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2021 ◽  
Vol 150 ◽  
pp. 110635
Seyyede-Ozra Yasrebi ◽  
Sara Momtazmanesh ◽  
Hossein Sanjari Moghaddam ◽  
Nazila Shahmansouri ◽  
Maryam Mehrpooya ◽  

2021 ◽  
Vol 101 ◽  
pp. 108237
Samaneh Abbasian ◽  
Mohammad Sadegh Soltani-Zangbar ◽  
Alireza Khabbazi ◽  
Rojin Farzaneh ◽  
Aida Malek Mahdavi ◽  

2021 ◽  
Vol 144 ◽  
pp. 112308
Cristina Esposito ◽  
Emanuele Ugo Garzarella ◽  
Cristina Santarcangelo ◽  
Alessandro Di Minno ◽  
Marco Dacrema ◽  

Kachonsak Yongwatana ◽  
Kamin Harinwan ◽  
Sakkarin Chirapongsathorn ◽  
Krit Opuchar ◽  
Theeranun Sanpajit ◽  

2021 ◽  
pp. 2100725
Akio Niimi ◽  
Junpei Saito ◽  
Tadashi Kamei ◽  
Masaharu Shinkai ◽  
Hiroyuki Ishihara ◽  

BackgroundThe purinoceptor subtype P2X3 has been shown to have significant involvement in the cough reflex; the heterotrimer version of the purinoceptor (P2X2/3) has been implicated in taste disturbance. The most advanced clinical candidate antagonist gefapixant has low selectivity among P2X3 receptors and induced taste disturbance, whereas newly developed sivopixant has high selectivity towards P2X3versus P2X2/3.MethodsIn a phase 2a, randomised, double-blind, placebo-controlled, crossover, multicentre study, adult patients with refractory or unexplained chronic cough received oral sivopixant 150 mg or placebo once daily for 2 weeks, followed by a 2–3-week washout period, and then crossed over to placebo or sivopixant for 2 weeks. Efficacy and safety of sivopixant were evaluated.ResultsOf 31 randomised patients, 15 in the sivopixant-first group and 15 in the placebo-first group completed the study. After 2 weeks’ treatment, the placebo-adjusted ratios of the average hourly number of coughs to baseline during daytime (primary endpoint) and over 24 h (secondary endpoint) were −31.6% (p=0.0546) and −30.9% (p=0.0386), respectively. Sivopixant also improved health-related quality of life. Treatment-related adverse events occurred in 12.9% and 3.2% of patients during sivopixant and placebo administration, respectively. Mild taste disturbance occurred in two patients (6.5%) during sivopixant administration.ConclusionsSivopixant reduced objective cough frequency and improved health-related quality of life, with a low incidence of taste disturbance, among patients with refractory or unexplained chronic cough.

Ji WooK Kim ◽  
A Ran Lee ◽  
Eun Sun Park ◽  
Min Su Yun ◽  
Sung Won Ryu ◽  

Background: This study assessed the effect of a single bolus administration of lidocaine on the prevention of tourniquet-induced hypertension (TIH) and compared the effect of lidocaine to that of ketamine in patients undergoing general anesthesia.Methods: This randomized, controlled, double-blind study included 75 patients who underwent lower limb surgery using a tourniquet. The patients were administered lidocaine (1.5 mg/kg, n = 25), ketamine (0.2 mg/kg, n = 25) or placebo (n = 25). The study drugs were administered intravenously 10 min before tourniquet inflation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before tourniquet inflation, after tourniquet inflation for 60 min at 10 min intervals, and immediately after tourniquet deflation. The incidence of TIH, defined as an increase of 30% or more in SBP or DBP during tourniquet inflation, was also recorded.Results: SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001). Conclusion: Single-bolus lidocaine effectively attenuated blood pressure increase due to tourniquet inflation, with an effect comparable to that of bolus ketamine.

2021 ◽  
Vol 3 (4) ◽  
pp. 536-546
Luciana F. R. Nogueira ◽  
Pollyanna Pellegrino ◽  
José Cipolla-Neto ◽  
Claudia R. C. Moreno ◽  
Elaine C. Marqueze

Night workers tend to eat irregularly, both in terms of meal times and composition. The disruption in energy metabolism caused by inappropriate eating habits can negatively affect the sleep quality of these individuals. The objectives of this study were to determine the interval between the last meal and bedtime and its relationship with both diurnal and nocturnal sleep parameters, as well as to evaluate the association of the adequacy of this meal with sleep parameters. The analyses were carried out for a usual sleep routine on a workday and a day off. This cross-sectional study was part of a controlled, randomized, double-blind, crossover clinical trial. The sample comprised 30 female nursing professionals who worked permanent night shifts of 12 × 36 h. Timing and composition of the last meal were obtained from food diaries, and sleep parameters were collected via actigraphy. On multiple linear regression analysis, every hour decrease in the interval between the last meal and sleep onset there was an increase of 0.39 h on diurnal sleep duration. Regarding food intake, every 1 g of fat and 1 g of carbohydrate consumed was associated with an increase in diurnal sleep onset latency of 0.13 h and 0.02 h, respectively. These findings suggest that both timing and composition of the last meal before bedtime may be potential key factors for good diurnal and nocturnal sleep among night-shift workers.

