scholarly journals Comparison of efficacy and safety profiles of epidural analgesia and opioid analgesia in Chinese patients with thoracic trauma: A preliminary report

2021 ◽  
Vol 19 (12) ◽  
pp. 2683-2689
Author(s):  
Xiaoping Yang ◽  
Danjie Zhang ◽  
Deling Kong ◽  
Jin Zhang ◽  
Bingwen Dang
Keyword(s):  
Epidural Analgesia ◽  
Thoracic Trauma ◽  
Rating Scale ◽  
Safety Data ◽  
Chinese Patients ◽  
Opioid Analgesia ◽  
Efficacy And Safety ◽  
Chi Square ◽  
Before And After ◽  
The Difference

Purpose: To compare the efficacy and safety profiles of epidural analgesia (EA) and opioid analgesia (OA) in Chinese patients with thoracic trauma (TT). Methods: Patients with confirmed diagnosis of thoracic trauma were given either EA (via a catheter) or slow-release OA. The following efficacy variables were assessed in the two treatment groups: pain score, and changes in cytokine and catecholamine levels from baseline after treatment. Moreover, respiratory parameters were determined before and after treatment. The safety associated with each anesthesia was also evaluated. Quantitative data were analyzed either with Student’s t-test or MannWhitney test, while  categorical data were analyzed using Fisher exact or Chi-square test, based on data size. Results: A total of 200 patients completed the study (100 patients in each group). Pain, as assessed by verbal rating scale (VRS), was slightly lower in patients after treatment with EA, when compared to the patients treated with OA. However, the difference was not statistically significant (p < 0.05). Maximum inspiratory force (cmH2O) and tidal volume (liters) were slightly improved in patients  treated with EA, when compared to OA-treated patients, although the difference was not statistically significant (p < 0.05). Moreover,  the two treatments produced comparable levels of cytokines and catecholamines. Conclusion: The efficacy and safety data for EA and OA in Chinese non-obese patients with TT indicate numerically favorable outcome for EA, when compared to OA. Keywords: Epidural analgesia, Opioid analgesia, Chinese patients, Thoracic trauma

scholarly journals P023: Code Resus - using a quality improvement approach to improve health care provider response during resuscitations

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S86-S86
Author(s):  
L.B. Chartier ◽  
S. Hansen ◽  
D. Lim ◽  
S. Yi ◽  
B. McGovern ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Providers ◽  
Rating Scale ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Change Initiatives ◽  
Chi Square ◽  
Before And After

Introduction: In order to achieve the best possible outcomes for patients requiring resuscitation (PRRs) in the emergency department (ED), health care providers (HCPs) must provide an efficient, multi-disciplinary and coordinated response. A quality improvement (QI) project was undertaken to improve HCP response to PRRs at two tertiary care hospital EDs in Toronto. Methods: We conducted a before-and-after mixed-method survey to evaluate the perception of the adequacy of HCP response and clarity of HCP role when responding to PRRs. The results were compared using the Chi-square test. Qualitative responses to the first survey were also used to inform the development of the QI project. Through interviews of key stakeholders and with continuous input from front-line ED HCPs, a multi-disciplinary team modified the ED resuscitation protocol. This included standardized pre-hospital communication form with paramedics, ED-wide overhead announcement of ‘Code Resus’, dedicated HCPs assigned to respond to PRRs, and specific duties assigned to each responder. Change initiatives were reinforced through education and posters in the ED. Six months after implementation, a second survey was conducted to evaluate the sustained effects of the intervention. Results: Baseline measures indicated that 16 of 52 (30.8%) nurses surveyed believed their role was often or always apparent to themselves and others when they attended to a PRR (on a 5-point rating scale). This proportion increased to 35 of 55 (63.6%) nurses in the post-implementation survey (p < 0.001). Regarding adequacy of the number of HCPs responding to PRRs, 17 of 39 (43.6%) physicians and 23 of 53 (43.4%) nurses surveyed thought the appropriate number of HCPs responded to PRRs; the remainder thought that there were too few or too many HCPs. In the post-implementation survey, 34 of 41 (82.9%) physicians (p < 0.001) and 36 of 56 (64.3%) nurses (p = 0.029) surveyed felt that the appropriate number of HCPs attended to PRRs. Conclusion: Using a quality improvement approach, we identified and quantified perceived deficiencies in HCP response to PRRs in the ED. Through feedback-based modifications of the ED resuscitation protocol and by engaging HCP stakeholders, change initiatives were implemented to improve HCP response. As a result, this project achieved significant and sustained improvements in HCPs’ perceived response to PRRs.

