Significant Improvement In Mean Values Research Articles

Switching from Galenic to Advanced Dressings or Vacuum Assisted Closure Therapy Can Improve Quality of Life of Patients with Chronic Non-Responsive Pressure Skin Ulcers: Preliminary Data with Italian Translation of WOUND-Q.

Objective: A few studies have focused on the quality of life (QoL) of patients with chronic non-responsive pressure skin ulcers. The aim of this study was to assess how correct treatment (advanced wound care [AWC] dressings alone or vacuum assisted closure [VAC] therapy alone) changes the QoL of these patients. Approach: One hundred six patients with chronic non-responsive pressure skin ulcers, who had previously used galenic dressings, applied without proper therapeutic indication, were included in this study. We administered the WOUND-Q, at time 0 and after 1 month of appropriate therapy, to assess patient-reported outcome measures. Group 1 consisted of 30 patients treated with advanced dressings, Group 2: 22 patients treated with VAC therapy, and Group 3: 30 patients continuing conventional galenic dressings (Control group). Statistical analysis allowed us to analyze QoL changes over time and to compare WOUND-Q Group 1 and 2 deltas with those of Group 3. The study followed the STROBE statement. Results and Innovation: In all the scales evaluated (Assessment, Drainage, Smell, Life impact, Psychological, Social, Sleep and Dressing), there were significant improvements in mean values for Groups 1 and 2. Kruskal-Wallis tests with Dunn's multiple-comparisons tests and Brown-Forsythe and Welch Analysis of Variance tests demonstrated significant differences between deltas of Group 1 and Group 2 compared with those of Group 3 for most scales analyzed. Conclusions: Administration of the WOUND-Q demonstrated that the application of advanced dressings alone or VAC therapy alone positively affects the QoL of patients with chronic nonresponsive pressure wounds, in comparison with galenic dressings alone. The WOUND-Q has been shown to be a valid tool in studying changes in QoL of these patients.

Impact of IM iron therapy in pregnant women with moderate anaemia

In India iron deficiency is the major factor responsible for anaemia. Earlier studies had shown that IM iron sorbitol citric acid injections with 900mg of elemental iron given to pregnant women with Hb levels between 5-7.9g/dL, raised their Hb by about 2 g/dL and did not correct anaemia in all. A study was taken up to assess the impact of 1500mg of IM iron therapy on Hb levels. Apparently healthy pregnant women (n=419) in second trimester, with Hb between 5.0- 7.9 g/dL were enrolled and given ten injections each consisting of iron sorbitol citric acid complex containing 150 mg elemental iron, and 1500 µg folic acid and 150 µg B-12. Impact of the therapy on Hb, course and outcome of pregnancy and birth weight of the offspring was recorded. In a subsample (72 women), the impact of IM iron therapy was assessed on Hb, serum iron and ferritin by comparing the values prior to and 8-12 weeks after IM iron therapy. Eighty-eight per cent of women completed all 10 injections. Following IM therapy there was a significant improvement in mean values of Hb (7.2±0.82 g/dL to 9.2 ±0.86 g/dL, P<0.0001). After IM iron therapy, mean ferritin levels rose from 12.9±12.23 µg/L to 36.2±22.84 µg/L; iron deficiency (ferritin levels < 12 µg/L) decreased from 66.7% to 8.3%. The mean birth weight of infants born to those who received IM iron therapy was 2818±292.9 g. This was significantly higher (P<0.0001) than mean birthweight (2345.4+334.2g) of infants born to women who had Hb less than 8g/dL at delivery. IM iron therapy nearly eliminated iron deficiency, improved Hb levels and birth weight. Women with persistent anaemia after IM iron therapy require investigations to find out factors responsible for anaemia.

Efficacy of manual therapy on psychological status and pain in patients with neck pain. A randomized clinical trial.

