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1.
Sci Rep ; 14(1): 12643, 2024 06 02.
Article in English | MEDLINE | ID: mdl-38825602

ABSTRACT

This study compared the radiologic and clinical outcomes of a new seven-axis robotic-assisted total hip arthroplasty (THA) and conventional THA. Hundred and four patients were randomly assigned to two groups-the robotic-assisted THA group (RAS group) and the conventional THA group (CON group). The preoperative and postoperative Harris Hip score (HHS), acetabular inclination, anteversion, femoral offset, and leg length discrepancy (LLD) were compared. During the follow-up, no patients had any complications that could be associated with the use of the robot. The proportion of acetabular cups in the safety zone was significantly higher in the RAS group than that in the CON group. The two groups had significantly different mean absolute difference of inclination and anteversion. There was no significant difference in the postoperative HHSs, changes in HHSs, femoral offset, and lower limb length between the two groups. The seven-axis robotic-assisted THA system is safe and effective, and leads to better acetabulum cup positioning compared to conventional THA. The improvements observed in the HHS, LLD, and femoral offset in the RAS group were similar to those in the CON group.Clinical trial registration time: 19/05/2022.Clinical trial registration number: ChiCTR2200060115.


Subject(s)
Arthroplasty, Replacement, Hip , Robotic Surgical Procedures , Humans , Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Hip/instrumentation , Male , Female , Robotic Surgical Procedures/methods , Middle Aged , Prospective Studies , Aged , Treatment Outcome , Acetabulum/surgery
2.
Adv Exp Med Biol ; 1447: 139-149, 2024.
Article in English | MEDLINE | ID: mdl-38724791

ABSTRACT

Dupilumab and tralokinumab are currently the only FDA-approved biologic therapies for the treatment of moderate-to-severe atopic dermatitis. Tralokinumab is approved for patients greater than 18 years old, and dupilumab is approved for patients as young as 6 months old. Both medications are effective in clinical trials at improving atopic dermatitis. With a good safety profile and low-risk adverse events, dupilumab and tralokinumab are generally excellent treatment options for patients with severe or refractory atopic dermatitis.


Subject(s)
Antibodies, Monoclonal, Humanized , Antibodies, Monoclonal , Dermatitis, Atopic , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/immunology , Humans , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Monoclonal, Humanized/adverse effects , Antibodies, Monoclonal/therapeutic use , Biological Therapy/methods , Treatment Outcome
3.
Front Immunol ; 15: 1298471, 2024.
Article in English | MEDLINE | ID: mdl-38633263

ABSTRACT

Introduction: In light of the public health burden of the COVID-19 pandemic, boosting the safety and immunogenicity of COVID-19 vaccines is of great concern. Numerous Traditional Chinese medicine (TCM) preparations have shown to beneficially modulate immunity. Based on pilot experiments in mice that showed that supplementation with Huoxiang Suling Shuanghua Decoction (HSSD) significantly enhances serum anti-RBD IgG titers after inoculation with recombinant SARS-CoV-2 S-RBD protein, we conducted this randomized, double-blind, placebo-controlled clinical trial aimed to evaluate the potential immunogenicity boosting effect of oral HSSD after a third homologous immunization with Sinovac's CoronaVac SARS-CoV-2 (CVS) inactivated vaccine. Methods: A total of 70 participants were randomly assigned (1:1 ratio) to receive a third dose of CVS vaccination and either oral placebo or oral HSSD for 7 days. Safety aspects were assessed by recording local and systemic adverse events, and by blood and urine biochemistry and liver and kidney function tests. Main outcomes evaluated included serum anti-RBD IgG titer, T lymphocyte subsets, serum IgG and IgM levels, complement components (C3 and C4), and serum cytokines (IL-6 and IFN-γ). In addition, metabolomics technology was used to analyze differential metabolite expression after supplementation with HSSD. Results: Following a third CVS vaccination, significantly increased serum anti-RBD IgG titer, reduced serum IL-6 levels, increased serum IgG, IgM, and C3 and C4 levels, and improved cellular immunity, evidenced by reduce balance deviations in the distribution of lymphocyte subsets, was observed in the HSSD group compared with the placebo group. No serious adverse events were recorded in either group. Serum metabolomics results suggested that the mechanisms by which HSSD boosted the immunogenicity of the CVS vaccine are related to differential regulation of purine metabolism, vitamin B6 metabolism, folate biosynthesis, arginine and proline metabolism, and steroid hormone biosynthesis. Conclusion: Oral HSSD boosts the immunogenicity of the CVS vaccine in young and adult individuals. This trial provides clinical reference for evaluation of TCM immunomodulators to improve the immune response to COVID-19 vaccines.


