scholarly journals Treatment with Oral Ondansetron for Ultramarathon-Associated Nausea: The TOO FUN Study

Sports ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 35
Author(s):  
Andrew V. Pasternak ◽  
David Fiore ◽  
Arthur Islas ◽  
Sarah Toti ◽  
Martin D. Hoffman
Keyword(s):  
Online Survey ◽  
Previous History ◽  
Medication Use ◽  
Nausea And Vomiting ◽  
Small Study ◽  
Group Differences ◽  
Double Blind ◽  
History Of ◽  
Study Participants ◽  
Oral Ondansetron

Nausea and vomiting are common for runners during ultramarathons and often contribute to non-finishes. We aimed to determine the efficacy of ondansetron, a commonly used antiemetic, to treat nausea and vomiting in runners during an ultramarathon. Runners who had a previous history of frequent nausea or vomiting during races and entered in 160, 80, and 55 km ultramarathons in 2018 and 2019 were randomized in a double-blind fashion to 4 mg ondansetron or placebo capsules to use if they developed nausea or vomiting during the race with the ability to take three additional doses. Study participants completed a post-race online survey to assess medication use and efficacy. Of 62 study participants, 31 took either ondansetron (20) or placebo (11). In this small study, there were no group differences in those reporting any improvement in nausea and vomiting (p = 0.26) or in the amount of improvement (p = 0.15). We found no evidence that ondansetron capsules improve nausea and vomiting during ultramarathons.

scholarly journals Unusual experiences and their association with metacognition: investigating ASMR and Tulpamancy

2021 ◽  
Author(s):  
Emma Claire Palmer-Cooper ◽  
Abigail Christine Wright ◽  
Nicola McGuire
Keyword(s):  
Clinical Population ◽  
Group Differences ◽  
Sense Making ◽  
Self Reflection ◽  
Sensory Experiences ◽  
Cognitive Insight ◽  
Metacognitive Beliefs ◽  
History Of ◽  
Study Participants ◽  
Clinical Populations

Background: Unusual experiences in Tulpamancer and Autonomous Sensory Meridian Response (ASMR) communities are generally positive and sought after, unlike hallucinations and delusions in clinical populations. Metacognition, the ability to reflect on self-referential experiences, may aid sense-making around unusual experiences, reducing distress. This study investigated group differences in hallucination-proneness, delusion-proneness, and metacognition in these communities compared to controls, and whether metacognition predicted unusual experiences. Methods: 243 participants reporting ASMR, Tulpamancy, or neither, with no history of psychosis, took part in an online observational study. Participants completed the Beck Cognitive Insight Scale, Metacognitions Questionnaire-30, and Brief Core Schema Scales to capture metacognition. A Tulpamancer+ (reporting ASMR) group was identified and included in analyses. ANCOVAs highlighted group differences in hallucination-proneness, with Tulpamancer+ scoring higher, and metacognitive beliefs, with Tulpamancers reporting lower metacognitive belief endorsement. There were no group differences in delusion-proneness, self-reflection, or self-schemas. Stepwise regression demonstrated metacognition does influence unusual experiences in the non-clinical population, and this influence varies across groups. Conclusions: In non-clinical populations, unusual sensory experiences are not associated with increased metacognitive beliefs, but having multiple unusual experiences is associated with higher hallucination-proneness. Results suggest improving metacognition in clinical groups may help reduce distress related to unusual sensory experiences.

scholarly journals Revaccination following suspected vaccine triggered hypersensitivity reactions: experience of a tertiary care centre

2021 ◽  
Vol 49 (1) ◽  
pp. 128-134
Author(s):  
Aysegul Ertugrul ◽  
Ozlem Cavkaytar ◽  
Ilknur Bostanci ◽  
Serap Ozmen
Keyword(s):  
Tertiary Care ◽  
Previous History ◽  
Atopic Disease ◽  
Hypersensitivity Reactions ◽  
Tertiary Care Centre ◽  
Provocation Tests ◽  
History Of ◽  
Study Participants ◽  
Actual Vaccine ◽  
Paediatric Allergy

