Pulmonary radiological change of COVID-19 patients with 99mTc-MDP treatment

AbstractBackgroundAs increasing cases of COVID-19 around world, urgent need for effective COVID-19-specific therapeutic drugs is necessary; therefore, we conducted a pilot randomized-controlled study to evaluate the efficacy of 99mTc-MDP for COVID-19 therapeutic treatment.MethodsA total of 21 mild patients with COVID-19 were enrolled in this pilot RCT from February 2020 through March 2020, and then were assigned, in a 1:1 ratio, into control (11 patients) and 99mTc-MDP group (10 patients). Patients in the control group received routine treatment and patients assigned to the 99mTc-MDP group received a combination of routine treatment and an administration of 99mTc-MDP injection of 5ml/day. Both of the patients in the control and 99mTc-MDP groups were treated for 7 days with the primary end point of CT-based radiological pulmonary changes during 7-day follow-up.FindingsFrom baseline to the day 7, 8 (80%) of 10 mild patients in the 99mTc-MDP group had a significant radiological improvement in lung and a decline in inflammatory infiltration, whereas only 1 (9.1%) of 11 patients in the control group had a radiological improvement in lung. None of the patients in the 99mTc-MDP group had disease progression from mild to severe, as well as an inflammatory cytokine storm, and 2 mild patients (18.2%) in the control group developed severe. During days 7 through 14, the number of patients with radiological improvement in the 99mTc-MDP group remained consistent, and only 1 additional case (22%) in the control group were reported.ConclusionIn this randomized pilot study, 99mTc-MDP had an effective inhibitory effect on the inflammatory disease progression for the therapy of COVID-19, and it can accelerate the absorption of pulmonary inflammation in a short period of time during the process of treatment.

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Autologous Platelet-Rich Fibrin (PRF) as an Adjunct in the Management of Osteoradionecrosis and Medication-Related Osteonecrosis of Jaws. Case Series in A Single Centre

Applied Sciences ◽

10.3390/app11083365 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3365

Author(s):

Benjie Law ◽

Hui Yuh Soh ◽

Syed Nabil ◽

Rama Krsna Rajandram ◽

Abd Jabar Nazimi ◽

...

Keyword(s):

Case Series ◽

Cost Effective ◽

Control Group ◽

Platelet Rich Fibrin ◽

Tissue Healing ◽

Number Of Patients ◽

Short Period ◽

Oral And Maxillofacial Region ◽

Surgical Adjunct ◽

Autologous Platelet

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.

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EFFECT OF ENVIRONMENTAL ILLUMINATION IN PREVENTION OF HYPERBILIRUBINEMIA OF PREMATURITY

PEDIATRICS ◽

10.1542/peds.44.2.162 ◽

1969 ◽

Vol 44 (2) ◽

pp. 162-167

Author(s):

Frank Giunta ◽

Jogeswor Rath

Keyword(s):

Premature Infants ◽

Serum Bilirubin ◽

Controlled Study ◽

Control Group ◽

Lower Serum ◽

Routine Treatment ◽

Indirect Bilirubin ◽

Environmental Lighting ◽

Light Group

A controlled study involving 96 babies weighing under 2,500 gm was done by placing 47 completely exposed infants, except for diapers, under environmental lights averaging 90 footcandles and 49 fully clothed infants under lights averaging 10 footcandles. A significantly lower serum bilirubin occurred in the light group from the second to the sixth day. Only three babies developed indirect bilirubin levels over 15 mg/100 ml in the light group against 14 in the control group. Exposure to this intensity of environmental lighting seems to be of much value in the routine treatment of premature infants for the prevention of hyperbilirubinemia.

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Effect of therapeutic suggestions during general anaesthesia on postoperative pain and opioid use: multicentre randomised controlled trial

BMJ ◽

10.1136/bmj.m4284 ◽

2020 ◽

pp. m4284 ◽

Cited By ~ 1

Author(s):

Hartmuth Nowak ◽

Nina Zech ◽

Sven Asmussen ◽

Tim Rahmel ◽

Michael Tryba ◽

...

