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Randomized Controlled Trial Multicenter Study
Study protocol: high-dose mizoribine with prednisolone therapy in short-term relapsing steroid-sensitive nephrotic syndrome to prevent frequent relapse (JSKDC05 trial).
Eighty percent of children with steroid-sensitive nephrotic syndrome (SSNS) relapse within 2 years and 40-50% patients show frequently-relapsing nephrotic syndrome (FRNS). Patients showing a relapse within 6 months after initial remission are at high risk of FRNS. Since frequent prednisolone treatment for FRNS induces severe prednisolone side effects, development of a treatment to prevent patients from shifting to FRNS is desirable. Mizoribine is an immunosuppressive drug with fewer side effects than prednisolone. Recent studies reported the efficacy of high-dose mizoribine in children with FRNS. ⋯ The results provide important data on use of high-dose mizoribine to prevent SSNS patients from shifting to FRNS. Since blood concentrations of mizoribine have not been investigated in detail until now, there is a possibility that mizoribine is underestimated in favor of other immunosuppressive drugs. In future, high-dose mizoribine therapy may lead to prevention of relapse in children at high risk of FRNS, and to decreased total dose of prednisolone.
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The Journal of pediatrics · Mar 2008
Randomized Controlled TrialEffect of an integrated care pathway on acute asthma/wheeze in children attending hospital: cluster randomized trial.
To determine whether an integrated care pathway (ICP) could improve care delivered to patients coming to an emergency department only or to patients who were subsequently admitted. ⋯ An acute asthma/wheeze ICP improved education and prescribing errors, modestly reduced the length of stay when discharge criteria were adhered to, but did not influence recovery time. Further consideration of the effect on staff workload is required.
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Arthritis and rheumatism · Aug 2002
Randomized Controlled Trial Clinical TrialEffects of video information on preoperative anxiety level and tolerability of joint lavage in knee osteoarthritis.
To investigate the impact of video information on preoperative anxiety of patients scheduled to undergo joint lavage for knee osteoarthritis, and tolerability of the lavage. ⋯ This prospective, controlled, randomized study confirms the usefulness of video information prior to an invasive rheumatology procedure.
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Randomized Controlled Trial
The effects of Valsalva manoeuvres on venepuncture pain.
Stimulating the vagus nerve reduces pain. The purpose of this study was to evaluate the effect of a Valsalva manoeuvre, which stimulates the vagus nerve, on perception of pain during peripheral venous cannulation in adult patients. ⋯ On the basis of data from this study, the Valsalva manoeuvre may be of the value before venous cannulation as a simple and practical method to reduce pain from venous cannulation.
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Randomized Controlled Trial Multicenter Study
Cerebral Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery: A Randomized Controlled Feasibility Trial.
Cerebral oxygen desaturation during cardiac surgery has been associated with adverse perioperative outcomes. Before a large multicenter randomized controlled trial (RCT) on the impact of preventing desaturations on perioperative outcomes, the authors undertook a randomized prospective, parallel-arm, multicenter feasibility RCT to determine whether an intervention algorithm could prevent desaturations. ⋯ Study sites were successful in reversal of desaturation, patient recruitment, randomization, and follow-up in cardiac surgery, supporting the feasibility of conducting a large multicenter RCT.