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Vitamin
2 Min Read
27 May

Parenteral n-3 polyunsaturated fatty acids enhances the postoperative recovery of individuals with Crohn's disease after bowel resection

According to a recent study, supplementation of parenteral n-3 polyunsaturated fatty acids improves postoperative recovery in Crohn's disease patients after bowel resection, leading to decreased complications and lower levels of inflammatory cytokines. This study’s findings were published in The American Journal of Clinical Nutrition.

In an unblinded, randomized, controlled clinical trial, 268 patients with Crohn's disease who underwent bowel resection were randomly assigned to two groups: 134 in the control group receiving a mix of long-chain and medium-chain fats at 1.0 g/kg/d, and 134 in the treatment group receiving long-chain, medium-chain, and n-3 polyunsaturated fats at 1.2 g/kg/d. This study compared postoperative complications, serum biochemical values, complete blood count, and cytokine concentrations in patients who received parenteral n-3 polyunsaturated fatty acids supplementation for 5 days after surgery and those who did not.

The results from both the intention-to-treat analysis and the per-protocol analysis indicate a significant decrease in overall complication rates (22.4% vs. 49.3%; P < 0.001 and 21.8% vs. 38.2%; P = 0.006) as well as a shorter postoperative stay (8.8 ± 4.5 d vs. 11.2 ± 6.8 d; P = 0.001 and 8.7 ± 4.0 d vs. 11.5 ± 7.3 d; P < 0.001) in patients who received parenteral n-3 polyunsaturated fatty acids supplementation compared to those in the control group. In terms of secondary outcomes, the treatment group exhibited significantly lower mean ± standard deviation levels of interleukin (IL)-6 (17.11 ± 2.14 pg/mL vs. 30.50 ± 5.14 pg/mL; P = 0.014), IL-1β (2.01 ± 0.05 pg/mL vs. 2.24 ± 0.09 pg/mL; P = 0.019), C-reactive protein concentrations (51.3 ± 4.2 mg/L vs. 64.4 ± 5.3 mg/L; P = 0.050), and tumor necrosis factor-α (2.09 ± 0.06 pg/mL vs. 2.29 ± 0.06 pg/mL; P = 0.029) on postoperative day 5 compared to the control group.

Thus, it can be concluded that the postoperative recovery in patients with Crohn's disease who have undergone bowel resection is significantly improved through the supplementation of parenteral n-3 polyunsaturated fatty acids. This intervention not only reduces complications but also lowers the levels of inflammatory cytokines.

Parenteral n-3 polyunsaturated fatty acids enhances the postoperative recovery of individuals with Crohn's disease after bowel resection

According to a recent study, supplementation of parenteral n-3 polyunsaturated fatty acids improves postoperative recovery in Crohn's disease patients after bowel resection, leading to decreased complications and lower levels of inflammatory cytokines. This study’s findings were published in The American Journal of Clinical Nutrition.

In an unblinded, randomized, controlled clinical trial, 268 patients with Crohn's disease who underwent bowel resection were randomly assigned to two groups: 134 in the control group receiving a mix of long-chain and medium-chain fats at 1.0 g/kg/d, and 134 in the treatment group receiving long-chain, medium-chain, and n-3 polyunsaturated fats at 1.2 g/kg/d. This study compared postoperative complications, serum biochemical values, complete blood count, and cytokine concentrations in patients who received parenteral n-3 polyunsaturated fatty acids supplementation for 5 days after surgery and those who did not.

The results from both the intention-to-treat analysis and the per-protocol analysis indicate a significant decrease in overall complication rates (22.4% vs. 49.3%; P < 0.001 and 21.8% vs. 38.2%; P = 0.006) as well as a shorter postoperative stay (8.8 ± 4.5 d vs. 11.2 ± 6.8 d; P = 0.001 and 8.7 ± 4.0 d vs. 11.5 ± 7.3 d; P < 0.001) in patients who received parenteral n-3 polyunsaturated fatty acids supplementation compared to those in the control group. In terms of secondary outcomes, the treatment group exhibited significantly lower mean ± standard deviation levels of interleukin (IL)-6 (17.11 ± 2.14 pg/mL vs. 30.50 ± 5.14 pg/mL; P = 0.014), IL-1β (2.01 ± 0.05 pg/mL vs. 2.24 ± 0.09 pg/mL; P = 0.019), C-reactive protein concentrations (51.3 ± 4.2 mg/L vs. 64.4 ± 5.3 mg/L; P = 0.050), and tumor necrosis factor-α (2.09 ± 0.06 pg/mL vs. 2.29 ± 0.06 pg/mL; P = 0.029) on postoperative day 5 compared to the control group.

Thus, it can be concluded that the postoperative recovery in patients with Crohn's disease who have undergone bowel resection is significantly improved through the supplementation of parenteral n-3 polyunsaturated fatty acids. This intervention not only reduces complications but also lowers the levels of inflammatory cytokines.

Vitamin
2 Min Read
27 May

Parenteral n-3 polyunsaturated fatty acids enhances the postoperative recovery of individuals with Crohn's disease after bowel resection

According to a recent study, supplementation of parenteral n-3 polyunsaturated fatty acids improves postoperative recovery in Crohn's disease patients after bowel resection, leading to decreased complications and lower levels of inflammatory cytokines. This study’s findings were published in The American Journal of Clinical Nutrition.