scholarly journals Efficacy and safety of rasagiline as an adjunct to levodopa treatment in Chinese patients with Parkinson's disease: a randomized, double-blind, parallel-controlled, multi-centre trial

2013 ◽  
Vol 16 (7) ◽  
pp. 1529-1537 ◽  
Author(s):  
Lina Zhang ◽  
Zhiqin Zhang ◽  
Yangmei Chen ◽  
Xinyue Qin ◽  
Huadong Zhou ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Chinese Patients ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Levodopa Treatment ◽  
Parallel Group ◽  
Disease Rating ◽  
Rasagiline Mesylate

Abstract Rasagiline mesylate is a highly potent, selective and irreversible monoamine oxidase type B (MAOB) inhibitor and is effective as monotherapy or adjunct to levodopa for patients with Parkinson's disease (PD). However, few studies have evaluated the efficacy and safety of rasagiline in the Chinese population. This study was designed to investigate the safety and efficacy of rasagiline as adjunctive therapy to levodopa treatment in Chinese PD patients. This was a randomized, double-blind, placebo-controlled, parallel-group, multi-centre trial conducted over a 12-wk period that enrolled 244 PD patients with motor fluctuations. Participants were randomly assigned to oral rasagiline mesylate (1 mg) or placebo, once daily. Altogether, 219 patients completed the trial. Rasagiline showed significantly greater efficacy compared with placebo. During the treatment period, the primary efficacy variable – mean adjusted total daily off time – decreased from baseline by 1.7 h in patients treated with 1.0 mg/d rasagiline compared to placebo (p < 0.05). Scores using the Unified Parkinson's Disease Rating Scale also improved during rasagiline treatment. Rasagiline was well tolerated. This study demonstrated that rasagiline mesylate is effective and well tolerated as an adjunct to levodopa treatment in Chinese PD patients with fluctuations.

Preliminary results of a phase II trial of FOLFOX4 regimen in Chinese patients with unresectable primary liver cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14065-14065 ◽  
Author(s):  
S. K. Qin ◽  
Y. J. Wang ◽  
Q. Wu ◽  
B. C. Xing
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Phase Ii ◽  
Primary Liver Cancer ◽  
Safety Data ◽  
Median Number ◽  
Chinese Patients ◽  
Efficacy And Safety ◽  
Open Label ◽  
Number Of Cycles

14065 Background: Primary liver cancer (PLC) is the 3rd most common cancer in whole China. Development of systemic chemotherapy for the patients not eligible for operation as well as TACE commonly have been required. Oxalipaltin (Eloxatin)+ 5-FU/LV, namely FOLFOX 4 regimen was tried to investigate its efficacy and safety in inoperable PLC. Methods: It was an open-label, single arm and multi-center phase II study to explore RR, DCR,TTP and MST. All the pts had pathologically confirmed inoperable PLC with/without distant metastasis. The pts were treated with the standard FOLFOX 4 regimen, that is OXA 85mg/m2 d1; LV 200mg/m2 IV 2hrs d1,2; 5-FU 400mg/m2 bolus, d1,2 and 5-FU 600mg/m2 CIV 22hrs d1,2; q2w upto 6 cycles or until progression. Tumor evaluation was done every 6 weeks using RECIST criteria. Neurotoxicity was evaluated by Eloxatin specific neurotoxicity criteria (Sanofi-Aventis Co.Ltd) and other toxicities by the NCI CTC AE version 2.0. Results: From July 2004 to Sep. 2005, 27 pts (21 male, 6 female) were recruited from the 4 cancer centers with average age of 56 ±13 years old. 25 patients (92.6%) had hepatocellular carcinoma, and 2 (7.4%) cholangiocellular carcinoma. 15 pts (55.6%) had metastatic disease. 1 pt received liver transplantation before inclusion. The median number of cycles was 4 per pt. 26 pts were evaluable for efficacy and safety. The RR was 19.2% (5/26; 1 CR and 4 PR), and DCR 57.7% (15/26; including 10 SD). 4 of the 5 responsive pts had hepatocellular carcinoma, and 1 had cholangiocarcinoma. Serum AFP level was significantly decreased (mean 131,890.4ug/dl at the baseline and 1,298.6ug/dl after 6 cycles) for the first 16 pts. The first 16 pts’ safety data were available in detail: 11 NCI grade 3/4 events were observed from a total of 76 cycles administered: including 5 neutropenia, 3 leucopenia, 1 thrombocytopenia, 1 infection and 1 liver dysfunction. Grade II & III neurotoxicity was found in 3 & 2 patients respectively. The TTP,MST and further safety data were under follow-up. Conclusions: The preliminary data of the FOLFOX 4 regimen for the advanced Chinese pts with inoperable PLC have shown encouraging results with the better efficacy and favorable safety profile. Further exploration in this area is warranted, especially in hepatocellular carcinoma. No significant financial relationships to disclose.

