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Levodopa-carbidopa intestinal gel (LCIG) is an advanced therapy for patients with Parkinson Disease (PD). Weight loss has been pointed out as an adverse event of LCIG infusion.
To compare weight changes between three groups of PD patients patients treated with LCIG, patients within the first year of subthalamic deep brain stimulation (STN-DBS) and patients treated exclusively with oral treatment during 1 year of follow up.
Patients treated with LCIG were retrospectively matched by age, gender, disease duration and Hoehn and Yahr to patients undergoing STN-DBS and to patients both receiving the standard of care treatment and unwilling advanced therapies (SOC). Clinical features and weight were collected at baseline, and 12 months after introducing the treatment (LCIG and STN-DBS groups) or for one year of treatment (SOC).
Eighteen patients were included in each group. They had no differences in clinical and demographic features, except for cognitive impairment. There was a mean weight (-5.8kg ±6.8) and BMI (-2.1kg/m
±2.6) reduction in the LCIG group after 12 months, while there was a slight weight loss in the SOC (-1.4kg ±3.1) and a weight increase in the STN-DBS group (5.4kg ±4.7). Differences of weight were statistically different between, LCIG and STN-DBS (P<0.001), LCIG and SOC (P=0.002) and STN-DBS and SOC (P<0.001).
The study shows a significant weight reduction after starting LCIG infusion compared to the other groups. Weight loss should be closely monitored in patients treated with LCIG.
The study shows a significant weight reduction after starting LCIG infusion compared to the other groups. Weight loss should be closely monitored in patients treated with LCIG.An infusion of 100cc of 0,2% potassium chloride was accidental performed through a thoracic epidural catheter, inserted to perioperative analgesia, to a 66years old man who was scheduled for right hemicolectomy, 48hours after surgery. Paresis of upper limbs, flaccid paralysis of lower limbs and a sensitive level at T8 was observed. An epidural lavage with an initial dose of 20cc of saline was slowly injected, followed for a saline infusion of 20cc per hour. Neurologic signs were totally reverted some hours later and 24hours after the incident the physical exam was normal. We reviewed the clinical presentation of the complication and its mechanisms, the more frequent clinical evolution, as well as treatment measures and strategies to prevent the incident.Mastocytosis is characterized by clonal expansion of mast cells, with abnormal accumulation in different organs. Perioperatively, numerous stimuli may lead to the release of vasoactive substances by mast cells. Parturients with systemic mastocytosis pose a challenge to the anesthesiologist on one hand, the pain and stress of labor may lead to greater mast cell activation and, on the other, the administration of drugs that may possibly trigger the release of mast cell mediators. The authors describe a case of a 34-year-old pregnant woman with systemic mastocytosis who requests labor analgesia. An epidural analgesia was performed after induction of labor, after considering anesthetic particularities. Proteases antagonist The epidural procedure, labor and delivery were uneventful. A review of systemic mastocytosis is provided and its anesthetic considerations are discussed.
The difficult airway is an important scenario in anaesthesia due to the impact of its potential complications, and the difficulty in predicting its presence in current clinical practice.
Systematic review of articles in English and Spanish retrieved from MEDLINE (Ovid), LILACS and Embase up to March 2018. The search strategy was defined by the authors. The reviewers uploaded the studies to specially designed tables in order to qualitatively analyse the results of each paper.
A total of 3602 studies were identified. Thirty-four of these were included in the qualitative review. The most commonly used definition of difficulty was the Cormack-Lehane3 or 4 classification, with a weighted mean incidence of 7.23%. The most relevant finding was the methodological weaknesses in obtaining these scales.
Available prediction models show limited discrimination, and weaknesses were detected in the methodology used to develop these prediction rules.
Available prediction models show limited discrimination, and weaknesses were detected in the methodology used to develop these prediction rules.Cyanobacteria are emerging as a popular system in both basic and applied microbial research. However, the incomplete understanding of their molecular biology hinders their practical applications in the industrial, agricultural, and environmental sectors. We present the potential of recently developed omics approaches to obtain deeper insights into cyanobacterial molecular physiology.
Photogrammetry technology has been used for the digitalization of multiple dental implants, but its trueness and precision remain uncertain.
The purpose of this invitro investigation was to compare the accuracy (trueness and precision) of multisite implant recordings between the conventional method and a photogrammetry dental system.
A definitive cast of an edentulous maxilla with 6 implant abutment replicas was tested. Two different recording methods were compared, the conventional technique and a photogrammetry digital scan (n=10). For the conventional group, the impression copings were splinted to an additively manufactured cobalt-chromium metal with autopolymerizing acrylic resin, followed by recording the maxillary edentulous arch with an elastomeric impression using an additively manufactured open custom tray. For the photogrammetry group, a scan body was placed on each implant abutment replica, followed by the photogrammetry digital scan. A coordinate-measuring machine was selected to assess the ficant higher overall accuracy values compared with the photogrammetry system tested, with a trueness difference of 3 μm and a precision difference of 18 μm between the systems. The conventional method transferred the implant abutment positions with a uniform 3-dimensional discrepancy, but the photogrammetry system obtained an uneven overall discrepancy among the implant abutment positions.