In an unblinded, randomized, controlled clinical trial, 268 patients with Crohn's disease who underwent bowel resection were randomly assigned to two groups: 134 in the control group receiving a mix of long-chain and medium-chain fats at 1.0 g/kg/d, and 134 in the treatment group receiving long-chain, medium-chain, and n-3 polyunsaturated fats at 1.2 g/kg/d. This study compared postoperative complications, serum biochemical values, complete blood count, and cytokine concentrations in patients who received parenteral n-3 polyunsaturated fatty acids supplementation for 5 days after surgery and those who did not.

The results from both the intention-to-treat analysis and the per-protocol analysis indicate a significant decrease in overall complication rates (22.4% vs. 49.3%; P < 0.001 and 21.8% vs. 38.2%; P = 0.006) as well as a shorter postoperative stay (8.8 ± 4.5 d vs. 11.2 ± 6.8 d; P = 0.001 and 8.7 ± 4.0 d vs. 11.5 ± 7.3 d; P < 0.001) in patients who received parenteral n-3 polyunsaturated fatty acids supplementation compared to those in the control group. In terms of secondary outcomes, the treatment group exhibited significantly lower mean ± standard deviation levels of interleukin (IL)-6 (17.11 ± 2.14 pg/mL vs. 30.50 ± 5.14 pg/mL; P = 0.014), IL-1β (2.01 ± 0.05 pg/mL vs. 2.24 ± 0.09 pg/mL; P = 0.019), C-reactive protein concentrations (51.3 ± 4.2 mg/L vs. 64.4 ± 5.3 mg/L; P = 0.050), and tumor necrosis factor-α (2.09 ± 0.06 pg/mL vs. 2.29 ± 0.06 pg/mL; P = 0.029) on postoperative day 5 compared to the control group.

Thus, it can be concluded that the postoperative recovery in patients with Crohn's disease who have undergone bowel resection is significantly improved through the supplementation of parenteral n-3 polyunsaturated fatty acids. This intervention not only reduces complications but also lowers the levels of inflammatory cytokines.

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Oncology
2 Min Read
24 May

CNS efficacy of osimertinib plus chemotherapy in epidermal growth factor receptor-mutated advanced non-small-cell lung cancer

A recent study showed that the combination of osimertinib with platinum-pemetrexed exhibited improved central nervous system (CNS) efficacy when compared to osimertinib monotherapy. This study’s findings were published in the Journal of clinical oncology. 

In the phase 3 FLAURA2 trial, patients were assigned randomly to receive either osimertinib with platinum-pemetrexed (n= 279) or osimertinib monotherapy (n=278) until disease progression or discontinuation. Brain scans were conducted for all patients at the baseline and upon progression, as well as at scheduled evaluations until progression for those with baseline CNS metastases. The scans were evaluated by a neuroradiologist through a CNS blinded independent central review (BICR).

Based on the baseline CNS BICR, a total of 118 out of 279 patients in the combination group and 104 out of 278 patients in the monotherapy group were included in the CNS full analysis set (cFAS) due to having ≥ one measurable and/or nonmeasurable CNS lesion. Among them, 40 patients from the combination group and 38 patients from the monotherapy group had ≥ one measurable target CNS lesion and were part of the post hoc CNS evaluable-for-response set (cEFR). The hazard ratio (HR) for CNS progression or death was 0.58 in the cFAS , while it was 0.67 for patients who did not have CNS metastases at baseline. The CNS objective response rates in the cFAS were 73% (combination; 64 to 81) versus 69% (monotherapy; 59 to 78), with 59% versus 43% achieving CNS complete response (CR). In the cEFR, CNS ORRs were 88% (73 to 96) versus 87% (72 to 96), with 48% versus 16% achieving CNS CR.

Thus, it can be concluded that the combination of osimertinib and platinum-pemetrexed demonstrated enhanced CNS efficacy compared to osimertinib alone. Additionally, this combination therapy may delay CNS progression, regardless of the baseline CNS metastasis status. These findings strongly support the use of this treatment as a new first-line approach for patients diagnosed with EGFR-mutated advanced non-small cell lung cancer (NSCLC), including those with CNS metastases.

CNS efficacy of osimertinib plus chemotherapy in epidermal growth factor receptor-mutated advanced non-small-cell lung cancer

A recent study showed that the combination of osimertinib with platinum-pemetrexed exhibited improved central nervous system (CNS) efficacy when compared to osimertinib monotherapy. This study’s findings were published in the Journal of clinical oncology. 

In the phase 3 FLAURA2 trial, patients were assigned randomly to receive either osimertinib with platinum-pemetrexed (n= 279) or osimertinib monotherapy (n=278) until disease progression or discontinuation. Brain scans were conducted for all patients at the baseline and upon progression, as well as at scheduled evaluations until progression for those with baseline CNS metastases. The scans were evaluated by a neuroradiologist through a CNS blinded independent central review (BICR).