The Effect of Using an Electric Fan on Dyspnea in Chinese Patients With Terminal Cancer

2016 ◽  
Vol 34 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Sio Leng Wong ◽  
Sok Man Leong ◽  
Cheng Man Chan ◽  
Sut Peng Kan ◽  
Hon Wai Benjamin Cheng
Keyword(s):  
Advanced Cancer ◽  
Large Scale ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Relevant Literature ◽  
Chinese Patients ◽  
Control Group ◽  
Significant Difference ◽  
Before And After ◽  
Experimental Group

Background: Fan therapy is often suggested for relieving the symptom of dyspnea in patients with advanced cancer, but relevant literature among Asians is limited. Objective: Phase 2 clinical trial to assess the clinical feasibility and outcome of using an electric fan to alleviate the symptom of dyspnea in Chinese patients with advanced cancer. Methods: Thirty patients with advanced cancer having unresolved breathlessness were recruited from Hospice and Palliative Care Centre of Kiang Wu Hospital in Macau. Participants were randomly and equally allocated to the experimental group and the control group, respectively. Outcome Measures: Verbal numerical rating scale (NRS) of breathlessness, respiratory rate (RR), and saturation of peripheral oxygen (SpO2) was collected before and after the intervention. Results: T test was used to analyze the data collected. There was a significant difference in the NRS scores of the experimental group ( P < .01), indicating a significant reduction in the patients’ sensation of breathlessness after fan therapy, whereas no significant difference was found in the objective statistic results of RR and SpO2. No significant difference ( P > .05) was found in the control group for all the 3 variables before and after routine treatment. Conclusion: The results of the study suggested that fan therapy could be effective in alleviating dyspnea in Chinese patients with advanced cancer. It should be considered as one of the nonpharmacological treatment option. Future large-scale phase 3 clinical trials are warranted.

scholarly journals Cryotherapy as A Prophylaxis of Mucositis in Children with Cancer Undergoing Chemotherapy at Dr. M. Djamil General Hospital

2021 ◽  
Vol 15 (4) ◽  
pp. 183
Author(s):  
Hidayatul Hasni ◽  
Mayetti Mayetti ◽  
Dwi Novrianda
Keyword(s):  
Intervention Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
Children With Cancer ◽  
Chi Square ◽  
Control Group Design ◽  
Severe Problem ◽  
Oral Cryotherapy ◽  
Before And After ◽  
The Difference

Background: Mucositis is one of the side effects of chemotherapy, which can be a severe problem for children with cancer. Cryotherapy can cause vasoconstriction and decrease blood flow to the oral mucosa, resulting in lower concentrations of chemotherapy agents to prevent mucositis. This study aims at determining the effectiveness of oral cryotherapy as prophylaxis mucositis in children with cancer undergoing chemotherapy.Methods: This quasi-experiment study with a pretest-posttest control-group design involved 45 respondents (22 in the intervention group and 23 in the control group) selected using consecutive sampling. The data collection instrument was the WHO mucositis scale. Results: Of the 45 children undergoing chemotherapy, 24 (53.3%) were of school age, 25 (55.6%) were male, 33 (73.3%) had good nutritional status, and 17 (37.8%) had mild neutropenia before undergoing chemotherapy. All respondents (100%) did not experience mucositis, but after chemotherapy, 9 children (40.9%) in the intervention group had mucositis, and 19 children (82.6%) experienced mucositis in the control group. The data were analyzed using the Wilcoxon test to see the difference between the intervention group and the control group and the Chi-Square test with Yates’s correction to see the effect of cryotherapy on the prevention of mucositis. The results showed that there was a difference in the incidence of mucositis between before and after intervention in the intervention group (p = 0.003) and the control group (p = 0.000), and cryotherapy was effective in preventing mucositis (p = 0.01).Conclusions: Cryotherapy is effective against the prevention of mucositis. Nurses and families need to be able to apply oral cryotherapy and other evidence-based treatment as a method to prevent mucositis 

scholarly journals MERIDIAN: A phase 2, randomized, double-blind, placebo-controlled, multicenter study to evaluate the efficacy and safety of pegcetacoplan in patients with amyotrophic lateral sclerosis

