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1.
N Engl J Med ; 390(23): 2178-2190, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38899695

RESUMO

BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by autoantibody-mediated platelet destruction. Treatment with CM313, a novel anti-CD38 monoclonal antibody, can result in targeted clearance of CD38-positive cells, including plasma cells. METHODS: We conducted a phase 1-2, open-label study to evaluate the safety and efficacy of CM313 in adult patients with ITP. CM313 was administered intravenously at a dose of 16 mg per kilogram of body weight every week for 8 weeks, followed by a 16-week follow-up period. The primary outcomes were adverse events and documentation of two or more consecutive platelet counts of at least 50×109 per liter within 8 weeks after the first dose of CM313. The status of peripheral-blood immune cells in patients and changes in the mononuclear phagocytic system in passive mouse models of ITP receiving anti-CD38 therapy were monitored. RESULTS: Of the 22 patients included in the study, 21 (95%) had two consecutive platelet counts of at least 50×109 per liter during the treatment period, with a median cumulative response duration of 23 weeks (interquartile range, 17 to 24). The median time to the first platelet count of at least 50×109 per liter was 1 week (range, 1 to 3). The most common adverse events that occurred during the study were infusion-related reaction (in 32% of the patients) and upper respiratory tract infection (in 32%). After CD38-targeted therapy, the percentage of CD56dimCD16+ natural killer cells, the expression of CD32b on monocytes in peripheral blood, and the number of macrophages in the spleen of the passive mouse models of ITP all decreased. CONCLUSIONS: In this study, anti-CD38 targeted therapy rapidly boosted platelet levels by inhibiting antibody-dependent cell-mediated cytotoxicity on platelets, maintained long-term efficacy by clearing plasma cells, and was associated with mainly low-grade toxic effects. (Funded by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences and others; ClinicalTrials.gov number, NCT05694767).


Assuntos
ADP-Ribosil Ciclase 1 , Anticorpos Monoclonais , Púrpura Trombocitopênica Idiopática , Humanos , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Feminino , Pessoa de Meia-Idade , Animais , Camundongos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais/efeitos adversos , Masculino , ADP-Ribosil Ciclase 1/antagonistas & inibidores , Idoso , Adulto , Contagem de Plaquetas
2.
Signal Transduct Target Ther ; 9(1): 102, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38653983

RESUMO

Patients with refractory immune thrombocytopenia (ITP) frequently encounter substantial bleeding risks and demonstrate limited responsiveness to existing therapies. Umbilical cord-derived mesenchymal stem cells (UC-MSCs) present a promising alternative, capitalizing on their low immunogenicity and potent immunomodulatory effects for treating diverse autoimmune disorders. This prospective phase I trial enrolled eighteen eligible patients to explore the safety and efficacy of UC-MSCs in treating refractory ITP. The research design included administering UC-MSCs at escalating doses of 0.5 × 106 cells/kg, 1.0 × 106 cells/kg, and 2.0 × 106 cells/kg weekly for four consecutive weeks across three cohorts during the dose-escalation phase, followed by a dose of 2.0 × 106 cells/kg weekly for the dose-expansion phase. Adverse events, platelet counts, and changes in peripheral blood immunity were monitored and recorded throughout the administration and follow-up period. Ultimately, 12 (with an addition of three patients in the 2.0 × 106 cells/kg group due to dose-limiting toxicity) and six patients were enrolled in the dose-escalation and dose-expansion phase, respectively. Thirteen patients (13/18, 72.2%) experienced one or more treatment emergent adverse events. Serious adverse events occurred in four patients (4/18, 22.2%), including gastrointestinal hemorrhage (2/4), profuse menstruation (1/4), and acute myocardial infarction (1/4). The response rates were 41.7% in the dose-escalation phase (5/12, two received 1.0 × 106 cells/kg per week, and three received 2.0 × 106 cells/kg per week) and 50.0% (3/6) in the dose-expansion phase. The overall response rate was 44.4% (8/18) among all enrolled patients. To sum up, UC-MSCs are effective and well tolerated in treating refractory ITP (ClinicalTrials.gov ID: NCT04014166).


