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Lippman SA, Libby MK, Nakphong MK, Arons A, Balanoff M, Mocello AR, Arnold EA, Shade SB, Qurashi F, Downing A, Moore A, Dow WH, Lightfoot MA. A guaranteed income intervention to improve the health and financial well-being of low-income black emerging adults: study protocol for the Black Economic Equity Movement randomized controlled crossover trial. Front Public Health 2023; 11:1271194. [PMID: 38026401 PMCID: PMC10658785 DOI: 10.3389/fpubh.2023.1271194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Economic inequity systematically affects Black emerging adults (BEA), aged 18-24, and their healthy trajectory into adulthood. Guaranteed income (GI)-temporary, unconditional cash payments-is gaining traction as a policy solution to address the inequitable distribution of resources sewn by decades of structural racism and disinvestment. GI provides recipients with security, time, and support to enable their transition into adulthood and shows promise for improving mental and physical health outcomes. To date, few GI pilots have targeted emerging adults. The BEEM trial seeks to determine whether providing GI to BEA improves financial wellbeing, mental and physical health as a means to address health disparities. Methods/design Using a randomized controlled crossover trial design, 300 low-income BEA from San Francisco and Oakland, California, are randomized to receive a $500/month GI either during the first 12-months of follow-up (Phase I) or during the second 12-months of a total of 24-months follow-up (Phase II). All participants are offered enrollment in optional peer discussion groups and financial mentoring to bolster financial capability. Primary intention-to-treat analyzes will evaluate the impact of GI at 12 months among Phase I GI recipients compared to waitlist arm participants using Generalized Estimating Equations (GEE). Primary outcomes include: (a) financial well-being (investing in education/training); (b) mental health status (depressive symptoms); and (c) unmet need for mental health and sexual and reproductive health services. Secondary analyzes will examine effects of optional financial capability components using GEE with causal inference methods to adjust for differences across sub-strata. We will also explore the degree to which GI impacts dissipate after payments end. Study outcomes will be collected via surveys every 3 months throughout the study. A nested longitudinal qualitative cohort of 36 participants will further clarify how GI impacts these outcomes. We also discuss how anti-racism praxis guided the intervention design, evaluation design, and implementation. Discussion Findings will provide the first experimental evidence of whether targeted GI paired with complementary financial programming improves the financial well-being, mental health, and unmet health service needs of urban BEA. Results will contribute timely evidence for utilizing GI as a policy tool to reduce health disparities. Clinical trial registration https://clinicaltrials.gov, identifier NCT05609188.
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Affiliation(s)
- Sheri A. Lippman
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | | | - Michelle K. Nakphong
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Abigail Arons
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | | | - Adrienne Rain Mocello
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Emily A. Arnold
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Starley B. Shade
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | | | | | | | - William H. Dow
- Department of Health Policy and Management, University of California, Berkeley, Berkeley, CA, United States
| | - Marguerita A. Lightfoot
- Oregon Health & Science University – Portland State University School of Public Health, Portland, OR, United States
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2
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Senn S. Viewpoint: Do not resurrect the two-stage procedure. Pharm Stat 2022; 21:808-814. [PMID: 35819114 DOI: 10.1002/pst.2224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/18/2022] [Accepted: 04/04/2022] [Indexed: 11/10/2022]
Abstract
In 1989, Peter Freeman published a paper that challenged a commonly accepted approach for analyzing cross-over trials, the so-called two-stage procedure. Freeman himself recommended using the Bayesian approach of Andy Grieve. The flaws Freeman exposed were serious and led many statisticians to conclude that the procedure was unacceptable. Unfortunately, more than 30 years later, one still encounters its use. This note explains, using a simple simulation, why the two-stage procedure is, indeed, as Freeman showed unacceptable and should not be used.