2021 ◽  
Author(s):  
Frederico Mennucci de Haidar Jorge ◽  
Angela Genge ◽  
Ammar Al- Chalabi ◽  
Orla Hardiman ◽  
Alice Shen ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Rating Scale ◽  
Phase 2 ◽  
Efficacy And Safety ◽  
Open Label ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Sporadic Als ◽  
The Difference ◽  
Lateral Sclerosis

Introduction: Inflammation underlies the pathogenesis of numerous neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS). In ALS, the complement system has been implicated in the neuropathology of disease and disease progression. Pegcetacoplan, a subcutaneously administered C3 complement inhibitor, is being investigated in hematology, nephrology, and neurology. The current clinical study (NCT04579666) is investigating whether pegcetacoplan can improve survival and function in people diagnosed with apparent sporadic ALS. Objectives and Methodology: Evaluate the efficacy and safety of pegcetacoplan compared to placebo among people diagnosed with ALS in a global, multicenter, randomized, double-blind, placebo-controlled, phase 2 study. Approximately 228 patients diagnosed with apparent sporadic ALS, ≥18 years of age and with an ALS Functional Rating Scale-Revised (ALSFRS-R) score ≥30, slow vital capacity (SVC) ≥60% of the predicted value at screening, and with symptom onset within 72 weeks before screening, are eligible for enrollment. After screening, patients will be randomized 2:1 to treatment groups receiving either subcutaneous pegcetacoplan (1080 mg) or placebo twice weekly for a duration of 52 weeks. The primary efficacy endpoint is the difference in the Combined Assessment of Function and Survival (CAFS) ranked score at 52 weeks after treatment initiation. Additional, secondary functional efficacy (ALSFRS-R, percent SVC, muscle strength, quality of life, and caregiver burden) and safety endpoints will be analyzed at 52 weeks. After the placebo-controlled period, all patients will have the option to receive pegcetacoplan in an open-label period for an additional 52 weeks. Results: This ongoing study is currently enrolling participants. Conclusions: Results of this study will determine the role of complement and C3 inhibition in patients with ALS.

scholarly journals PERBEDAAN TINGKAT NYERI DADA SEBELUM DAN SETELAH DILAKUKAN TERAPI MUROTALL AL-QURAN

2019 ◽  
Vol 11 (2) ◽  
pp. 135-142
Author(s):  
Priyanto Priyanto ◽  
Idia Indar Anggraeni
Keyword(s):  
Chest Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
P Value ◽  
Pain Level ◽  
Paired Sample ◽  
Before And After ◽  
Post Test ◽  
The Difference ◽  
Numeric Rating

Nyeri dada merupakan keluhan utama yang sering dirasakan oleh penderita penyakit jantung koroner. Nyeri dada muncul karena suplai oksigen ke miokardium menurun. Terapi murottal Al-Qur’an merupakan terapi religi dimana seseorang akan diperdengarkan ayat-ayat Al-Qur’an selama beberapa menit sehingga akan memberikan dampak positif bagi tubuh seseorang, salah satunya untuk mengurangi rasa nyeri. Penelitian ini bertujuan untuk mengetahui perbedaan tingkat nyeri dada sebelum dan setelah dilakukan terapi murottal Al-Qur’an. Desain penelitian ini menggunakan metode pre-experimental dengan desain one group Pre-test dan Post-test. Metode sampling yang digunakan adalah accidental sampling, dan jumlah sampel sebanyak 17 responden. Instrument penelitian yang digunakana dalah Numeric Rating Scale untuk mengukur skala nyeri sebelum dan setelah terapi murottal Al-Qur’an, pemberiannya sekali selama 20 menit. Uji statistic yang digunakan adalah paired sample T test. Hasil dari penelitian ini menunjukkan bahwa ada perbedaan yang bermakna tingkat nyeri dada sebelum dan setelah dilakukan terapi murottal Al-Qur’an dengan nilai p-value 0,000 (p < α (0,05)). Terapi murottal Al-Qur’an dapat menurunkan skala nyeri dada pasien.   Kata kunci: nyeri dada, terapi murottal al-qur’an THE DIFFERENCE  BETWEEN CHEST PAIN LEVEL BEFORE AND AFTER MUROTTAL AL-QUR'AN THERAPY   ABSTRACT Chest pain is a major complaint that is often felt by people with coronary heart disease. Chest pain occurs because of decreased supply of oxygen to the myocardium. Murottal Al-Qur'an therapy is a religious therapy where someone will be heard verses of Al-Qur’an for a few minutes so it will have a positive impact on one’s body, one of them is to reduce pain. This study aims to find out the difference  between chest pain level before and after murottal Al-Qur'an therapy.This research design used pre-experimental method with one grouppre-test and post-test. The sampling method was accidental sampling, the number of sampling were 17 respondents. The research instrument used the Numeric Rating Scale to measure pain scale before and after murottal Al-Qur'an therapy, giving it once for 20 minutes. The test statistic used is paired sample T test.The results of this study indicate that there are significan differences in chest pain levels before and after murottal Al-Qur'an therapy with a p-value of 0.004 (p <α (0.05)).Murottal Al-Qur'an therapy can reduce the scale of patient's chest pain.   Keywords : chest pain, murottal al-qur’an therapy