Assuntos
Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Púrpura Trombocitopênica Idiopática , Humanos , Feminino , Masculino , Púrpura Trombocitopênica Idiopática/terapia , Púrpura Trombocitopênica Idiopática/imunologia , Pessoa de Meia-Idade , Adulto , Transplante de Células-Tronco Mesenquimais/efeitos adversos , Células-Tronco Mesenquimais/imunologia , Cordão Umbilical/citologia , Estudos Prospectivos , Idoso
4.
Sci Rep ; 14(1): 9898, 2024 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-38688967

RESUMO

The clinical significance of the combination of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) is unclear. This study investigated the predictive value of pretreatment NLR (pre-NLR) combined with pretreatment PLR (pre-PLR) for the survival and prognosis of nasopharyngeal carcinoma (NPC). A total of 765 patients with non-metastatic NPC from two hospitals were retrospectively analyzed. The pre-NLR-PLR groups were as follows: HRG, high pre-NLR and high pre-PLR. MRG, high pre-NLR and low pre-PLR or low pre-NLR and high pre-PLR. LRG, neither high pre-NLR nor high pre-PLR. Receiver operating characteristic (ROC) curves were used to identify the cutoff-value and discriminant performance of the model. We compared survival rates and factors affecting the prognosis among different groups. The 5-year overall survival (OS), local regional recurrence-free survival (LRRFS) and distant metastasis-free survival (DMFS) of NPC patients in HRG were significantly poorer than those in MRG and LRG. The pre-NLR-PLR score was positively correlated with T stage, clinical stage, ECOG, and pathological classification. Multivariate cox regression analysis showed that pre-NLR-PLR scoring system, ECOG, pre-ALB, pre-CRP and pre-LMR were independent risk factors affecting 5-year OS, LRRFS and DMFS. The ROC curve showed that area under the curve (AUC) values of pre-NLR-PLR of 5-year OS, LRRFS and DMFS were higher than those of pre-NLR and pre-PLR. pre-NLR-PLR is an independent risk factor for the prognosis of NPC. The pre-NLR-PLR scoring system can be used as an individualized clinical assessment tool to predict the prognosis of patients with non-metastatic NPC more accurately and easily.


Assuntos
Plaquetas , Linfócitos , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Neutrófilos , Humanos , Masculino , Feminino , Neutrófilos/patologia , Estudos Retrospectivos , Pessoa de Meia-Idade , Prognóstico , Carcinoma Nasofaríngeo/mortalidade , Carcinoma Nasofaríngeo/sangue , Carcinoma Nasofaríngeo/patologia , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/mortalidade , Neoplasias Nasofaríngeas/sangue , Linfócitos/patologia , Plaquetas/patologia , Adulto , Idoso , Curva ROC , Contagem de Plaquetas , Contagem de Linfócitos , Carcinoma/sangue , Carcinoma/mortalidade , Carcinoma/patologia , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-38607329

RESUMO

OBJECTIVE: To investigate the effects of barbed and conventional sutures on reproductive outcomes and ovarian reserve after laparoscopic treatment for benign non-endometrioma ovarian cysts. METHODS: This retrospective study was conducted at an affiliated women's hospital between May 2017 and December 2019. Patients with benign non-endometriotic ovarian cysts undergoing laparoscopic cystectomy were included. RESULTS: Patients received barbed sutures (221 patients) or conventional smooth sutures (203 patients) intraoperatively. The two groups had comparable baseline characteristics. The surgical duration and ovarian suturing time were significantly shorter in the barbed suture group than in the conventional smooth suture group (P < 0.001 and P = 0.002, respectively). The rate of postoperative hemoglobin decline and serum anti-Müllerian hormone decline were similar between the two groups (P > 0.05). A total of 316 (74.53%) patients experienced at least one pregnancy postoperatively: 170 (76.92%) and 146 (71.92%) patients in the barbed suture and conventional smooth suture groups, respectively (χ2 = 1.395, P = 0.238). Multivariate Poisson regression demonstrated that barbed sutures had no significant effect on the overall postoperative pregnancy rate (adjusted incidence rate ratio, 1.10; 95% confidence interval, 0.93-1.36; P = 0.382). CONCLUSION: In patients with benign non-endometriotic ovarian cysts undergoing laparoscopic ovarian cystectomy, barbed sutures had a reproductive outcome similar to that of conventional smooth sutures while providing higher surgical efficiency without adverse effects on the postoperative ovarian reserve. Barbed sutures are probably a viable option to conventional smooth sutures.