Subject(s)
COVID-19 Vaccines , COVID-19 , Drugs, Chinese Herbal , Vaccines, Inactivated , Adult , Humans , Animals , Mice , Interleukin-6 , Pandemics , SARS-CoV-2 , Immunoglobulin G , Immunoglobulin M
4.
Trials ; 24(1): 702, 2023 Oct 31.
Article in English | MEDLINE | ID: mdl-37907996

ABSTRACT

BACKGROUND: Supraspinatus tendon reconstruction (STR) was recently introduced as a new treatment option for irreparable posterosuperior massive rotator cuff tears (IPMRCT). STR was thought to be more advantageous than superior capsule reconstruction (SCR) for restoring supraspinatus (SSP) dynamics. However, there has been no prospective randomized controlled study on the early clinical efficacy of STR. METHODS: A single-site, prospective, observers and patients double-blinding randomized controlled trial was designed. Fifty-eight patients aged 50-85 years with IPMRCT will be randomized 1:1 to receive either STR or SCR. The clinical outcomes were evaluated using the American Society for Shoulder and Elbow Surgery (ASES) score, range of motion (ROM), visual analogue scale (VAS) for pain, acromiohumeral distance (AHD), Goutlliar grade for fatty infiltration in the SSP, Sugaya grade for the autogenous fascia latas, isokinetic muscle strength testing and surface electromyography (EMG) testing for shoulder abduction muscle strength and complications. DISCUSSION: The results of this study will contribute to the treatment algorithm of IPMRCT and assist surgeons in making treatment decisions. This is the first randomized controlled trial to compare the effects of STR and SCR for the treatment of IPMRCT. TRIAL REGISTRATION: We registered the trial in chictr.org.cn on July 17, 2023 (register number: ChiCTR2300073716). Items from the WHO trial registry were found within the protocol.


Subject(s)
Rotator Cuff Injuries , Shoulder Joint , Humans , Rotator Cuff/diagnostic imaging , Rotator Cuff/surgery , Rotator Cuff Injuries/diagnostic imaging , Rotator Cuff Injuries/surgery , Fascia Lata/transplantation , Prospective Studies , Shoulder Joint/diagnostic imaging , Shoulder Joint/surgery , Treatment Outcome , Range of Motion, Articular/physiology , Arthroscopy/methods , Retrospective Studies , Randomized Controlled Trials as Topic
5.
Ther Adv Musculoskelet Dis ; 15: 1759720X231169839, 2023.
Article in English | MEDLINE | ID: mdl-37197024

ABSTRACT

Osteoarthritis (OA) is a prevalent and severely debilitating disease with an unmet medical need. In order to alleviate OA symptoms or prevent structural progression of OA, new drugs, particularly disease-modifying osteoarthritis drugs (DMOADs), are required. Several drugs have been reported to attenuate cartilage loss or reduce subchondral bone lesions in OA and thus potentially be DMOADs. Most biologics (including interleukin-1 (IL-1) and tumor necrosis factor (TNF) inhibitors), sprifermin, and bisphosphonates failed to yield satisfactory results when treating OA. OA clinical heterogeneity is one of the primary reasons for the failure of these clinical trials, which can require different therapeutic approaches based on different phenotypes. This review describes the latest insights into the development of DMOADs. We summarize in this review the efficacy and safety profiles of various DMOADs targeting cartilage, synovitis, and subchondral bone endotypes in phase 2 and 3 clinical trials. To conclude, we summarize the reasons for clinical trial failures in OA and suggest possible solutions.

