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A Multidomain Intervention Program for Older People with Dementia: A Pilot Study 一项针对老年痴呆症患者的多领域干预计划:一项试点研究
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-04-01 DOI: 10.2147/oajct.s403282
Thanh Xuan Nguyen, Huyen Thi Thanh Vu, T. Nguyen, A. Esterman, Luc Viet Tran, Janani Thillainadesan, V. Naganathan, H. Brodaty, Anh Trung Nguyen
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引用次数: 0
Randomized Clinical Trial Comparing Insulin Fast Dissolving Films versus Control Group for Anosmic Patients for Improving Their Health and Social Qualities of Life 比较胰岛素快速溶解膜与对照组对嗅觉丧失患者改善其健康和社会生活质量的随机临床试验
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-12-01 DOI: 10.2147/oajct.s389489
Soad A Mohamad, S. M. Sayed, A. A. Sadek, A. Badawi
Background: Olfactory anomalies are the most common diseases among post-COVID-19 disorders. Only 15% of patients completed their prescribed treatment plans, even though several different treatment strategies were recommended;this had a detrimental effect on the patients' physical, social, and emotional wellbeing.Purpose: The aim of this study was approving intranasal fast-dissolving insulin films as the treatment of choice for anosmia in comparison to the control group, and the innovative treatment for anosmic post-COVID-19 is assessed in terms of the patients' health-related quality of life (HRQoL).Methods: For therapy and evaluation, a randomized clinical trial with forty adult anosmic post-viral patients was performed. The recruited participants were recruited between October 1 and March 8 of 2021 based on predetermined criteria. A validated smell assessment questionnaire concerning the participants' olfactory, physical, and psychological outcomes was given to them. Recruited patients were randomly subdivided into two groups: intervention and control group. Intervention was treated with insulin intranasal films, while control group took plain films (placebo).Results: The physical, emotional, and social health quality of life were significantly (p-value <0.0001) improved after 4 consecutive weeks of treatment with the intervention group compared to the control group. The data were analyzed statistically with the aid of GraphPad Prism 9.1.0.Conclusion: The lowest HRQoLs, which significantly impact their quality of life, are found in post-COVID-19 anosmic patients treated with insulin films. It is advised to employ this new intervention (insulin films) as the main therapy approach and to gather additional industry data for its development and dissemination. Problems with self-hygiene, eating, sense of danger and emotional satisfaction were significantly enhanced with insulin intervention versus placebo.
背景:嗅觉异常是covid -19后疾病中最常见的疾病。尽管推荐了几种不同的治疗策略,但只有15%的患者完成了规定的治疗计划;这对患者的身体、社交和情感健康产生了不利影响。目的:与对照组相比,本研究的目的是批准鼻内速溶胰岛素膜作为嗅觉缺失的首选治疗方法,并根据患者的健康相关生活质量(HRQoL)评估新型治疗方法对covid -19后嗅觉缺失的治疗效果。方法:对40例成人病毒感染后嗅觉丧失患者进行随机临床试验,以进行治疗和评估。被招募的参与者是在2021年10月1日至3月8日之间根据预先确定的标准招募的。一份关于参与者嗅觉、身体和心理结果的有效嗅觉评估问卷被发给他们。纳入的患者随机分为干预组和对照组。干预组采用胰岛素鼻内膜治疗,对照组采用普通膜(安慰剂)治疗。结果:干预组患者连续治疗4周后,身体、情绪、社会健康生活质量较对照组有显著改善(p值<0.0001)。使用GraphPad Prism 9.1.0软件对数据进行统计分析。结论:胰岛素贴片治疗的新冠肺炎后嗅觉丧失患者的HRQoLs最低,显著影响患者的生活质量。建议采用这种新的干预措施(胰岛素膜)作为主要治疗方法,并收集更多的行业数据,以促进其发展和推广。与安慰剂相比,胰岛素干预显著提高了自我卫生、饮食、危险感和情绪满意度方面的问题。
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引用次数: 0
Treatment of Oropharyngeal Symptoms: A Prospective, Single-Dose, Placebo-Controlled, Randomized Clinical Trial 口咽症状的治疗:一项前瞻性、单剂量、安慰剂对照、随机临床试验
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-03-01 DOI: 10.2147/oajct.s331883
Katharina Kapoor, D. Wilhelm, C. Neumeister, M. R. Götz, U. Schwantes, G. Bleckert, Lilli Gerstenmaier, A. Jambrecina
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引用次数: 0
Post-Trial Considerations for an Early Phase Optogenetic Trial in the Human Brain 人脑早期光遗传学试验的试验后考虑因素
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-02-01 DOI: 10.2147/oajct.s345482
Michael White, R. Whittaker