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Affiliation(s)
- Stephen Senn
- School of Health and Related Research, Medical Statistics Group, University of Sheffield, Edinburgh, UK
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Avellanet M, Boada-Pladellorens A, Pages E, Dorca A, Sabria B, Pfeifer M, Gea E. A Comparative Study of a Novel Postural Garment Versus Exercise for Women with Nonspecific Cervical Pain: A Randomized Cross-over Trial. Spine (Phila Pa 1976) 2021; 46:1517-1524. [PMID: 34292213 PMCID: PMC8553007 DOI: 10.1097/brs.0000000000004123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/24/2021] [Accepted: 03/08/2021] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Randomized cross-over study. OBJECTIVE The aim of this study was to compare exercise, the criterion standard, to the postural garment PosturePlusForce in the management of nonspecific cervical pain in women. We also analyzed both interventions with regards to baseline posture, use of pharmacological pain relievers, compliance, and comfort. SUMMARY OF BACKGROUND DATA The prevalence of neck pain has increased during the last decade, preferentially affecting women. Those suffering from this condition may manifest a decrease in quality of life and inability to work. Consistent recommendations highlight the importance of exercise and posture for neck pain improvement. METHODS A total of 32 female health care professionals with cervical pain (≥3 on the visual analogue scale) entered the trial. Participants were allocated to either performing exercises or wearing the postural garment. The cross-over between interventions was separated by a 3-month washout period. Primary outcomes included pain intensity and posture. Secondary outcomes comprised cervical pain-related disability, psychological factors, physical activity, global perceived effect of treatment, and garment comfort. Treatment compliance, medication use, and adverse events were also recorded. RESULTS Both interventions showed a significant improvement in pain in subjects with an adherence >60%. However, in participants with dorsal hyperkyphosis (>45°), the garment demonstrated a greater reduction in pain than exercise (P = 0.019). Additionally, those wearing the garment needed fewer pain relievers than those performing exercises (P = 0.007). Compliance was >50% for both interventions and comfort was contingent on season. CONCLUSION In our study, PosturePlusForce showed, at least, a similar effect on pain to exercise, although those with dorsal hyperkyphosis exhibited a greater reduction in pain and related variables with the garment. Pain relievers were less required by those wearing PosturePlusForce than by those performing the exercises.Level of Evidence: 1.
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Affiliation(s)
- Merce Avellanet
- Rehabilitation Department, Hospital Nostra Sra. de Meritxell, Andorra, Research Group on Health Sciences and Health Services, University of Andorra, Andorra
| | - Anna Boada-Pladellorens
- Rehabilitation Department, Hospital Nostra Sra. de Meritxell, Andorra, Research Group on Health Sciences and Health Services, University of Andorra, Andorra
| | - Esther Pages
- Rehabilitation Department, Hospital Nostra Sra. de Meritxell, Andorra, Research Group on Health Sciences and Health Services, University of Andorra, Andorra
| | | | | | | | - Elvira Gea
- Head of Pharmacy Department, Hospital Nostra Sra de Meritxell, Andorra
- Research Group on Health Sciences and Health Services, University of Andorra, Andorra
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Miller JM, Sadak KT, Shahriar AA, Wilson NJ, Hampton M, Bhattacharya M, Towle A, Turcotte LM. Cancer survivors exercise at higher intensity in outdoor settings: The GECCOS trial. Pediatr Blood Cancer 2021; 68:e28850. [PMID: 33369068 DOI: 10.1002/pbc.28850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE This randomized cross-over group pilot trial assessed feasibility of recruiting survivors from a long-term follow-up clinic to an exercise group and measured whether outdoor or indoor exercise sessions better supported exercise motivation and behaviors in survivors of cancer. METHODS Sixteen adolescent and young adult survivors of any cancer completed indoor and outdoor exercise sessions in this randomized cross-over pilot trial. Measures of physical activity, motivation, and fatigue were taken 2 weeks before and 2 weeks after indoor sessions and 2 weeks before and 2 weeks after outdoor sessions. Measures of physical activity and fatigue were also taken during each exercise session. RESULTS Initial recruiting of 19 participants met recruiting goals. Survivors who attended the most sessions lived an average of 8.7 km closer to the clinic. Objectively measured physical activity intensity was 0.63 metabolic equivalents of a task (METs) per minute greater during outdoor exercise sessions as compared to indoor exercise sessions. There were no meaningful differences in long term, habitual physical activity behavior, motivation, or fatigue in the weeks following the outdoor exercise sessions as compared to the indoor exercise sessions. CONCLUSIONS This study shows the feasibility of recruiting survivors from a long-term follow-up clinic to community-based exercise groups. Although this brief pilot intervention did not show significant effects on habitual physical activity behavior or motivation in adolescent and young adult survivors of cancer, the greater exercise intensity during the outdoor exercise sessions indicate that holding group exercise sessions for survivors outdoors may promote greater intensity during exercise.
