The impact of warmed and humidified CO2 insufflation during robotic radical prostatectomy: Results of a randomized controlled trial

2019 ◽  
Vol 86 (3) ◽  
pp. 130-140
Author(s):  
Marco Oderda ◽  
Elisabetta Cerutti ◽  
Paolo Gontero ◽  
Tilde Manetta ◽  
Giulio Mengozzi ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Body Core Temperature ◽  
Blood Gas ◽  
Randomized Controlled ◽  
Hot Air ◽  
Pain Scores ◽  
Significant Difference ◽  
Cytokine Levels ◽  
Warming Blanket ◽  
The Impact

Background: Cool and dry gas insufflation during laparoscopy induces hypothermia and cytokine increase, with significant perioperative morbidity. Our aim was to assess if warmed and humidified CO2 insufflation with HumiGard™ device can achieve significant benefits over standard insufflation in terms of risk of hypothermia, cytokine response, blood gases, and intra- and postoperative parameters, in the setting of robot-assisted radical prostatectomy (RARP). Methods: This was a prospective, randomized controlled clinical trial. Sixty-four patients with prostate cancer undergoing RARP were randomized to receive warmed and humidified CO2 insufflation with HumiGard device, plus hot air warming blanket (treatment group, H + WB), or standard CO2 insufflation, plus hot air warming blanket (control group, WB). Body core temperature (BCT), plasma levels of IL-6 and TNF-α, pain scores, and intraoperative parameters were recorded. The data were analyzed according to the Bayesian paradigm. Results: Intraoperative BCT increased in both groups during surgery, with a statistically significant difference favoring group H + WB, ending at 0.2°C higher on average than group WB. No difference across groups was shown for cytokine levels. Blood gas parameters were not affected by warmed CO2 insufflation. No statistical differences were noted for pain scores and the other intra- and postoperative parameters. Conclusions: During RARP, warm and humidified CO2 insufflation with the HumiGard device was more effective than the standard CO2 insufflation in maintaining the patient’s heat homeostasis, even if the difference was minimal. No imbalances were detected on blood gas analyses. No benefit could be shown in terms of cytokine levels and pain scores.

scholarly journals Interest of a standardized hypnotic message for the reduction of pain and anxiety in cancer patients treated by capsaicin patch for neuropathic pain: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rémi Etienne ◽  
Myriam Laurent ◽  
Aline Henry ◽  
Antoine Bioy ◽  
Julia Salleron ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neuropathic Pain ◽  
Rating Scales ◽  
Controlled Trial ◽  
Standard Group ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Numerical Rating ◽  
Reduction Of Pain ◽  
The Impact

Abstract Background Neuropathic pain is characterized by spontaneous painful symptoms. Medical therapies include the use of a capsaicin 8% patch (Qutenza®, Grünenthal Gmbh, Germany), and patients may experience a sharp burning sensation at application and removal of the patch. This study aimed to evaluate the impact of playing a standardized hypnosis recording during application, on the pain and anxiety induced by capsaicin treatment. Methods In a randomized, controlled trial, we assessed the benefits of the intervention firstly on pain and secondly on anxiety, as measured using numerical rating scales. All patients had application of the capsaicin patch, including the possibility for the patient to apply a cold patch. Participants were randomly assigned to one of 3 groups, namely the “Standard group” (no intervention), “Hypnosis group”, in which a standardized hypnotic message was played during application, or the “Music group” in which relaxing music was played during application of the patch. Results Sixty-nine patients were included. Overall, there was no significant difference in pain scores between groups (p = 0.355). Compared to standard application, anxiety was significantly lower in the hypnosis group after application (p = 0.007), with no significant difference between the standard and music arms (p = 0.271), or between the hypnosis and music arms (p = 0.423). Conclusions Listening to a standardized hypnotic message during application of a capsaicin patch was found to significantly lower anxiety. These findings indicate that the use of a hypnotic message can reduce discomfort and warrant its evaluation in other indications of pain or anxiety during treatment procedures. Trial registration NCT02822625.

