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Xi-Qing Pan, Jin-Hui Liu, Jiang-Li Zhang, An Chai, Feng Li, Lei Shu, Wei Zhao Department of Joint Surgery, Third Hospital of Shijiazhuang, Shijiazhuang, Hebei, People’s Republic of ChinaCorrespondence: Jin-Hui Liu, Department of Joint Surgery, Third Hospital of Shijiazhuang, No. 15 Tiyu South Street, Shijiazhuang, Hebei, 050011, People’s Republic of China, Tel +86 13191872146, Fax +86 31185990628, Email jinhuiauliu6@126.comObjective: In this study, we aim to examine the effects of osteotomy under varying posterior slope angles on knee joint function recovery following knee arthroplasty.Methods: We conducted a retrospective analysis from September 2015 to September 2018 on 240 patients who underwent knee arthroplasty three years previously. The study participants were categorized based on changes in the angle of the posterior slope before and after surgery: Group 1, > 5°; Group 2, 3°– 5°; Group 3, 0°– 3°; Group 4, − 3°– 0°; Group 5, < − 3°. All participants were affected with knee osteoarthritis. The Knee Society Clinical Rating System (KSS) knee function score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) knee function score, Visual Analogue Scale (VAS) pain score, and postoperative complications were measured 3 years after surgery.Results: The level of pain experienced by the patients decreased significantly than before, with pain scores ranging from 1.0– 3.0, and there was a statistical difference between groups (H = 93.400, P

Aldo Torre,1,2 Jacqueline Córdova-Gallardo,3 Alberto C Frati Munari4 1Guest Research, Metabolic Unit Department, Instituto Nacional de Ciencias Médicas Y Nutrición “Salvador Zubirán”, México City, Mexico; 2Guest Research, Liver Unit Department, Hospital General de México, México City, Mexico; 3Hepatology department, Hospital General Dr. Manuel GEA González, Mexico City, Mexico; 4Internal Medicine Department; Hospital Médica Sur, Mexico City, MexicoCorrespondence: Aldo Torre, Guest Research, Metabolic Unit Department, Instituto Nacional de Ciencias Médicas Y Nutrición “Salvador Zubirán”, México City, Mexico, Email detoal@yahoo.comAbstract: RFX, a rifamycin-based antibacterial agent obtained by the culture of the actinomycete Streptomyces mediterranei, has a broad antibacterial spectrum covering gram- positive, gram-negative, aerobic, and anaerobic bacteria. RFX is an antibiotic that elicits its effect by inhibiting bacterial RNA synthesis. When administered orally, its intestinal absorption is extremely low (< 0.4%), restricting antibacterial activity mainly in the intestinal tract, with few systemic side effects. RFX has been recommended by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver guidelines for the treatment of HE. RFX may contribute to restore hepatic function and to decrease the development of liver fibrosis. Its efficacy has been shown in patients with previous hepatic encephalopathy and several complications, such as infections, including spontaneous bacterial peritonitis, ascites and oesophageal variceal bleeding. Thus, RFX has an outstanding role in the therapeutic arsenal in hepatic cirrhosis, under the concept of disease modifier.Keywords: rifaximin, liver disease, modifier, hepatic cirrhosis therapy

Zhenni Zhao,1 Jiawei Li,2 Jiamin Wen,2 Yanyan He,2 Zhiling Sun2 1Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, People’s Republic of China; 2School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of ChinaCorrespondence: Zhiling Sun, School of Nursing, Nanjing University of Chinese Medicine, 138 Xian Lin Road, Nanjing, People’s Republic of China, Tel +86 13813892093, Email szl@njucm.edu.cnBackground and Objective: Moxibustion is effective for low back pain (LBP), and inflammatory cytokines may play an important role in the mechanism of moxibustion treatment. The purpose of this meta-analysis was to explore the mechanism of moxibustion in LBP in terms of inflammatory cytokines.Methods: We searched China National Knowledge Infrastructure, Wanfang database, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Embase, PubMed, and Web of Science to identify eligible randomized controlled trials (RCTs). There was no restriction on the publication date.Results: Thirty RCTs measuring interleukin (IL-) 1, IL-1β, IL-6, IL-12, IL-17, IL-23, and tumor necrosis factor (TNF-) α were included in this meta-analysis. Compared to controls: single moxibustion could effectively decrease levels IL-6 and IL-23 (SMD, − 0.71, 95% CI: − 1.25 to − 0.17, p = 0.01; SMD, − 1.61, 95% CI: − 2.20 to − 1.03, p < 0.01, respectively); combined moxibustion had significant effects on IL-1, IL-1β, IL-6, IL-12, IL-17, and TNF-α (p < 0.05). Overall, for LBP, single or combined moxibustion could effectively down-regulate levels of pro-inflammatory cytokines (p = 0.007 and p < 0.00001, respectively). For safety of moxibustion, the incidence rate of side effects was similar to that of controls (RD, − 0.01, 95% CI: − 0.02 to 0.01, p = 0.59). Sensitivity analysis showed that the pooled estimates were robust, and publication bias analysis showed there was a significant small study effect (

Alexandra Arias-Mendoza,1 Jorge A Ortega-Hernández,1 Diego Araiza-Garaygordobil,1 Héctor González-Pacheco,1 Mireya Martínez-García,2 Enrique Hernández-Lemus,3 Rodrigo Gopar-Nieto,1 Tomás Tadeo Sandoval-Aguilar,1 Daniel Sierra-Lara Martinez,1 Salvador Mendoza-García,1 Alfredo Altamirano-Castillo,1 José Luis Briseño-de-la-Cruz,1 Midori Alondra Ortega-Hernández,4 Luis Alejandro Soliz-Uriona,1 Jorge Gaspar-Hernández5 1Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico; 2Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico; 3Computational Genomics, Instituto Nacional de Medicina Genómica, Mexico City, Mexico; 4Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City, Mexico; 5Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoCorrespondence: Alexandra Arias-Mendoza, Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano, Sección XVI, 14080, Tlalpan, Mexico City, Mexico, Tel +52-55- 54852219, Fax +52-55-54852219, Email aariasm@yahoo.comPurpose: While pharmacoinvasive strategy (PI) is a safe and effective approach whenever access to primary percutaneous intervention (pPCI) is limited, data on each strategy’s economic cost and impact on in-hospital stay are scarce. The objective is to compare the cost-effectiveness of a PI with that of pPCI for the treatment of ST-elevation myocardial infarction (STEMI) in a Latin-American country.Patients and Methods: A total of 1747 patients were included, of whom 470 (26.9%) received PI, 433 (24.7%) pPCI, and 844 (48.3%) NR. The study’s primary outcome was the incremental cost-effectiveness ratio (ICER) for PI compared with those for pPCI and non-reperfused (NR), calculated for 30-day major cardiovascular events (MACE), 30-day mortality, and length of stay.Results: For PI, the ICER estimates for MACE showed a decrease of &dollar;– 35.81/per 1% (95 confidence interval, – 11