Keyword(s):

Postoperative Pain ◽

Confidence Interval ◽

General Anaesthesia ◽

Intervention Group ◽

Controlled Study ◽

Control Group ◽

Number Needed To Treat ◽

Opioid Use ◽

Number Of Patients ◽

Randomised Controlled

Abstract Objective To investigate the effect of therapeutic suggestions played to patients through earphones during surgery on postoperative pain and opioid use. Design Blinded randomised controlled study. Setting Five tertiary care hospitals in Germany. Participants 385 of 400 patients consecutively recruited from January to December 2018 who were to undergo surgery for 1-3 hours under general anaesthesia. In the per protocol analysis 191 patients were included in the intervention group and 194 patients in the control group. Intervention The intervention comprised an audiotape of background music and positive suggestions based on hypnotherapeutic principles, which was played repeatedly for 20 minutes followed by 10 minutes of silence to patients through earphones during general anaesthesia. Patients in the control group were assigned to a blank tape. Main outcome measures The main outcome was dose of opioid administered by patient controlled analgesia or nurse controlled analgesia within the first postoperative 24 hours, based on regular evaluation of pain intensity on a numerical rating scale (range 0-10, with higher scores representing more severe pain). Results Compared with the control group, the intervention group required a significantly (P=0.002) lower opioid dose within 24 hours after surgery, with a median of 4.0 mg (interquartile range 0-8) morphine equivalents versus 5.3 (2-12), and an effect size (Cohen’s d) of 0.36 (95% confidence interval 0.16 to 0.56). The number of patients who needed opioids postoperatively was significantly (P=0.001) reduced in the intervention group: 121 of 191 (63%, 95% confidence interval 45% to 70%) patients in the intervention group versus 155 of 194 (80%, 74% to 85%) in the control group. The number needed to treat to avoid postoperative opioids was 6. Pain scores were consistently and significantly lower in the intervention group within 24 hours after surgery, with an average reduction of 25%. No adverse events were reported. Conclusions Therapeutic suggestions played through earphones during general anaesthesia could provide a safe, feasible, inexpensive, and non-drug technique to reduce postoperative pain and opioid use, with the potential for more general use. Based on the finding of intraoperative perception by a considerable number of patients, surgeons and anaesthetists should be careful about background noise and conversations during surgery. Trial registration German Clinical Trial Register DRKS00013800.

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Transcutaneous Electrical Acupoint Stimulation Before Induction of Anesthesia Prevents Sufentanil-Induced Cough: A Prospective, Randomized, Controlled Study

10.21203/rs.3.rs-35069/v1 ◽

2020 ◽

Author(s):

Junjie Xie ◽

Yunchang Mo ◽

Junkai Wang ◽

Lili Yang ◽

Haijuan He ◽

...

Keyword(s):

Statistical Difference ◽

Inhibitory Effect ◽

Controlled Study ◽

Common Side Effect ◽

Control Group ◽

Trial Registry ◽

Clinical Trial Registry ◽

Randomized Controlled ◽

The Mean ◽

Acupoint Stimulation

Abstract Background. Sufentanil-induced cough is a common side effect during the induction of general anesthesia.This study is to determine the inhibitory effect of transcutaneous electrical acupoint stimulation(TEAS) on sufentanil-induced cough.Methods. A total of 339 patients were recruited in this trial.After the unqualified patients were removed,300 patients were enrolled and randomly allocated into five groups(n=60):Patients did not receive TEAS in control group(C group);Patients received 2Hz TEAS at Hegu/Neiguan(LI4/PC6) in 2A group;Patients received 100Hz TEAS at LI4/PC6 in 100A group;Patients received 2Hz TEAS at Zusanli/sanyinjiao(ST36/SP6) in 2B group;Patients received 100Hz TEAS at ST36/SP6 in 100B group.Except for C group,all groups received TEAS for 30 min before the induction.Then 0.5μg/kg sufentanil was given within 2 s,the occurrence of cough was observed and recorded for 1 min.The severity of cough was graded as mild(1-2 coughs),moderate(3-5 cough),and severe(>5 coughs).The mean arterial pressure(MAP) and heart rate(HR) before (T0) and 1 min after(T1) sufentanil injection were recorded.Results. The incidence of sufentani-induced cough in C group,2A group,2Bgroup,100A group and 100B group were 37%,27%,27%,12% and 13%,respectively.Compared with C group,the incidence of 100A group and 100B group were significantly lower(P<0.05).The MAP and HR between five groups had no statistical difference.Conclusion. Groups the received 100Hz TEAS for 30 min before sufentanil injection can effectively reduce the incidence of sufentanil-induced cough during the induction of general anesthesia.Trial registration: Chinese clinical trial registry(ChiCTRINR16008759)