Objectives:To compare the effectiveness of Maitland versus Mulligan mobilization techniques on pain, functional disability, and psychological status in patients with neck pain.Methods:Forty-four patients with nonspecific neck pain were randomly assigned to the Maitland group (n=22 patients received Maitland therapy [central or unilateral postero-anterior pressure] for 2 sessions/week for 3 weeks) and Mulligan group (n=22 patients received Mulligan sustained natural apophyseal glides for 2 sessions/week for 3 weeks). This study was conducted at the Rehabilitation Clinic, King Abdulaziz Hospital, Jeddah, Kingdom of Saudi Arabia between December 2016 to May 2017. The outcome measures were the numeric pain rating scale score, neck disability index score, beck depression inventory score, State-trait anxiety inventory score, fear avoidance beliefs questionnaire, and pain catastrophic scale results. The independent t-test, Shapiro-Wilk test, and paired t-test were used in data analysis.Results:There were significant improvements in mean values of the numeric pain rating scale, neck disability index, beck depression inventory, state-trait anxiety inventory scores, and pain catastrophic scale results after the interventions in both groups (p<0.05, all except fear avoidance beliefs results in mulligan group p>0.05), and there were no significant differences in mean values between the groups (p>0.05).Conclusion:In patients with nonspecific neck pain, Maitland and Mulligan mobilization techniques have positive effects on neck pain, functional disability, and selected psychological features with no significant difference between them.

Evaluation of the effects of probiotics on the treatment of peri‐implant mucositis – A preliminary randomized controlled trial

Background New strategies for the treatment prevention of peri-implant diseases are sought, since conventional mechanical treatment may not completely eliminate the disease or prevent its recurrence. The use of probiotics on peri-implantitis and peri-implant mucositis may represent a significant advance in the treatment of these diseases that affect a large part of the population rehabilitated with dental implants. Aim/Hypothesis The purpose of this study is to evaluate the adjuvant effect of a probiotic therapy on the treatment of peri-implant mucositis. Material and Methods 20 subjects were divided into two experimental groups- Control and Test. In the Control Group, sites with peri-implant mucositis received conventional mechanical debridement associated with topical administration of a placebo preparation. In the Test Group, peri-implant mucositis sites were treated with conventional mechanical therapy associated with topical administration of probiotics (Bifidobacterium animalis subsp. lactis HN019, Lactobacillus rhamnosus and Lactobacillus paracasei). Patients in the Test and Control groups also performed mouthwash using the probiotic microorganisms and placebo, respectively, twice a day for 12 weeks. Clinical monitoring was performed at baseline (pre-intervention period) and 12 and 24 weeks after the beginning of the study. Data obtained were statistically analyzed (P < 0.05). Results At baseline, no significant differences were observed between experimental groups in relation to all clinical parameters (modified gingival index – MGI, modified plaque index – MPI, probing depth – PD and bleeding on probing – BOP). Significant improvement in mean values of MGI and BOP was observed in both groups after 12 and 24 weeks (P < 0.05). Test Group presented MGI and BOP values significantly reduced when compared with Control Group at both 12 and 24 weeks (P < 0.05). A significant increase in BOP values from 12 to 24 weeks was observed only in Control Group (P < 0.05). Conclusion and Clinical Implications The use of probiotic therapy as an adjunct to mechanical debridement promoted additional clinical benefits compared with mechanical debridement alone in the treatment of patients with peri-implant mucositis.

Arthroscopic assisted stabilization of acute acromioclavicular dislocations by cortical fixation buttons for acute acromioclavicular dislocation