: For many clinical trials, the issue of post-trial access to research treatments is straightforward. Sponsors offer a range of follow-on studies, compassionate use programs or expanded access programs to allow participants to continue accessing beneficial experimental treatments. But there are times when this is not always the case and participants are required to stop beneficial treatments and return to standard care. Guidance states that post-trial access should be made available for “those participants who still need an intervention identified as beneficial”. This broad statement has allowed sponsors to make their own interpretation of when an intervention is still “needed” and when it is “beneficial”. As a result, there have been a number of situations where participants of clinical trials have been left afterwards with feelings of abandonment. Participants involved in studies with long-term, invasive treatments can be seen as being particularly vulnerable. Optogenetic technology has the potential to offer hope to people with neurological conditions, especially people who may not respond to current approved treatments. Optogenetics typically involves two components: a gene therapy medicinal product (GTMP) that induces long-term expression of light-reactive proteins within cells, and an active implantable device to stimulate the light-sensitised cells. Neither works without the other, hence for long-term patient benefit, both must remain active and may therefore require maintenance or replacement. With the potential life-long consequences of both components and the difficulty of accessing the brain, there is a need to reconsider post-trial guidelines and whether they are suitable to support early phase optogenetic trial participants. This paper considers the ethical and regulatory requirements in place for post-trial access and care in relation to optogenetic treatments of neurological conditions. We propose that a new perspective with wider responsibilities for sponsors is required when it comes to these types of novel therapies.
:对于许多临床试验来说,试验后获得研究治疗的问题很简单。赞助商提供一系列后续研究、同情使用计划或扩大获取计划,让参与者继续获得有益的实验治疗。但有时情况并非总是如此,参与者被要求停止有益的治疗并返回标准护理。指导意见指出,应为“那些仍然需要被确定为有益干预的参与者”提供试验后的访问。这一宽泛的声明使提案国能够对何时仍然“需要”干预以及何时干预“有益”做出自己的解释。因此,在许多情况下,临床试验的参与者事后都有被抛弃的感觉。参与长期侵入性治疗研究的参与者可能被视为特别脆弱。光遗传学技术有可能为神经系统疾病患者带来希望,尤其是那些对目前批准的治疗方法可能没有反应的人。光遗传学通常包括两个组成部分:一种是诱导细胞内光反应蛋白长期表达的基因治疗药物(GTMP),另一种是刺激光敏细胞的有源植入式设备。两者都不能在没有另一种的情况下工作,因此为了患者的长期利益,两者都必须保持活跃,因此可能需要维护或更换。鉴于这两种成分的潜在终身后果和进入大脑的困难,有必要重新考虑试验后指南,以及它们是否适合支持早期光遗传学试验参与者。本文考虑了与神经疾病的光遗传学治疗相关的试验后获取和护理的伦理和监管要求。我们建议,当涉及到这些类型的新疗法时,需要一个新的视角,对赞助商承担更广泛的责任。
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引用次数: 5
Reviewing Treatments for Cocaine Consume Problems: The Gabapentinoid Alternative 回顾可卡因消费问题的治疗:加巴喷丁类药物的替代品
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-09-23 DOI: 10.2147/OAJCT.S327934
Gabriel C Quintero Garzola
Background: Cocaine use disorder is a worldwide problem. Presently, however, no adequate treatments exist. Gabapentin has been explored recently as an alternative for treating different substance use disorders, including cocaine. Methods: The aim of the present paper is to assess the effectiveness of gabapentin for treating cocaine use disorders. For this purpose, a systematic review of the literature was performed using the publication database, PubMed, with search limits from January 1, 1983 to February 28, 2018. The search terms used were combined as follows: “gabapentin” AND “cocaine”. Initially, 41 articles were identified, with additional 23 articles identified through reference exploration or web search. These 23 complementary articles relate mainly to the general description of gabapentin and discussion. After the analysis of the titles and abstracts, 18 references were removed, resulting in 46 articles for further analysis. Results and Discussion: Gabapentin is inadequate for treating cocaine dependence and relapse, and alleviating the subjective effects of cocaine. More research is necessary for exploring gabapentin alleviation of cocaine intoxication, and further investigation is required for confirming the gabapentin’s utility for treating cocaine addiction.