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Diphenhydramine Definitely Suppresses Fentanyl-Induced Cough During General Anesthesia Induction: A Double-Blind, Randomized, and Placebo-Controlled Study

ACTA MEDICA IRANICA ◽

10.18502/acta.v57i5.1868 ◽

2019 ◽

Author(s):

Pejman Pourfakhr ◽

Seyed Hashem Ziaei ◽

Farhad Etezadi ◽

Mohamadreza Sharifinia ◽

Mohammad Reza Khajavi

Keyword(s):

Recovery Room ◽

Controlled Trial ◽

Study Groups ◽

Secondary Outcome ◽

Controlled Study ◽

Control Group ◽

Anesthesia Induction ◽

Analgesic Requirement ◽

Double Blind ◽

Number Of Patients

Fentanyl-induced cough (FIC) is a known complication, and many studies have been conducted to prevent it. The aim of this study was to evaluate the effectiveness of Diphenhydramine as an antihistamine in suppressing of FIC during induction of anesthesia. In a prospective, double-blind, randomized controlled trial, a total of 100 patients, ASA Class I and II, scheduled for elective laparoscopy surgery were randomly assigned into two equally sized groups (n=50). Diphenhydramine diluted with distilled water as 10 mg/ml. Then, patients in Group D, received diphenhydramine 30 mg (3 ml) through peripheral IV line within 1 min and Group C received the same volume normal saline 0.9% as placebo. Two min later, fentanyl 2 µg/kg was administered through the peripheral IV line within 5 sec in all patients. The occurrence and intensity of cough within 2 min after the fentanyl injection were observed and recorded by a resident who was blinded to the study groups. The frequency of PONV, analgesic requirement in the recovery room and as a secondary outcome were recorded. The incidences of FIC were 47% in the control group, and there is no cough in the diphenhydramine group (P=0.02). The frequency of PONV was also reduced in diphenhydramine group (16% vs. 40%) and less number of patients in diphenhydramine group was needed to analgesia in the recovery room (60% vs. 82%). Our study determines that diphenhydramine (30 mg, IV) bolus injection 2 min before fentanyl injection can prevent FIC and PONV and also reduce analgesic requirement inthe recovery room. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(5):316-319.

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Is symptom improvement in patients with small cell lung cancer (SCLC) associated with clinical response? An analysis using the Patient Symptom Assessment Lung Cancer (PSALC) scale in a randomized trial comparing oral topotecan (OT) with best supportive care (BSC)

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.7725 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 7725-7725 ◽

Cited By ~ 1

Author(s):

M. E. O'Brien ◽

M. Duh ◽

L. Chen ◽

L. Antras ◽

M. Neary ◽

...

Keyword(s):

Lung Cancer ◽

Survival Data ◽

Symptom Relief ◽

Symptom Control ◽

Controlled Study ◽

Symptom Improvement ◽

Control Group ◽

Symptomatic Disease ◽

Major Response ◽

Number Of Patients

7725 Background: SCLC is a highly symptomatic disease with poor survival in prior treated patients. To evaluate the role of chemotherapy, a recent multicenter trial randomized 141 patients with prior treatment to receive either OT + BSC or BSC only. This was the first trial to use a BSC control group in SCLC while evaluating survival, response and symptoms. Survival data were reported (O'Brien et al JCO 2006; median survival of 25.9 weeks on OT + BSC vs 13.9 weeks on BSC, p = 0.01). 51% on OT had “disease control” (partial response [PR] + stable disease [SD]); no patient on BSC was reported to have a major response, although response was not an endpoint for this group. Trials have shown that those with progressive disease have the most symptom worsening, as occurred in this trial. The objective of this analysis is to determine if patients with PR report greater symptom relief than those with SD, in that SD can reflect a more indolent course in some patients while PR is due to treatment effect only. Methods: We used the investigators evaluation of response (PR or SD) and analyzed these groups by the patients’ scoring of their symptoms using the PSALC instrument which evaluates 9 SCLC symptoms, in the 71 patients on the OT + BSC arm. Results: Patients with lower ECOG PS at baseline reported more severe symptoms (higher PSALC score). Mean changes in PSALC score from baseline are shown in the Table and demonstrate an association between tumor response and decrease in symptoms. Conclusions: Patients who achieved a major response on OT treatment reported significantly better symptom control than those whose best response was SD. This indicates that in addition to a survival benefit, treatment with this chemotherapy can aid in symptom control. While the small number of patients limits the strength of the conclusions, this trial represents the largest BSC controlled study in SCLC. No significant financial relationships to disclose. [Table: see text]