Daniel Legese Achalu,1 Foziya Getachew Mohammed,2 Mekonnen Teferi1 1Clinical Trial Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 2Knowledge Management Directorate, Armauer Hansen Research Institute, Addis Ababa, EthiopiaCorrespondence: Daniel Legese Achalu, Tel +251912750932, Email danigateline@gmail.comBackground: Since its launch as a standardized treatment for multidrug-resistant tuberculosis (MDR-TB) in Ethiopia in April 2018, the safety profile of the shorter injectable regimen under a programmatic setting has not been well studied. Thus, this study aimed to assess the status of adverse events in patients treated with a shorter injectable regimen in Ethiopia.Methods: This is a retrospective cohort study. Data were collected using a structured data abstraction form and analyzed using SPSS, version 25, both descriptively and analytically. Logistic regression was conducted to assess predictors, and Kaplan–Meier analysis was used to examine the time to AEs and survival experiences.Results: Of 256 patients, 245 (95.7%) were eligible for the study. Of 245, 107 (43.7%) patients experienced at least one AE. In total, 276 AE cases were observed out of which the most common were nausea/vomiting (20.3%), dyspepsia (18.1%), and ototoxicity (11.6%). Of 276 AEs, approximately 49 (17.8%) were serious. AEs led to drug discontinuation, dose modification, and regimen change in 29 (27%), 15 (14%) and 10 (9.3%) patients, respectively. Only 19.2% of 276 the overall AEs and 22.6% of 62 AE of special interest (AESI) were reported to the National Pharmacovigilance Center.Conclusion: Although the observed extent of AEs associated with the shorter regimen (SR) seemed to be moderate, it significantly influenced the treatment schemes and patient conditions. Reporting of AEs was low, irrespective of their severity and AESI. Therefore, strengthening the implementation of active drug safety monitoring and management is required.Keywords: adverse events, adverse eve

Li Luo,1 Jiduan Jiang,2 Min Zhang,1 Zhiqiang Guo,1 Xianzheng Zhang,1 Fenglin Wang,1 Fan Yang1 1Department of Anesthesiology, Suining Central Hospital, Suining City, Sichuan Province, People’s Republic of China; 2Department of Anesthesiology, Suining First People’s Hospital, Suining City, Sichuan Province, People’s Republic of ChinaCorrespondence: Fan Yang, Department of Anesthesiology, Suining Central Hospital, Suining City, Sichuan Province, 629000, People’s Republic of China, Email yanglifan2@163.comObjective: To study the efficacy and safety of different doses of remimazolam used for induction and maintenance in short laparoscopic surgery.Methods: A randomized controlled trial was conducted between May 2021 and May 2022 on patients underwent laparoscopic surgery for 30 minutes to an hour. Based on the drug used and the infusion rate, included patients were allocated into the Low-group of remimazolam (using a constant infusion rate of 6.0 mg/kg/h for induction and the rate of 1 mg/kg/h for maintenance), the Median-group (9.0 mg/kg/h for induction, 2 mg/kg/h for maintenance), the High-group (12.0 mg/kg/h for induction, 3.0 mg/kg/h for maintenance), and the Propofol group. The postoperative extubation time was used as the primary outcome.Results: A total of 192 patients were included in the study, with 47, 48, 48, and 49 patients in the Low-, Median-, High-, and Propofol group, respectively. There was a significant difference in postoperative extubation time, with the High-group having the highest duration of 15.21± 2.34 minutes compared to the Median-group (13.17± 1.71 minutes, p< 0.001), Low- group (12.72± 1.31 minutes, p< 0.001), and the Propofol group (12.24± 1.23 minutes, p< 0.001). No significant difference was found between the Low-group and the Propofol group, while the Median-group still showed higher postoperative extubation time compared to the Propofol group (p=0.008).Conclusion: Compared to propofol, total intravenous induction and

Léa El Haddad,1 Mainur Khan,1 Rania Soufny,1 David Mummy,2 Bastiaan Driehuys,2 Wissam Mansour,3 Priya S Kishnani,4 Mai K ElMallah1 1Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA; 2Department of Radiology, Duke University Medical Center, Durham, NC, USA; 3Division of Pulmonary and Sleep Medicine, Department of Medicine, Duke University Medical Center, Durham, NC, USA; 4Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, NC, USACorrespondence: Mai K ElMallah, Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC, 27710, USA, Tel +1-919-684-3577, Email mai.elmallah@duke.eduAbstract: Pompe disease (PD) is a neuromuscular disorder caused by a deficiency of acid alpha-glucosidase (GAA) – a lysosomal enzyme responsible for hydrolyzing glycogen. GAA deficiency leads to accumulation of glycogen in lysosomes, causing cellular disruption. The severity of PD is directly related to the extent of GAA deficiency – if no or minimal GAA is produced, symptoms are severe and manifest in infancy, known as infantile onset PD (IOPD). If left untreated, infants with IOPD experience muscle hypotonia and cardio-respiratory failure leading to significant morbidity and mortality in the first year of life. In contrast, late-onset PD (LOPD) patients have more GAA activity and present later in life, but also have significant respiratory function decline. Despite FDA-approved enzyme replacement therapy, respiratory insufficiency remains a major cause of morbidity and mortality, emphasizing the importance of early detection and management of respiratory complications. These complications include impaired cough and airway clearance, respiratory muscle weakness, sleep-related breathing issues, and pulmonary infections. This review aims to provide an overview of the respiratory pathology, monitoring, and management of

Yanmei Luo,1,&ast; Jie Liu,2,&ast; Zhihui Jiang,3,&ast; Xinghai Yang,1 Song Lin,1 Xiaowen Mao1 1Department of Pediatric Surgery, Maternal and Child Health Hospital of Hubei, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, People’s Republic of China; 3Department of General Surgery, Qingdao Women and Children’s Hospital, Qingdao, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaowen Mao; Song Lin, Department of Pediatric Surgery, Maternal and Child Health Hospital of Hubei, Tongji Medical College, Huazhong University of Science and Technology, No. 58 Guanggu Third Road, Donghu New Technology Development Zone, Wuhan City, 430070, Hubei Province, People’s Republic of China, Email xiaowenmao0927@163.com; yes888111@sina.cnPurpose: To compare and analyze the therapeutic effects of endoscopy-assisted laparoscopic surgery (EALS) and laparoscopic surgery (LS) in the treatment of gastric duplication cysts (GDCs).Patients and Methods: We reviewed the clinical data of children with GDCs who underwent surgical treatment at Hubei Maternal and Child Health Hospital, Yijishan Hospital of Wannan Medical College, and Qingdao Women and Children’s Medical Center from September 2014 to November 2022.Results: The study comprised 29 children with GDCs, including 14 in the EALS group and 15 in the LS group. There was no significant difference between the two groups in terms of age, sex, weight, and cyst size characteristics. There was a significant difference between the two groups in terms of average surgical time (P> 0.05), which was 1.100 ± 0.833 hours in the EALS group and 1.933 ± 0.159 hours in the LS group. There was a significant difference between the two groups (P< 0.05) in average intraoperative blood loss, which was 7.93 ± 3.81 milli

Yu Li,1 Zhi-Peng Yan,1 Nan-Nan Zhang,1 Jun Ni,1,2 Zhi-Yong Wang1 1Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People’s Republic of China; 2Department of Rehabilitation Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of ChinaCorrespondence: Zhi-Yong Wang, Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital of Fujian Medical University, 999 Huashan Road, Fuzhou, 350212, People’s Republic of China, Tel +86-13635298857, Email fjykdxwzy@163.comObjective: The aim of this study is to explore the therapeutic effects of transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) on post stroke shoulder pain (PSSP).Methods: We enrolled 13 individuals in this study who underwent three different treatments in a random sequence: active tDCS+active TENS, active tDCS+sham TENS, and sham tDCS+active TENS. Each treatment was administered once, with a 3-day washout period between interventions. A blinded rater assessed the visual analog scale (VAS) scores, fNIRS readings, and sensory and pain tolerance thresholds of the participants before and after the stimulation.Results: All three treatment methods can significantly alleviate PSSP (p< 0.05). Compared with using tDCS alone, tDCS+TENS can significantly improve pain, with a statistically significant difference (p< 0.05). In the 2KHz PTT task, the three treatment methods showed significant differences (p< 0.05) in the mean oxygenated hemoglobin (HbO) levels in the false premotor cortex (PMC)/auxiliary motor area (SMA) before and after intervention.Conclusion: The combination of tDCS+TENS can increase the pain-relieving impact on PSSP when compared to using tDCS alone. TENS may contribute an additional effect on the inhibitory systems influen