背景:可卡因使用障碍是一个全球性的问题。然而,目前还没有足够的治疗方法。加巴喷丁最近被探索作为治疗包括可卡因在内的不同物质使用障碍的替代品。方法:评价加巴喷丁治疗可卡因使用障碍的疗效。为此,使用出版物数据库PubMed对1983年1月1日至2018年2月28日的文献进行了系统综述,检索范围为。使用的搜索词组合如下:“加巴喷丁”和“可卡因”。最初,共确定了41篇文章,另有23篇文章是通过参考资料探索或网络搜索确定的。这23篇补充文章主要涉及加巴喷丁的一般描述和讨论。在对标题和摘要进行分析后,删除了18篇参考文献,产生了46篇文章供进一步分析。结果与讨论:加巴喷丁不足以治疗可卡因依赖和复发,也不足以减轻可卡因的主观影响。需要更多的研究来探索加巴喷丁对可卡因中毒的缓解作用,还需要进一步的研究来证实加巴喷汀对治疗可卡因成瘾的效用。
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引用次数: 0
Social Support Intervention for Self-Management of Type 2 Diabetes Mellitus: Study Protocol for a Randomized Controlled Trial 社会支持干预对2型糖尿病自我管理的作用:一项随机对照试验的研究方案
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-07-26 DOI: 10.2147/OAJCT.S314030
Claudia Milena Garizábalo-Dávila, Alba Luz Rodríguez-Acelas, R. Mattiello, Wilson Cañón-Montañez
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引用次数: 3
Impacts of Research Staff Burnout for a National Large Scale Pragmatic Clinical Trial 研究人员职业倦怠对国家大型实用临床试验的影响
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-07-01 DOI: 10.2147/OAJCT.S312365
Alison Majkut Klint, Jacob I. McPherson, Abhinav Tella, W. Vang, Srihari I Raju, Rebecca Windschitl, A. Ishani
Introduction: Burnout can have a negative impact on job satisfaction and productivity. Antecedents to burnout include workload, control, values, fairness, reward, community and job-person incongruency. Purpose: To better understand the impact of burnout in research staff, these seven antecedents to burnout were analyzed retrospectively within the call centers for the Diuretic Comparison Project. Methods: Two call centers were analyzed with respect to these antecedents to burnout. Consent rates and employee turnover of the two call centers were compared as a means of comparing productivity and job satisfaction, respectively. Results: An odds ratio of 0.13 (95% CI=[0.0164, 1.0853]) indicates that an employee at the Minneapolis call center had lower odds of leaving than an employee at the Canandaigua call center. The call center in Canandaigua had a consent rate of 2.7% (Figure 2). The consent rate for the same months of the following year in Minneapolis came out to 14.6%. Conclusion: A higher consent rate and lower turnover rate of the call center in Minneapolis could be a result of lower levels of burnout among callers. The confidence interval of the odds ratio calculated for turnover indicates that the result is not statistically significant. Due to the retrospective nature of the analysis, extraneous variables were not controlled for analyzing this data. The protocol of the Minneapolis call center appears to take into consideration the antecedents to burnout more than that of the Canandaigua call center. Further studies on burnout prevention methods for clinical research are needed. Research staff could benefit from strategies to help reduce burnout. Organizations should provide proper protocols and training concerning stress and burnout to improve the well-being of employees and, in turn, their productivity.