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Acute and chronic consequences of polidocanol foam injection in the lung in experimental animals

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2012.012120 ◽

2013 ◽

Vol 28 (8) ◽

pp. 441-444 ◽

Cited By ~ 3

Author(s):

L Grandi ◽

R A Grandi ◽

C D Tomasi ◽

J L Da Rocha ◽

V Cardoso ◽

...

Keyword(s):

Pulmonary Embolism ◽

Histopathological Examination ◽

Pulmonary Inflammation ◽

Left Lung ◽

Histological Evaluation ◽

Control Group ◽

Pulmonary Perfusion ◽

Lung Scintigraphy ◽

Inflammatory Infiltration ◽

Experimental Animals

Objective To assess the presence of pulmonary embolism and inflammation after polidocanol foam injection into the peripheral veins of rabbits. Method The animals were treated with polidocanol foam (1 or 3 mg/kg) or vehicle. Early (15 minutes) and late (30 days) animals were evaluated by perfusional lung scintigraphy and histopathological examination. Results In the control group no alterations were found. After polidocanol foam injection it was observed that an important reduction of pulmonary perfusion in the early periods, was mainly in the left lung ( P < 0.001), with consequent embolism in the histological evaluation. In late periods it was observed that the presence of thrombus was with fibrin in small veins, compatible with chronic thrombus and the presence of chronic pulmonary inflammation. Conclusions The injection of polidocanol foam in experimental animals can induce venous embolism and chronic inflammatory infiltration.

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Clinical Outcome of Intravascular Ultrasound Guided Left Main Coronary Intervention

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i1330552 ◽

2020 ◽

pp. 46-58

Author(s):

Mohamed Ezzelregal ◽

Luca Testa ◽

Medhat Alashmawy ◽

Ayman Elsaid ◽

Hanan Kassem

Keyword(s):

Myocardial Infarction ◽

Intravascular Ultrasound ◽

Coronary Intervention ◽

Target Lesion ◽

Target Lesion Revascularization ◽

Controlled Study ◽

Control Group ◽

P Value ◽

Left Main ◽

Number Of Patients

Introduction: Intravascular ultrasound is a new imaging modality that facilitate the process of coronary intervention. The angiographic evaluation of left main lesions significance is always questionable, IVUS detect the significance, guide the procedure and some studies proves a benefit in mortality. Objectives: To investigate whether intravascular ultrasound IVUS guided Left Main coronary intervention could improve clinical outcomes compared with angiographic-guided Left main coronary PCI. Patients and Methods: This controlled study was carried out between June 2017 and June 2019, in Tanta university Hospital and San Donato Hospital, Milan, 83 patients eligible to Left Main coronary intervention divided into two groups, IVUS-guided group (n=19) and angiographic-guided group(n=64). The occurrence of major adverse cardiac events (MACE): death, non-fatal myocardial infarction, or target lesion revascularizations) were recorded 6 and18 Months of follow-up. Results: The IVUS-guided group had a lower rate of 18-months MACE than the control group. The incidence of target lesion revascularization was lower in the IVUS-guided group than in the control group. The incidence of TLR after 6 months was not different between both groups (1 cases in IVUS group (5.3%), 6 cases in angiography group (9.4%) (P value 0.686) while the incidence of TLR after 18 months was significantly different between both groups (1 cases in IVUS group (5.3%), 17 cases in angiography group (26.6%) (P value 0.048), However, there were no differences in death, myocardial infarction, stent thrombosis and number of patients treated with CABG in the 2 groups. Conclusion: The present study demonstrates that IVUS-guided LM angioplasty can improve 18 -months MACE events especially the incidence of target lesion revascularization.