Based on the baseline CNS BICR, a total of 118 out of 279 patients in the combination group and 104 out of 278 patients in the monotherapy group were included in the CNS full analysis set (cFAS) due to having ≥ one measurable and/or nonmeasurable CNS lesion. Among them, 40 patients from the combination group and 38 patients from the monotherapy group had ≥ one measurable target CNS lesion and were part of the post hoc CNS evaluable-for-response set (cEFR). The hazard ratio (HR) for CNS progression or death was 0.58 in the cFAS , while it was 0.67 for patients who did not have CNS metastases at baseline. The CNS objective response rates in the cFAS were 73% (combination; 64 to 81) versus 69% (monotherapy; 59 to 78), with 59% versus 43% achieving CNS complete response (CR). In the cEFR, CNS ORRs were 88% (73 to 96) versus 87% (72 to 96), with 48% versus 16% achieving CNS CR.

Thus, it can be concluded that the combination of osimertinib and platinum-pemetrexed demonstrated enhanced CNS efficacy compared to osimertinib alone. Additionally, this combination therapy may delay CNS progression, regardless of the baseline CNS metastasis status. These findings strongly support the use of this treatment as a new first-line approach for patients diagnosed with EGFR-mutated advanced non-small cell lung cancer (NSCLC), including those with CNS metastases.

Oncology
2 Min Read
24 May

CNS efficacy of osimertinib plus chemotherapy in epidermal growth factor receptor-mutated advanced non-small-cell lung cancer

A recent study showed that the combination of osimertinib with platinum-pemetrexed exhibited improved central nervous system (CNS) efficacy when compared to osimertinib monotherapy. This study’s findings were published in the Journal of clinical oncology. 

In the phase 3 FLAURA2 trial, patients were assigned randomly to receive either osimertinib with platinum-pemetrexed (n= 279) or osimertinib monotherapy (n=278) until disease progression or discontinuation. Brain scans were conducted for all patients at the baseline and upon progression, as well as at scheduled evaluations until progression for those with baseline CNS metastases. The scans were evaluated by a neuroradiologist through a CNS blinded independent central review (BICR).

Based on the baseline CNS BICR, a total of 118 out of 279 patients in the combination group and 104 out of 278 patients in the monotherapy group were included in the CNS full analysis set (cFAS) due to having ≥ one measurable and/or nonmeasurable CNS lesion. Among them, 40 patients from the combination group and 38 patients from the monotherapy group had ≥ one measurable target CNS lesion and were part of the post hoc CNS evaluable-for-response set (cEFR). The hazard ratio (HR) for CNS progression or death was 0.58 in the cFAS , while it was 0.67 for patients who did not have CNS metastases at baseline. The CNS objective response rates in the cFAS were 73% (combination; 64 to 81) versus 69% (monotherapy; 59 to 78), with 59% versus 43% achieving CNS complete response (CR). In the cEFR, CNS ORRs were 88% (73 to 96) versus 87% (72 to 96), with 48% versus 16% achieving CNS CR.

Thus, it can be concluded that the combination of osimertinib and platinum-pemetrexed demonstrated enhanced CNS efficacy compared to osimertinib alone. Additionally, this combination therapy may delay CNS progression, regardless of the baseline CNS metastasis status. These findings strongly support the use of this treatment as a new first-line approach for patients diagnosed with EGFR-mutated advanced non-small cell lung cancer (NSCLC), including those with CNS metastases.

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Neuro
2 Min Read
23 May

Comparison between ticagrelor and clopidogrel in acute large-vessel ischemic stroke

A recent study showed that individuals diagnosed with acute large-vessel ischemic stroke who were administered ticagrelor within the initial 24 hours after the stroke experienced improved clinical outcomes in terms of recurrent stroke rates, reduction in National Institutes of Health Stroke Scale (NIHSS) scores, and favorable modified Rankin scale (mRS) rates when compared to individuals who were given clopidogrel. This study’s findings were published in the journal, CNS drugs.

In this randomized, controlled trial, a cohort of 580 individuals who had suffered their first-ever large-vessel occlusion (LVO) ischemic stroke were enrolled. These participants were then randomly assigned to receive either ticagrelor or clopidogrel, with loading and maintenance doses administered. The screening, randomization, and commencement of treatment were all conducted within the first 24 hours after the occurrence of the stroke.

At the end of the 90-day period, 30 patients in the ticagrelor group and 49 patients in the clopidogrel group had experienced either a new ischemic or hemorrhagic stroke. Additionally, a composite of a new stroke, myocardial infarction, or death due to vascular insults was observed in 36 patients from the ticagrelor group and 57 patients from the clopidogrel group. Patients who received ticagrelor demonstrated more favorable clinical outcomes in terms of NIHSS reduction and achieving a favorable mRS score. There were no significant differences between ticagrelor and clopidogrel in terms of non-hemorrhagic and hemorrhagic complications.

Thus, it can be concluded that individuals diagnosed with acute large-vessel ischemic stroke who received ticagrelor within the first 24 hours after the stroke showed enhanced clinical outcomes in terms of reduced rates of recurrent stroke, decreased NIHSS scores, and improved mRS rates compared to those who were administered clopidogrel.

Comparison between ticagrelor and clopidogrel in acute large-vessel ischemic stroke

A recent study showed that individuals diagnosed with acute large-vessel ischemic stroke who were administered ticagrelor within the initial 24 hours after the stroke experienced improved clinical outcomes in terms of recurrent stroke rates, reduction in National Institutes of Health Stroke Scale (NIHSS) scores, and favorable modified Rankin scale (mRS) rates when compared to individuals who were given clopidogrel. This study’s findings were published in the journal, CNS drugs.