Introduction and objectives: Suspected hypersensitivity reactions (HRs) associated with vaccines are frequently reported, but confirmed cases of vaccine-triggered HRs are rare. Suspected HRs should be distinguished from actual HRs. The aims of this study are to identify the rate of actual vaccine-triggered hypersensitivity in patients who were referred to the paediatric allergy clinic due to a suspected HR and to explore the rate of revaccination in a real clinical setting. Materials and methods: A retrospective study was performed with a group of preschool children who were evaluated by skin and/or provocation tests (PTs) for the suspected HRs following vaccination. Results: A total of 26 paediatric patients (61.5% male; median age 9 months) with a previous history of suspected vaccine-triggered HR were included. In this group, 69.2% and 38.5% of the patients had a pre-existing atopic disease and an immediate reaction (emerging <1 hour after vaccine administration), respectively. Skin rash was the most frequent clinical presentation (96.1%). Vaccine-triggered anaphylaxis was reported in six patients (23.1%). Measles-mumps-rubella was the most frequently suspected vaccine causing HRs. The skin test positivity with the suspected vaccine was 4%, whereas PTs revealed no reaction after reimmunisation in 76.9% (20/26) of the study participants tested. Conclusions: Most incidents of skin rashes after immunisation are not suggestive of actual HRs. The results in the current study showed that the majority of the patients presenting with suspected HRs tolerated revaccination, including those with a previous history of suspected anaphylaxis. Revaccination of these patients is safe with adequate precautions. It is absolutely essential to be equipped for the management of anaphylaxis.

scholarly journals Predictors of healthcare worker burnout during the COVID-19 pandemic

2020 ◽  
Author(s):  
Amy V Ferry ◽  
Ryan Wereski ◽  
Fiona E Strachan ◽  
Nicholas L Mills
Keyword(s):  
Healthcare Worker ◽  
Online Survey ◽  
Previous History ◽  
Multivariate Logistic Regression Analysis ◽  
Primary Outcome Measure ◽  
General Anxiety ◽  
Patient Health ◽  
History Of ◽  
Anxiety Depression ◽  
History Of Depression

Objective We aim to provide a snapshot of the levels of burnout, anxiety, depression and distress among healthcare workers during the COVID-19 pandemic. Design, setting, participants We distributed an online survey via social media in June 2020 that was open to any healthcare worker. The primary outcome measure was symptoms of burnout as measured using the Copenhagen Burnout Inventory (CBI). Secondary outcomes of depression, anxiety and distress as measured using the Patient Health Questionnaire-9, General Anxiety Scale-7, and Impact of Events Scale-Revised were recorded along with subjective measures of stress. Multivariate logistic regression analysis was performed to identify factors associated with burnout, depression, anxiety and distress. Results Of 539 persons responding to the survey, 90% were female, and 26% were aged 41-50 years, 53% were nurses. Participants with moderate-to-severe burnout were younger (49% [206/424] versus 33% [38/115] under 40 years, P=0.004), and more likely to have pre-existing comorbidities (21% versus 12%, P=0.031). They were twice as likely to have been redeployed from their usual role (22% versus 11%; adjusted odds ratio [OR] 2.2, 95% confidence interval [CI] 1.5-3.3, P=0.042), or to work in an area dedicated to COVID-19 patients (50% versus 32%, adjusted OR 1.6, 95% CI 1.4-1.8, P<0.001), and were almost 4-times more likely to have previous depression (24% versus 7%; adjusted OR 3.6, 95% CI 2.2-5.9, P=0.012). A supportive workplace team and male sex protected against burnout reducing the odds by 40% (adjusted OR 0.6, 95% CI 0.5-0.7, P<0.001) and 70% (adjusted OR 0.3, 95% CI 0.2-0.5, P=0.003), respectively. Conclusion Independent predictors of burnout were younger staff, redeployment to a new working area, working with patients with confirmed COVID-19 infection, and being female or having a previous history of depression. Evaluation of existing psychological support interventions is required with targeted approaches to ensure support is available to those most at risk.

Aprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with a broad range of moderately emetogenic chemotherapies and tumor types: A randomized, double-blind study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9626-9626
Author(s):  
J. A. Boice ◽  
H. Schmoll ◽  
C. Brown ◽  
A. Taylor
Keyword(s):  
Rescue Medication ◽  
Medication Use ◽  
Complete Response ◽  
Emetogenic Chemotherapy ◽  
Nausea And Vomiting ◽  
Phase Iii ◽  
Double Blind Study ◽  
Double Blind ◽  
Therapy Regimen ◽  
Control Regimen

9626 Background: Aprepitant (A) has been shown in a previous trial to be effective for prevention of chemotherapy-induced nausea and vomiting (CINV) with moderately emetogenic chemotherapy (MEC) in breast cancer patients receiving cyclophosphamide and anthracycline. This study assessed A in patients with a variety of tumors receiving a broad range of MEC regimens. Methods: This Phase III, randomized, gender-stratified, double-blind, trial enrolled female and male patients ≥18 years old with confirmed malignancies naïve to MEC or highly emetogenic chemotherapy and scheduled to receive a single dose of 1 or more MEC agent. Patients received A triple-therapy regimen (A 125 mg, ondansetron [O] 8 mg b.i.d., and dexamethasone [D] 12 mg on Day 1 of chemotherapy, A 80 mg q.d. on Days 2–3) or a control regimen (O 8 mg b.i.d. and D 20 mg on Day 1, and O 8 mg q12h on Days 2–3) all administered orally. Episodes of vomiting, nausea, and rescue medication use were recorded in a patient diary. Tolerability was assessed by physical and lab examinations, and adverse event (AE) reporting. Primary and key secondary efficacy endpoints were proportions of patients with No Vomiting and Complete Response (no vomiting and no rescue medication use), respectively, during the 120 hours postchemotherapy. Results: Among 848 randomized patients, 77% were female while 52, 20, 13, and 5% of patients had breast, colorectal, lung, or ovarian cancer, respectively. Significantly more patients in the A group achieved No Vomiting and Complete Response (a difference of 14.1 &12.4 percentage points vs. control, respectively). The incidences of AEs were generally similar in the aprepitant (61.9%) and control groups (66.5%). Conclusions: The aprepitant regimen provided superior efficacy over the control regimen in the treatment of CINV in a broad range of patients receiving MEC in both No Vomiting and Complete Response endpoints. Aprepitant was generally well tolerated. [Table: see text] [Table: see text]

scholarly journals Who chooses to enroll in a new national gambling self-exclusion system? A general population survey in Sweden

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
A. Håkansson ◽  
V. Henzel
Keyword(s):  
Logistic Regression ◽  
Psychological Distress ◽  
Problem Gambling ◽  
Online Survey ◽  
Previous History ◽  
Moderate Risk ◽  
Addictive Disorders ◽  
Problem Gamblers ◽  
Younger Age ◽  
History Of

