A new editor and new features for our readers and authors

Griggs, Robert C.; Pieper, Kathleen M.

doi:10.1212/01.wnl.0000229468.02136.f6

Cited by 2 publications

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“…High frequency chest wall oscillation (HFCWO) creates high velocity, low amplitude oscillatory airflows when applied through a pneumatic vest worn over the thorax, and is used for airway mucus clearance in patients with cystic fibrosis, bronchiectasis, and neuromuscular disorders [12-15]. Studies in patients with cystic fibrosis suggest that HFCWO applied via a pneumatic vest is as effective as other modes of airway mucus clearance, including hand-held devices (e.g., flutter devices) and conventional chest physiotherapy[16].…”

Section: Introductionmentioning

confidence: 99%

High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trial

et al. 2011

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BackgroundHigh frequency chest wall oscillation (HFCWO) is used for airway mucus clearance. The objective of this study was to evaluate the use of HFCWO early in the treatment of adults hospitalized for acute asthma or chronic obstructive pulmonary disease (COPD).MethodsRandomized, multi-center, double-masked phase II clinical trial of active or sham treatment initiated within 24 hours of hospital admission for acute asthma or COPD at four academic medical centers. Patients received active or sham treatment for 15 minutes three times a day for four treatments. Medical management was standardized across groups. The primary outcomes were patient adherence to therapy after four treatments (minutes used/60 minutes prescribed) and satisfaction. Secondary outcomes included change in Borg dyspnea score (≥ 1 unit indicates a clinically significant change), spontaneously expectorated sputum volume, and forced expired volume in 1 second.ResultsFifty-two participants were randomized to active (n = 25) or sham (n = 27) treatment. Patient adherence was similarly high in both groups (91% vs. 93%; p = 0.70). Patient satisfaction was also similarly high in both groups. After four treatments, a higher proportion of patients in the active treatment group had a clinically significant improvement in dyspnea (70.8% vs. 42.3%, p = 0.04). There were no significant differences in other secondary outcomes.ConclusionsHFCWO is well tolerated in adults hospitalized for acute asthma or COPD and significantly improves dyspnea. The high levels of patient satisfaction in both treatment groups justify the need for sham controls when evaluating the use of HFCWO on patient-reported outcomes. Additional studies are needed to more fully evaluate the role of HFCWO in improving in-hospital and post-discharge outcomes in this population.Trial RegistrationClinicalTrials.gov: NCT00181285

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Section: Introductionmentioning

confidence: 99%

High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trial

et al. 2011

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A randomized placebo-controlled trial of Ginkgo biloba for the prevention of cognitive decline

Dodge¹,

Zitzelberger²,

Oken³

et al. 2008

Neurology

134

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Objective-To assess the feasibility, safety, and efficacy of Ginkgo biloba extract (GBE) on delaying the progression to cognitive impairment in normal elderly aged 85 and older.Methods-Randomized, placebo-controlled, double-blind, 42-month pilot study with 118 cognitively intact subjects randomized to standardized GBE or placebo. Kaplan-Meier estimation, Cox proportional hazard, and random-effects models were used to compare the risk of progression from Clinical Dementia Rating (CDR) = 0 to CDR = 0.5 and decline in episodic memory function between GBE and placebo groups.Results-In the intention-to-treat analysis, there was no reduced risk of progression to CDR = 0.5 (log-rank test, p = 0.06) among the GBE group. There was no less of a decline in memory function among the GBE group (p = 0.05). In the secondary analysis, where we controlled the medication adherence level, the GBE group had a lower risk of progression from CDR = 0 to CDR = 0.5 (HR = 0.33, p = 0.02), and a smaller decline in memory scores (p = 0.04). There were more ischemic strokes and TIAs in the GBE group (p = 0.01).Conclusions-In unadjusted analyses, Ginkgo biloba extract (GBE) neither altered the risk of progression from normal to Clinical Dementia Rating (CDR) = 0.5, nor protected against a decline in memory function. Secondary analysis taking into account medication adherence showed a protective effect of GBE on the progression to CDR = 0.5 and memory decline. Results of larger prevention trials taking into account medication adherence may clarify the effectiveness of GBE. More stroke and TIA cases observed among the GBE group requires further study to confirm.One of the most pressing public health problems facing society in the coming decades is the rapidly growing number of aging individuals who, because of their age alone, are highly susceptible to dementia. 1 Because of this major increase in those affected with dementia, the potential of delaying or preventing cognitive decline before onset of symptoms (primary prevention) is thus of great importance. Very few studies of primary prevention of dementia have been completed. In part, this is related to the challenges of conducting such studies which include selection of non-toxic agents to be administered over long follow-up periods in relatively large subject cohorts. Given these challenges, one approach toward developing optimized dementia prevention studies is to focus on high-risk (for developing dementia) populations using readily available agents.In this article we describe the results of a randomized placebo-controlled primary prevention trial of standardized Ginkgo biloba extract (GBE) designed for the purpose of demonstrating that 1) a primary prevention trial in the high risk for dementia, oldest old (age ≥ 85) is feasible; 2) GBE is safe in the oldest old; and 3) there is a trend for GBE to delay the onset of progression to cognitive impairment. The study was designed within a constrained budget, conceived of as a feasibility study and as a means to estimate future study ...

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A new editor and new features for our readers and authors

Cited by 2 publications

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High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trial

High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trial

A randomized placebo-controlled trial of Ginkgo biloba for the prevention of cognitive decline

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