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Medicine Jun 2024Combining hydromorphone with ropivacaine in ultrasound-guided erector spinae plane blocks enhances postoperative analgesia and reduces interleukin-6 expression in breast... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Combining hydromorphone with ropivacaine in ultrasound-guided erector spinae plane blocks enhances postoperative analgesia and reduces interleukin-6 expression in breast surgery patients.
METHODS
In this study, breast cancer patients undergoing modified radical mastectomy were randomized into 3 groups for anesthesia (30 patients in each group): standard general (group C), Erector Spinae Plane Block (ESPB) with ropivacaine (group R), and ESPB with ropivacaine plus hydromorphone (group HR). Diagnosis: Breast cancer patients. Postsurgery, pain levels, IL-6, anesthetic doses, additional analgesia needs, and recovery milestones were compared to evaluate the efficacy of the ESPB enhancements.
RESULTS
The 3 groups were not significantly different in baseline characteristics, operation time, number of cases with postoperative nausea, and serum IL-6 concentrations at T1 (the time of being returned to the ward after surgery). At T2 (at 6:00 in the next morning after surgery), the serum IL-6 concentration in group HR was significantly lower than that in groups R and C (P < .05); the intraoperative doses of remifentanil, sufentanil, and propofol were significantly lower in groups HR and R than those in group C (P < .05); Groups HR and R had significantly lower visual analog scale scores at T3 (4 hours postoperatively), T4 (12 hours postoperatively), and T5 (24 hours postoperatively) than those in group C (P < .05); the proportions of patients receiving postoperative remedial analgesia were significantly lower in groups HR and R than in group C (P < .05); groups HR and R had significantly lower proportions of patients with postoperative nausea than group C (P < .05); the time to the first anal exhaust and the time to the first ambulation after surgery were significantly shorter in groups HR and R than those in group C (P < .05).
CONCLUSION
Hydromorphone combined with ropivacaine for ESPB achieved a greater postoperative analgesic effect for patients receiving MRM under general anesthesia. The combined analgesia caused fewer adverse reactions and inhibited the expression level of the inflammatory factor IL-6 more effectively, thereby facilitating postoperative recovery. ESPB using hydromorphone with ropivacaine improved pain control post-MRM, reduced adverse effects, and more effectively suppressed IL-6, enhancing recovery.
Topics: Humans; Ropivacaine; Female; Hydromorphone; Middle Aged; Nerve Block; Pain, Postoperative; Prospective Studies; Anesthetics, Local; Breast Neoplasms; Mastectomy, Modified Radical; Analgesics, Opioid; Adult; Interleukin-6; Paraspinal Muscles; Ultrasonography, Interventional; Drug Therapy, Combination; Pain Measurement
PubMed: 38941366
DOI: 10.1097/MD.0000000000038758 -
PloS One 2024Data on COVID-19 vaccine effectiveness to support regional vaccine policy and practice are limited in Africa. Thus, this review aimed to evaluate the efficacy and...
BACKGROUND
Data on COVID-19 vaccine effectiveness to support regional vaccine policy and practice are limited in Africa. Thus, this review aimed to evaluate the efficacy and effectiveness of COVID-19 vaccines administered in Africa.
METHODS
We systematically searched peer-reviewed randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies that reported on VE in Africa. We carried out a risk of bias assessment, and the findings of this review were synthesized and presented in a narrative form, including tables and figures. The synthesis was focused on COVID-19 VE against various levels of the disease condition and outcomes (infection, hospitalization or critical, and death), time points, and variants of concern.
RESULTS
A total of 13 studies, with a total sample size of 913,285 participants, were included in this review. The majority (8/13) of studies were from South Africa and 38.5% (5/13) were randomized clinical trials. The studies reported that a full dose of Pfizer-BioNTech vaccine had a VE of 100% against COVID-19 infection by Beta (B.1.351) and Delta variants and 96.7% against hospitalization by Delta variant. The Johnson and Johnson vaccine had VE ranging from 38.1%-62.0% against hospitalization and 51.9%- 86% against critical disease by Beta (B 1.351) variant. The Oxford-AstraZeneca vaccine had a VE of 89.4% against hospitalization by the Omicron variant but was not effective against the B.1.351 variant (10.4%). The Sinopharm vaccine had a VE of 67% against infection and 46% against hospitalization by Delta variant.