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Affiliation(s)
- Jonathan M Miller
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Karim T Sadak
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Arman A Shahriar
- Medical School, University of Minnesota-Twin Cities, Minneapolis, Minnesota
| | - Natalie J Wilson
- Medical School, University of Minnesota-Twin Cities, Minneapolis, Minnesota
| | | | | | - Ali Towle
- The Loppet Foundation, Minneapolis, Minnesota
| | - Lucie M Turcotte
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
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Tyson CC, Luciano A, Modliszewski JL, Corcoran DL, Bain JR, Muehlbauer M, Ilkayeva O, Pourafshar S, Allen J, Bowman C, Gung J, Asplin JR, Pendergast J, Svetkey LP, Lin PH, Scialla JJ. Effect of Bicarbonate on Net Acid Excretion, Blood Pressure, and Metabolism in Patients With and Without CKD: The Acid Base Compensation in CKD Study. Am J Kidney Dis 2021; 78:38-47. [PMID: 33810868 DOI: 10.1053/j.ajkd.2020.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/10/2020] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Patients with CKD are at elevated risk of metabolic acidosis due to impaired net acid excretion (NAE). Identifying early markers of acidosis may guide prevention in chronic kidney disease (CKD). This study compared NAE in participants with and without CKD, as well as the NAE, blood pressure (BP), and metabolomic response to bicarbonate supplementation. STUDY DESIGN Randomized order, cross-over study with controlled feeding. SETTING & PARTICIPANTS Participants consisted of 8 patients with CKD (estimated glomerular filtration rate 30-59mL/min/1.73m2 or 60-70mL/min/1.73m2 with albuminuria) and 6 patients without CKD. All participants had baseline serum bicarbonate concentrations between 20 and 28 mEq/L; they did not have diabetes mellitus and did not use alkali supplements at baseline. INTERVENTION Participants were fed a fixed-acid-load diet with bicarbonate supplementation (7 days) and with sodium chloride control (7 days) in a randomized order, cross-over fashion. OUTCOMES Urine NAE, 24-hour ambulatory BP, and 24-hour urine and plasma metabolomic profiles were measured after each period. RESULTS During the control period, mean NAE was 28.3±10.2 mEq/d overall without differences across groups (P=0.5). Urine pH, ammonium, and citrate were significantly lower in CKD than in non-CKD (P<0.05 for each). Bicarbonate supplementation reduced NAE and urine ammonium in the CKD group, increased urine pH in both groups (but more in patients with CKD than in those without), and increased; urine citrate in the CKD group (P< 0.2 for interaction for each). Metabolomic analysis revealed several urine organic anions were increased with bicarbonate in CKD, including 3-indoleacetate, citrate/isocitrate, and glutarate. BP was not significantly changed. LIMITATIONS Small sample size and short feeding duration. CONCLUSIONS Compared to patients without CKD, those with CKD had lower acid excretion in the form of ammonium but also lower base excretion such as citrate and other organic anions, a potential compensation to preserve acid-base homeostasis. In CKD, acid excretion decreased further, but base excretion (eg, citrate) increased in response to alkali. Urine citrate should be evaluated as an early and responsive marker of impaired acid-base homeostasis. FUNDING National Institute of Diabetes and Digestive and Kidney Diseases and the Duke O'Brien Center for Kidney Research. TRIAL REGISTRATION Registered at ClinicalTrials.gov with study number NCT02427594.