Purpose: To evaluate the results of 15 patients following arthroscopically assisted AC joint fixation using cortical fixation buttons (AC tightrope or dog bone fiber tape construct) for acute AC joint separations.Patients and Methods: Patients with acute AC joint injuries (Rockwood grades III–V) of less than 3 weeks duration were included in the study. We had 15 cases of AC joint injuries, which fulfilled the inclusion criteria. All patients were diagnosed based on history, examination and plain radiographs. Patients with grades III–V were selected for arthroscopic assisted fixation using cortical fixation buttons (AC tightrope or dog bone fiber tape construct or double endobutton, Zip Tight). Functional outcome of patients was assessed using constant shoulder score, Quick DASH score preoperatively and postoperatively.Results: VAS for pain in 80% of patients there was a minimal pain VAS score of (0-2). Mean post-operative constant score at one year was 92.33. The Quick DASH subjective functional disability score was ≤ 10 in 75% of patients. The difference in Coracoclavicular distance between the injured and uninjured sides showed a significant improvement in mean values between the preoperative and 1-year evaluations (9.3 mm and 2 mm, respectively; p < 10–6). All patients had satisfactory outcome. We reported only one case of coracoid fracture, which was the 2nd case operated due to improper exposure of coracoid base & was fixed with hook plate. Conclusion: Arthroscopic fixation using the cortical fixation buttons (AC Tightrope or dog bone fiber tape construct) for acute AC joint dislocation achieves satisfactory outcome.

Effects of pistachio nuts on body composition, metabolic, inflammatory and oxidative stress parameters in Asian Indians with metabolic syndrome: A 24-wk, randomized control trial

ObjectiveThe aim of this study was to evaluate the effects of pistachio nuts as an adjunct to diet and exercise on body composition, metabolic, inflammatory, and oxidative stress parameters in Asian Indians with metabolic syndrome. MethodsIn this 24-wk randomized control trial, 60 individuals with the metabolic syndrome were randomized to either pistachio (intervention group) or control group (diet as per weight and physical activity profile, modulated according to dietary guidelines for Asian Indians) after 3 wk of a diet and exercise run in. In the first group, unsalted pistachios (20% energy) were given daily. A standard diet and exercise protocol was followed for both groups. Body weight, waist circumference (WC), magnetic resonance imaging estimation of intraabdominal adipose tissue and subcutaneous abdominal adipose tissue, fasting blood glucose (FBG), fasting serum insulin, glycosylated hemoglobin, lipid profile, high-sensitivity C-reactive protein (hs-CRP), adiponectin, free fatty acids (FFAs), tumor necrosis factor (TNF)-α, leptin, and thiobarbituric acid reactive substances (TBARS) were assessed before and after the intervention. ResultsStatistically significant improvement in mean values for various parameters in the intervention group compared with control group were as follows: WC (P < 0.02), FBG (P < 0.04), total cholesterol (P < 0.02), low-density lipoprotein cholesterol (P < 0.006), hs-CRP (P < 0.05), TNF-α (P < 0.03), FFAs (P < 0.001), TBARS (P < 0.01), and adiponectin levels (P < 0.001). ConclusionA single food intervention with pistachios leads to beneficial effects on the cardiometabolic profile of Asian Indians with metabolic syndrome.

A high-resolution hindcast of wind and waves for the North Sea, the Norwegian Sea, and the Barents Sea

[1] A combined high-resolution atmospheric downscaling and wave hindcast based on the ERA-40 reanalysis covering the Norwegian Sea, the North Sea, and the Barents Sea is presented. The period covered is from September 1957 to August 2002. The dynamic atmospheric downscaling is performed as a series of short prognostic runs initialized from a blend of ERA-40 and the previous prognostic run to preserve the fine-scale surface features from the high-resolution model while maintaining the large-scale synoptic field from ERA-40. The nested WAM wave model hindcast consists of a coarse 50 km model covering the North Atlantic forced with ERA-40 winds and a nested 10–11 km resolution model forced with downscaled winds. A comparison against in situ and satellite observations of wind and sea state reveals significant improvement in mean values and upper percentiles of wind vectors and the significant wave height over ERA-40. Improvement is also found in the mean wave period. ERA-40 is biased low in wind speed and significant wave height, a bias which is not reproduced by the downscaling. The atmospheric downscaling also reproduces polar lows, which cannot be resolved by ERA-40, but the lows are too weak and short-lived as the downscaling is not capable of capturing their full life cycle.