CONCLUSIONS
COVID-19 vaccines administered in Africa were effective in preventing infections, hospitalization, and death. These review findings underscore the need for concerted efforts of all stakeholders to enhance the access and availability of COVID-19 vaccines and reinforce public awareness to reach the high-risk, unvaccinated group of the African population.
Topics: Humans; COVID-19 Vaccines; COVID-19; SARS-CoV-2; Africa; Vaccine Efficacy; Hospitalization; Randomized Controlled Trials as Topic
PubMed: 38941303
DOI: 10.1371/journal.pone.0306309 -
JAMA Health Forum Jun 2024Despite growing interest in psychedelics, there is a lack of routine population-based surveillance of psychedelic microdosing (taking "subperceptual" doses of...
IMPORTANCE
Despite growing interest in psychedelics, there is a lack of routine population-based surveillance of psychedelic microdosing (taking "subperceptual" doses of psychedelics, approximately one-twentieth to one-fifth of a full dose, over prolonged periods). Analyzing Google search queries can provide insights into public interest and help address this gap.
OBJECTIVE
To analyze trends in public interest in microdosing in the US through Google search queries and assess their association with cannabis and psychedelic legislative reforms.
DESIGN, SETTING, AND PARTICIPANTS
In this cross-sectional study, a dynamic event-time difference-in-difference time series analysis was used to assess the impact of cannabis and psychedelic legislation on microdosing search rates from January 1, 2010, to December 31, 2023. Google search rates mentioning "microdosing," "micro dosing," "microdose," or "micro dose" within the US and across US states were measured in aggregate.
EXPOSURE
Enactment of (1) local psychedelic decriminalization laws; (2) legalization of psychedelic-assisted therapy and statewide psychedelic decriminalization; (3) statewide medical cannabis use laws; (4) statewide recreational cannabis use laws; and (5) all cannabis and psychedelic use restricted.
MAIN OUTCOME AND MEASURES
Microdosing searches per 10 million Google queries were measured, examining annual and monthly changes in search rates across the US, including frequency and nature of related searches.
RESULTS
Searches for microdosing in the US remained stable until 2014, then increased annually thereafter, with a cumulative increase by a factor of 13.4 from 2015 to 2023 (7.9 per 10 million to 105.6 per 10 million searches, respectively). In 2023, there were 3.0 million microdosing searches in the US. Analysis at the state level revealed that local psychedelic decriminalization laws were associated with an increase in search rates by 22.4 per 10 million (95% CI, 7.5-37.2), statewide psychedelic therapeutic legalization and decriminalization were associated with an increase in search rates by 28.9 per 10 million (95% CI, 16.5-41.2), statewide recreational cannabis laws were associated with an increase in search rates by 40.9 per 10 million (95% CI, 28.6-53.3), and statewide medical cannabis laws were associated with an increase in search rates by 11.5 per 10 million (95% CI, 6.0-16.9). From August through December 2023, 27.0% of the variation in monthly microdosing search rates between states was explained by differences in cannabis and psychedelics legal status.
CONCLUSION AND RELEVANCE
This cross-sectional study found that state-led legislative reforms on cannabis and psychedelics were associated with increased public interest in microdosing psychedelics.
Topics: Hallucinogens; Humans; United States; Cross-Sectional Studies; Cannabis; Legislation, Drug
PubMed: 38941086
DOI: 10.1001/jamahealthforum.2024.1653 -
Alternative Therapies in Health and... Jun 2024This study evaluated the effectiveness of nalbuphine combined with propofol in reducing visceral pain and preserving cognitive function during laparoscopic ovarian tumor...
OBJECTIVE
This study evaluated the effectiveness of nalbuphine combined with propofol in reducing visceral pain and preserving cognitive function during laparoscopic ovarian tumor resection.
METHODS
A total of 100 patients undergoing laparoscopic ovarian tumor resection from January 2019 to January 2022 were randomly assigned to either the control group or the research group (50 patients each). The control group received fentanyl combined with propofol for anesthesia, while the research group received nalbuphine combined with propofol. Various anesthetic parameters, hemodynamics, visceral pain(Visual analog scale was used to evaluate the degree of pain at rest and during movement at 2h, 6h, and 12h after the operation), cognitive function (Mini-Mental State Examination (MMSE) scale was used to assess the cognitive function before the operation and 1 day, 3 days, and 5 days after the operation, including time and place, language, orientation, calculation, delayed memory and useability), and incidence of adverse reactions were assessed and compared between the two groups.