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Affiliation(s)
- Crystal C Tyson
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Alison Luciano
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
| | - Jennifer L Modliszewski
- Center for Genomic and Computational Biology, Duke University School of Medicine, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC
| | - David L Corcoran
- Center for Genomic and Computational Biology, Duke University School of Medicine, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC
| | - James R Bain
- Department of Medicine, Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC
| | - Michael Muehlbauer
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC
| | - Olga Ilkayeva
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC
| | - Shirin Pourafshar
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA
| | - Jenifer Allen
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Cassandra Bowman
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Joseph Gung
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - John R Asplin
- Litholink Corp, Laboratory Corporation of America Holdings, Chicago, IL
| | - Jane Pendergast
- Department of Medicine, Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC
| | - Laura P Svetkey
- Department of Medicine, Duke University School of Medicine, Durham, NC; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC
| | - Pao-Hwa Lin
- Department of Medicine, Duke University School of Medicine, Durham, NC; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC
| | - Julia J Scialla
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA.
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Sokal P, Malukiewicz A, Kierońska S, Murawska J, Guzowski C, Rudaś M, Paczkowski D, Rusinek M, Krakowiak M. Sub-Perception and Supra-Perception Spinal Cord Stimulation in Chronic Pain Syndrome: A Randomized, Semi-Double-Blind, Crossover, Placebo-Controlled Trial. J Clin Med 2020; 9:E2810. [PMID: 32878061 PMCID: PMC7563558 DOI: 10.3390/jcm9092810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/18/2020] [Accepted: 08/29/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The introduction of modern sub-perception modalities has improved the efficacy of spinal cord stimulation (SCS) in refractory pain syndromes of the trunk and lower limbs. The objective of this study was to evaluate the effectiveness of low and high frequency SCS among patients with chronic pain. MATERIAL AND METHODS A randomised, semi-double-blind, placebo controlled, four period (4 × 2 weeks) crossover trial was conducted from August 2018 to January 2020. Eighteen patients with SCS due to failed back surgery syndrome and/or complex regional pain syndrome were randomised to four treatment arms without washout periods: (1) low frequency (40-60 Hz), (2) 1 kHz, (3) clustered tonic, and (4) sham SCS (i.e., placebo). The primary outcome was pain scores measured by visual analogue scale (VAS) preoperatively and during subsequent treatment arms. RESULTS Pain scores (VAS) reported during the preoperative period was M (SD) = 8.13 (0.99). There was a 50% reduction in pain reported in the low frequency tonic treatment group (M (SD) = 4.18 (1.76)), a 37% reduction in the 1 kHz treatment group (M (SD) = 5.17 (1.4)), a 34% reduction in the clustered tonic settings group (M (SD) = 5.27 (1.33)), and a 34% reduction in the sham stimulation group (M (SD) = 5.42 (1.22)). The reduction in pain from the preoperative period to the treatment period was significant in each treatment group (p < 0.001). Overall, these reductions were of comparable magnitude between treatments. However, the modality most preferred by patients was low frequency (55% or 10 patients). CONCLUSIONS The pain-relieving effects of SCS reached significance and were comparable across all modes of stimulation including sham. Sub-perception stimulation was not superior to supra-perception. SCS was characterised by a high degree of placebo effect. No evidence of carryover effect was observed between subsequent treatments. Contemporary neuromodulation procedures should be tailored to the individual preferences of patients.
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Affiliation(s)
- Paweł Sokal
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (A.M.); (S.K.); (M.R.); (D.P.); (M.R.); (M.K.)
- Faculty of Health Sciences, Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toruń, Jagielońska 13-15 85-067 Bydgoszcz, Poland
| | - Agnieszka Malukiewicz
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (A.M.); (S.K.); (M.R.); (D.P.); (M.R.); (M.K.)
| | - Sara Kierońska
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (A.M.); (S.K.); (M.R.); (D.P.); (M.R.); (M.K.)
| | - Joanna Murawska
- Students’ Scientific Circle at the Department of Neurosurgery, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (J.M.); (C.G.)
| | - Cezary Guzowski
- Students’ Scientific Circle at the Department of Neurosurgery, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (J.M.); (C.G.)
| | - Marcin Rudaś
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (A.M.); (S.K.); (M.R.); (D.P.); (M.R.); (M.K.)
| | - Dariusz Paczkowski
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (A.M.); (S.K.); (M.R.); (D.P.); (M.R.); (M.K.)
| | - Marcin Rusinek
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (A.M.); (S.K.); (M.R.); (D.P.); (M.R.); (M.K.)
| | - Mateusz Krakowiak
- Department of Neurosurgery and Neurology, Jan Biziel University Hospital Nr 2, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (A.M.); (S.K.); (M.R.); (D.P.); (M.R.); (M.K.)