The impact of fibropapillomatosis on clinical characteristics, blood gas, plasma biochemistry, and hematological profiles in juvenile green turtles ( Chelonia mydas)

2020 ◽  
Vol 96 (4) ◽  
pp. 723-734
Author(s):  
Tsung-Hsien Li ◽  
Chao-Chin Chang
Keyword(s):  
White Blood Cells ◽  
Extracellular Fluid ◽  
Chelonia Mydas ◽  
Sea Turtle ◽  
Total Carbon ◽  
Blood Gas ◽  
Green Turtles ◽  
Cell Counts ◽  
Significant Difference ◽  
The Impact

Fibropapillomatosis (FP) is a tumor- forming disease that afflicts all marine turtles and is the most common in green turtles (Chelonia mydas). In this study, the morphometric characteristics, blood gas, biochemistry, and hematological profiles of 28 (6 FP-positive and 22 FP-negative) green turtles from the coast of Taiwan were investigated. The results indicated that body weight ( P < 0.001) and curved carapace length (CCL; P < 0.001) in green turtles with FP were significantly higher than in turtles without FP. Furthermore, green turtles with FP had a significantly lower value of hemoglobin (HB; P = 0.010) and packed cell volume (PCV; P = 0.005) than turtles without FP. Blood cell counts of white blood cells (WBC; P = 0.008) and lymphocytes ( P = 0.022) were observed with significant difference; green turtles with FP had lower counts than turtles without FP. In addition, turtles with FP had significantly higher pH ( P = 0.036), base excess in extracellular fluid (BEecf; P = 0.012), bicarbonate (HCO3– ; P = 0.008), and total carbon dioxide (TCO2 ; P = 0.025) values than turtles without FP. The findings of this study provide valuable clinical parameters for the medical care of the species in sea turtle rehabilitation centers and help us to understand the physiological response of green turtles to different tumor-forming conditions.

scholarly journals Interest of a standardized hypnotic message for the reduction of pain and anxiety in cancer patients treated by capsaicin patch for neuropathic pain: A randomized-controlled trial

2021 ◽  
Author(s):  
Rémi Etienne ◽  
Myriam Laurent ◽  
Aline Henry ◽  
Antoine Bioy ◽  
Julia Salleron ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neuropathic Pain ◽  
Rating Scales ◽  
Controlled Trial ◽  
Standard Group ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Numerical Rating ◽  
Reduction Of Pain ◽  
The Impact

Abstract BackgroundNeuropathic pain is characterised by spontaneous painful symptoms. Medical therapies include the use of a capsaicin 8% patch (Qutenza ®, Grünenthal Gmbh, Germany), and patients may experience a sharp burning sensation at application and removal of the patch. This study aimed to evaluate the impact of playing a standardized hypnosis recording during application, on the pain and anxiety induced by capsaicin treatment.MethodsIn a randomized-controlled trial, we assessed the benefits of the intervention firstly on pain and secondly on anxiety, as measured using numerical rating scales. All patients had application of the capsaicin patch, including the possibility for the patient to apply a cold patch. Participants were randomly assigned to one of 3 groups, namely the “Standard group” (no intervention), “Hypnosis group”, in which a standardized hypnotic message was played during application, or the “Music group” in which relaxing music was played during application of the patch.ResultsSixty-nine patients were included. Overall, there was no significant difference in pain scores between groups (p = 0.355). Compared to standard application, anxiety was significantly lower in the hypnosis group after application (p = 0.007), with no significant difference between the standard and music arms (p = 0.271), or between the hypnosis and music arms (p = 0.423).ConclusionsListening to a standardized hypnotic message during application of a capsaicin patch was found to significantly lower anxiety. These findings indicate that the use of a hypnotic message can reduce discomfort and warrant its evaluation in other indications of pain or anxiety during treatment procedures.Trial Registration : NCT02822625

scholarly journals Downmodulation of Vaccine-Induced Immunity and Protection against the Intracellular BacteriumFrancisella tularensisby the Inhibitory Receptor FcγRIIB