Abstract Background Self-exclusion from gambling is a common method for prevention and harm reduction in hazardous gambling. However, few national self-exclusion programs, involving a large number of gambling operators and activities in a country, have been assessed scientifically. This study aimed to examine characteristics of individuals who chose to enroll in a recently introduced (January, 2019) national self-exclusion system in Sweden. Methods Adults and adolescents (from age 16 and above) were addressed with an online survey sent to members of the web panel of a market survey company (1940 respondents). Psychological distress, previous history of addictive disorders, sociodemographic data, and recent history of gambling patterns and over-indebtedness were recorded. Logistic regression tested associations with self-exclusion, with unadjusted analyses conducted for the sub-group of moderate-risk or problem gamblers. Results Four percent reported having self-excluded using the new national self-exclusion system. In logistic regression, self-exclusion was significantly associated with younger age (OR 0.65 [0.54–0.79] for increasing age groups) and with the highest level of problem gambling (OR 2.84 [1.10–7.37]). In moderate-risk or problem gamblers, in unadjusted analyses, younger age (p < 0.05) and psychological distress (p = 0.02) were associated with self-exclusion. In none- or low-risk gamblers, 3% had self-excluded, which was significantly associated with younger age (p < 0.001) and self-reported over-indebtedness (p < 0.001). Conclusions In a national, multi-venue online and land-based self-exclusion system, aiming to reduce the harm of problem gambling, self-exclusion is expectedly more common in problem gamblers, but also occurs among people without recent gambling problems. Further efforts may be needed in order to increase gambling self-exclusion in problem gamblers, and research in reasons for self-excluding, even in non-problem gamblers, is needed.

Effect of Fenticonazole in Vaginal Candidiasis: A Double-Blind Clinical Trial versus Clotrimazole

1986 ◽  
Vol 14 (6) ◽  
pp. 306-310 ◽  
Author(s):  
Earl Brewster ◽  
Piero Monici Preti ◽  
Ralf Ruffmann ◽  
John Studd
Keyword(s):  
Clinical Trial ◽  
Previous History ◽  
Vaginal Candidiasis ◽  
Control Group ◽  
Apparent Difference ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
Antimycotic Activity ◽  
Objective Evidence ◽  
History Of

Fenticonazole is an imidazole derivative which possesses a broad spectrum antimycotic activity, including activity against Candida albicans. Its therapeutic activity and tolerability have been evaluated, in a double-blind clinical trial versus clotrimazole, in 54 patients affected by mycologically confirmed symptomatic vaginal candidiasis. Both drugs were administered intravaginally as a cream once a day for 7 days. Assessment was by laboratory mycological investigations and symptomatic evaluation. Patients ‘cured’ at the end of the trial were re-evaluated after 4–6 weeks for possible relapses. Both treatments resulted in a progressive, statistically significant reduction in vaginal symptoms (itching and discharge) and in elimination of Candida in more than 95% of patients. When ‘cured’ patients were reassessed 4–6 weeks after therapy, relapses occurred in four patients after fenticonazole treatment, but in none following clotrimazole treatment. This apparent difference between treatments is far from being statistically significant and, therefore, may have been a chance occurrence. It should also be noted that patients from the fenticonazole group had a previous history of significantly more frequent episodes of candidiasis suggesting that they may have been at greater risk of re-infection than patients from the control group. The tolerance of both treatments was excellent since no local or systemic signs or symptoms of toxicity were reported. An equally high efficacy and safety for both drugs in the elimination of symptoms and objective evidence of vaginal candidiasis is indicated.

Coping Processes and Behavioral Outcomes in Children of Divorce

1995 ◽  
Vol 11 (1) ◽  
pp. 52-64 ◽  
Author(s):  
Linda Kurtz
Keyword(s):  
Coping Strategies ◽  
Problem Behaviors ◽  
Behavioral Outcomes ◽  
Previous History ◽  
Marital Disruption ◽  
Maladaptive Behavior ◽  
Group Differences ◽  
Coping Processes ◽  
History Of ◽  
Children's Coping

This investigation comparatively examines coping strategies and maladaptive behavior in elementary schoolchildren who have experienced parental divorce and their peers from nondivorced families. A sample of 122 elementary school children and their parents participated in this study. Half the sample was from families where marital disruption had occurred, and the remainder was from homes with no previous history of marital separation. Although children from the two family configurations demonstrated differences in problem behaviors, no significant between-group differences with respect to children's coping strategies were noted. The frequency and effectiveness of children's coping strategies were found to vary as a function of the time since marital disruption.

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