Yin-Gang Wu,1,&ast; Bowen Wang,2,&ast; Hao Cui,3,&ast; Hao Zhu,1 Ge Gao1– 3 1Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China; 2Department of Neurosurgery, Wannan Medical College, Wuhu, Anhui, 241001, People’s Republic of China; 3Department of Neurosurgery, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ge Gao, Department of Neurosurgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, People’s Republic of China, Email gegao1012@163.comObjective: To retrospectively evaluate the efficacy and security of Willis covered stent (WCS) deployment for complex vascular diseases of the internal carotid (ICA) and vertebral (VA) arteries.Methods: Retrospective analysis was performed on complex vascular disease patients (n=36) treated with WCSs at our center between March 2017 and December 2022, with a 3– 36-months follow-up surveillance and digital subtraction angiography (DSA) examination.Results: The WCSs were successfully deployed in all the patients. The 36 included lesions were carotid-cavernous sinus fistulas (CCFs; n=10) (27.8%), complex saccular aneurysms (n=10) (27.8%), traumatic pseudoaneurysms (n=7) (19.4%), blood blister-like aneurysms (BBAs; n=5) (13.9%), and iatrogenic carotid or vertebral artery ruptures (n=4) (11.1%). The WCS was released at the communicating segment (n=2) (5.6%), the ophthalmic segment (n=3) (8.3%), the clinoid and cavernous segment (n=28) (77.8%), the petrous segment (n=2) (5.6%) of ICA and the V3 segment (n=1) (2.8%) of VA. Postoperative DSA showed complete lesion occlusion in 26 patients (72.2%) who were immediately treated with WCSs, and endoleaks occurred in 3 patients (8.3%) (endoleaks resolved postadjustment in 7 patients

Heather D Anderson,1 Vanessa Paul Patterson,1 Garth Wright,1 Julia E Rawlings,1 Gina D Moore,1 Jim Leonard,2 Robert L Page II1 1Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Aurora, CO, USA; 2Colorado Department of Health Care Policy and Financing, Denver, CO, USACorrespondence: Robert L Page II, Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd, Mail Stop C238, Aurora, CO, 80045, USA, Tel +1 303-724-2616, Fax +1 303-724-2627, Email robert.page@cuanschutz.eduObjective: COVID-19, coinciding with the opioid epidemic in the United States, has had significant impacts on health-care utilization. While mixed, early analyses signaled a potential resurgence in opioid use following the pandemic. The primary study objective was to assess the association of the COVID-19 pandemic with opioid utilization among Health First Colorado (Colorado’s Medicaid Program) members and a non-Medicaid managed care cohort who did not have a diagnosis of cancer or sickle cell disease.Patients and Methods: Using an interrupted time series and segmented regression analysis, this population-level study assessed the association of the COVID-19 pandemic on prescribed utilization of long- and short-acting opioid analgesics among Health First Colorado members and a random sample of non-Medicaid managed care members. Pharmacy claims data for both cohorts were assessed between October 1, 2018, and September 30, 2021, with April 2020 identified as the interruption of interest. We evaluated the following monthly opioid use measures separately for short-acting and long-acting opioids: number of members filling an opioid, total fills, and total days supplied.Results: Short- and long-acting opioid utilization was significantly decreasing among Health First Colorado members in the 18 months prior to the start of COVID-19. After the onset of the pande

Zu-Fei Wu,1,&ast; Wen-Tao Su,2,3,&ast; Shi Chen,4 Bai-Da Xu,2 Gang-Jun Zong,2,3 Cun-Ming Fang,1 Zheng Huang,1 Xue-Jun Hu,1 Gang-Yong Wu,2,3 Xiao-Lin Ma1 1Department of Cardiology, Xuancheng People’s Hospital, Xuanchen, Anhui, 242000, People’s Republic of China; 2Department of Cardiology, the 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, 214044, People’s Republic of China; 3Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu, 214044, People’s Republic of China; 4Department of Cardiology, Wuxi No.5 People’s Hospital, Wuxi, Jiangsu, 214044, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Gang-Yong Wu, Department of Cardiology, the 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, 214044, People’s Republic of China, Email wuwangyi520@sina.comObjective: To investigate the correlation between serum parathyroid hormone (PTH) levels and in-hospital major adverse cardiovascular events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI), and establish a risk prediction model based on parameters such as PTH for in-hospital MACE.Methods: This observational retrospective study consecutively enrolled 340 patients who underwent primary PCI for STEMI between January 2016 and December 2020, divided into a MACE group (n=92) and a control group (n=248). The least absolute shrinkage and selection operator (LASSO) and logistic regression analyses were used to determine the risk factors for MACE after primary PCI. The rms package in R-studio statistical software was used to construct a nomogram, to detect the line chart C-index, and to draw a calibration curve. The decision curve analysis (DCA) method was used to evaluate the clinical application value and net benefit.Results: Correlation analysis revealed that PTH level positively correlated w

Yan Zhang,1,&ast; Wenjun Meng,2,&ast; Chengwen Hu,1 Meirong Dong,1 Youqun Chu,1 Fang Kang,2 Juan Li,2 Xia Chen1 1Department of Nursing, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China; 2Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xia Chen; Juan Li, Department of Nursing; Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China, Email ChenXiaahslyy@163.com; huamuzi1999@126.comBackground: Sore throat is a common complication after general anesthesia. Oral care solutions have been used to reduce the incidence of oral complications or ventilator-associated pneumonia, but their effect on postoperative sore throat (POST) is unclear. This study aims to investigate whether oral care solution can alleviate POST in patients undergoing i-gel laryngeal mask general anesthesia.Methods: A total of 120 patients who were scheduled for elective surgery under laryngeal mask general anesthesia were enrolled. The patients were randomly assigned to an experimental group (oral care solution) and a control group (0.9% saline) and gargled for 1 min with 10mL of oral care solution or saline 5 min before anesthesia induction. The primary outcomes were the overall incidence of sore throat within 24 h and incidence at 20 min, 1 h, 6 h, 24 h after removal of i-gel. The secondary outcomes were the severity of sore throat at the four time points and incidence of hoarseness, cough within 24 h after removal of i-gel.Results: A total of 111 patients were included in the analysis. The overall incidence of sore throat wi