Report of 12 cases of ankylosing spondylitis patients treated with Tripterygium wilfordii

ObjectiveDescription of the clinical response of 12 consecutive cases of disease-active ankylosing spondylitis (AS) treated with the herbal medicine Tripterygium wilfordii Hook f (TwHf; lei gong teng, thunder god vine), which has been reported in controlled studies to be effective in rheumatoid arthritis (RA).MethodsThe clinical status of 12 patients with active AS who were started on 60 mgday-1 of a commercial tablet preparation of TwHf extract. were monitored at weeks 1, 3, and 6.ResultsCompared to baseline, there was significant improvement in mean values of physician assessment, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis global score (BAS-G) at weeks 3 and 6, with no changes in liver enzymes or complete blood count (CBC).ConclusionA placebo-controlled double-blind study for Tripterygium is warranted. Until then, this particular report should be considered as case reports and not an endorsement of the use of Tripterygium in clinical practice.

Attainment of Goals from National Guidelines among Persons with Type 2 Diabetes: A Cohort Study in an Academic Family Medicine Setting

Cardiovascular disease is the leading cause of mortality in patients with diabetes, but goals for reduction of modifable cardiovascular risk factors are difficult to achieve in primary care. We evaluated the change in risk factor control for a cohort of patients with diabetes and hyperlipidemia over a four-year period, as well as the change in proportion of patients meeting clinical practice guideline goals. Medical records were reviewed from a cohort of 86 randomly selected persons with type 2 diabetes in an academic family medicine setting. Data were abstracted to assess the attainment of and change in five treatment goals related to glycemic, blood pressure, and lipid control from 1999-2003. Descriptive statistics were applied to demographic variables. Mean differences in outcomes were assessed with the paired t-test. The McNemar test was used to assess non-parametric variables, and the Wilcoxon signed ranks test was applied to differences achieved in mean goal scores for outcome variables. The mean numbers of treatment goals attained were 2.76 (SD = 0.92) in 1999 and 2.48 (SD = 1.1) in 2003. Significant improvements were noted in the mean values of HbA1c (0.4% decrease, p = 0.03), diastolic blood pressure (4.3mmHg decrease, p < 0.001), low-density lipoprotein cholesterol (LDL-C; 10.6 mg/dL decrease, p < 0.01), and high-density lipoprotein cholesterol (HDL-C; 8.3 mg/dL increase, p < 0.001) over the four-year study interval. No significant differences were noted in the percent at goal during the study for HDL-C or for HbA1c. A significant decrease was found in the percent at goal from 1999-2003 for LDL-C from 79% to 40%, respectively). The decrease in the percent LDL-C at goal was explained by the more stringent practice guideline goals introduced in 2001 for diabetes (i.e., LDL-C < 100 mg/dL). Despite significant improvement in mean values of modifiable risk factors, the percent of patients meeting 2003 guideline goals for HbA1c, systolic blood pressure, and LDL cholesterol did not improve. These findings suggest that patient-level improvements may not be adequate indicators of a practices achievement of guideline recommendations. Percent attainment of guideline goals may be a useful peformance measure of practice-level quality improvement initiatives.

Treatment of Rheumatoid Arthritis with Flurbiprofen or Ibuprofen

Flurbiprofen and ibuprofen were compared in a six-week double-blind randomized study in 208 patients with rheumatoid arthritis. Daily dosages were 120 mg flurbiprofen and 2400 mg ibuprofen for six weeks. Both drugs were effective in providing partial control of RA symptoms. Either or both drugs produced statistically significant improvement in mean values of time of onset of fatigue, grip strength and tender and swollen joint counts. All other standard endpoints of efficacy (except ESR) were improved but not at a statistically significant level. Slightly more than half of the patients improved during the trial. There was no statistically significant difference in the efficacy of the drugs. The incidence of side effects was low with both drugs. Most side effects were related to gastrointestinal tract irritation.