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Ultrasound-guided erector spinae plane block versus rhomboid intercostal block for postoperative analgesia following thoracotomy: a prospective, randomized, controlled study

10.22541/au.163323122.27799773/v1 ◽

2021 ◽

Author(s):

Tahsin Şimşek ◽

Fatih Dogu Geyik ◽

Aynur Kaynar Simsek ◽

Yucel Yuce ◽

Kemal Tolga Saracoglu ◽

...

Keyword(s):

Postoperative Analgesia ◽

Controlled Trial ◽

Erector Spinae ◽

Controlled Study ◽

Control Group ◽

Randomized Controlled ◽

Erector Spinae Plane Block ◽

Number Of Patients ◽

Vas Scores ◽

Intercostal Block

Introduction For pain relief after thoracotomy, opioids and thoracic paravertebral and epidural interventions are frequently used. In recent years, interfascial blocks such as the erector spinae plane block (ESPB) and rhomboid intercostal block (RIB) have started to be used for analgesia. We aimed to compare the postoperative analgesic effect of ESPB, RIB, and a control group in pain management after open thoracotomy. Material and methods This is a randomized controlled trial. A total of 75 patients were included in three groups as the ESPB, RIB, and control (C) groups. In block groups, the blockage was performed with 20 ml 0.25% bupivacaine. In Group C, no procedures other than the standard postoperative analgesia protocol were performed. The postoperative analgesic consumptions of the patients, time of first analgesic need, and visual analog scale (VAS) values were recorded. Results The mean 24-hour tramadol consumption was 124±29.08 mg in group ESPB and 116±28.65 mg in group RIB, and the results were statistically similar (p>0.05). In Group C, the consumption is 204±44.06 mg; significantly higher than group ESPB and group RIB (p=0.004). Time to the first analgesic requirement was 355±55.69 min in group ESPB and 339.12±54.39 min in group RIB. There was no difference between groups (p>0.05). In Group C, this time was 218.91±56.73 minutes. We observed that group ESPB and group RIB needed analgesics later (p=0.006). VAS scores and the number of patients requiring analgesics were similar in group ESPB and group RIB (p>0.05). In Group C, on the other hand, VAS scores and the number of patients requiring analgesics were higher than both groups in which block was applied (p<0.05). Conclusion ESPB and RIB were similar and they are more effective in comparison to the standard protocol in the control group, whereas the former did not have superiority over each other.

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Morphometric analysis of peroxisomes in hepatocytes of alcohol-fed rats

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100157486 ◽

1989 ◽

Vol 47 ◽

pp. 1100-1101

Author(s):

D.C. Dominguez ◽

J.T. Ellzey

Keyword(s):

Caloric Intake ◽

Volume Density ◽

Controlled Study ◽

Control Group ◽

Numerical Density ◽

Cacodylate Buffer ◽

Paired Control ◽

Experimental Group ◽

Liver Peroxisomes ◽

Single Lesion

Peroxisomes which participate in 1ipid metabolism have been shown to be altered in several metabolic disorders and toxic conditions. In alcoholic liver disease, the single lesion most frequently found is lipid accumu1ation in hepatocytes. However, the mechanisms for this 1ipid accumu1ation are not clear. The occurrence of modifications of liver peroxisomes due to excess alcohol consumption has not been subjected to a controlled study. We utilized a combination of cytochemica1 and morphometrictechniques to study the size and number of liver peroxisomes in rats fed an alcohol-supplemented diet compared to those of matched-paired control animals.Male Sprague-Daw1ey rats (400-500 g) received a liquid diet. The experimental group (N = 5/group) was fed a diet containing 30% ethanol-derived calories (EDC) and the control group was fed an isocaloric diet to 30% EDC. A pair feeding procedure was employed to control for caloric intake. Small pieces of liver randomly selected, were fixed in 2.3% -glutaraldehyde in 0.1 M sodium cacodylate buffer, pH 7.2, incubated in a DAB medium and postfixed with. 2% aqueous osmium tetroxide. EM photographs were taken from sections of 3 tissue blocks from each sample (7,200X) with a Zeiss EM10-A (60 kV). With the use of a point counting method and a digital planimeter the volume density (Vv) and numerical density (Nv) were determined.

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