Ahmad Al-Azayzih, Roaa J Kanaan, Shoroq M Altawalbeh Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, JordanCorrespondence: Ahmad Al-Azayzih, Clinical Pharmacy Department, Faculty of Pharmacy-Jordan University of Science and Technology, Irbid, 22110, Jordan, Email aaazayzih@just.edu.joAims of the Study: This study aimed to investigate the prevalence and predictors of Drug-related problems (DRPs), as well as to evaluate the impact of DRPs on the health-related quality of life in geriatric patients with type 2 diabetes mellitus.Methodology: A cross-sectional study was conducted over a three-month period. Patients aged 60 years and older visited diabetes clinics from October 1, 2022, to December 31, 2022, were included in the study. Data were collected through structured questionnaires, whereas lab results, medication records, comorbidities, and the consequences of DRPs were collected from electronic medical records. DRPs were identified and classified using the PCNE V501 classification system. Health-related quality of life (HRQoL) was evaluated using the validated EuroQol criteria.Results: A total of 491 patients participated in the study, and the mean age of the patients was 67.51 years (SD = 5.84 years). Female patients represented 52.34% of total subjects. A total of 461 (around 94%) experienced at least one drug-related problem (DRP), ranging from one to nine DRPs per patient, with a total number of DRPs equal to 1625 identified. The most common DRP was the drug choice problem, affecting 52.98% of patients. Factors such as high drug frequency, living conditions, the number of diabetes medications, comorbidities, and smoking were significantly associated with higher numbers of DRPs. Higher numbers of DRPs were found to significantly worsen health-related quality of life (HRQoL) among patients.Conclusion: Geriatric individuals with type 2 diabetes mellitus encounter a significant prevalence of DRPs, with drug

Christiyanti Dewi,1 Falerina Puspita,1 Irma Melyani Puspitasari,1,2 Neily Zakiyah1,2 1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia; 2Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, IndonesiaCorrespondence: Neily Zakiyah, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 45363, Indonesia, Tel +62 22 84288888, Ext. 3510, Email neily.zakiyah@unpad.ac.idPurpose: This study aims to systematically review the hepatic safety of febuxostat and allopurinol in adult gout patients.Methods: We searched for information using the following databases: PubMed, Cochrane Library, and Scopus. The inclusion criteria were to review all randomized controlled trials (RCT) that compared allopurinol and febuxostat for adult gout patients that had an assessment of liver function outcomes. Non-English studies on case reports, case series, reviews, and abstracts only were excluded. We extracted information from the studies to answer the research question, ie, study design, publication year, population, sample size, patient characterization, duration, Jadad score, and liver function outcomes.Results: We screened 512 publications from the databases and identified 11 studies that met the inclusion criteria. Ten out of 11 included studies were double-blind RCTs. In the majority of the included studies, no statistically significant differences were observed in terms of hepatic safety data between febuxostat and allopurinol. However, in studies where allopurinol titration was used, it posed a challenge to maintain blinding. Notably, consistent adverse events related to liver function findings were observed across all reviewed RCTs. These abnormal liver function test results sometimes led to study withdrawal based on the investigators’ assessment. Nevertheless, the investigators classified most liver function test elevations as mild t

Xiaofeng Zhang,1,&ast; Jiaqi Zhang,1,&ast; Yongzhi Cai,1 Yue Li,1 Shiyun Qin,1 Jingtao Li,1 Decai Zeng,1 Tongtong Huang,1 Liu Liu Huang,2 Yanfen Zhong,1 Lihui Wei,1 Ji Wu1 1Department of Ultrasonic Medicine, the First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ji Wu, Email gxnnwuji@163.comBackground: Rheumatic mitral stenosis(RMS) may leads to left ventricular remodeling (LVR), which can persist even after valve surgery. Identifying markers for early structure and function in patients with rheumatic heart disease who are at risk for adverse LVR after surgery can help determine the optimal timing of intervention. This study aimed to investigate whether preoperative parameters of global left ventricular long-axis strain (LVGLS) and mechanical discretization (MD) could predict postoperative adverse LVR.Methods: A total of 109 adult patients with RMS and 50 healthy controls were enrolled in this study. Baseline clinical features, conventional echocardiography results, LVGLS, and MD were compared between the two groups. Pre- and post-surgery echocardiography measurements were collected, and adverse LVR was defined as a> 15% increase in left ventricular end-diastolic volume or > 10% decrease in left ventricular ejection fraction. Binary regression analysis was used to determine independent predictors of poor left ventricular remodeling.Results: The variables associated with adverse LVR in this study were LVGLS (P< 0.001, odds ratio: 1.996, 95% CI: 1.394– 2.856) and MD (P=0.011, odds ratio: 1.031, 95% CI: 1.007– 1.055). The poorly reconstructed group had lower absolute values of LVGLS and higher MD than the healthy control group and the non-poorly reconstructed group. A LVGLS cutoff of − 15.0% was t

Heng Rong,1,&ast; Weixin Dai,1,&ast; Yinying Qin,1,&ast; Zhikeng Meng,2 Xia Zou,3 Binbin Wang,4 Qiufeng Wei,1 Yubo Xie1,5 1Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Anesthesiology, The First People’s Hospital of Yulin, Yulin, People’s Republic of China; 3Department of Anesthesiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China; 4Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 5Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yubo Xie, Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang-Yong Road, Nanning, Guangxi, 530021, People’s Republic of China, Email xybdoctor@163.comPurpose: In this prospective observational study, an ultrasonographic measurement of antral cross-sectional area (ACSA) was conducted to evaluate the gastric content and volume as well as to identify high-risk stomach in non-pregnant adult surgical patients adhering to preanesthetic fasting guidelines.Patients and Methods: Fasted patients undergoing gastrointestinal endoscopy under sedation were included. Ultrasonographic measurements of ACSA were conducted in both semi-recumbent and right lateral decubitus positions before endoscopic procedures. Gastroscopy was employed to guide the measurement of suctioned gastric volume (GV). Ultrasonography was performed to assess gastric contents and identify patients with high-risk stomach. The relationship between ACSA and suctioned GV was also evaluated.Results: ACSA was evaluated in 736 out of 782 patients. A significant positive correlation was di

Song Lyu,1 Guobin Wu,2 Yingfen Wu1 1Department of Anesthesiology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People’s Republic of China; 2Medical Record Management Department, The Second Affiliated Hospital of Hainan Medical University, Haikou, People’s Republic of ChinaCorrespondence: Song Lyu, Department of Anesthesiology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People’s Republic of China, Fax +8689866808208, Email Lssjk1@126.comObjective: To investigate the potential relationship between the prone jackknife position during percutaneous nephroscopy and the occurrence of intraoperative hypotension.Methods: A retrospective analysis was conducted on 651 patients who underwent percutaneous nephroscopy at the Second Affiliated Hospital of Hainan Medical University. The primary focus was to investigate the occurrence of hypotension during the surgical procedure and assess the duration of hypotensive episodes. Patients were categorized into the prone jackknife position group and the lateral position group. To compare the incidence of intraoperative hypotension between the two groups, a 1:1 propensity match was performed. Following the matching process, intraoperative hypotension was assessed and compared between the two groups before and after the match. The binary logistic regression analysis determined the probability of intraoperative hypotension occurred in each group. Furthermore, linear regression analysis was used to analyze the duration of hypotensive episodes experienced by patients in both groups.Results: After propensity score matching, a total of 272 patients with similar characteristics were obtained (136 in each group). The prone jackknife group had a significantly higher incidence of intraoperative hypotension than the lateral group after the match, with an odds ratio of 2.71 (95% confidence interval: 1.595– 4.605). Binary logistic regression analysis showed that age and body position exhibited