6.
Gynecol Endocrinol ; 38(10): 856-860, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36062569

ABSTRACT

Objectives: The aim of this study was to access the efficacy of probiotics combined with metformin on improvement of menstrual and metabolic patterns in women with polycystic ovary syndrome (PCOS). Methods: In this single-centre, controlled, randomized clinical trial (NCT03336840), 60 non-obese women with PCOS were randomly assigned (1:1:1) to receive probiotics (4 g daily), metformin (1.5 g daily) or their combination for 12 weeks. The primary outcome was the improvement of menstrual patterns. The secondary outcomes included changes in anthropometric, metabolic profiles and hormonal levels. Results: After 12-week treatment, the recovery rate of menstrual cycle was 40% in probiotics group, 55% in metformin group and 80% in combination group (p = 0.035). Meanwhile, the ovulation rate was 30% in probiotics group, 55% in metformin group and 75% in combination group (p = 0.017). Serum anti-Müllerian hormone, testosterone, free androgen index, BMI, fasting blood glucose, HOMA-IR, lipid profiles were decreased after probiotics or metformin treatment in non-obese women with PCOS. Conclusion: In the present trial, probiotics combined with metformin was superior to probiotics or metformin alone to improve menstrual patterns in women with PCOS. Metabolic and hormonal profiles were also improved after probiotics or metformin treatment.


Subject(s)
Metformin , Polycystic Ovary Syndrome , Probiotics , Female , Humans , Metformin/therapeutic use , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/drug therapy , Hypoglycemic Agents/therapeutic use , Menstruation , Probiotics/therapeutic use
7.
CNS Neurosci Ther ; 28(8): 1205-1217, 2022 08.
Article in English | MEDLINE | ID: mdl-35545932

ABSTRACT

AIMS: Our team tested spinal cord fusion (SCF) using the neuroprotective agent polyethylene glycol (PEG) in different animal (mice, rats, and beagles) models with complete spinal cord transection. To further explore the application of SCF for the treatment of paraplegic patients, we developed a new clinical procedure for SCF called vascular pedicle hemisected spinal cord transplantation (vSCT) and tested this procedure in eight paraplegic participants. METHODS: Eight paraplegic participants (American Spinal Injury Association, ASIA: A) were enrolled and treated with vSCT (PEG was applied to the sites of spinal cord transplantation). Pre- and postoperative pain intensities, neurologic assessments, electrophysiologic monitoring, and neuroimaging examinations were recorded. RESULTS: Of the eight paraplegic participants who completed vSCT, objective improvements occurred in motor function for one participant, in electrophysiologic motor-evoked potentials for another participant, in re-establishment of white matter continuity in three participants, in autonomic nerve function in seven participants, and in symptoms of cord central pain for seven participants. CONCLUSIONS: The postoperative recovery of paraplegic participants demonstrated the clinical feasibility and efficacy of vSCT in re-establishing the continuity of spinal nerve fibers. vSCT could provide the anatomic, morphologic, and histologic foundations to potentially restore the motor, sensory, and autonomic nervous functions in paraplegic patients. More future clinical trials are warranted.


Subject(s)
Neuroprotective Agents , Spinal Cord Injuries , Animals , Dogs , Evoked Potentials, Motor/physiology , Humans , Mice , Neuroprotective Agents/therapeutic use , Neurosurgical Procedures , Rats , Spinal Cord/diagnostic imaging , Spinal Cord/pathology , Spinal Cord/surgery , Spinal Cord Injuries/diagnostic imaging , Spinal Cord Injuries/pathology , Spinal Cord Injuries/surgery
8.
Front Neurosci ; 16: 808983, 2022.
Article in English | MEDLINE | ID: mdl-35237120

