall

Objectives. Cricothyrotomy is a rescue procedure in “cannot intubate, cannot oxygenate” scenarios where other methods of nonsurgical airway management have failed. We compared 2 cuffed cricothyrotomy sets, bougie-assisted cricothyrotomy (BACT) and novel percutaneous TracheoQuick Plus, on a live porcine model in a simulated periarrest situation. Methods. Thirty-four anesthetized minipigs were randomly allocated into two groups: BACT technique (n=17) and TracheoQuick Plus (n=17). The primary outcome was duration of cricothyrotomy while secondary outcomes were total success rate, number of attempts, location of incision, changes in heart rate, oxygen saturation, and the incidence of complications. Results. BACT was significantly faster than TracheoQuick Plus cricothyrotomy, with a median time of 69 sec (IQR 56–85) versus 178 sec (IQR 152–272). The total success rate was without difference. 94% of BACT was performed successfully on the first attempt, while in the TracheoQuick Plus group, it was only 18% (P<0.001). Trauma to the posterior tracheal wall was observed once in the BACT group and 5 times in the TracheoQuick Plus group. Oxygen saturation was significantly higher in the BACT group both during and after the procedure. Conclusions. BACT is superior to TracheoQuick Plus cricothyrotomy on a live animal model.

scholarly journals Self-concept in poor readers: a systematic review and meta-analysis

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8772 ◽  
Author(s):  
Genevieve M. McArthur ◽  
Nicola Filardi ◽  
Deanna A. Francis ◽  
Mark E. Boyes ◽  
Nicholas A. Badcock
Keyword(s):  
Systematic Review ◽  
Primary Outcome ◽  
Strong Association ◽  
Physical Appearance ◽  
Self Concept ◽  
Poor Reading ◽  
Quality Of Evidence ◽  
Secondary Outcomes ◽  
Meta Analyses

Background The aims of this systematic review and meta-analyses were to determine if there is a statistically reliable association between poor reading and poor self-concept, and if such an association is moderated by domain of self-concept, type of reading impairment, or contextual factors including age, gender, reading instruction, and school environment. Methodology We searched 10 key databases for published and unpublished studies, as well as reference lists of included studies, and studies that cited included studies. We calculated standardised mean differences (SMDs) and 95% confidence intervals for one primary outcome (average self-concept) and 10 secondary outcomes (10 domains of self-concept). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. Results Thirteen studies with 3,348 participants met our selection criteria. Meta-analyses revealed statistically significant SMDs for average self-concept (−0.57) and five domains of self-concept (reading/writing/spelling: −1.03; academic: −0.67; math: −0.64; behaviour: −0.32; physical appearance: −0.28). The quality of evidence for the primary outcome was moderate, and for secondary outcomes was low, due to lack of data. Conclusions These outcomes suggest a probable moderate association between poor reading and average self-concept; a possible strong association between poor reading and reading-writing-spelling self-concept; and possible moderate associations between poor reading and self-concept in the self-concept domains of academia, mathematics, behaviour, and physical appearance.

scholarly journals Use of Virtual Reality to Improve the Quality of the Hospital Stay for Patients in Neurosurgery

2021 ◽  
Vol 2 ◽  
Author(s):  
Pia Vayssiere ◽  
Paul E. Constanthin ◽  
Nalla Silva Baticam ◽  
Bruno Herbelin ◽  
Christine Degremont ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Statistical Difference ◽  
Primary Outcome ◽  
Pain Reduction ◽  
Anxiety Management ◽  
Positive Effects ◽  
Duration Of Hospitalization ◽  
Secondary Outcomes ◽  
Simple Spine

Background: Virtual Reality (VR) technologies have numerous beneficial applications for patients during hospitalization (through complete immersion in a virtual, distant place allowing to “escape” from the context of hospitalization). Their positive effects in pain and anxiety management, neurorehabilitation and psychotherapy have been demonstrated. Here, we evaluated the effects of VR on the quality of hospitalization and postoperative pain after neurosurgery.Methods: Patients hospitalized in our department between 2019 and 2020 were prospectively enrolled and divided into a group that received a personal, 30-minutes-long, VR session using an Oculus Go ™ VR headset (VR group) or not (non-VR group). Surgeries were classified in simple or complex spinal and simple or complex cranial. Patient‘s overall satisfaction was considered as primary outcome, with secondary outcomes encompassing duration of hospitalization, pain reduction and patients’ opinion regarding VR.Results: 161 patients were enrolled (77 in the VR group and 84 in the non-VR group). There was no statistical difference between the two groups regarding satisfaction. The VR group presented with a significantly longer duration of hospitalization and higher maximal pain. Interestingly, pain reduction during hospitalization was significantly higher in the VR group, particularly in simple surgeries and spine surgeries. A vast majority of the VR group patients appreciated their VR experience (89.2%) and advocated for its systematic use (83.8%).Conclusion: VR can improve pain reduction during hospitalization after neurosurgery, particularly for simple spine surgeries. Furthermore, patients experiencing VR appear to appreciate it and advocate for its systematic use in neurosurgery. Further research is warranted to identify patients for whom addition of VR during hospitalization might bring the most benefit.

Sign in / Sign up

Export Citation Format

Share Document