Yi Chen,1– 3 Yongli Gao1– 3 1Emergency Department of West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu City, Sichuan Province, People’s Republic of China; 2Institute of Disaster Medicine, Sichuan University, Chengdu City, Sichuan Province, People’s Republic of China; 3Nursing Key Laboratory of Sichuan Province, Chengdu City, Sichuan Province, People’s Republic of ChinaCorrespondence: Yongli Gao, Emergency Department of West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, 610041, People’s Republic of China, Email gaoyongli0320@163.comBackground: Fluid resuscitation is routinely needed for critically ill patients. However, the optimal choice between crystalloids and normal saline is in heat debate.Objective: To conduct a meta-analysis comparing normal saline and balanced crystalloids in the treatment of critically ill patients with composite mortality as the primary outcome.Methods: PubMed, Embase, Medline, Web of Science, and Cochrane Library were searched from inception up to March 2022. Studies of critically ill adult patients assigned to receive normal saline or balanced crystalloids were included. We conducted a meta-analysis using an inverse variance, random-effects model in addition to trial sequential analysis (TSA). The primary outcome was composite mortality. Subgroup analyses were also conducted.Results: Eighteen full-text studies (n=36,224) were included. Balanced crystalloids were associated with lower mortality compared with normal saline (risk ratio [RR]=0.96; 95% confidential interval [CI] 0.93, 1; p=0.03; I2=0) and lower incidence of acute kidney injury/acute renal failure (RR =0.93; 95% CI = 0.87, 0.99; p=0.03). No significant difference was observed in other outcomes. In the sepsis patients, the balanced crystalloid showed a lower composite mortality rate compared with normal saline (RR =0.9

Yongkang Xu, Shumin Fu, Kan Liu, Ye Mao, Jianbing Wu Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of ChinaCorrespondence: Jianbing Wu, Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China, Email hhgwjb@163.comPurpose: To evaluate the clinical outcomes of lenvatinib plus PD-1 inhibitors (LP) and regorafenib (R) in patients with advanced hepatocellular carcinoma (HCC) after sorafenib failure.Methods: From June 2018 to September 2021, 68 patients from a single center who received lenvatinib combined with PD-1 inhibitors or regorafenib after sorafenib treatment failure were analyzed. The tumor response and survival outcomes were compared between the LP group and R group. Prognostic factors for OS and PFS were determined using Cox proportional hazard regression models.Results: The ORR increased in the LP group (19.5% vs 7.4%, p =0.294), and the DCR was better in the R group (73.2% vs 44.4%, p =0.017). Additionally, median PFS and OS were not significantly different between the LP group and R two groups in survival analysis (PFS: 5.3 months vs 3.0 months, p =0.633; OS: 11.8 months vs 8.0 months, p =0.699). The common adverse events (≥grade 3) were hand-foot skin reactions (13.1%). In multivariate analyses, AFP≥ 400 ng/mL and ECOG PS 2 were independent risk factors for poor prognosis.Conclusion: The LP group appeared to have a trend of greater tumor response and a higher disease control rate than the R group among patients with sorafenib-resistant HCC, although PFS and OS did not differ significantly between the two groups.Keywords: hepatocellular carcinoma, lenvatinib, PD-1 inhibitors, regorafenib, sorafenib, overall survival

Theo Moraes Teixeira,1 Luis Filipe de Souza Godoy,2 Wellingson Silva Paiva1 1LIM 62, Division of Neurosurgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil; 2Institute of Radiology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, BrazilCorrespondence: Wellingson Silva Paiva, LIM 62, Division of Neurosurgery, Hospital das Clínicas, University of São Paulo Medical School, Av. Dr. Enéas Carvalho de Aguiar, 255, São Paulo, 05403-010, Brazil, Email wellingsonpaiva@yahoo.com.br

Na Zhao,1,2,&ast; Bowen Sun,1,&ast; Yuan Cheng,1 Jianliu Wang1 1Department of Gynecology and Obstetrics, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China; 2Department of Obstetrics and Gynecology, Peking University International Hospital, Beijng, 102206, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jianliu Wang; Yuan Cheng, Department of Gynecology and Obstetrics, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China, Tel +86-10-88324385 ; +86-10-88324474, Email wangjianliu1203@163.com; chengyuan@bjmu.edu.cnBackground: The role of immune checkpoint inhibitors in endometrial cancer is limited. At present, the anti-programmed cell death protein 1 (anti-PD-1) antibody is only used in patients with recurrence or metastasis. CD40 is an important immune checkpoint, which is expressed in tumor cells and immune cells, but its distribution characteristics in endometrial carcinoma have not been explored.Methods: Sixty-eight cases of primary endometrial carcinoma treated in Peking University People’s Hospital from January 2010 to December 2020 were collected, including 28 cases of poorly differentiated endometrioid adenocarcinoma, 23 cases of serous carcinoma and 17 cases of clear cell carcinoma. The relationship of CD40 expression and PD-L1 expression with their prognosis was analyzed by immunohistochemistry.Results: We found that CD40 had higher expression in non-endometrioid endometrial carcinoma, which lead to the worse prognosis. The effect of high expression of CD40 on the prognosis of endometrioid adenocarcinoma was not significantly different, and most patients with good prognosis. We found that the proportion of CD40 distribution in tumor cells and immune cells may be associated with this heterogeneity.Conclusion: The expression of CD40 in different endometrial cancers may indicate the difference prognosis, which may become a potential tar

Hui Xu, Shuhui Hou, Zhengyi Ruan, Jianhua Liu Department of Obstetrics and Gynecology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of ChinaCorrespondence: Zhengyi Ruan; Jianhua Liu, Department of Obstetrics and Gynecology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, No. 639, Zhi Zaoju Road, Shanghai, 200011, People’s Republic of China, Email ruan19800616@163.com; Drliu.2006@aliyun.comObjective: This study aimed to compare the anatomical and functional outcomes of the modified McIndoe vaginoplasty for Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome using swine small intestinal submucosa (SIS) graft or homologous skin grafts.Methods: A total of 115 patients with MRKHs who underwent neovaginoplasty between January 2012 and December 2021 were included in the study. Among them, 84 patients received vaginal reconstruction with SIS graft, whereas 31 neovaginoplasty underwent a skin graft procedure. The length and width of the neovagina were measured, and sexual satisfaction was evaluated using the Female Sexual Function Index (FSFI). The operation details, cost, and complications were also assessed.Results: The SIS graft group had a significantly shorter mean operation time (61.13± 7.17min) and less bleeding during the operation (38.57± 9.46mL) compared to the skin graft group (92.1± 9.47min and 55.81± 8.28mL, respectively). The mean length and width of the neovagina in the SIS group were comparable to the skin graft group at 6 months follow-up (7.73± 0.57 cm versus 7.6± 0.62cm, P=0.32). The SIS group had a higher total FSFI index than the skin graft group (27.44± 1.58 versus 25.33± 2.16, P=0.001).Conclusion: The modified McIndoe neovaginoplasty using SIS graft is a safe and effective alternative to homologous skin grafts. It results in comparable anatomical outcomes and superior sexual and functional outcomes. Overall, these results suggest that the

Wenbing Zhang,1 Jian Ding,2 Wenhai Wang,1 Duo Wang,3 Yinping Pan,4 Dexin Xu5 1Department of Cardiology, Jilin Province FAW General Hospital, Changchun, 130000, People’s Republic of China; 2Department of Electrodiagnosis, Jilin Province FAW General Hospital, Changchun, 130000, People’s Republic of China; 3Department of Geriatrics, Jilin Province FAW General Hospital, Changchun, 130000, People’s Republic of China; 4Department of Pediatrics, Jilin Province FAW General Hospital, Changchun, 130000, People’s Republic of China; 5Department of Orthopedics, Jilin Province FAW General Hospital, Changchun, 130000, People’s Republic of ChinaCorrespondence: Dexin Xu, Department of Orthopedics, Jilin Province FAW General Hospital, Changchun, 130000, People’s Republic of China, Email bonewax@sina.comAbstract: Accumulation of aberrant proteins in the heart causes cardiac amyloidosis, an uncommon and complicated illness. It can be classified into two main types: light chain (AL) and transthyretin (ATTR). The diagnosis of cardiac amyloidosis is challenging due to its non-specific clinical presentation and lack of definitive diagnostic tests. Diagnostic accuracy has increased with the advent of modern imaging methods, including cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. Depending on the severity of cardiac amyloidosis, a number of treatments may be attempted and specified according to the subtype of amyloidosis and the presence of complications. However, there are still significant challenges in treating this condition due to its complexity and lack of effective treatments. The prognosis for patients with cardiac amyloidosis is poor. Despite recent advances in diagnosis and treatment, there is still a need for more effective treatments to improve outcomes for patients with this condition. Therefore, we aim to review the current and future therapeutics reported in the literature and among ongoing clinical trials recruiting patient