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Brian J. Franz ◽  
Ying Li ◽  
Constantine Bitsaktsis ◽  
Bibiana V. Iglesias ◽  
Giang Pham ◽  
...  
Keyword(s):  
Vaccine Development ◽  
Immune Protection ◽  
Fc Gamma Receptor ◽  
Gamma Receptor ◽  
Significant Difference ◽  
Cytokine Levels ◽  
Iga Production ◽  
Protection Against Infection ◽  
The Impact

Fc gamma receptor IIB (FcγRIIB) is the only Fc gamma receptor (FcγR) which negatively regulates the immune response, when engaged by antigen- (Ag-) antibody (Ab) complexes. Thus, the generation of Ag-specific IgG in response to infection or immunization has the potential to downmodulate immune protection against infection. Therefore, we sought to determine the impact of FcγRIIB on immune protection againstFrancisella tularensis(Ft), a Category A biothreat agent. We utilized inactivatedFt(iFt) as an immunogen. Naïve and iFt-immunized FcγRIIB knockout (KO) or wildtype (WT) mice were challenged withFt-live vaccine strain (LVS). While no significant difference in survival between naïve FcγRIIB KO versus WT mice was observed, iFt-immunized FcγRIIB KO mice were significantly better protected than iFt-immunized WT mice.Ft-specific IgA in serum and bronchial alveolar lavage, as well as IFN-γ, IL-10, and TNF-αproduction by splenocytes harvested from iFt-immunized FcγRIIB KO, were also significantly elevated. In addition, iFt-immunized FcγRIIB KO mice exhibited a reduction in proinflammatory cytokine levelsin vivoat 5 days after challenge, which correlates with increased survival followingFt-LVS challenge in published studies. Thus, these studies demonstrate for the first time the ability of FcγRIIB to regulate vaccine-induced IgA production and downmodulate immunity and protection. The immune mechanisms behind the above observations and their potential impact on vaccine development are discussed.

scholarly journals Effect of Chinese Propolis as an Intracanal Medicament on Post-Operative Endodontic Pain: A Double-Blind Randomized Controlled Trial

2020 ◽  
Vol 17 (2) ◽  
pp. 445 ◽  
Author(s):  
Juzer Shabbir ◽  
Fazal Qazi ◽  
Waqas Farooqui ◽  
Shahbaz Ahmed ◽  
Tazeen Zehra ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Controlled Trial ◽  
Repeated Measure ◽  
P Value ◽  
Time Intervals ◽  
Pain Scores ◽  
Significant Difference ◽  
Bonferroni Test ◽  
The Impact ◽  
Chinese Propolis

Propolis is a potent anti-microbial and natural anti-inflammatory by-product obtained from the beehive. Studies have demonstrated the superior biocompatibility and anti-microbial properties of propolis as compared to calcium hydroxide. However, its effect on postoperative endodontic pain is unknown. Therefore, this study aimed to investigate the impact of Chinese propolis paste as an intracanal medicament on postoperative endodontic pain intensities compared with calcium hydroxide (control) at different time intervals in necrotic teeth with periapical radiolucency. Eighty patients with single-rooted necrotic teeth with visible periapical radiolucency were recruited and randomly allocated to either the calcium hydroxide or propolis groups. After chemo-mechanical preparation and intracanal medicament insertion, patients were given the VAS (visual analogue scale) to record pain scores. Inter-group data were compared and analyzed using two-way repeated measure ANOVA (Bonferroni test). A p-value of < 0.025 was considered significant. In total, >78% of the patients experienced no or only mild post-operative pain in both the groups at all time intervals, without any significant difference in pain scores between the two groups (p > 0.025). An overall flare-up rate of 14.8% was found. The results suggest that either of these medicaments can be used as an inter-appointment medication for the prevention of postoperative pain in necrotic cases.

scholarly journals Changes in Bone Marrow Fat upon Dietary-Induced Weight Loss

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1509
Author(s):  
Manuela Spurny ◽  
Yixin Jiang ◽  
Solomon A. Sowah ◽  
Ruth Schübel ◽  
Tobias Nonnenmacher ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Weight Loss ◽  
Study Cohort ◽  
Marrow Fat ◽  
Bone Marrow Fat ◽  
Randomized Controlled ◽  
Cell Counts ◽  
Significant Difference ◽  
Metabolic Biomarkers ◽  
The Impact