In this randomized, controlled trial, a cohort of 580 individuals who had suffered their first-ever large-vessel occlusion (LVO) ischemic stroke were enrolled. These participants were then randomly assigned to receive either ticagrelor or clopidogrel, with loading and maintenance doses administered. The screening, randomization, and commencement of treatment were all conducted within the first 24 hours after the occurrence of the stroke.

At the end of the 90-day period, 30 patients in the ticagrelor group and 49 patients in the clopidogrel group had experienced either a new ischemic or hemorrhagic stroke. Additionally, a composite of a new stroke, myocardial infarction, or death due to vascular insults was observed in 36 patients from the ticagrelor group and 57 patients from the clopidogrel group. Patients who received ticagrelor demonstrated more favorable clinical outcomes in terms of NIHSS reduction and achieving a favorable mRS score. There were no significant differences between ticagrelor and clopidogrel in terms of non-hemorrhagic and hemorrhagic complications.

Thus, it can be concluded that individuals diagnosed with acute large-vessel ischemic stroke who received ticagrelor within the first 24 hours after the stroke showed enhanced clinical outcomes in terms of reduced rates of recurrent stroke, decreased NIHSS scores, and improved mRS rates compared to those who were administered clopidogrel.

Neuro
2 Min Read
23 May

Comparison between ticagrelor and clopidogrel in acute large-vessel ischemic stroke

A recent study showed that individuals diagnosed with acute large-vessel ischemic stroke who were administered ticagrelor within the initial 24 hours after the stroke experienced improved clinical outcomes in terms of recurrent stroke rates, reduction in National Institutes of Health Stroke Scale (NIHSS) scores, and favorable modified Rankin scale (mRS) rates when compared to individuals who were given clopidogrel. This study’s findings were published in the journal, CNS drugs.

In this randomized, controlled trial, a cohort of 580 individuals who had suffered their first-ever large-vessel occlusion (LVO) ischemic stroke were enrolled. These participants were then randomly assigned to receive either ticagrelor or clopidogrel, with loading and maintenance doses administered. The screening, randomization, and commencement of treatment were all conducted within the first 24 hours after the occurrence of the stroke.

At the end of the 90-day period, 30 patients in the ticagrelor group and 49 patients in the clopidogrel group had experienced either a new ischemic or hemorrhagic stroke. Additionally, a composite of a new stroke, myocardial infarction, or death due to vascular insults was observed in 36 patients from the ticagrelor group and 57 patients from the clopidogrel group. Patients who received ticagrelor demonstrated more favorable clinical outcomes in terms of NIHSS reduction and achieving a favorable mRS score. There were no significant differences between ticagrelor and clopidogrel in terms of non-hemorrhagic and hemorrhagic complications.

Thus, it can be concluded that individuals diagnosed with acute large-vessel ischemic stroke who received ticagrelor within the first 24 hours after the stroke showed enhanced clinical outcomes in terms of reduced rates of recurrent stroke, decreased NIHSS scores, and improved mRS rates compared to those who were administered clopidogrel.

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Urology
2 Min Read
22 May

Effectiveness of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi

A recent study suggests the use of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) led to an increased stone-free rate (SFR) in cases of staghorn calculi, necessitated fewer percutaneous tracts, decreased the necessity for staged surgery, and resulted in a shorter operative duration compared to single percutaneous nephrolithotomy (sPNL ). The study findings were published in the journal, Urolithiasis.

A total of 160 patients were included in this prospective randomized controlled study, with 81 patients in the sPNL group and 79 patients in the aPNL group. Initially, the study focused on comparing the overall differences between sPNL and aPNL. Subsequently, the patients were categorized into two subgroups: Group 1 (patients with < 5 stone branches) and Group 2 (patients with ≥ 5 stone branches). The differences between these two subgroups were analyzed.

The study results revealed that aPNL exhibited a higher SFR and required fewer percutaneous tracts, with a shorter operation time compared to sPNL. Additionally, aPNL reduced the need for staged surgery, especially in patients with ≥ 5 stone branches. There were no significant variances in hemoglobin level changes and the requirement for blood transfusions between the sPNL and aPNL groups, and the frequency of multiple tracts was lower in the aPNL group.

Thus, it can be concluded that aPNL led to an increased SFR in staghorn calculi, necessitated fewer percutaneous tracts, minimized the requirement for staged surgery, and had a shorter operative duration compared to PNL alone. This was particularly notable in patients with ≥ 5 stone branches.

Effectiveness of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi

A recent study suggests the use of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) led to an increased stone-free rate (SFR) in cases of staghorn calculi, necessitated fewer percutaneous tracts, decreased the necessity for staged surgery, and resulted in a shorter operative duration compared to single percutaneous nephrolithotomy (sPNL ). The study findings were published in the journal, Urolithiasis.

A total of 160 patients were included in this prospective randomized controlled study, with 81 patients in the sPNL group and 79 patients in the aPNL group. Initially, the study focused on comparing the overall differences between sPNL and aPNL. Subsequently, the patients were categorized into two subgroups: Group 1 (patients with < 5 stone branches) and Group 2 (patients with ≥ 5 stone branches). The differences between these two subgroups were analyzed.