ABSTRACT

BACKGROUND: Spinal cord injury (SCI) can cause paralysis and serious chronic morbidity, and there is no effective treatment. Based on our previous experimental results of spinal cord fusion (SCF) in mice, rats, beagles, and monkeys, we developed a surgical protocol of SCF for paraplegic human patients. We designed a novel surgical procedure of SCF, called sural nerve transplantation (SNT), for human patients with lower thoracic SCI and distal cord dysfunction. METHODS: We conducted a clinical trial (ChiCTR2000030788) and performed SNT in 12 fully paraplegic patients due to SCI between T1 and T12. We assessed pre- and postoperative central nerve pain, motor function, sensory function, and autonomic nerve function. Conduction of action potentials across the sural nerve transplant was evaluated. Neural continuity was also examined by diffusion tensor imaging (DTI). RESULTS: Among the 12 paraplegic patients enrolled in this clinical trial, seven patients demonstrated improved autonomic nerve functions. Seven patients had clinically significant relief of their symptoms of cord central pain. One patient, however, developed postoperative cord central pain (VAS: 4). Five patients had varying degrees of recovered sensory and/or motor functions below the single neurologic level 1 month after surgery. One patient showed recovery of electrophysiologic, motor-evoked potentials 6 months after the operation. At 6 months after surgery, DTI indicated fusion and nerve connections of white cord and sural nerves in seven patients. CONCLUSION: SNT was able to fuse the axonal stumps of white cord and sural nerve and at least partially improve the cord central pain in most patients. Although SNT did not restore the spinal cord continuity in white matter in some patients, SNT could restore spinal cord continuity in the cortico-trunco-reticulo-propriospinal pathway, thereby restoring in part some motor and sensory functions. SNT may therefore be a safe, feasible, and effective method to treat paraplegic patients with SCI. Future clinical trials should be performed to optimize the type/technique of nerve transplantation, reduce surgical damage, and minimize postoperative scar formation and adhesion, to avoid postoperative cord central pain. CLINICAL TRIAL REGISTRATION: [http://www.chictr.org.cn/showproj.aspx?proj=50526], identifier [ChiCTR2000030788].

10.
Front Cell Infect Microbiol ; 11: 759435, 2021.
Article in English | MEDLINE | ID: mdl-34737978

ABSTRACT

Autism spectrum disorder (ASD) is a severe brain development disorder that is characterized by deficits in social communication and restricted, repetitive and stereotyped behaviors. Accumulating evidence has suggested that gut microbiota disorders play important roles in gastrointestinal symptoms and neurodevelopmental dysfunction in ASD patients. Manipulation of the gut microbiota by fecal microbiota transplantation (FMT) was recently shown to be a promising therapy for the treatment of various diseases. Here, we performed a clinical trial to evaluate the effect of FMT on gastrointestinal (GI) and ASD symptoms and gut microbiota alterations in children with ASD. We found that there was a large difference in baseline characteristics of behavior, GI symptoms, and gut microbiota between children with ASD and typically developing (TD) control children. FMT could improve GI symptoms and ASD symptoms without inducing any severe complications. Similarly, FMT significantly changed the serum levels of neurotransmitters. We further observed that FMT could promote the colonization of donor microbes and shift the bacterial community of children with ASD toward that of TD controls. The abundance of Eubacterium coprostanoligenes pre-FMT was positively correlated with high GSRS scores, whereas a decrease in Eubacterium coprostanoligenes abundance induced by FMT was associated with the FMT response. Our data suggest that FMT might be a promising therapeutic strategy to improve the GI and behavioral symptoms of patients with ASD, possibly due to its ability to alter gut microbiota and highlight a specific microbiota intervention that targets Eubacterium coprostanoligenes that can enhance the FMT response. This trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (trial registration number ChiCTR1800014745).


Subject(s)
Autism Spectrum Disorder , Autistic Disorder , Gastrointestinal Microbiome , Autism Spectrum Disorder/therapy , Child , Eubacterium , Fecal Microbiota Transplantation , Humans
11.
Front Immunol ; 12: 819405, 2021.
Article in English | MEDLINE | ID: mdl-35069604

ABSTRACT

Breast cancer (BC) is the most common malignancy among females. Chemotherapy drugs remain the cornerstone of treatment of BC and undergo significant shifts over the past 100 years. The advent of immunotherapy presents promising opportunities and constitutes a significant complementary to existing therapeutic strategies for BC. Chemotherapy as a cytotoxic treatment that targets proliferation malignant cells has recently been shown as an effective immune-stimulus in multiple ways. Chemotherapeutic drugs can cause the release of damage-associated molecular patterns (DAMPs) from dying tumor cells, which result in long-lasting antitumor immunity by the key process of immunogenic cell death (ICD). Furthermore, Off-target effects of chemotherapy on immune cell subsets mainly involve activation of immune effector cells including natural killer (NK) cells, dendritic cells (DCs), and cytotoxic T cells, and depletion of immunosuppressive cells including Treg cells, M2 macrophages and myeloid-derived suppressor cells (MDSCs). Current mini-review summarized recent large clinical trials regarding the combination of chemotherapy and immunotherapy in BC and addressed the molecular mechanisms of immunostimulatory properties of chemotherapy in BC. The purpose of our work was to explore the immune-stimulating effects of chemotherapy at the molecular level based on the evidence from clinical trials, which might be a rationale for combinations of chemotherapy and immunotherapy in BC.