RESULTS
The research group exhibited significantly lower propofol dosage and anesthesia recovery time compared to the control group (P < .05). Hemodynamic stability, as indicated by SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), and SpO2 (Peripheral Capillary Oxygen Saturation)levels, was better maintained in the research group, especially at the beginning of the operation (P < .05). VAS (Visual Analog Scale) scores for pain at rest and during exercise were significantly lower in the research group at 2h and 6h post-operation (P < .05). MMSE (Mini-Mental State Examination) scores were higher in the research group compared to the control group at 1and3 days post-operation (P < .05). Additionally, the incidence of adverse reactions was significantly lower in the research group (8.00%) compared to the control group (20.00%, P < .05).The above results were subjected to t test and χ2 test.
CONCLUSIONS
Nalbuphine combined with propofol effectively alleviates visceral pain during laparoscopic ovarian tumor resection, stabilizes hemodynamics, and preserves cognitive function. This combination demonstrates promising analgesic and sedative effects with high safety, suggesting its potential for widespread clinical use.
PubMed: 38940805
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024To compare the operation-related indexes, complication rates, and cardiac function indexes of bioresorbable scaffolds with drug-eluting scaffolds in coronary non-left...
AIM
To compare the operation-related indexes, complication rates, and cardiac function indexes of bioresorbable scaffolds with drug-eluting scaffolds in coronary non-left main stem lesions and to clarify the clinical value of bioresorbable scaffolds in percutaneous coronary intervention for non-left main stem lesions.
METHODS
The retrospective study sample consisted of 60 non-left main stem lesions treated using bioresorbable stent or drug-eluting stents between June 2022 and June 2023. Comparison of surgical operation-related indexes, intraoperative and postoperative complications, cardiac function indexes, adverse cardiovascular events, and surgical success rate between the two groups.
RESULTS
The surgical operation time and X-ray exposure time of the experimental group were shorter than those of the control group, and contrast agent dosage was lower than that of the control group (P < .05). Left ventricular ejection fraction (LVEF) was higher than that in the control group at one month after surgery, and left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) in the experimental group was lower than that in the control group, and the difference was statistically significant (P < .05). The total incidence of major adverse cardiovascular events was lower in the experimental group than in the control group (15.6% VS. 71.4%)(P < .05).
CONCLUSION
Bioresorbable scaffolds are more effective than drug-eluting scaffolds in treating non-left main stem lesions by percutaneous coronary intervention. Furthermore, bioresorbable scaffolds could be considered a preferable option for certain patients undergoing percutaneous coronary intervention for non-left main stem lesions.
PubMed: 38940777
DOI: No ID Found -
Translational Vision Science &... Jun 2024To compare changes in superficial retinal vascular density (SRVD), deep retinal vascular density (DRVD), and retinal thickness (RT) of the macular zone after repeated... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
PURPOSE
To compare changes in superficial retinal vascular density (SRVD), deep retinal vascular density (DRVD), and retinal thickness (RT) of the macular zone after repeated low-level red light (RLRL) and 0.01% atropine exposure in premyopic schoolchildren.
METHODS
Prospective randomized trial. Sixty-nine schoolchildren with cycloplegic refraction >-0.75 D and ≤0.50 D were randomly assigned to RLRL and 0.01% atropine groups. SRVD, DRVD, and RT were measured using swept-source optical coherence tomography at baseline and six months. The macular zone was divided into three concentric rings (fovea, parafovea, and perifovea) using the Early Treatment Diabetic Retinopathy Study.
RESULTS
After six months, the whole, parafoveal, and perifoveal SRVD significantly increased in the two groups (all P < 0.05). Multivariate regression analyses showed that none of these changes varied significantly between the two groups (all P > 0.05), whereas foveal SRVD remained stable in both groups (all P > 0.05). In the RLRL group, the whole and perifoveal DRVD increased significantly (all P < 0.05), whereas no statistical difference was observed in the foveal and parafoveal DRVD. DRVD remained stable in the 0.01% atropine group (all P > 0.05). No significant differences were observed in RT changes between the two groups (all P > 0.05). In comparison, there were no significant changes in SRVD, DRVD, or RT after six months in the placebo group in our previous study.
