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Objectives: This preliminary randomized double-blind controlled trial was performed to test the efficacy of ultramicronized palmitoylethanolamide treatment in the burning mouth syndrome., Materials and Methods: Patients with referred burning mouth intensity greater than 4, according to the Numeric Rating Scale, were included in the study according to established inclusion and exclusion criteria. Patients were randomized into two groups and received either placebo or ultramicronized palmitoylethanolamide 600 mg twice daily for 60 days. Patients were assessed at baseline, 30 and 60 days after treatment start, and 4 months after treatment discontinuation. In order to evaluate the change in the burning mouth sensation over time, the generalized linear mixed model was employed., Results: A total of 35 patients were considered eligible, among which 6 withdrew prior to the end of treatment. A statistically significant reduction of burning mouth sensation (p < 0.0132) was registered at the end of the active treatment in the ultramicronized palmitoylethanolamide group compared to the placebo one. Any side effect related to the active treatment was neither observed nor reported both by patients and by physicians., Conclusions: The significant decrease of burning sensation in the ultramicronized palmitoylethanolamide group compared to the placebo group suggests to consider this naturally occurring molecule as a viable therapy in the management of burning mouth syndrome., Clinical Relevance: The use of an effective compound to manage the burning mouth syndrome, devoid of adverse effects for the patient and that does not interfere with other pharmacological therapies, could find wide employability from clinicians.

In the health care community, nurses are important agents of change and vehicles for improvements in clinical practice and policy. Pediatric nurses empowered with the tools of evidence-based practice and clinical expertise collaborated in 2007 with other health care professionals to make changes in clinical practice for pediatric patients with vascular access devices (VADs). Nurses recognized that there was a need for a change in the heparinization policy for children with short- and long-term VADs. Data were methodically collected over a 1-year period on 500 VAD. Data collection demonstrated a range of VAD volumes that did not exceed 2 mL. The group analysis of the results gave support for changes in the volumes needed for heparinization. Establishment of appropriate heparin dosing based on scientific data led to a decrease in heparin used to maintain pediatric VAD patency and aided in lowering the risk of side effects in patients.