Subject(s)
Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/immunology , Immunity/immunology , Immunomodulation/drug effects , Adaptive Immunity/drug effects , Alarmins/genetics , Alarmins/metabolism , Animals , Antigens, Neoplasm/immunology , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor , Clinical Trials as Topic , Disease Management , Disease Susceptibility , Female , Gene Expression Regulation/drug effects , Humans , Immune Checkpoint Proteins/genetics , Immune Checkpoint Proteins/metabolism , Immunity, Innate/drug effects , Treatment Outcome
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(3): 245-249, 2020 Mar 06.
Article in Chinese | MEDLINE | ID: mdl-32187930

ABSTRACT

The safety of prophylactic vaccine is one of the key points both in clinical trials and evaluation. Based on the review practice of vaccine registration clinical trials in recent years, we puts forward a series of thoughts and suggestions on the common problems of safety study on vaccine, including the hypothesis of safety study, the consideration of inclusion/exclusion criteria and suspension/termination criteria for study; the routine requirements of safety study and some special issue such as medical laboratory test index, vaccine virus shedding and safety of adjuvant, and further clarifies the requirements of safety observation on sequential enrollment; also emphasized the scientific judgment of causality and the quality of safety monitoring. It can be used for reference by vaccine researchers and to explore appropriate solutions to promote vaccine research & development and risk control in China.


Subject(s)
Clinical Trials as Topic , Research Design , Vaccines , China
13.
Clin Gastroenterol Hepatol ; 16(5): 715-721, 2018 05.
Article in English | MEDLINE | ID: mdl-29111136

ABSTRACT

BACKGROUND & AIMS: Biofeedback therapy is effective for dyssynergic defecation (DD), but it is not widely available or reimbursed, and is labor intensive. It is therefore important to select the appropriate patients for this treatment. We investigated symptoms and demographic, manometric, and other factors associated with outcomes of biofeedback therapy in patients with DD. METHODS: We performed a post hoc analysis of 2 prospective studies of biofeedback therapy in 127 adult outpatients (18-75 years old, 120 female) with chronic constipation who failed to respond to treatment with dietary fiber or laxatives (>1 year) and were diagnosed with DD based on standard criteria. In each study, patients received 1-hour, biweekly office biofeedback therapy (6 sessions) or home biofeedback therapy with a device. A therapist used visual feedback, postural, and diaphragmatic breathing techniques to teach subjects to improve defecation. Treatment success was defined by a composite of normalization of dyssynergia pattern and increase of 20 mm in baseline bowel satisfaction score. Factors were compared between the treatment success and failure groups. Intention-to-treat analysis was performed. RESULTS: Of the 127 patients enrolled, 77 (61%) had treatment success. Dyssynergia was corrected in 78% of patients and bowel satisfaction improved in 64% of patients. Baseline demographic features, constipation symptoms, manometric and sensory parameters, balloon expulsion time, and colonic transit results were similar between treatment failure and success groups. Patients with lower baseline bowel satisfaction score (P = .008) and patients who used digital maneuvers (P = .04) were more likely to have successful biofeedback therapy. CONCLUSIONS: Biofeedback therapy is successful in more than 60% of patients with DD. Patients who used digital maneuvers and patients with lower baseline levels of bowel satisfaction were more likely to have treatment success, whereas other factors were not associated with success. Biofeedback therapy should be offered to all patients with DD, irrespective of baseline symptoms or anorectal physiology findings.


Subject(s)
Ataxia/therapy , Biofeedback, Psychology/methods , Constipation/therapy , Defecation , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Treatment Outcome , Young Adult
14.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-733735

ABSTRACT

We analyzed the current dilemma of infectious disease training considering the current status of infectious disease, especially the new diagnosis and treatment mode of liver disease. Since the tra-ditional teaching mode could not meet the current teaching needs, we introduced case-based teaching and thus combined typical case discussions with theoretical lectures. Standardized patients were recruited and trained for students' inquiry and physical examination and standardized assessments about their perfor-mance were conducted. The design and follow up process of clinic trials were introduced to students. Teaching resources of other departments and infectious disease specialist hospitals were integrated to make up for the shortage of special infectious diseases. Multiple teaching modes were combined to improve the quality of clinical training for infectious diseases.