7.
Br J Haematol ; 204(6): 2418-2428, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38513635

RESUMO

This study aimed to identify key proteomic analytes correlated with response to splenectomy in primary immune thrombocytopenia (ITP). Thirty-four patients were retrospectively collected in the training cohort and 26 were prospectively enrolled as validation cohort. Bone marrow biopsy samples of all participants were collected prior to the splenectomy. A total of 12 modules of proteins were identified by weighted gene co-expression network analysis (WGCNA) method in the developed cohort. The tan module positively correlated with megakaryocyte counts before splenectomy (r = 0.38, p = 0.027), and time to peak platelet level after splenectomy (r = 0.47, p = 0.005). The blue module significantly correlated with response to splenectomy (r = 0.37, p = 0.0031). KEGG pathways analysis found that the PI3K-Akt signalling pathway was predominantly enriched in the tan module, while ribosomal and spliceosome pathways were enriched in the blue module. Machine learning algorithm identified the optimal combination of biomarkers from the blue module in the training cohort, and importantly, cofilin-1 (CFL1) was independently confirmed in the validation cohort. The C-index of CFL1 was >0.7 in both cohorts. Our results highlight the use of bone marrow proteomics analysis for deriving key analytes that predict the response to splenectomy, warranting further exploration of plasma proteomics in this patient population.


Assuntos
Aprendizado de Máquina , Proteômica , Púrpura Trombocitopênica Idiopática , Esplenectomia , Humanos , Masculino , Feminino , Proteômica/métodos , Púrpura Trombocitopênica Idiopática/cirurgia , Púrpura Trombocitopênica Idiopática/sangue , Púrpura Trombocitopênica Idiopática/genética , Adulto , Pessoa de Meia-Idade , Biomarcadores/sangue , Idoso , Estudos Retrospectivos
9.
Eur Geriatr Med ; 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38446408

RESUMO

PURPOSE: To investigate the changes in pain, physical and activities of daily living (ADL) functioning in vulnerable older adults with chronic pain after proactive primary care intervention. METHODS: This study was embedded in a prospective, pragmatic, matched-control multicenter trial at 19 primary care practices in Sweden, with proactive medical and social care (Intervention Group, IG, n = 134) in comparison with usual care (Control Group, CG, n = 121). Patients with chronic pain, defined as pain experienced longer than 3 months, were included in this subgroup analysis. Data on pain aspects, physical and ADL functioning were collected in the questionnaires at baseline, one- and two-year follow-up (FU-1 and FU-2). Data on prescribed pain medications was collected by local health authorities. RESULTS: Mean age was 83.0 ± 4.7 years with almost equal representation of both genders. From baseline until FU-2, there were no significant within-group or between-group changes in pain intensity. Small adjustments of pain medication prescriptions were made in both groups. Compared to FU-1, the functional changes were more measurable at FU-2 as fewer participants had impaired physical functioning in IG (48.4%) in comparison to CG (62.6%, p = 0.027, Effect Size φ = 0.14). Higher scores of ADL-staircase (more dependent) were found in both groups (p < 0.01, Effect Size r = 0.24 in CG and r = 0.16 in IG). CONCLUSION: Vulnerable older adults with chronic pain seemed to remain physical and ADL functioning after proactive primary care intervention, but they may need tailored strategies of pain management to improve therapeutic effects. TRIAL REGISTRATION: ClinicalTrials.gov 170608, ID: NCT03180606.

