1.
Glucose solution is more effective in relieving pain in neonates than non-nutritive sucking: A randomized clinical trial.
Lima, AG, Santos, VS, Nunes, MS, Barreto, JA, Ribeiro, CJ, Carvalho, J, Ribeiro, MC
European journal of pain (London, England). 2017;(1):159-165
Abstract
BACKGROUND Few studies have compared the analgesic effect of 25% glucose and non-nutritive sucking. We compared the analgesic effect of 25% glucose and non-nutritive sucking in newborns undergoing hepatitis B vaccination. Our hypothesis is that 25% glucose is more effective in relieving pain than non-nutritive sucking. METHODS A randomized clinical trial with 78 healthy newborns was performed. Neonates were assigned randomly to receive 25% glucose (G25) and non-nutritive sucking (NNS). Pain was assessed using the Neonatal Infant Pain Scale (NIPS) before and during the immunization procedure. In addition, we evaluated various physiological parameters and crying time. RESULTS Neonates who received 25% glucose registered lower NIPS scores than those from the NNS group [mean (SD), 3.3 (2.1) vs. 5.6 (1.6), p < 0.001]. The crying time was shorter among newborns in the G25 group than in the NNS and control groups. CONCLUSION The use of 25% glucose before the vaccination procedure was more effective in relieving acute pain, with newborns in the G25 group registering scores two times lower on the NIPS scale. The clinical practice of administering 25% glucose is therefore a suggested nondrug measure for pain relief during painful procedures. SIGNIFICANCE Neonates who received 25% glucose registered lower NIPS scores than those from the NNS group; the crying time was shorter among newborns in the G25 group than in the NNS and control groups; the use of 25% glucose before the vaccination procedure was more effective in relieving acute pain.
2.
Comparison of analgesic effect of direct breastfeeding, oral 25% dextrose solution and placebo during 1st DPT vaccination in healthy term infants: a randomized, placebo controlled trial.
Goswami, G, Upadhyay, A, Gupta, NK, Chaudhry, R, Chawla, D, Sreenivas, V
Indian pediatrics. 2013;(7):649-53
Abstract
OBJECTIVE To compare analgesic effect of direct breast feeding, 25% dextrose solution and placebo as we give 1st intramuscular whole cell DPT injection to 6week - 3month old infants. DESIGN Randomized, placebo controlled trial. SETTINGS Immunization clinic of Department of Pediatrics, LLRM Medical College. PARTICIPANTS Infants coming for their 1st DPT vaccination were randomized in to three groups of 40 each. OUTCOME MEASURES The primary outcome variable was the duration of cry after vaccination. Secondary outcome variables were Modified Facial Coding Score (MFCS) and latency of onset of cry. RESULTS 120 babies were equally enrolled in breast feed group, 25% dextrose fed group and distilled water fed group. Median (interquartile range) of duration of cry was significantly lower in breast fed (33.5 (17-54) seconds) and 25% dextrose fed babies (47.5 (31-67.5) seconds) as compared to babies given distilled water (80.5 (33.5-119.5) seconds) (P<0.001). MFCS at 1 min and 3 min was significantly lower in direct breast fed and dextrose fed babies. CONCLUSION Direct breastfeeding and 25% dextrose act as analgesic in young infants undergoing DPT vaccination in young infants less than 3 month of age.
3.
Transcriptional signatures related to glucose and lipid metabolism predict treatment response to the tumor necrosis factor antagonist infliximab in patients with treatment-resistant depression.
Mehta, D, Raison, CL, Woolwine, BJ, Haroon, E, Binder, EB, Miller, AH, Felger, JC
Brain, behavior, and immunity. 2013;:205-15
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Abstract
The tumor necrosis factor (TNF) antagonist infliximab was recently found to reduce depressive symptoms in patients with increased baseline inflammation as reflected by a plasma C-reactive protein concentration >5 mg/L. To further explore predictors and targets of response to infliximab, differential gene expression was examined in peripheral blood mononuclear cells from infliximab responders (n=13) versus non-responders (n=14) compared to placebo at baseline and 6 h, 24 h, and 2 weeks after the first infliximab infusion. Treatment response was defined as 50% reduction in depressive symptoms at any point during the 12-week trial. One-hundred-forty-eight gene transcripts were significantly associated (1.2-fold, adjusted p≤0.01) with response to infliximab and were distinct from placebo responders. Transcripts predictive of infliximab response were associated with gluconeogenesis and cholesterol transport, and were enriched in a network regulated by hepatocyte nuclear factor (HNF)4-alpha, a transcription factor involved in gluconeogenesis and cholesterol and lipid homeostasis. Of the 148 transcripts differentially expressed at baseline, 48% were significantly regulated over time in infliximab responders, including genes related to gluconeogenesis and the HNF4-alpha network, indicating that these predictive genes were responsive to infliximab. Responders also demonstrated inhibition of genes related to apoptosis through TNF signaling at 6 h and 24 h after infusion. Transcripts down-regulated in responders 2 weeks after infliximab were related to innate immune signaling and nuclear factor-kappa B. Thus, baseline transcriptional signatures reflective of alterations in glucose and lipid metabolism predicted antidepressant response to infliximab, and infliximab response involved regulation of metabolic genes and inhibition of genes related to innate immune activation.
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Oral glucose as an analgesic to reduce infant distress following immunization at the age of 3, 5 and 12 months.
Thyr, M, Sundholm, A, Teeland, L, Rahm, VA
Acta paediatrica (Oslo, Norway : 1992). 2007;(2):233-6
Abstract
AIM: To evaluate oral glucose as an analgesic to reduce infant distress after immunization during the first year of life and to investigate if these effects change during this period. METHODS A prospective controlled trial of the effectiveness of glucose on crying response to immunizations at 3, 5 and 12 months of age. A total of 110 infants were randomized to receive 2 mL of 30% glucose or water. The same solution was given at 3, 5 and 12 months. Crying was registered from onset of the injection up to 120 seconds. Infanrix Polio Hib was administered intra-muscular in the thigh. Observation nurse and parents were blind to the nature of the solution. RESULTS Administration of glucose reduced the mean crying time by 22% at 3 months, 62% at 5 months and 52% at 12 months. The difference was significant at 5 and at 12 months. In the water group, there was a significant correlation between the children who cried at 3 months and who subsequently cried at 5 and 12 months. No correlations were found in the glucose group. CONCLUSION Sweet solution can be used as a simple and safe method to reduce the distress following immunization in infants up to 12 months.