15.
Rev. habanera cienc. méd ; 15(5): 0-0, set.-oct. 2016. ilus, tab
Article in Spanish | LILACS | ID: biblio-845229

ABSTRACT

Introducción: La colonoscopía es la técnica de elección para el estudio de la enfermedad del colon y una opción terapéutica en ciertas patologías. La insuflación del colon habitualmente con aire ambiente durante su realización contribuye a que esta pueda ser una técnica dolorosa. La insuflación con dióxido de carbono (CO2) se ha asociado con menos dolor abdominal. Objetivo: Evaluar la eficacia y seguridad de la insuflación con CO2 durante la colonoscopía. Material y Métodos: Se realizó un ensayo clínico aleatorizado y controlado (Fase-IIb) a doble ciego. Universo: todos los pacientes con indicación de colonoscopía que cumplieron con los criterios de selección y acudieron en el período de octubre a diciembre de 2014 al Centro Nacional de Cirugía de Mínimo Acceso de La Habana. La muestra quedó conformada por un total de 100 pacientes mayores de 18 años de los cuales se les realizó a 50 la técnica de insuflación con aire y 50 con insuflación con CO2. Resultados: El dolor abdominal tras realizarse la colonoscopía fue significativamente menor en el grupo CO2. La hipoxemia y las dosis de propofol empleadas fueron similares en ambos grupos. Los valores de presión media de CO2 fueron mayores en el grupo CO2 durante el proceder pero dentro del rango normal sin complicaciones clínicas. Conclusiones: El uso de CO2 en la colonoscopía causa significativamente menos dolor en la primera hora. Su uso en pacientes con sedación profunda es seguro y la técnica no se ve modificada ni sus tiempos reducidos(AU)


Introduction: Colonoscopy is the technique of choice for the study of colon's disease and in certain pathologies a therapeutic option. Colon insufflation normally performed using ambient air which led this technique to be painful. Insufflation with carbon dioxide (CO2) causes less abdominal pain. Objective: To evaluate, the efficacy and safety of CO2 insufflation during colonoscopy. Material and Methods: A double-blind randomized controlled trial (Phase IIb) was performed. Universe: all patients with indication of colonoscopies that met the selection criteria and assist to the Minimal Access Surgery National Centre in Havana in the period from October to December 2014. The sample consisted of a total of 100 patients over 18 years of which 50 were subject to the air insufflation technique and 50 with CO2 insufflation. Results: Abdominal pain after colonoscopy was significantly lower in the group that received the CO2 insufflation. Hypoxemia and propofol doses used were similar in both groups. CO2 average pressure values were higher in the case of the CO2 group during the procedure but within the normal range; without clinical complications. Conclusions: The use of CO2 in colonoscopy causes significantly less pain in the first hour. Its use in patients with deep sedation is safe and the technique is not altered and doesn't have a time reduction(AU)


Subject(s)
Humans , Male , Female , Carbon Dioxide/therapeutic use , Colonoscopy/methods , Randomized Controlled Trial
16.
Rev. habanera cienc. méd ; 15(5): 0-0, set.-oct. 2016. ilus, tab
Article in Spanish | CUMED | ID: cum-68811

ABSTRACT

Introducción: La colonoscopía es la técnica de elección para el estudio de la enfermedad del colon y una opción terapéutica en ciertas patologías. La insuflación del colon habitualmente con aire ambiente durante su realización contribuye a que esta pueda ser una técnica dolorosa. La insuflación con dióxido de carbono (CO2) se ha asociado con menos dolor abdominal. Objetivo: Evaluar la eficacia y seguridad de la insuflación con CO2 durante la colonoscopía. Material y Métodos: Se realizó un ensayo clínico aleatorizado y controlado (Fase-IIb) a doble ciego. Universo: todos los pacientes con indicación de colonoscopía que cumplieron con los criterios de selección y acudieron en el período de octubre a diciembre de 2014 al Centro Nacional de Cirugía de Mínimo Acceso de La Habana. La muestra quedó conformada por un total de 100 pacientes mayores de 18 años de los cuales se les realizó a 50 la técnica de insuflación con aire y 50 con insuflación con CO2. Resultados: El dolor abdominal tras realizarse la colonoscopía fue significativamente menor en el grupo CO2. La hipoxemia y las dosis de propofol empleadas fueron similares en ambos grupos. Los valores de presión media de CO2 fueron mayores en el grupo CO2 durante el proceder pero dentro del rango normal sin complicaciones clínicas.Conclusiones: El uso de CO2 en la colonoscopía causa significativamente menos dolor en la primera hora. Su uso en pacientes con sedación profunda es seguro y la técnica no se ve modificada ni sus tiempos reducidos(AU)