引言:职业倦怠会对工作满意度和工作效率产生负面影响。倦怠的前因包括工作量、控制、价值观、公平、奖励、社区和工作-人不协调。目的:为了更好地了解研究人员倦怠的影响,在利尿剂比较项目的呼叫中心回顾性分析了这七个倦怠的前因。方法:对两个呼叫中心的工作倦怠前因进行分析。分别比较了两个呼叫中心的同意率和员工流动率,作为比较生产力和工作满意度的一种手段。结果:比值比为0.13 (95% CI=[0.0164, 1.0853])表明,明尼阿波利斯呼叫中心的员工离职的几率低于加拿大呼叫中心的员工。在Canandaigua的呼叫中心的同意率为2.7%(图2)。在明尼阿波利斯,第二年的相同月份的同意率为14.6%。结论:明尼阿波利斯呼叫中心较高的同意率和较低的离职率可能是呼叫者较低的倦怠水平的结果。换手率计算的比值比置信区间表明结果不具有统计学意义。由于分析的回顾性性质,分析该数据时没有控制无关变量。明尼阿波利斯呼叫中心的协议似乎比加南代瓜呼叫中心更多地考虑到倦怠的前因。对职业倦怠的预防方法进行进一步的研究,以供临床研究。研究人员可以从减少倦怠的策略中受益。组织应该提供适当的关于压力和倦怠的协议和培训,以提高员工的幸福感,进而提高他们的生产力。
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引用次数: 0
Intensive Home Blood Pressure Lowering in Advanced Chronic Kidney Disease: A Pilot Randomized Controlled Trial Protocol 强化家庭降压治疗晚期慢性肾病:一项试点随机对照试验方案
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-06-24 DOI: 10.2147/oajct.s311821
S. Bae, C. McCulloch, Raymond K. Hsu, E. Ku
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引用次数: 0
Clinical Efficacy of an Osmotic, Antiviral and Anti-Inflammatory Polymeric Nasal Film to Treat Covid-19 Early-Phase Respiratory Symptoms 渗透性抗病毒抗炎聚合物鼻膜治疗新冠肺炎早期呼吸道症状的临床疗效
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-05-18 DOI: 10.2147/OAJCT.S307144
R. Shrivastava, Megha Vijay, Nathalie Maneby, R. Shrivastava
Background: Covid-19 infection is a multifactorial disease where the virus mainly enters through the nasal cavity, grows, triggers inflammation, and destroys nasal mucosa cells, allowing systemic virus entry and infection of other organs. When symptoms appear, the disease physiopathology is already established. The immune system tries to control the infection but if the infection persists, it gets tired, fatigued, stressed, and finally, there is burnout. Therefore, an effective treatment should be multi-targeted and should not focus only on one parameter. Minimizing virus concentration, reducing nasal mucosa inflammation, and keeping the nasal surface clean should lessen systemic infection and the probability of developing severe respiratory distress. We evaluated clinical efficacy and safety of an osmotic nasal surface cleaning, virus and cytokine trapping polymeric film, in early-stage Covid-19 positive symptomatic patients. Methods: A randomized, multicentric, observational study was performed to evaluate the efficacy and safety of the osmotic film in 213 patients, randomized in 2 equal arms, and confined for 14-days just after the RT-PCR+ test. Due to ethical reasons, all patients received symptomatic treatments (ST). In addition, the patients in Arm-1 received the test product (ST+TP, 2-3 sprays, 4-5 times/ day) for 14-days. Leicester Cough Questionnaire, Visual Analogue Scale, and Covid-19-associated symptoms such as fever, pain, taste, smell, and headache were evaluated daily. Home-confined patients were immediately hospitalized in case of aggravation of any life-threatening clinical sign. Results: Among 213 patients, 98 in the ST and 102 in the ST+TP group completed the study. Thirteen patients did not complete the study as 8 in the ST group and 5 in the ST+TP group were hospitalized during the study due to low blood oxygen levels or sudden health deterioration and were excluded from the study. In the remaining control standard treatment group (n=98), clinical signs sharply aggravated on day 1-2 followed by stabilisation between days 3-6 and progressive reduction thereafter. In the test product group (n=102), symptoms were stabilized just after the first application and improved progressively. Only 42/102 patients in the test product group presented nasal discharge or irritation due to the osmotic properties of the product. Conclusion: The continuous multi-target approach of detaching and neutralizing virus particles and pro-inflammatory cytokines from the nasal surface to minimize systemic virus exposure is a very logical and efficient approach to avoid Covid-19-induced systemic pathology.