CONCLUSIONS
SRVD increased similarly in the RLRL and 0.01% atropine groups, whereas DRVD increased only in the former group. There were no significant RT changes in either group after six months of treatment in premyopic schoolchildren.
TRANSLATIONAL RELEVANCE
This research observed the effects of low-level red light and 0.01% atropine on retinal vasculature, offering valuable insights into myopia progression prevention.
Topics: Humans; Atropine; Male; Female; Child; Prospective Studies; Retinal Vessels; Mydriatics; Tomography, Optical Coherence; Myopia; Ophthalmic Solutions; Phototherapy; Microvascular Density; Red Light
PubMed: 38940757
DOI: 10.1167/tvst.13.6.23 -
Clinical Cardiology Jul 2024Chronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains uncertain.
HYPOTHESIS
Receiving supplementary thiamine may not confer benefits to patients with CHF.
METHODS
A comprehensive search was conducted across the Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov, and Web of Science databases up until May 2023 to identify articles investigating the effects of thiamine supplementation in CHF patients. Predefined criteria were utilized for selecting data on study characteristics and results.
RESULTS
Seven randomized, double-blind, controlled trials (five parallel trials and two crossover trials) involving a total of 274 patients were enrolled. The results of the meta-analysis pooling these studies did not reveal any significant effect of thiamine treatment compared with placebo on left ventricular ejection fraction (WMD = 1.653%, 95% CI: -1.098 to 4.405, p = 0.239, I = 61.8%), left ventricular end-diastolic volume (WMD = -6.831 mL, 95% CI: -26.367 to 12.704, p = 0.493, I = 0.0%), 6-min walking test (WMD = 16.526 m, 95% CI: -36.582 to 69.634, p = 0.542, I = 66.3%), N-terminal pro-B type natriuretic peptide (WMD = 258.150 pg/mL, 95% CI: -236.406 to 752.707, p = 0.306, I = 21.6%), or New York Heart Association class (WMD = -0.223, 95% CI: -0.781 to 0.335, p = 0.434, I = 87.1%). However, it effectively improved the status of thiamine deficiency (TD).
CONCLUSIONS
Our meta-analysis indicates that thiamine supplementation does not have a direct therapeutic effect on CHF, except for correcting TD.
Topics: Humans; Heart Failure; Thiamine; Randomized Controlled Trials as Topic; Dietary Supplements; Chronic Disease; Ventricular Function, Left; Stroke Volume; Vitamin B Complex; Treatment Outcome
PubMed: 38940395
DOI: 10.1002/clc.24309 -
Brain and Behavior Jul 2024Examining the safety of theBNT162b2 mRNA vaccine in multiple sclerosis (MS) patients remains inconclusive, particularly regarding the potential for disease...
INTRODUCTION
Examining the safety of theBNT162b2 mRNA vaccine in multiple sclerosis (MS) patients remains inconclusive, particularly regarding the potential for disease exacerbations. This study aims to assess the effects of BNT162b2 COVID-19 vaccination on disease activity in MS patients through sequential MRI imaging.
METHODS
A retrospective study of 84 MS patients from five Israeli hospitals was conducted. MS lesion load was determined from three brain MRI scans, one postvaccination and two prevaccination scans. A post hoc analysis compared subgroups featuring vaccinated and unvaccinated patients respectively, with early onset MS.
RESULTS
The cohort included 70 women with early onset (mean age 16.4 ± 0.8 years) and adult onset (mean age 34.9 ± 1.1 years) MS. Among the early onset group, vaccinated patients showed an increased risk of new lesions (p = .00026), while there was no increased risk among adult-onset patients. Additionally, a comparison between early onset vaccinated and nonvaccinated groups revealed a higher risk of increased lesions in the vaccinated group (p = .024).
DISCUSSION
Overall, the study suggests that the BNT162b2 vaccine is generally safe in MS patients, with no association found between vaccination and new lesions in most patients. However, close MRI follow-up is recommended for early-onset MS cases to monitor lesion development.