The study results revealed that aPNL exhibited a higher SFR and required fewer percutaneous tracts, with a shorter operation time compared to sPNL. Additionally, aPNL reduced the need for staged surgery, especially in patients with ≥ 5 stone branches. There were no significant variances in hemoglobin level changes and the requirement for blood transfusions between the sPNL and aPNL groups, and the frequency of multiple tracts was lower in the aPNL group.

Thus, it can be concluded that aPNL led to an increased SFR in staghorn calculi, necessitated fewer percutaneous tracts, minimized the requirement for staged surgery, and had a shorter operative duration compared to PNL alone. This was particularly notable in patients with ≥ 5 stone branches.

Urology
2 Min Read
22 May

Effectiveness of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy for staghorn calculi

A recent study suggests the use of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) led to an increased stone-free rate (SFR) in cases of staghorn calculi, necessitated fewer percutaneous tracts, decreased the necessity for staged surgery, and resulted in a shorter operative duration compared to single percutaneous nephrolithotomy (sPNL ). The study findings were published in the journal, Urolithiasis.

A total of 160 patients were included in this prospective randomized controlled study, with 81 patients in the sPNL group and 79 patients in the aPNL group. Initially, the study focused on comparing the overall differences between sPNL and aPNL. Subsequently, the patients were categorized into two subgroups: Group 1 (patients with < 5 stone branches) and Group 2 (patients with ≥ 5 stone branches). The differences between these two subgroups were analyzed.

The study results revealed that aPNL exhibited a higher SFR and required fewer percutaneous tracts, with a shorter operation time compared to sPNL. Additionally, aPNL reduced the need for staged surgery, especially in patients with ≥ 5 stone branches. There were no significant variances in hemoglobin level changes and the requirement for blood transfusions between the sPNL and aPNL groups, and the frequency of multiple tracts was lower in the aPNL group.

Thus, it can be concluded that aPNL led to an increased SFR in staghorn calculi, necessitated fewer percutaneous tracts, minimized the requirement for staged surgery, and had a shorter operative duration compared to PNL alone. This was particularly notable in patients with ≥ 5 stone branches.

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PainAnalgesia
2 Min Read
21 May

Effect of transcutaneous electrical nerve stimulation on the reduction of postoperative acute pain after hip fracture surgery

According to a recent study, the application of transcutaneous electrical nerve stimulation (TENS) to the surgical wound, sciatic nerve, and lumbar plexus, based on anatomical landmarks has been shown to greatly decrease postoperative pain. This is demonstrated by the elevated VAS scores, increased total analgesic consumption, and heightened need for additional analgesics in the control group following hip fracture surgery. This study’s findings were published in the journal, European Review for Medical and Pharmacological Sciences.

In this double-blinded randomized clinical trial 120 patients undergoing hip surgery were divided into three distinct groups. The first group was provided with patient-controlled analgesia (PCA) including epidural fentanyl and supplementary medications. The second group underwent lumbar plexus and sciatic nerve transcutaneous electrical nerve stimulation (LS-TENS) in conjunction with the identical medication regimen as the first group. The third group was subjected to the same medication regimen as the first group, in addition to surgical wound transcutaneous electrical nerve stimulation (SW-TENS). Pain levels were evaluated using a Visual Analog Scale (VAS) score, and the quantity of opioid analgesics consumed by each patient was documented.

At 30 minutes postoperatively, the control group demonstrated higher VAS scores in comparison to the SW-TENS group (1.58±2.49 vs 0.70±2.15), while the SW-TENS group had higher VAS scores than the LS-TENS group at 24 hours (2.33±1.29 vs 1.63±1.05). Additionally, the total analgesic consumption over 48 hours was significantly elevated in the control group compared to the LS-TENS group.

The above study demonstrated that the application of TENS to the surgical incision, sciatic nerve, and lumbar plexus, guided by anatomical landmarks, has been found to significantly diminish postoperative pain. This is evidenced by the elevated VAS scores, heightened total analgesic consumption, and increased demand for supplementary analgesics in the control group following hip fracture surgery.

Effect of transcutaneous electrical nerve stimulation on the reduction of postoperative acute pain after hip fracture surgery

According to a recent study, the application of transcutaneous electrical nerve stimulation (TENS) to the surgical wound, sciatic nerve, and lumbar plexus, based on anatomical landmarks has been shown to greatly decrease postoperative pain. This is demonstrated by the elevated VAS scores, increased total analgesic consumption, and heightened need for additional analgesics in the control group following hip fracture surgery. This study’s findings were published in the journal, European Review for Medical and Pharmacological Sciences.

In this double-blinded randomized clinical trial 120 patients undergoing hip surgery were divided into three distinct groups. The first group was provided with patient-controlled analgesia (PCA) including epidural fentanyl and supplementary medications. The second group underwent lumbar plexus and sciatic nerve transcutaneous electrical nerve stimulation (LS-TENS) in conjunction with the identical medication regimen as the first group. The third group was subjected to the same medication regimen as the first group, in addition to surgical wound transcutaneous electrical nerve stimulation (SW-TENS). Pain levels were evaluated using a Visual Analog Scale (VAS) score, and the quantity of opioid analgesics consumed by each patient was documented.

At 30 minutes postoperatively, the control group demonstrated higher VAS scores in comparison to the SW-TENS group (1.58±2.49 vs 0.70±2.15), while the SW-TENS group had higher VAS scores than the LS-TENS group at 24 hours (2.33±1.29 vs 1.63±1.05). Additionally, the total analgesic consumption over 48 hours was significantly elevated in the control group compared to the LS-TENS group.