背景:Covid-19感染是一种多因素疾病,病毒主要通过鼻腔进入,生长,引发炎症,破坏鼻黏膜细胞,使病毒进入全身并感染其他器官。当症状出现时,疾病的生理病理已经确立。免疫系统试图控制感染,但如果感染持续存在,它就会变得疲惫、疲劳、紧张,最后,会精疲力竭。因此,有效的治疗应该是多靶点的,而不应该只关注一个参数。尽量减少病毒浓度,减少鼻黏膜炎症,保持鼻表面清洁,可减少全身感染和发生严重呼吸窘迫的可能性。我们评估了渗透性鼻表面清洁、病毒和细胞因子捕获聚合膜在早期Covid-19阳性症状患者中的临床疗效和安全性。方法:采用随机、多中心、观察性研究,对213例患者进行渗透膜的疗效和安全性评估,随机分为2个相等组,在RT-PCR+检测后仅限14天。由于伦理原因,所有患者均接受对症治疗(ST)。另外,第1组患者接受试验产品(ST+TP, 2-3次喷雾,4-5次/天),疗程14天。每天评估莱斯特咳嗽问卷、视觉模拟量表以及与covid -19相关的症状,如发烧、疼痛、味觉、嗅觉和头痛。如果任何危及生命的临床症状加重,则立即住院治疗。结果:213例患者中,ST组98例,ST+TP组102例完成研究。13例患者未完成研究,ST组8例,ST+TP组5例在研究期间因低血氧水平或健康突然恶化住院,被排除在研究之外。在其余对照标准治疗组(n=98)中,临床症状在第1-2天急剧加重,第3-6天稳定,此后逐渐减轻。在测试产品组(n=102)中,首次使用后症状稳定并逐渐改善。试验产品组102例患者中只有42例由于产品的渗透性而出现鼻溢液或刺激。结论:持续多靶点从鼻表面分离和中和病毒颗粒和促炎细胞因子,以减少全身性病毒暴露,是一种非常合乎逻辑和有效的方法,可以避免covid -19诱导的全身病理。
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引用次数: 3
Effectiveness of a Structured Nutrition Education Course for Caregivers of Children and Adolescents with Type 1 Diabetes in Improving Glycemic and Dietary Outcomes: A Cluster-Randomized Controlled Trial Protocol 1型糖尿病儿童和青少年护理人员结构化营养教育课程在改善血糖和饮食结局方面的有效性:一项集群随机对照试验方案
IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-04-01 DOI: 10.2147/OAJCT.S304290
N. B. Ndahura, J. Munga, J. Kimiywe, E. Mupere
Purpose: This study will aim to evaluate whether the provision of a structured nutrition education course to caregivers of children and adolescents with type 1 diabetes mellitus (T1DM) will help improve their children’s glycemic control, dietary intake, and diversity. Research Design and Methods: The study will be a cluster randomized controlled trial conducted at 10 health facilities with established T1DM clinics in Uganda. The facilities will include: Mulago National Referral Hospital, St. Francis Hospital, Lubaga Hospital, Mbale Regional Referral Hospital, Soroti Regional Referral Hospital, Holy innocents’ Hospital, Virika Hospital, Kagando Hospital, Nyakibale Hospital, and Wakiso Health Centre IV. The facilities will be randomized to control or intervention at a ratio of 1:1. A total of 100 caregiver-child pairs will be recruited. The participants in the control group will continue to receive routine medical care, while those in the intervention group will receive routine medical care and attend a structured group nutrition education course. The course will be delivered over 3 months, it will consist of a total of 8 face-to-face sessions lasting 45 minutes each. A two-member team of a diabetes specialist nurse and dietician will conduct the sessions. Each session will be conducted once a week and a question-and-answer session held every after 2 sessions. The primary outcome which is a change in glycated hemoglobin (HbA1c) and secondary outcomes (caregivers’ level of knowledge on general and diabetes-specific nutrition knowledge, children’s dietary diversity score, and children’s mean intake of energy, protein, and fat) will be assessed at baseline, 3, and 6 months. Intention-to-treat analysis will be conducted. Data will be reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement for cluster-randomized trials. The trial is registered with the Pan African Clinical Trials Registry (PACTR201902548129842).
目的:本研究旨在评估为1型糖尿病儿童和青少年(T1DM)的照顾者提供结构化的营养教育课程是否有助于改善他们孩子的血糖控制、饮食摄入和多样性。研究设计和方法:该研究将是一项集群随机对照试验,在乌干达10个已建立T1DM诊所的卫生机构进行。这些设施将包括:穆拉戈国家转诊医院、圣弗朗西斯医院、卢巴加医院、姆巴莱地区转诊医院、索罗蒂地区转诊医院、神圣无辜者医院、维里卡医院、卡甘多医院、尼亚基巴莱医院和瓦基索第四保健中心。这些设施将按1:1的比例随机分配到对照或干预组。总共将招募100对看护人-儿童对。对照组的参与者将继续接受常规医疗护理,而干预组的参与者将接受常规医疗护理并参加有组织的群体营养教育课程。该课程将在3个月内交付,它将包括8个面对面的会议,每次会议持续45分钟。由糖尿病专家、护士和营养师组成的两人小组将指导这些会议。每节课每周进行一次,每两节课后举行一次问答环节。主要终点是糖化血红蛋白(HbA1c)的变化,次要终点是护理者对一般和糖尿病特异性营养知识的知识水平、儿童饮食多样性评分以及儿童平均能量、蛋白质和脂肪摄入量,将在基线、3个月和6个月时进行评估。将进行意向治疗分析。数据将根据分组随机试验的综合报告标准(CONSORT)声明进行报告。该试验已在泛非临床试验登记处注册(PACTR201902548129842)。
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引用次数: 0
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Open Access Journal of Clinical Trials
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