10.
Res Pract Thromb Haemost ; 8(1): 102318, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38433975

RESUMO

Background: Acquired hemophilia A (AHA) is a rare hemorrhagic disorder caused by factor (F)VIII inhibitors. The diagnosis and management of AHA remains challenging because of its rarity and heterogeneity. Objectives: To analyze the characteristics of AHA to enhance our understanding of this disease and identify effective treatment strategies. To analyze the characteristics of AHA to enhance our understanding of this disease and identify effective treatment strategies. Methods: Clinical features of 165 patients with AHA from a single center between July 1997 and December 2021 were retrospectively analyzed. Results: The median age of patients at diagnosis was 45 years. The median time to diagnosis was 30 days. All 165 patients experienced bleeding, with a median bleeding score (BS) of 4 (range, 2-12). Hemostatic therapy was administered to 129 (78.2%) patients. Bleeding control was achieved in 80.0% of patients who received prothrombin complex concentrate and in 92.3% of patients who were treated with recombinant activated FVII. Of the 163 patients who received immunosuppressive therapy, 80 (49.1%) received rituximab-based therapy with a 93.3% complete remission (CR) rate, 50 (30.7%) received steroids plus cyclophosphamide with an 85.0% CR rate, and 22 (13.5%) received steroids alone with an 82.4% CR rate. Six cases relapsed after a median duration of 330 days. Immunosuppressive therapy-related adverse events were reported in 17 patients. Seven deaths were recorded. FVIII inhibitor titer of ≥15 BU/mL and BS of ≥6 were identified as significantly poor prognostic factors for CR. Conclusion: Immunosuppressive therapies yield remarkably high response rates, with a CR rate exceeding 80%; notably, the regimen containing rituximab exhibits a CR rate of approximately 90%. FVIII inhibitor titer of ≥5 BU/mL and BS of ≥6 were poor predictors of CR in patients with AHA.

11.
Sci Rep ; 14(1): 4705, 2024 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-38409442

RESUMO

Healthcare professionals often meet pain patients with a poor nutritional status such as obesity, unhealthy dietary behaviors, and a suboptimal dietary intake. A poor nutritional status may play a significant role in the occurrence, development, and prognosis of chronic pain. This study investigated eating habits in a specialized pain rehabilitation center using data (N = 2152) from the Swedish quality registry for pain rehabilitation during the period 2016-2021. Patients answered a lifestyle questionnaire regarding their eating habits and desire to modify their lifestyle. The mean (SD) patient age was 46.1 (14.6) years, with 24.8% classified as obese. Suboptimal eating habits included irregular mealtimes (27.2%), weekly consumption of fast-food (20.3%) and nearly daily consumption of confectionery (33.3%). Approximately 20% (n = 426) reported a desire to eat healthier. Frequent confectionery intake (Odds ratio [OR] 1.23, 95% Confidence Interval (CI) 1.04-1.47) and fast-food consumption (OR 1.58, 95% CI 1.24-2.02) increased the likelihood to desire healthier eating. Younger patients (18-29 years), those classified as obese, and those with more extended spatial pain were more likely to express a desire to eat healthier. Eating habits should be addressed in pain management and interdisciplinary pain rehabilitation teams are encouraged to provide nutritional care tailored to the patient's needs.


Assuntos
Dor Crônica , Humanos , Pessoa de Meia-Idade , Obesidade/epidemiologia , Dieta , Comportamento Alimentar , Ingestão de Alimentos
12.
J Appl Lab Med ; 9(1): 14-27, 2024 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-38167775

RESUMO

BACKGROUND: The Karius Test (KT), a cell-free DNA metagenomic next-generation sequencing assay, has potential to improve diagnostic evaluation of infectious diseases. Published data describing clinical impact of positive KT results are limited. We attempt to elucidate the clinical interpretation and impact of positive KT results based on types and patterns of detected pathogens and patient characteristics. METHODS: All positive KT results from a single institution in 2022 were screened. Patients with results that met predefined categories were included for review by a panel of 3 infectious diseases physicians and one clinical microbiologist. Predefined categories included reports with fungal, parasitic, notable bacterial, notable viral pathogens, or polybacterial results (≥3 bacteria). Polybacterial results were further classified into patterns of microbiome detected. Clinical impact and its correlation with result or patient characteristics were explored. RESULTS: Ninety-two patients met the inclusion criteria, most were immunocompromised (73%). Positive KT results that met predefined categories had the following clinical impact: positive in 30.4%, negative in 2.2%, and none in 65.2%. Polybacterial results, especially interpreted as oral flora had lowest clinical impact (7.1% and 0.0%, respectively), while detection of parasites or notable bacterial pathogens had the highest clinical impact (100% and 77.8%, respectively). There was no correlation between patient characteristics and clinical impact. CONCLUSIONS: Among a cohort of largely immunocompromised patients, we were able to demonstrate clinical impact of specific KT result types and patterns but did not find correlation between patient characteristics and clinical impact. Our results should be confirmed in future larger cohorts.