Örs Péter Horváth,1 Szabolcs Bellyei,2 Éva Pozsgai,3,4 András Vereczkei1 1Department of Surgery, University of Pécs Clinical Center, Pécs, 7624, Hungary; 2Department of Oncotherapy, University of Pécs Clinical Center, Pécs, 7624, Hungary; 3Department of Public Health, University of Pécs Medical School, Pécs, 7624, Hungary; 4Department of Primary Health Care, University of Pécs Medical School, Pécs, 7623, HungaryCorrespondence: Örs Péter Horváth, Department of Surgery, University of Pécs Clinical Center, Ifjúság Street 13, Pécs, 7624, Hungary, Tel +3672535806, Email horvath.ors.peter@pte.huAbstract: From a surgical point of view, the development of preoperative oncological treatment has had a profound effect on the surgical treatment trends of cancer as well as on the outcomes of cancer patients. Consequently, these changes have challenged formerly entrenched oncological surgical principles. In our short report, we aimed to summarize the main shifts regarding the surgical principles of cancer treatment due to the development of preoperative oncological therapy in recent years. As a result of successful preoperative treatment, surgeons may perform less radical surgeries, the required free resection margin has been narrowed down to a few millimeters in dimension and preoperative treatment is justified in both definitely resectable tumors and in oligometastatic tumors as well. For prognosis assessment, the post-preoperative oncological treatment stage is now considered decisive, rather than the pretreatment stage as previously thought. Other changes include the introduction of the watch and wait strategy and the reverse order of treatment of the primary tumor and metastasis. Observing the continuously improving outcomes of cancer patients and the developments in oncological treatment modalities, a further expansion of the indication of preoperative treatments is to be expected.Keywords: preoperative oncological therapy, neoadjuvant, downstaging, comp

Patricia López-Chicón,1,2,* Maria Luisa Pérez,1,3,* Cristina Castells-Sala,1,2,* Ana Rita Piteira,1,2,* Oscar Fariñas,1,2 Jaime Tabera,1,2 Anna Vilarrodona1,3 1Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST), Barcelona, Spain; 2Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain; 3Vall Hebron Institute of Research (VHIR), Barcelona, Spain*These authors contributed equally to this workCorrespondence: Maria Luisa Pérez, Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST, GenCAT), Passeig Taulat 116, Barcelona, E-08005, Spain, Tel +34 935 57 35 00, Email mlperez@bst.catBackground: The activities of tissue establishments are constantly and rapidly evolving. The development of a new type of allograft, full-thickness acellular dermal matrix, with high mechanical properties to be used in tendon repair surgeries and abdominal wall reconstruction, has determined the need for quality by design process in order to assess evidence of quality, safety and efficacy. The EuroGTPII methodologies were specifically tailored to perform the risk assessment, identify and suggest tests in order to mitigate the potential risk consequences of a novel tissue preparation implementation.Methods: The new allograft and associated preparation processes were assessed using the EuroGTP methodologies and characterized to properly evaluate the novelty (Step 1), identify and quantify the potential risks and risk consequences (Step 2), and define the extent of pre-clinical and clinical assessments required to mitigate the risks identified in the assessment (Step 3).Results: Four risk consequences associated with the preparation process were identified: (i) implant failure related with tissue procurement and the reagents used during the decellularization protocol; (ii) unwanted immunogenicity related with the processing; (iii) disease transmission linked with the processing, reagents used, reduction in th

Yongfeng Liu,1 Qian Wang,1 Qinghai Zuo2 1Department of Anesthesiology, Medical Center Hospital of Qionglai, Qionglai City, Sichuan Province, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital of Hechuan, Chongqing City, People’s Republic of ChinaCorrespondence: Qinghai Zuo, Department of Anesthesiology, People’s Hospital of Hechuan, 1366 Hill Avenue, Hechuan District, Chongqing City, 401519, People’s Republic of China, Tel +23-42823120, Fax +23-42824243, Email zuoqinghai2023@163.comObjective: The effect of labor analgesia on gastric emptying rate will affect the management of fasting during the perinatal period. To evaluate gastric emptying after labor analgesia using the gastric antrum ultrasound examination.Methods: From September 2022 to January 2023, a prospective controlled observational study was conducted. The Study group (epidural analgesia group) and Observation group (pharmacological and non-pharmacological interventions group) were successively enrolled and grouped using the random envelope method. However, labor analgesia was supplied according to maternal women’s wishes, and intention-to-treat (ITT) and per-protocol (PP) analyses were performed to establish its effect on stomach emptying. The gastric emptying rate during the first stage of labor was considered to be the primary outcome.Results: From September 2022 to January 2023, 120 persons were studied, 90 in the Study group and 30 in the Observation group. 33 people’s analgesic selection was discordant with the grouped one. ITT analysis showed that the Study group’s cross-sectional area (CSA) fell from baseline (624.19 ± 92.70 mm2) to 334.64 ± 46.32 mm2 after 1 hour and to 217.26 ± 29.90 mm2 after 2 hours. In the Observation group, the CSA similarly dropped from 620.10 ± 100.73 mm2 to 331.30 ± 51.19 mm2 and 214.70 ± 28.73 mm2, p< 0.001. CSA was not significantly different between groups, p> 0.05. The PP analysis also indicated no significant chan

Shuchi Lin,1,&ast; Xiaofan Huang,1,&ast; Ying Zhang,1 Xiaohan Zhang,1 Erhong Cheng,1 Jindong Liu1– 4 1Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 3Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 4NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jindong Liu, Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Huaihai Road West, Quanshan District, Xuzhou, Jiangsu, People’s Republic of China, Tel +86-13951355136, Email liujindong1818@163.comPurpose: Myocardial injury after non-cardiac surgery is closely related to major adverse cardiac and cerebrovascular event and is difficult to identify. This study aims to investigate how to predict the myocardial injury of thoracic surgery and whether intraoperative variables contribute to the prediction of myocardial injury.Methods: The prospective study included adult patients with high cardiovascular risk who underwent elective thoracic surgery from May 2022 to October 2022. Multivariate logistic regression was used to establish a model with baseline variables and a model with baseline and intraoperative variables. We compare the predictive performance of two models for postoperative myocardial injury.Results: In general, 31.5% (94 of 298) occurred myocardial injury. Age ≥ 65 years old, obesity, smoking, preoperative hsTnT, and one-lung ventilation time were independent predictors of myocardial injury. Compared with baseline model, the intraoperative variables improved model fit, modestly imp