The above study demonstrated that the application of TENS to the surgical incision, sciatic nerve, and lumbar plexus, guided by anatomical landmarks, has been found to significantly diminish postoperative pain. This is evidenced by the elevated VAS scores, heightened total analgesic consumption, and increased demand for supplementary analgesics in the control group following hip fracture surgery.

PainAnalgesia
2 Min Read
21 May

Effect of transcutaneous electrical nerve stimulation on the reduction of postoperative acute pain after hip fracture surgery

According to a recent study, the application of transcutaneous electrical nerve stimulation (TENS) to the surgical wound, sciatic nerve, and lumbar plexus, based on anatomical landmarks has been shown to greatly decrease postoperative pain. This is demonstrated by the elevated VAS scores, increased total analgesic consumption, and heightened need for additional analgesics in the control group following hip fracture surgery. This study’s findings were published in the journal, European Review for Medical and Pharmacological Sciences.

In this double-blinded randomized clinical trial 120 patients undergoing hip surgery were divided into three distinct groups. The first group was provided with patient-controlled analgesia (PCA) including epidural fentanyl and supplementary medications. The second group underwent lumbar plexus and sciatic nerve transcutaneous electrical nerve stimulation (LS-TENS) in conjunction with the identical medication regimen as the first group. The third group was subjected to the same medication regimen as the first group, in addition to surgical wound transcutaneous electrical nerve stimulation (SW-TENS). Pain levels were evaluated using a Visual Analog Scale (VAS) score, and the quantity of opioid analgesics consumed by each patient was documented.

At 30 minutes postoperatively, the control group demonstrated higher VAS scores in comparison to the SW-TENS group (1.58±2.49 vs 0.70±2.15), while the SW-TENS group had higher VAS scores than the LS-TENS group at 24 hours (2.33±1.29 vs 1.63±1.05). Additionally, the total analgesic consumption over 48 hours was significantly elevated in the control group compared to the LS-TENS group.

The above study demonstrated that the application of TENS to the surgical incision, sciatic nerve, and lumbar plexus, guided by anatomical landmarks, has been found to significantly diminish postoperative pain. This is evidenced by the elevated VAS scores, heightened total analgesic consumption, and increased demand for supplementary analgesics in the control group following hip fracture surgery.

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Oncology
2 Min Read
20 May

Efficacy of enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer

A recent study found that treatment involving enfortumab vedotin and pembrolizumab produced significantly better outcomes than chemotherapy for patients with untreated locally advanced or metastatic urothelial carcinoma. The results of this study were published in the New England Journal of Medicine.

In this randomized, global, open-label phase 3 trial, a total of 886 patients were assigned in a 1:1 ratio to receive 3-week cycles of enfortumab vedotin (administered intravenously at a dose of 1.25 mg per kilogram of body weight on days 1 and 8) and pembrolizumab (administered intravenously at a dose of 200 mg on day 1) in the enfortumab vedotin-pembrolizumab group (N=442), or gemcitabine and either cisplatin or carboplatin in the chemotherapy group (N=444). Progression-free survival and overall survival were the primary endpoints of the study.

The enfortumab vedotin-pembrolizumab group exhibited a longer progression-free survival compared to the chemotherapy group, with a median of 12.5 months versus 6.3 months, respectively. Similarly, the overall survival was also prolonged in the enfortumab vedotin-pembrolizumab group, with a median of 31.5 months compared to 16.1 months in the chemotherapy group. In terms of treatment cycles, the enfortumab vedotin-pembrolizumab group had a median of 12 cycles (range, 1-46), while the chemotherapy group had a median of 6 cycles (range, 1-6). Notably, treatment-related adverse events of grade 3 or higher were observed in 55.9% of patients in the enfortumab vedotin-pembrolizumab group and in 69.5% of patients in the chemotherapy group.

Based on the above results, it can be concluded that treatment with enfortumab vedotin and pembrolizumab in patients with untreated locally advanced or metastatic urothelial carcinoma resulted in improved outcomes compared to chemotherapy.

Efficacy of enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer

A recent study found that treatment involving enfortumab vedotin and pembrolizumab produced significantly better outcomes than chemotherapy for patients with untreated locally advanced or metastatic urothelial carcinoma. The results of this study were published in the New England Journal of Medicine.

In this randomized, global, open-label phase 3 trial, a total of 886 patients were assigned in a 1:1 ratio to receive 3-week cycles of enfortumab vedotin (administered intravenously at a dose of 1.25 mg per kilogram of body weight on days 1 and 8) and pembrolizumab (administered intravenously at a dose of 200 mg on day 1) in the enfortumab vedotin-pembrolizumab group (N=442), or gemcitabine and either cisplatin or carboplatin in the chemotherapy group (N=444). Progression-free survival and overall survival were the primary endpoints of the study.

The enfortumab vedotin-pembrolizumab group exhibited a longer progression-free survival compared to the chemotherapy group, with a median of 12.5 months versus 6.3 months, respectively. Similarly, the overall survival was also prolonged in the enfortumab vedotin-pembrolizumab group, with a median of 31.5 months compared to 16.1 months in the chemotherapy group. In terms of treatment cycles, the enfortumab vedotin-pembrolizumab group had a median of 12 cycles (range, 1-46), while the chemotherapy group had a median of 6 cycles (range, 1-6). Notably, treatment-related adverse events of grade 3 or higher were observed in 55.9% of patients in the enfortumab vedotin-pembrolizumab group and in 69.5% of patients in the chemotherapy group.