scholarly journals Comparative Therapeutic Efficacy and Safety of Remdesivir monotherapy and its Combination of Lopinavir/Ritonavir in COVID-19 Patients

2021 ◽  
Author(s):  
Marian Boshra ◽  
haitham saeed ◽  
Ahmed E. Abou Warda ◽  
Rania Sarhan
Keyword(s):  
Therapeutic Efficacy ◽  
Laboratory Data ◽  
Efficacy And Safety ◽  
Once Daily ◽  
Infection Treatment ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
Severity Of The Disease ◽  
Enzyme Elevation

Objectives: The treatment of COVID-19 infection remains a challenge because till now, there is no approved therapy for it. This study aimed to estimate the difference in the therapeutic efficacy and safety between remdesivir as monotherapy and its use in combination with lopinavir/ritonavir provided with standard supportive care. Methods: This is a prospective randomized cohort study included 1043 adult patients with confirmed moderate and severe COVID-19 infection. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocol as the first group received IV remdesivir 200 mg on day 1, followed by 100 mg once daily, for 5 days while the second group received lopinavir/ritonavir 400/100 mg twice daily, for 5 days with the same remdesivir regimen in the first group. All laboratory and clinical parameters were assessed before and after treatment duration. Results: There was no significant difference related to improvement parameters such as laboratory data and improvement time between the two groups. On the other hand, hepatotoxicity of the second group (combination) was significantly higher compared with that of the first one. The elevation on liver enzymes was affected by the severity of the disease, the severe cases showed a high enzyme elevation rate. Conclusion: Remdesivir as monotherapy and its use in combination with lopinavir/ritonavir is effective in the management of moderate COVID 19 subjects than severe cases. The combination of remdesivir with lopinavir/ritonavir is not recommended due to the increased hepatotoxicity effect.

scholarly journals Perbedaan Abnormal Return Sebelum dan Sesudah Pemilihan Umum Gubernur DKI Jakarta Tahun 2017

2018 ◽  
pp. 1413
Author(s):  
Luh Gede Hari Purnama Sari ◽  
Gayatri Gayatri
Keyword(s):  
Abnormal Return ◽  
Sampling Technique ◽  
General Election ◽  
Market Theory ◽  
Chi Square ◽  
Analysis Technique ◽  
Before And After ◽  
Efficient Market Theory ◽  
Chi Square Test ◽  
The Difference

The General Election of DKI Jakarta Governor Year 2017 is a political events affecting the capital market. This study aims to determine abnormal return around the events and to determine the difference of abnormal return before and after the events. This study was conducted in companies incorporated the Compass Index 100 period February to July Year 2017. The samples are 92 companies, determined by nonprobability sampling method, especially purposive sampling technique. Research analysis technique is Chi-Square Test and Wilcoxon Signed Ranks Test. The result are that there is abnormal return around the events of General Election of Governor of DKI Jakarta Year 2017. There are differences of abnormal return before and after General Election of DKI Jakarta Governor Year 2017. The events contains information and make investors react. This research can prove efficient market theory of a half strong form as a representation of the market response to an event. Keywords: abnormal return, market reaction

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