Bo Cong,1,2 Tao Sun,1,2 Yuchi Zhao,1,2 Mingqi Chen1 1Department of Orthopedics, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, 264003, People’s Republic of China; 2Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, 264003, People’s Republic of ChinaCorrespondence: Mingqi Chen, Department of Orthopedics, Yantaishan Hospital, Yantai, 264003, People’s Republic of China, Email c185463260@163.comAbstract: Articular cartilage repair is a sophisticated process that has is being recently investigated. There are several different approaches that are currently reported to promote cartilage repair, like cell-based therapies, biologics, and physical therapy. Cell-based therapies involve the using stem cells or chondrocytes, which make up cartilage, to promote the growth of new cartilage. Biologics, like growth factors, are also being applied to enhance cartilage repair. Physical therapy, like exercise and weight-bearing activities, can also be used to promote cartilage repair by inducing new cartilage growth and improving joint function. Additionally, surgical options like osteochondral autograft, autologous chondrocyte implantation, microfracture, and others are also reported for cartilage regeneration. In the current literature review, we aim to provide an up-to-date discussion about these approaches and discuss the current research status.Keywords: chondrogenesis, osteoarthritis, tissue engineering, mesenchymal stem cells, surgical repair

Than-Van Sy,1,2,&ast; Le Thanh Dung,1– 3,&ast; Bui-Van Giang,4 Nguyen Quang Nghia,5 Ninh Viet Khai,5 Cao Manh Thau,6 Pham Gia Anh,6 Trinh Hong Son,6 Nguyen Minh Duc7 1Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam; 2Department of Radiology, Viet Duc University Hospital, Ha Noi, Vietnam; 3Department of Radiology, VNU University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam; 4Department of Radiology, Vinmec Healthcare System, Hanoi, Vietnam; 5Center of Organ Transplantation, Viet Duc University Hospital, Ha Noi, Vietnam; 6Department of Oncology, Viet Duc University Hospital, Ha Noi, Vietnam; 7Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam&ast;These authors contributed equally to this workCorrespondence: Nguyen Minh Duc, Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam, Email bsnguyenminhduc@pnt.edu.vnObjective: This study aimed to evaluate the safety and efficacy of liver venous deprivation (LVD) following transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).Methods: Between January 2021 and December 2022, HCC patients indicated for hepatectomy with initial insufficient future liver remnant (FLR) underwent LVD after TACE to induce preoperative liver hypertrophy.Results: Twenty-seven HCC patients with a median age of 55 years underwent LVD. No TACE or LVD procedure-associated complications occurred, except for 1 case presenting with grade A liver failure after LVD (then recovered after 7 days). The FLR volume was 29.3% (interquartile range [IQR] = 7.5) and 48.9% (IQR = 8.6) of the total liver volume before and after LVD, respectively (p < 0.001). The degree of hypertrophy and FLR hypertrophy rate were 14.8% (IQR = 8.4) and 55.2% (IQR = 36.7), respectively. All 27 patients demonstrated sufficient FLR after LVD (24 patients at three weeks post-LVD, one at six weeks, and two at ten weeks), but

María A Rodríguez-Scarpetta,1,2 Andrés M Sepúlveda-Tobón,3 Jorge E Daza-Arana,1,2 Heiler Lozada-Ramos,2,4,5 Rodrigo A Álzate-Sánchez3 1Physiotherapy Program, Universidad Santiago de Cali, Santiago de Cali, Colombia; 2Research Group on Health and Movement, Universidad Santiago de Cali, Santiago de Cali, Colombia; 3Master in Epidemiology, Universidad Libre, Santiago de Cali, Colombia; 4Medicine Program, Universidad Santiago de Cali, Palmira, Colombia; 5Doctoral Program in Infectious Diseases, Universidad de Santander, Bucaramanga, ColombiaCorrespondence: María A Rodríguez-Scarpetta, Physiotherapy Program, Universidad Santiago de Cali, Calle 5 &num; 62-00, Santiago de Cali, Colombia, Tel +57 301 4158934, Email maria.rodriguez10@usc.edu.coPurpose: Central venous oxygen saturation (ScvO2) has been reported as a prognostic marker of in-hospital mortality when it is below 60% in certain situations. Nevertheless, it has not been widely reported in patients undergoing coronary artery bypass graft (CABG). The study determined the association between ScvO2 and in-hospital mortality in patients undergoing CABG in a high-complexity health institution in Santiago de Cali, Colombia.Patients and Methods: A retrospective cohort study was conducted with patients undergoing isolated CABG. The subject sample included 515 subjects aged 18 years or older. Exposure was defined as ScvO2 < 60% upon admission to the intensive care unit (ICU) following surgery. The major outcome was mortality rates after 30 days. Furthermore, exposure variables were measured at preoperative, intra-operative, and postoperative time points.Results: A total of 103 exposed and 412 unexposed subjects were included. The final model revealed a higher mortality risk in individuals with ScvO2 < 60% upon ICU admission compared with those with higher saturation levels (relative risk 4.2, 95% confidence interval: 2.4– 7.2; p = 0.001). Values were adjusted using variables such as age (> 75 years)

Felice Alfonso Nava,1 Alessandra Mangia,2 Marco Riglietta,3 Lorenzo Somaini,4 Francesco Giuseppe Foschi,5 Ernesto Claar,6 Ivana Maida,7 Claudio Ucciferri,8 Francesca Frigerio,9 Candido Hernandez,10 Melania Dovizio,11 Valentina Perrone,11 Luca Degli Esposti,11 Massimo Puoti12 1U.O. Sanità Penitenziaria e Area Dipendenze, Azienda ULSS 6 Euganea, Padova, Italy; 2UOS Epatologia, Istituto di Ricovero e Cura “Casa Sollievo della Sofferenza”, S. Giovanni Rotondo, Italy; 3UOC Dipendenze, ASST Papa Giovanni XXIII, Bergamo, Italy; 4Servizio per le Dipendenze, SERT di Cossato, Biella, Italy; 5UOC Medicina Interna, Ospedale di Faenza, Faenza, Italy; 6UOC Medicina Interna, Ospedale Evangelico “Villa Betania”, Napoli, Italy; 7UOC Malattie Infettive e Parassitarie, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy; 8Clinica di Malattie Infettive Ospedale “SS Annunziata”, Chieti, Italy; 9Gilead Sciences, Milano, Italy; 10Gilead Sciences, Global Medical Affairs, Stockley Park, London, UB11 1BD, UK; 11CliCon S.R.L. Società Benefit, Health Economics and Outcomes Research, Bologna, Italy; 12SC Malattie Infettive, ASST Grande Ospedale Metropolitano Niguarda, Milano, ItalyCorrespondence: Luca Degli Esposti, CliCon S.r.l. Società Benefit, Health, Economics & Outcomes Research, Via Murri, 9, Bologna, 40137, Italy, Tel +39 544 38393, Fax +39 544 212699, Email luca.degliesposti@clicon.itPurpose: Hepatitis C virus (HCV) spreads from contact with blood of an infected person. HCV infections are common among people who use drugs (PWUDs), when sharing needles, syringes, or other equipment for injected drugs. The advent of pangenotypic direct-antiviral agents (DAA) in 2017 transformed the treatment landscape for HCV, but PWUDs remain a complex and hard-to-treat population with high risk of HCV reinfection. The aim of this real-world analysis was to characterize the demographic and clinical features of PWUDs in Italy, also focusing on comorbidity profile, treatment wit