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van Diemen JJK, Madsen MC, Vrancken P, de Bie K, van der Bom JG, Veen G, Bonten TN, Fuijkschot WW, Smulders YM, Thijs A. Evening aspirin intake results in higher levels of platelet inhibition and a reduction in reticulated platelets - a window of opportunity for patients with cardiovascular disease? Platelets 2020; 32:821-827. [PMID: 32838616 DOI: 10.1080/09537104.2020.1809643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cardiovascular events occur most frequently in the early morning. Similarly, the release of reticulated platelets (RP) by megakaryocytes has a peak in the late night and early morning. Which aspirin regimen most effectively inhibits platelets during these critical hours is unknown. Hence, the primary objective of this trial was to assess platelet function and RP levels at 8.00 AM, in stable cardiovascular (CVD) patients, during three different aspirin regimens. In this open-label randomized cross-over study subjects were allocated to three sequential aspirin regimens: once-daily (OD) 80 mg morning; OD-evening, and twice-daily (BID) 40 mg. Platelet function was measured at 8.00 AM & 8.00 PM by serum Thromboxane B2 (sTxB2) levels, the Platelet Function Analyzer (PFA)-200® Closure Time (CT), Aspirin Reaction Units (ARU, VerifyNow®), and RP levels. In total, 22 patients were included. At 8.00 AM, sTxB2 levels were the lowest after OD-evening in comparison with OD-morning (p = <0.01), but not in comparison with BID. Furthermore, RP levels were similar at 8.00 AM, but statistically significantly reduced at 8.00 PM after OD-evening (p = .01) and BID (p = .02) in comparison with OD-morning. OD-evening aspirin intake results in higher levels of platelet inhibition during early morning hours and results in a reduction of RP levels in the evening. These findings may, if confirmed by larger studies, be relevant to large groups of patients taking aspirin to reduce cardiovascular risk.
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Affiliation(s)
- J J K van Diemen
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - M C Madsen
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - P Vrancken
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - K de Bie
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,JJ Van Rood Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - G Veen
- Department of Cardiology, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - T N Bonten
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - W W Fuijkschot
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - Y M Smulders
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - A Thijs
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
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Schreglmann SR, Büchele F, Kägi G, Baumann CR. Pyridostigmine bromide versus fludrocortisone in the treatment of orthostatic hypotension in Parkinson's disease - reply. Eur J Neurol 2018; 25:e27-e28. [PMID: 29356263 DOI: 10.1111/ene.13541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 12/01/2017] [Indexed: 11/29/2022]
Affiliation(s)
- S R Schreglmann
- Department of Neurology, University Hospital Zurich, Zurich.,Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - F Büchele
- Department of Neurology, University Hospital Zurich, Zurich
| | - G Kägi
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - C R Baumann
- Department of Neurology, University Hospital Zurich, Zurich
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Simões RM, Castro Caldas A, Ferreira JJ. Comments on: 'Pyridostigmine bromide versus fludrocortisone in the treatment of orthostatic hypotension in Parkinson's disease - a randomized controlled trial'. Eur J Neurol 2018; 25:e4. [PMID: 29271586 DOI: 10.1111/ene.13475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 10/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- R M Simões
- Neurology Department, Hospital Beatriz Ângelo, Loures, Portugal.,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - A Castro Caldas
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,Neurology Service, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal
| | - J J Ferreira
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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10
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Johnson SR, Khanna D, Allanore Y, Matucci-Cerinic M, Furst DE. Systemic Sclerosis Trial Design Moving Forward. J Scleroderma Relat Disord 2016; 1:177-80. [PMID: 29492470 DOI: 10.5301/jsrd.5000198] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The 2013 ACR-EULAR classification criteria for systemic sclerosis (SSc) have shifted the construct of SSc. The new reality is that patients recruited for trials may not be so severe and not so advanced. We can now look for therapeutics that might stop disease evolution and/or prevent organ involvement. This article highlights recent advances in research methodology, and broadens the potential range of design and analytic considerations when planning a SSc trial.
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