Topics: Humans; Female; Magnetic Resonance Imaging; Adult; BNT162 Vaccine; Multiple Sclerosis; Retrospective Studies; COVID-19; COVID-19 Vaccines; Adolescent; Brain; Israel; Male; Vaccination; Young Adult
PubMed: 38940313
DOI: 10.1002/brb3.3587 -
The rapidly progressing and fatal outcome of rhombencephalitis by listeriosis in a 61-year-old male.Annals of Agricultural and... Jun 2024Listeria monocytogenes is a Gram-positive facultative anaerobic bacterium that is ubiquitous in the environment and can cause severe infections in immunocompromised...
Listeria monocytogenes is a Gram-positive facultative anaerobic bacterium that is ubiquitous in the environment and can cause severe infections in immunocompromised individuals, pregnant women, and newborns. Listeriosis can manifest as meningitis, encephalitis, or sepsis, and its diagnosis requires a high index of suspicion. The case is reported of a rare presentation of rhombencephalitis by listeriosis in a 61-year-old male who initially suffered from subacute gastric disturbances and fever. Neurological consultation showed abnormal functions of cranial nerves and meningeal signs were observed. MRI revealed a poorly demarcated focus of approximately 45 × 16 × 15mm, indicating possible inflammatory processes, necessitating a lumbar puncture. Assessment of the CSF indicated infection with the bacterium- Listeria Monocytogenes, with the final diagnosis of Listeriosis encephalitis. Despite antibiotic therapy of Ceftazidine and Ampicillin, the patient's condition deteriorated, followed by death.
Topics: Humans; Male; Listeriosis; Middle Aged; Fatal Outcome; Listeria monocytogenes; Encephalitis; Anti-Bacterial Agents; Rhombencephalon
PubMed: 38940119
DOI: 10.26444/aaem/178178 -
Journal of Integrative Neuroscience Jun 2024root, cataloged as "" in the Korean Pharmacopeia, is rich in various anthraquinones known for their anti-inflammatory and antioxidant properties. Formulations...
BACKGROUND
root, cataloged as "" in the Korean Pharmacopeia, is rich in various anthraquinones known for their anti-inflammatory and antioxidant properties. Formulations containing are traditionally employed for treating neurological conditions. This study aimed to substantiate the antiepileptic and neuroprotective efficacy of root extract (RTE) against trimethyltin (TMT)-induced epileptic seizures and hippocampal neurodegeneration.
METHODS
The constituents of RTE were identified by ultra-performance liquid chromatography (UPLC). Experimental animals were grouped into the following five categories: control, TMT, and three TMT+RTE groups with dosages of 10, 30, and 100 mg/kg. Seizure severity was assessed daily for comparison between the groups. Brain tissue samples were examined to determine the extent of neurodegeneration and neuroinflammation using histological and molecular biology techniques. Network pharmacology analysis involved extracting herbal targets for and disease targets for epilepsy from multiple databases. A protein-protein interaction network was built using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database, and pivotal targets were determined by topological analysis. Enrichment analysis was performed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) tool to elucidate the underlying mechanisms.
RESULTS
The RTE formulation was found to contain sennoside A, sennoside B, chrysophanol, emodin, physcion, (+)-catechin, and quercetin-3-O-glucuronoid. RTE effectively inhibited TMT-induced seizures at 10, 30, and 100 mg/kg dosages and attenuated hippocampal neuronal decay and neuroinflammation at 30 and 100 mg/kg dosages. Furthermore, RTE significantly reduced mRNA levels of tumor necrosis factor (), glial fibrillary acidic protein (), and in hippocampal tissues. Network analysis revealed TNF, Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), Protein c-fos (FOS), RAC-alpha serine/threonine-protein kinase (AKT1), and Mammalian target of rapamycin (mTOR) as the core targets. Enrichment analysis demonstrated significant involvement of components in neurodegeneration ( = 4.35 × 10-5) and TNF signaling pathway ( = 9.94 × 10-5).
CONCLUSIONS
The and analyses performed in this study suggests that RTE can potentially modulate TMT-induced epileptic seizures and neurodegeneration. Therefore, root is a promising herbal treatment option for antiepileptic and neuroprotective applications.
Topics: Animals; Neuroprotective Agents; Trimethyltin Compounds; Plant Extracts; Rheum; Plant Roots; Male; Anticonvulsants; Epilepsy; Hippocampus; Disease Models, Animal; Neurodegenerative Diseases; Computer Simulation; Network Pharmacology; Protein Interaction Maps; Rats
PubMed: 38940090
DOI: 10.31083/j.jin2306122