Syah Mirsya Warli,1,2 Steven Steven,3 Dhirajaya Dharma Kadar,1 Fauriski Febrian Prapiska,1 Ginanda Putra Siregar1 1Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara – Haji Adam Malik General Hospital, Medan, Indonesia; 2Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia; 3Department of Urology, Faculty of Medicine, Universitas Indonesia - Haji Adam Malik General Hospital, Medan, IndonesiaCorrespondence: Syah Mirsya Warli, Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Dr. Mansyur No. 5 Medan, North Sumatera, 20154, Indonesia, Tel +6261-8364930, Email warli@usu.ac.idPurpose: Erectile dysfunction (ED) contributes to a large burden and impairs the quality of life among males. Avanafil appears to be a promising treatment for ED; however, its efficacy and safety profile remain unclear. This study aimed to evaluate the efficacy and safety of avanafil for the treatment of ED.Patients and Methods: An extensive search of PubMed, ScienceDirect, Web of Science, and Embase databases with 11 publications was performed, with outcomes evaluated are International Index of Erectile Function – Erectile Function (IIEF-EF), Sexual Encounter Profile (SEP), and Treatment-Emergent Adverse Events (TEAE). Statistical parameter Mean Difference (MD) and Risk Ratio (RR) with 95% Confidence Interval (CI) were used to measure effect size.Results: The pooled estimates demonstrated that changes in IIEF-EF function (MD=4.39, 95% CI [3.41, 5.37], p< 0.001), SEP-2 (RR=3.43, 95% CI [2.79, 4.22], p< 0.001), SEP-3 (RR=2.30, 95% CI [2.01, 2.62], p< 0.001), and TEAE (RR=1.49, 95% CI [1.12, 1.96], p=0.005) were significantly higher in the avanafil group than in the placebo group. Moreover, 200 mg avanafil was superior to that mg 100 mg-avanafil, indicated by the IIEF-EF score (MD=− 1.15, 95% CI [− 1.40, − 0.89], p< 0.001). In contrary, there wer

Maria Komariah,1,&ast; Shakira Amirah,2,&ast; Sidik Maulana,3 Muhammad Fahd Abdurrahman,2 Kusman Ibrahim,4 Hesti Platini,4 Juan Alessandro Jeremis Maruli Nura Lele,5 Kelvin Kohar,6 Laili Rahayuwati,7 Mohd Khairul Zul Hasymi Firdaus8 1Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 2Undergraduate Medical Education, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia; 3Nursing Internship Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 4Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 5Undergraduate Medical Education, Faculty of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia; 6Clinical Clerkship Program, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo, Central Hospital, Jakarta, Indonesia; 7Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 8Department of Medical-Surgical Nursing, Faculty of Nursing, International Islamic University Malaysia, Kuala Lumpur, Malaysia&ast;These authors contributed equally to this workCorrespondence: Maria Komariah, Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM. 21, Hegarmanah, Jatinangor, Kabupaten, Sumedang, West Java, 45363, Indonesia, Tel + 6281294686288, Email maria.komariah@unpad.ac.id Shakira Amirah, Email shakira.amirah@ui.ac.idBackground: The COVID-19 pandemic continues, and this condition has caused many cases in various countries around the world, resulting in more than 6 million deaths worldwide. Herbal medicines can act as immunomodulators, anti-inflammatories, antioxidants, antimicrobials, and others depending on the type and content of the herbs used. Previous studies have shown that several types of herbs, such as Echinacea purpurea, Curcumin or Turmeric, Nigella sativa, and Zingiber officinale, have proven their effectiv

Jiajun Wu,1,2,&ast; Lei Gao,1,2,&ast; Qiao Shi,3 Chunhui Qin,4 Kai Xu,1,2 Zhaoshun Jiang,1,2 Xixue Zhang,1,2 Ming Li,5 Jianjian Qiu,6,&ast; Weidong Gu1,2,&ast; 1Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China; 2Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People’s Republic of China; 3Department of Anesthesiology, International Peace Maternity and Child Health Hospital of China, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, People’s Republic of China; 4Department of Pain Management, Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China; 5Department of Radiology, Huadong Hospital affiliated to Fudan University, Shanghai, 200040, People’s Republic of China; 6Department of Radiation Oncology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Weidong Gu; Jianjian Qiu, Email hdmz0800@163.com; qiujianjian@fudan.edu.cnPurpose: To evaluate the accuracy of mixed reality (MR)-guided visualization technology for spinal puncture (MRsp).Methods: MRsp involved the following three steps: 1. Lumbar spine computed tomography (CT) data were obtained to reconstruct virtual 3D images, which were imported into a HoloLens (2nd gen). 2. The patented MR system quickly recognized the spatial orientation and superimposed the virtual image over the real spine in the HoloLens. 3. The operator performed the spinal puncture with structural information provided by the virtual image. A posture fixation cushion was used to keep the subjects’ lateral decubitus position consistent. 12 subjects were recruited to verify the setup error and the registration error. The setup error was calculated using the

Ping-Chen Hou,1,&ast; Nathalie del Agua,2,3,&ast; Su M Lwin,4 Chao-Kai Hsu,1– 3 John A McGrath1,3,4 1Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 2Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan; 4St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK&ast;These authors contributed equally to this workCorrespondence: Chao-Kai Hsu, Department of Dermatology, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan City, Taiwan, Tel +886-62353535 Ext.5415, Fax +886-62766180, Email kylehsu@mail.ncku.edu.tw John A McGrath, St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK, Tel +44-2071886409, Fax +44-2071888050, Email john.mcgrath@kcl.ac.ukAbstract: Dystrophic epidermolysis bullosa (DEB) is one of the major types of EB, a rare hereditary group of trauma-induced blistering skin disorders. DEB is caused by inherited pathogenic variants in the COL7A1 gene, which encodes type VII collagen, the major component of anchoring fibrils which maintain adhesion between the outer epidermis and underlying dermis. DEB can be subclassified into dominant (DDEB) and recessive (RDEB) forms. Generally, DDEB has a milder phenotype, while RDEB patients often have more extensive blistering, chronic inflammation, skin fibrosis, and a propensity for squamous cell carcinoma development, collectively impacting on daily activities and life expectancy. At present, best practice treatments are mostly supportive, and thus there is a considerable burden of disease with unmet therapeutic need. Over the last 20 years, considerable translational research efforts have focused on either trying to cure DEB by d

Hanqing Liu,1,&ast; Man Lu,1,&ast; Jiawei Hu,1 Guangzhao Fu,2 Qinyu Feng,3 Shengrong Sun,1 Chuang Chen1 1Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China; 2Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China; 3Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chuang Chen; Shengrong Sun, Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan University, Jiefang Road 238, Wuhan, 430060, People’s Republic of China, Tel/Fax +86 27 88041911, Email chenc2469@163.com; sun137@sina.comPurpose: Levothyroxine is a common prescribed drug. Many medications and food, however, can interfere with its bioavailability. The aim of this review was to summarize the medications, food and beverages that interact with levothyroxine and to assess their effects, mechanisms and treatments.Methods: A systematic review on interfering substances that interact with levothyroxine was performed. Web of Science, Embase, PubMed, the Cochrane library, grey literature from other sources and the lists of references were searched for human studies comparing the levothyroxine efficacy with and without interfering substances. The patient characteristics, drug classes, effects and mechanism were extracted. The NHLBI study quality assessment tools and the JBI critical appraisal checklist were used to assess the quality of included studies.Results: A total of 107 articles with 128 studies were included. Drugs interactions were revealed in calcium and iron supplements, proton pump inhibitors, bile acid sequestrants, phosphate binders, sex hormones, anticonvulsants and other drugs. Some food and beverage could also induce malabsorption. Proposed mechanisms included direct complexing, alkalization, alterat