Introduction: Colonoscopy is the technique of choice for the study of colons disease and in certain pathologies a therapeutic option. Colon insufflation normally performed using ambient air which led this technique to be painful. Insufflation with carbon dioxide (CO2) causes less abdominal pain. Objective: To evaluate, the efficacy and safety of CO2 insufflation during colonoscopy. Material and Methods: A double-blind randomized controlled trial (Phase IIb) was performed. Universe: all patients with indication of colonoscopies that met the selection criteria and assist to the Minimal Access Surgery National Centre in Havana in the period from October to December 2014. The sample consisted of a total of 100 patients over 18 years of which 50 were subject to the air insufflation technique and 50 with CO2 insufflation. Results: Abdominal pain after colonoscopy was significantly lower in the group that received the CO2 insufflation. Hypoxemia and propofol doses used were similar in both groups. CO2 average pressure values were higher in the case of the CO2 group during the procedure but within the normal range; without clinical complications. Conclusions: The use of CO2 in colonoscopy causes significantly less pain in the first hour. Its use in patients with deep sedation is safe and the technique is not altered and doesnt have a time reduction(AU)


Subject(s)
Humans , Colonoscopy/methods , Carbon Dioxide/therapeutic use , Insufflation/methods
17.
Article in French | AIM (Africa) | ID: biblio-1264261

ABSTRACT

Le sulfate de magnesium (MgSO4) previent et traite les manifestations neurologiques notamment les crises convulsives induites par les syndromes vasculo- renaux severes. L'objectif de notre etude etait d'evaluer son efficacite et sa tolerance.Nous avons mene une etude a la fois retrospective et prospective sur 30 mois a l'Hopital de la Mere et Enfant Lagune (HOMEL) de Cotonou chez 211 patientes souffrant de pre- eclampsie severe et d'eclampsie. Le sulfate de magnesium (MgSO4) etait utilisee a la dose d'attaque de 4g d'une concentration a 20par voie intra- veineuse lente (IVL) sur une duree de 15 a 20 mn associee a 10g intra- musculaire (IM) d'une concentration a 50(repartis pour 5g dans chaque muscle fessier) ; la dose d'entretien etait de 5g a 50IM (2;5g dans chaque muscle fessier) toutes les 4 heures. La surveillance des reflexes osteo- tendineux; de la frequence respiratoire et de la diurese etait assuree toutes les heures.760 cas etaient colliges sur 17.753 accouchements(4;28) dont 211cas traites par le MgSO4 ( 74 et 134 cas respectivement de pre- eclampsie severe et d'eclampsie; soit 1;27et 3;01des accouchements) ; l'age moyen des patientes etait de 24;74 ans. Les pressions arterielles systolique(PAS) et diastolique(PAD) etaient respectivement de 160 et compris entre 110- 120 mm Hg dans 91;94 et 86des cas; accompagnees notamment de crises convulsives(65) et de coma(12). L'efficacite du MgSO4 etait nette des la 24eme heure a la seule dose d'attaque avec amendement des convulsions dans 53;68des cas sans recidives. Le pronostic neonatal etait satisfaisant ; la morbidite maternelle etait amelioree et la letalite de 0;94etait tres en deca du taux (8;05) rapporte a l'HOMEL de Cotonou en 2001 avant l'utilisation du MgSO4


Subject(s)
Humans , Benin , Clinical Trial , Eclampsia , Magnesium Sulfate/therapeutic use , Pre-Eclampsia
18.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-562827

ABSTRACT

0.05).Conclusion: Lamiophlomis rotata capsule showed the similar curative effect and safety as Radix Notoginseng capsule did on dysmenorrhea.

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