2021 ◽  
Vol 42 ◽  
pp. 281-311
R Puts ◽  
L Vico ◽  
N Beilfuß ◽  
M Shaka ◽  

Impaired bone-fracture healing is associated with long-term musculoskeletal disability, pain and psychological distress. Low-intensity pulsed ultrasound (LIPUS) is a non-invasive and side-effect-free treatment option for fresh, delayed- and non-union bone fractures, which has been used in patients since the early 1990s. Several clinical studies, however, have questioned the usefulness of the LIPUS treatment for the regeneration of long bones, including those with a compromised healing. This systematic review addresses the hurdles that the clinical application of LIPUS encounters. Low patient compliance might disguise the effects of the LIPUS therapy, as observed in several studies. Furthermore, large discrepancies in results, showing profound LIPUS effects in regeneration of small-animal bones in comparison to the clinical studies, could be caused by the suboptimal parameters of the clinical set-up. This raises the question of whether the so-called “acoustic dose” requires a thorough characterisation to reveal the mechanisms of the therapy. The adequate definition of the acoustic dose is especially important in the elderly population and patients with underlying medical conditions, where distinct biological signatures lead to a delayed regeneration. Non-industry-funded, randomised, double-blind, placebo-controlled clinical trials of the LIPUS application alone and as an adjuvant treatment for bones with complicated healing, where consistent control of patient compliance is ensured, are required.

2021 ◽  
Harri Hakovirta ◽  
Juho Jalkanen ◽  
Eija Saimanen ◽  
Tiia Kukkonen ◽  
Pekka Romsi ◽  

Abstract Background: Mortality remains high after emergency open surgery for a ruptured abdominal aortic aneurysm (RAAA). The aim of the present study was to assess, if intravenous (IV) Interferon (IFN) beta-1a improve survival after surgery by up-regulating Cluster of differentiation (CD73). Methods: This is a multi-center phase II double-blind, 2:1 randomized, parallel group comparison of the efficacy and safety of IV IFN beta-1a vs. placebo for the prevention of death after open surgery for an infra-renal RAAA. All study patients presented a confirmed infra-renal RAAA, survived the primary emergency surgery and were treated with IFN beta-1a (10μg) or matching placebo for 6 days after surgery. Major exclusion criteria included irreversible hemorrhagic shock, chronic renal replacement therapy, diagnosed liver cirrhosis, severe congestive heart failure, advanced malignant disease, primary attempt of endovascular aortic repair (EVAR), and per-operative suprarenal clamping over 30 minutes. Main outcome measure was all-cause mortality at day 30 (D30) from initial emergency aortic reconstruction. Results: The study was pre-maturely stopped due to a reported drug-drug interaction and was left under-powered. Out of 40 randomized patients 38 were included in the outcome analyses (27 IFN beta-1a and 11 placebo). There was no statistically significant difference between treatment groups at baseline. However, from surgery more open-abdomen and intestinal ischemia was present in the IFN beta-1a arm. D30 all-cause mortality was 22.2% (6/27) in the IFN beta-1a arm and 18.2% (2/11) in the placebo arm (OR 1.30; 95% CI, 0.21 – 8.19). The most common adverse event relating to the IFN beta-1a was pyrexia (20.7% in the IFN beta-1a arm vs. 9.1% in the placebo arm). High level of serum CD73 associated with survival (P = 0.001) whereas the use of glucocorticoids and the presence of IFN beta neutralizing antibodies associated with a poor CD73 response and survival.Conclusions: Due to the size of the study and several confounding factors a benefit from IFN beta-1a could not be determined. Survival after open RAAA surgery associated strongly with up-regulation of serum CD73. The use of glucocorticoids and IFN beta neutralizing antibodies blocked the up regulation of CD73. Trial registration: NCT03119701. Registered 19/04/2017 (retrospectively registered).

2021 ◽  
Irene Martín‐Marcos ◽  
Nuria Fernández‐Morte ◽  
María Balsategui‐Martín ◽  
Alexandra Ortiz‐Cantero ◽  
Cristina Bermúdez‐Ampudia ◽  

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