Background: Bone marrow fat is implicated in metabolism, bone health and haematological diseases. Thus, this study aims to analyse the impact of moderate weight loss on bone marrow fat content (BMFC) in obese, healthy individuals. Methods: Data of the HELENA-Trial (Healthy nutrition and energy restriction as cancer prevention strategies: a randomized controlled intervention trial), a randomized controlled trial (RCT) among 137 non-smoking, overweight or obese participants, were analysed to quantify the Magnetic Resonance Imaging (MRI)-derived BMFC at baseline, after a 12-week dietary intervention phase, and after a 50-week follow-up. The study cohort was classified into quartiles based on changes in body weight between baseline and week 12. Changes in BMFC in respect of weight loss were analysed by linear mixed models. Spearman’s coefficients were used to assess correlations between anthropometric parameters, blood biochemical markers, blood cells and BMFC. Results: Relative changes in BMFC from baseline to week 12 were 0.0 ± 0.2%, −3.2 ± 0.1%, −6.1 ± 0.2% and −11.5 ± 0.6% for Q1 to Q4. Across all four quartiles and for the two-group comparison, Q1 versus Q4, there was a significant difference (p < 0.05) for changes in BMFC. BMFC was not associated with blood cell counts and showed only weaker correlations (<0.3) with metabolic biomarkers. Conclusion: Weight loss is associated with a decrease of BMFC. However, BMFC showed no stronger associations with inflammatory and metabolic biomarkers.

The Impact of Alvimopan on Return of Bowel Function After Major Spine Surgery – A Prospective, Randomized, Double-Blind Study

Neurosurgery ◽  
2019 ◽  
Vol 85 (2) ◽  
pp. E233-E239
Author(s):  
Lauren K Dunn ◽  
Robert H Thiele ◽  
Michelle C Lin ◽  
Edward C Nemergut ◽  
Marcel E Durieux ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Bowel Movement ◽  
Bowel Function ◽  
Blind Study ◽  
Double Blind Study ◽  
Opioid Use ◽  
Double Blind ◽  
Pain Scores ◽  
Significant Difference ◽  
The Impact

Abstract BACKGROUND Pain management following major spine surgery requires high doses of opioids and is associated with a risk of opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs. OBJECTIVE To investigate the impact of alvimopan in opioid-naive patients undergoing major spine surgery. METHODS Patients undergoing >3 levels of thoracic and/or lumbar spine surgery were enrolled in this prospective, randomized, double-blind study to receive either alvimopan or placebo prior to and following surgery. Opioid consumption; pain scores; and time of first oral intake, flatus, and bowel movement were recorded. RESULTS A total of 24 patients were assigned to the active group and 25 were assigned to the placebo group. There was no significant difference in demographics between the groups. Postoperatively, the alvimopan group reported earlier time to first solid intake [median (range): alvimopan: 15 h (3-25) vs placebo: 17 h (3-46), P < .001], passing of flatus [median (range): alvimopan: 22 h (7-63) vs placebo: 28 h (10-58), P < .001], and first bowel movement [median (range): alvimopan: 50 h (22-80) vs placebo: 64 h (40-114), P < .001]. The alvimopan group had higher pain scores (maximum, minimum, and median); however, there was no significant difference between the groups with postoperative opioid use. CONCLUSION This study shows that the perioperative use of alvimopan significantly reduced the time to return of bowel function with no increase in postoperative opioid use despite a slight increase in pain scores.