Based on the above results, it can be concluded that treatment with enfortumab vedotin and pembrolizumab in patients with untreated locally advanced or metastatic urothelial carcinoma resulted in improved outcomes compared to chemotherapy.

Oncology
2 Min Read
20 May

Efficacy of enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer

A recent study found that treatment involving enfortumab vedotin and pembrolizumab produced significantly better outcomes than chemotherapy for patients with untreated locally advanced or metastatic urothelial carcinoma. The results of this study were published in the New England Journal of Medicine.

In this randomized, global, open-label phase 3 trial, a total of 886 patients were assigned in a 1:1 ratio to receive 3-week cycles of enfortumab vedotin (administered intravenously at a dose of 1.25 mg per kilogram of body weight on days 1 and 8) and pembrolizumab (administered intravenously at a dose of 200 mg on day 1) in the enfortumab vedotin-pembrolizumab group (N=442), or gemcitabine and either cisplatin or carboplatin in the chemotherapy group (N=444). Progression-free survival and overall survival were the primary endpoints of the study.

The enfortumab vedotin-pembrolizumab group exhibited a longer progression-free survival compared to the chemotherapy group, with a median of 12.5 months versus 6.3 months, respectively. Similarly, the overall survival was also prolonged in the enfortumab vedotin-pembrolizumab group, with a median of 31.5 months compared to 16.1 months in the chemotherapy group. In terms of treatment cycles, the enfortumab vedotin-pembrolizumab group had a median of 12 cycles (range, 1-46), while the chemotherapy group had a median of 6 cycles (range, 1-6). Notably, treatment-related adverse events of grade 3 or higher were observed in 55.9% of patients in the enfortumab vedotin-pembrolizumab group and in 69.5% of patients in the chemotherapy group.

Based on the above results, it can be concluded that treatment with enfortumab vedotin and pembrolizumab in patients with untreated locally advanced or metastatic urothelial carcinoma resulted in improved outcomes compared to chemotherapy.

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Pediatric
2 Min Read
17 May

Prognostic scoring system for Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children

A recent study suggests that a prognostic scoring system identified three high risk groups in children with statistically significant differences in survival curves based on the baseline characteristics that helped in risk prediction. The findings of this study were published in the journal, Pediatric Blood & Cancer.

This multicenter retrospective study included 264 children, aged 0-14 years who were diagnosed with Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (EBV-HLH). The pediatric population was randomly divided into two groups: derivation (n=185) and verification (n=79). In order to establish a prognostic scoring system for death events, risk predictors were investigated using a Cox regression model during the follow-up period. Chronic active EBV infection (CAEBV) history, plasma EBV-DNA copy number, pulmonary infection hemorrhage of digestive tract, and hypoxemia prognostic scoring system (CEPHO-PSS) were developed which demarcated patients into low-risk (0-1 points), middle-risk (2-3 points), and high-risk (4-8 points) groups.

At the end of the study, the three risk groups showed survival curves with statistically significant differences. Receiver operating characteristic (ROC) and calibration curves in the derivation and verification cohorts, respectively, were used for internal and external verification of CEPHO-PSS, confirming good accuracy and applicability.

Thus, it can be concluded that the CEPHO-PSS may identify three risk groups in children with statistically significant differences in survival curves. This may help clinicians to check for risk prediction.

Prognostic scoring system for Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children

A recent study suggests that a prognostic scoring system identified three high risk groups in children with statistically significant differences in survival curves based on the baseline characteristics that helped in risk prediction. The findings of this study were published in the journal, Pediatric Blood & Cancer.

This multicenter retrospective study included 264 children, aged 0-14 years who were diagnosed with Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (EBV-HLH). The pediatric population was randomly divided into two groups: derivation (n=185) and verification (n=79). In order to establish a prognostic scoring system for death events, risk predictors were investigated using a Cox regression model during the follow-up period. Chronic active EBV infection (CAEBV) history, plasma EBV-DNA copy number, pulmonary infection hemorrhage of digestive tract, and hypoxemia prognostic scoring system (CEPHO-PSS) were developed which demarcated patients into low-risk (0-1 points), middle-risk (2-3 points), and high-risk (4-8 points) groups.

At the end of the study, the three risk groups showed survival curves with statistically significant differences. Receiver operating characteristic (ROC) and calibration curves in the derivation and verification cohorts, respectively, were used for internal and external verification of CEPHO-PSS, confirming good accuracy and applicability.

Thus, it can be concluded that the CEPHO-PSS may identify three risk groups in children with statistically significant differences in survival curves. This may help clinicians to check for risk prediction.

Pediatric
2 Min Read
17 May

Prognostic scoring system for Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children

A recent study suggests that a prognostic scoring system identified three high risk groups in children with statistically significant differences in survival curves based on the baseline characteristics that helped in risk prediction. The findings of this study were published in the journal, Pediatric Blood & Cancer.

