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The outcome regarding serious versus normal neuromuscular block about intraoperative security in the course of laparoscopic medical procedures: a major international multicenter randomized managed double-blind method tryout -- EURO-RELAX TRIAL.
Hind Beheiry (Sudan), Irina Chazova (Russia), Albertino Damasceno (Mozambique), Anna Dominiczak (UK), Anastase Dzudie (Cameroon), Stephen Harrap (Australia), Hiroshi Itoh (Japan), Tazeen Jafar (Singapore), Marc Jaffe (USA), Patricio Jaramillo-Lopez (Colombia), Kazuomi Kario (Japan), Giuseppe Mancia (Italy), Ana Mocumbi (Mozambique), Sanjeevi N.Narasingan (India), Elijah Ogola (Kenya), Srinath Reddy (India), Ernesto Schiffrin (Canada), Ann Soenarta (Indonesia), Rhian Touyz (UK), Yudah Turana (Indonesia), Michael Weber (USA), Paul Whelton (USA), Xin Hua Zhang, (Australia), Yuqing Zhang (China).BACKGROUND Raynaud's phenomenon (RP) is a clinical syndrome characterized by recurrent episodes of digital vasospasm triggered by exposure to physical and chemical agents or emotional stress. Although many pharmacologic treatments have been tested, there is still no cure or gold standard therapy. Botulinum toxin treatment has been proved to reduce pain and increase arterial blood flow in treated hands of adult patients with RP. OBJECTIVE The aim of this study is to evaluate the efficacy of botulinum toxin A on younger than 18-year-old patients with primary and secondary RP. MATERIALS AND METHODS A single-center prospective study was performed, including 8 patients aged 14 to 17 years who were clinically diagnosed with primary or secondary RP. BTX was injected into each hand without sedation or anesthetic blockade. The primary outcome was pain reduction after BTX injection. Pain intensity was evaluated at baseline and in the first follow-up. Secondary outcomes included variations in the number and severity of RP episodes after the BTX injection. RESULTS All patients stated significant pain reduction and decreased cold sensitivity, except one patient who did not feel any changes. No patients reported any loss of strength on thumb-index finger. CONCLUSION BTX injection is a simple, noninvasive, and cost-effective treatment alternative, offering an important nonsurgical therapeutic option for the pediatric population. It could also help optimize the dose of other treatments used in these patients. The most commonly observed positive effect is a reduction in the pain associated with RP attacks. Further studies are needed to confirm these results.BACKGROUND Facial reticular veins can be treated with laser therapy, sclerotherapy, or surgical removal. The use of a 1,064 nm neodymium-doped yttrium aluminum garnet (NdYAG) laser has been reported to be successful in the treatment of facial reticular veins. OBJECTIVE To report a large retrospective study examining the efficacy, side effects, and satisfaction of a dynamically cooled, variable spot-sized 1,064 nm NdYAG laser for the treatment of facial reticular veins in the periorbital and temporal area. AR-C155858 chemical structure PATIENTS AND METHODS Contact was made with 100 patients from 2006 to 2019 who underwent treatment with a 1,064 nm NdYAG laser for facial reticular veins through office follow-up or telephone interviews. Percent resolution of veins, satisfaction, and adverse effects were evaluated. RESULTS Eighty-nine of the 100 patients ranked their satisfaction with the treatment as 3 or very satisfied. Most patients reported 75% to 100% improvement. The most commonly reported adverse event seen after treatment was mild edema. Sixty-eight percent of patients reported no adverse effects at all. CONCLUSION The dynamically cooled, variable spot-sized 1,064 nm NdYAG laser is a safe and effective treatment for facial reticular veins with minimal side effects. The results are usually immediate and, based on the long-term follow-up, tend to be long lasting.BACKGROUND Pulsed dye lasers (PDLs) are well-established for treatment of capillary malformations but are unable to penetrate the depth needed to treat deeper vascular lesions. A combined approach using a deeper penetrating wavelength with a "superficial" wavelength could more comprehensively treat vascular malformations than PDL alone. OBJECTIVE To evaluate the safety and efficacy of the long-pulsed 1064-nm neodymiumyttrium-aluminum-garnet (LP 1064-nm NdYAG) in conjunction with the 532-nm potassium titanyl phosphate (532-nm KTP) laser wavelengths for treatment of capillary venous and venous malformations. METHODS In this retrospective single-center study, we queried patient records who underwent treatment with the 532-nm KTP and LP 1064-nm NdYAG laser wavelengths. A blinded panel of 3 physicians evaluated improvement in lesion color, elevation, texture, and overall architecture on a four-point scale 0% to 25%; 26% to 50%, 51% to 75%, and 76% to 100%. RESULTS Our cohort consisted of 23 cases. Sixteen cases had sufficient information for clinical assessment. Treatment number and parameters varied depending on lesion, skin type, and end point. Clinical assessment of treatment effectiveness revealed average scores of 51% to 75% improvement for color, elevation, texture, and overall architecture. CONCLUSION This study illustrates that 2 wavelengths, 532-nm KTP to target superficial components and LP 1064-nm NdYAG for deeper components, can safely and effectively treat both capillary venous and venous malformations.BACKGROUND AND OBJECTIVES Hypertension is a disease affecting a large part of the world's population that causes millions of deaths annually. Physical exercise is proposed as an alternative to pharmacologic therapies used to reduce blood pressure. The main objective was to compare the effect of different types of strength training in blood pressure, as well as to analyse several variables that can modify the effect of strength training not combined with medication in SBP and DBP (SBP-DBP). METHODS The search was carried out in two scientific databases PubMed and Web of Science. Articles were included following three criteria analysing the chronic effect of strength training in blood pressure; the studies were conducted at least during 4 weeks; and the articles were published in English. RESULTS The analysis showed a significant decrease of blood pressure for all types of training. The effect on SBP was greater when training without medication was carried out with isometric exercises than when training was performed with dynamic exercises.
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