Evaluating the impact of African American ancestry among men with localized prostate cancer treated with radical prostatectomy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 41-41
Author(s):  
Daniel Canter ◽  
Julia E. Reid ◽  
Maria Latsis ◽  
Margaret Variano ◽  
Shams Halat ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Metastatic Disease ◽  
Proportional Hazards ◽  
Clinical Stage ◽  
Cox Proportional Hazards ◽  
Significant Difference ◽  
The Impact

41 Background: Prostate cancer (PC) is the most common male malignancy. Prior data has suggested that African American (AA) men present with more aggressive disease relative to men of other ancestries. Here, we examined the effects of ancestry on clinical and molecular measures of disease aggressiveness as well as pathologic outcomes in men treated with radical prostatectomy (RP) for localized PC. Methods: Data was collected from patients undergoing RP at the Ochsner Clinic from 2006 to 2011. Formalin−fixed paraffin embedded biopsy tissue was analyzed for the RNA expression of 31 cell cycle progression (CCP) genes and 15 housekeeping genes to obtain a CCP score (a validated molecular measure of PC aggressiveness). Cancer of the Prostate Risk Assessment (CAPRA) scores were also determined based on clinicopathologic features at the time of diagnosis. Clinical (Gleason score, tumor stage, CAPRA score) and molecular (CCP score) measures of disease aggressiveness were compared based on ancestry (AA versus non−AA). Cox proportional hazards models were used to test association of ancestry to biochemical recurrence (BCR) and progression to metastatic disease. Fisher’s exact and Wilcoxon rank sum tests were used to compare ancestries. Results: A total of 384 patients were treated with RP, including 133 (34.8%) AA men. At the time of diagnosis, the median age was 62 years (interquartile range (IQR) 56, 66) and PSA was 5.4 ng/mL (IQR 4.2, 7.6). When compared by ancestry, there were no significant differences in biopsy Gleason score (p = 0.26), clinical stage (p = 0.27), CAPRA score (p = 0.58), or CCP score (p = 0.87). In addition, there was no significant difference in the risk of BCR between ancestries (p = 0.55). Only non−AA men progressed to metastatic disease within the ten years of follow−up. Conclusions: Contrary to prior reports, these data appears to indicate that men of AA ancestry do not necessarily present with or develop a more biologically aggressive form of PC. Although these data represents only one institution’s experience, it contains a highly robust AA population compared to prior reports. Further research is required to account for the discrepancy in the previously published literature.

The impact of pharmacist telephone calls after discharge on satisfaction of oncology patients: A randomized controlled study

2017 ◽  
Vol 24 (5) ◽  
pp. 359-364 ◽  
Author(s):  
Sewar S Salmany ◽  
Lujeen Ratrout ◽  
Abdallah Amireh ◽  
Randa Agha ◽  
Noor Nassar ◽  
...  
Keyword(s):  
Emergency Room ◽  
Hospital Readmissions ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Emergency Room Visits ◽  
Oncology Patients ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Impact

Purpose The aim of the study was to determine the impact of telephone follow-up calls on satisfaction in oncology patients after hospital discharge. Method A randomized controlled study, in which patients were randomized into two groups: The experimental group with the telephone follow-up (TFU) calls (intervention) and the control group (no intervention). The telephone follow-up call was conducted within 72 h after discharge. During the call, patients were asked about their medications, namely, whether they received them, understood how to take them, and whether they developed any medication-related adverse effect. Both groups were contacted by phone two weeks later to assess their satisfaction with the discharge medication instructions and the provided pharmaceutical services, using the 5-point Likert scale. In addition, hospital records were reviewed for emergency room visits and hospital readmissions within 30 days after discharge. Results There was no difference in the percentage of patients who reported being very satisfied between both the intervention and the control groups (45% intervention vs. 48% control, P = 0.68). The mean time of the intervention phone call was 3 ± 1.7 (SD) min. During the telephone follow-up call, medication-related problems were identified in 20% of the patients. There was no significant difference in emergency room visits and hospital readmissions in the intervention group vs. control (44% vs. 53%, P = 0.123) and (37% vs. 43%, P = 0.317), respectively. Conclusion Telephone follow-up calls conducted by a pharmacist to discharged oncology patients did not improve patients' satisfaction, emergency room visits or hospital readmissions; however, they helped to identify medication-related adverse effects in the oncology patients.

Sign in / Sign up

Export Citation Format

Share Document