This multicenter retrospective study included 264 children, aged 0-14 years who were diagnosed with Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (EBV-HLH). The pediatric population was randomly divided into two groups: derivation (n=185) and verification (n=79). In order to establish a prognostic scoring system for death events, risk predictors were investigated using a Cox regression model during the follow-up period. Chronic active EBV infection (CAEBV) history, plasma EBV-DNA copy number, pulmonary infection hemorrhage of digestive tract, and hypoxemia prognostic scoring system (CEPHO-PSS) were developed which demarcated patients into low-risk (0-1 points), middle-risk (2-3 points), and high-risk (4-8 points) groups.

At the end of the study, the three risk groups showed survival curves with statistically significant differences. Receiver operating characteristic (ROC) and calibration curves in the derivation and verification cohorts, respectively, were used for internal and external verification of CEPHO-PSS, confirming good accuracy and applicability.

Thus, it can be concluded that the CEPHO-PSS may identify three risk groups in children with statistically significant differences in survival curves. This may help clinicians to check for risk prediction.

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Vitamin
2 Min Read
16 May

Active vitamin D treatment in mitigating the onset of sarcopenia among adults with prediabetes

A recent study showed that the use of eldecalcitol may help in preventing the onset of sarcopenia in individuals with prediabetes by enhancing skeletal muscle volume and strength.  This study’s findings were published in the Lancet Healthy Longevity.

In this randomised, placebo-controlled, double-blind, multicenter trial, a total of 1094 participants were divided into two groups, with 548 in the eldecalcitol group and 546 in the placebo group. The primary endpoint of the study was the incidence of sarcopenia over a 3-year period in the intention-to-treat population, characterised by weak handgrip strength (<18 kg for women and <28 kg for men) and low appendicular skeletal muscle index (<5·7 kg/m2 for women and <7·0 kg/m2 for men in bioelectrical impedance analysis). Hypercalcaemia was identified as 10·4 mg/dL (2·6 mmol/L) or higher, while a level of 11·0 mg/dL or higher was considered enough to warrant discontinuation of the study.

Eldecalcitol demonstrated a statistically significant preventive effect on the incidence of sarcopenia when compared to the placebo, with 25 participants (4.6%) out of 548 in the eldecalcitol group and 48 participants (8.8%) out of 546 in the placebo group. There was no variance in the occurrence of adverse events between the two groups.

Thus, it can be concluded that eldecalcitol could potentially prevent sarcopenia in individuals with prediabetes by increasing skeletal muscle strength and volume, ultimately reducing the risk of falls

Active vitamin D treatment in mitigating the onset of sarcopenia among adults with prediabetes

A recent study showed that the use of eldecalcitol may help in preventing the onset of sarcopenia in individuals with prediabetes by enhancing skeletal muscle volume and strength.  This study’s findings were published in the Lancet Healthy Longevity.

In this randomised, placebo-controlled, double-blind, multicenter trial, a total of 1094 participants were divided into two groups, with 548 in the eldecalcitol group and 546 in the placebo group. The primary endpoint of the study was the incidence of sarcopenia over a 3-year period in the intention-to-treat population, characterised by weak handgrip strength (<18 kg for women and <28 kg for men) and low appendicular skeletal muscle index (<5·7 kg/m2 for women and <7·0 kg/m2 for men in bioelectrical impedance analysis). Hypercalcaemia was identified as 10·4 mg/dL (2·6 mmol/L) or higher, while a level of 11·0 mg/dL or higher was considered enough to warrant discontinuation of the study.

Eldecalcitol demonstrated a statistically significant preventive effect on the incidence of sarcopenia when compared to the placebo, with 25 participants (4.6%) out of 548 in the eldecalcitol group and 48 participants (8.8%) out of 546 in the placebo group. There was no variance in the occurrence of adverse events between the two groups.

Thus, it can be concluded that eldecalcitol could potentially prevent sarcopenia in individuals with prediabetes by increasing skeletal muscle strength and volume, ultimately reducing the risk of falls

Vitamin
2 Min Read
16 May

Active vitamin D treatment in mitigating the onset of sarcopenia among adults with prediabetes

A recent study showed that the use of eldecalcitol may help in preventing the onset of sarcopenia in individuals with prediabetes by enhancing skeletal muscle volume and strength.  This study’s findings were published in the Lancet Healthy Longevity.

In this randomised, placebo-controlled, double-blind, multicenter trial, a total of 1094 participants were divided into two groups, with 548 in the eldecalcitol group and 546 in the placebo group. The primary endpoint of the study was the incidence of sarcopenia over a 3-year period in the intention-to-treat population, characterised by weak handgrip strength (<18 kg for women and <28 kg for men) and low appendicular skeletal muscle index (<5·7 kg/m2 for women and <7·0 kg/m2 for men in bioelectrical impedance analysis). Hypercalcaemia was identified as 10·4 mg/dL (2·6 mmol/L) or higher, while a level of 11·0 mg/dL or higher was considered enough to warrant discontinuation of the study.

Eldecalcitol demonstrated a statistically significant preventive effect on the incidence of sarcopenia when compared to the placebo, with 25 participants (4.6%) out of 548 in the eldecalcitol group and 48 participants (8.8%) out of 546 in the placebo group. There was no variance in the occurrence of adverse events between the two groups.

Thus, it can be concluded that eldecalcitol could potentially prevent sarcopenia in individuals with prediabetes by increasing skeletal muscle strength and volume, ultimately reducing the risk of falls

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