The conventional method obtained statistically significant higher overall accuracy values compared with the photogrammetry system tested, with a trueness difference of 3 μm and a precision difference of 18 μm between the systems. The conventional method transferred the implant abutment positions with a uniform 3-dimensional discrepancy, but the photogrammetry system obtained an uneven overall discrepancy among the implant abutment positions.Beetroot has recently become very popular among people as a medicinal superfood that decreases blood pressure and improves athletes' performance. The present meta-analysis aimed to investigate the effect of beetroot consumption on serum lipid profile. A literature search was conducted covering PubMed, ISI Web of Science, Scopus, and Google scholar of English human subject randomized clinical trials (RCT) up to December 2020. Pooled results showed that beetroot consumption had no significant effect on any of the variables. The mean difference (95% CI) between intervention and control groups for TC was 1.25 (-0.03, 2.53), for TG -0.47 (-1.16, 0.21), for HDL 0.54 (-0.13, 1.21) and for LDL was -0.48(-1.04, 0.09). Subgroup analysis by the health condition of subjects, the form of beetroot consumption, and type of intervention showed no significant differences. It can be concluded that beetroot cannot be categorized as an effective supplementation for adjustment of lipid profile.
As the second most common female malignant tumor, cervical cancer is also one of the most preventable and avoidable cancers. The World Health Organization has launched a global plan to accelerate the elimination of cervical cancer. Therefore, in the era of postvaccine, the role of HPV subtypes in cervical precancerous lesions and cervical cancer that are not covered by vaccine should be further discussed. The purpose of this study was to explore the role of HPV subtypes not covered by the nine-valent vaccine in high-grade cervical precancerous lesions and cervical cancer.
A retrospective analysis was performed on the clinical data of 5220 patients with an HPV infection who were diagnosed and treated in the Department of Gynecology of Shanghai General Hospital between October 2016 and February 2020. In addition, the clinical characteristics of the biopsy results of 470 cases of cervical intraepithelial neoplasia (CIN) 2-3 and 205 cases of cervical squamous cell carcinoma were analyzed.
Among patients wite infection rates of the corresponding HPV subtype decreased; however, HPV subtype infection not covered by the nine-valent vaccine should not be ignored.
Consensus regarding the optimal approach for the treatment of femoral neck fractures remains lacking. A new internal fixation femoral neck system (FNS) was developed and used in clinical practice. We aimed to investigate the biomechanical outcomes of different types of FNS in the treatment of unstable femoral neck fractures.
In this study, we constructed three different types of unstable femoral neck fractures of Pauwels classification with angles of 50°, 60°, and 70°. We set up four test groups, namely, the one-hole plated FNS group, two-hole plated FNS group, inverted cannulated screw group and triangle cannulated screw group. Under 2100 N axial loads, displacements and the von Mises stress of the femur and internal fixation components were measured for each fracture group.
When the Pauwels angle was 50°or 60°, the one-hole locking plated FNS was as superior as the two-hole plated FNS in terms of femur and internal fixation displacement, and the inverted cannulated screw had slightly better stability ated or double-hole locking plated FNS can be used to treat unstable femoral neck fractures. link2 However, when the angle of the fracture line is greater than 70°, we recommend using a double-hole locking plated FNS. This result needs further verification in further clinical studies.
Epidural anesthesia in infants undergoing open abdominal surgery has the potential to reduce opioid consumption, lower pain scores, and expedite tracheal extubation. We evaluated associations between use of continuous epidural chloroprocaine and improved intra- and post-operative outcomes.
This matched retrospective cohort study first identified 24 patients who between April 2018 through December 2019 were treated with a caudal catheter and epidural chloroprocaine infusion for a laparotomy at postnatal age of 6 months or less. link3 A matched comparator group of 24 patients was derived based on age and type of surgery. Exclusion criteria were the presence of a preoperative opioid infusion, comorbidities that would preclude appropriate pain assessment, or a recent surgical procedure. Primary outcomes included opioid consumption and pain scores; we secondarily analyzed intraoperative anesthetic requirements, other systemic analgesic use, vital signs, tracheal extubation time, and procedural times.
Treatment with epidural anesthesia was associated with lower 5-day total postoperative opioid consumption (3.2mg/kg vs. 19.7mg/kg in the respective epidural vs. systemic groups, p=0.001) and time to tracheal extubation (1.3 days vs. 3.2 days, p=0.005). Any statistically significant differences in pain scores were not clinically meaningful. There were no differences in mean arterial pressure or intraoperative inhaled anesthetic doses.
Continuous infusion of epidural chloroprocaine in infants following open abdominal surgery may limit exposure to systemic opioid medications while providing adequate postoperative analgesia and shortening time to tracheal extubation.
Continuous infusion of epidural chloroprocaine in infants following open abdominal surgery may limit exposure to systemic opioid medications while providing adequate postoperative analgesia and shortening time to tracheal extubation.
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