Assuntos
Ácidos Nucleicos Livres , Doenças Transmissíveis , Humanos , Estudos Retrospectivos , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/genética , Bactérias/genética , Metagenoma
13.
Dalton Trans ; 53(7): 3267-3279, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38258333

RESUMO

A series of La3(1-x)Ga5MO14:xSm3+ (M = Si or Ge) orange-red phosphors with high color purity, low correlated color temperature, and good thermal stability were successfully synthesized via a high-temperature solid-phase technique. The phase structure and morphology of La3Ga5SiO14(LGSi):xSm3+ and La3Ga5GeO14(LGGe):xSm3+ were investigated. Sm3+-doped LGSi and LGGe phosphors emitted orange-red light under an excitation of 403 nm, and the optimal doping concentrations were 3 mol% and 2 mol% with excellent color purities of 98.46% and 98.25%, respectively. The concentration quenching mechanism of both the samples was dominated by dipole-dipole interaction, and the effect of Si4+ and Ge4+ on luminescence performance was discussed. The internal quantum efficiencies of LGSi:0.03Sm3+ and LGGe:0.02Sm3+ were calculated to be 27.14% and 56.07%, respectively. The CIE and CCT values indicated that the luminescence of the prepared phosphors was in the orange-red region. Additionally, a white light-emitting diode (w-LED) was fabricated with LGGe:0.02Sm3+ phosphors, which was capable of emitting bright and warm white light and exhibiting a high color rendering index (CRI) of 87.17 and an appropriate correlated color temperature (CCT) of 6108 K. These results indicated that the prepared phosphors with excellent luminescent performances have potential application in indoor illumination.

15.
Radiother Oncol ; 191: 110027, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38008418

RESUMO

BACKGROUND AND PURPOSE: To examine the feasibility of level Ib-sparing intensity-modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC) who had high-risk factors classified based on the International Guideline (IG). MATERIALS AND METHODS: We evaluated 961 non-metastatic NPC cases based on IG recommendations for prophylactic Ib irradiation. Four high-risk factors were used to categorise patients into three cohorts: A, B, and C. Propensity score matching was used to balance baseline characteristics in Cohort C, resulting in a matched Cohort C. Recurrence rates at level Ib and regional relapse-free survival (RRFS) rates were evaluated. RESULTS: Among patients with negative Ib lymph nodes (LNs), 18, 54, 420, and 444 exhibited involvement of structures that drain to level Ib as the first echelon (FES), involvement of the submandibular gland (SMG), level II LNs with radiologic extranodal extension (rENE), and level II nodes with a maximal axial diameter (MAD) ≥ 2 cm, respectively. The recurrence rate was highest in Cohort A (11.1 %). Cohort B had no level Ib recurrence. In matched Cohort C, recurrence rates were low in both groups (Ib-sparing group: 0.6 % vs. Ib-covering group: 0.6 %, P > 0.999). No significant differences were observed in 5-year RRFS rates between the two groups in cohort A (p = 0.208), cohort B (p = 0.905), and matched cohort C (p = 0.423). CONCLUSIONS: Level Ib-sparing IMRT could be performed safely for NPC patients with level II LNs who had rENE and/or MAD ≥ 2 cm. Further research should determine the necessity of level Ib prophylactic irradiation for patients with FES or SMG involvement.


Assuntos
Neoplasias Nasofaríngeas , Radioterapia de Intensidade Modulada , Humanos , Carcinoma Nasofaríngeo/radioterapia , Radioterapia de Intensidade Modulada/métodos , Neoplasias Nasofaríngeas/patologia , Estudos de Viabilidade , Metástase Linfática , Recidiva Local de Neoplasia/prevenção & controle , Recidiva Local de Neoplasia/patologia , Fatores de Risco , Estudos Retrospectivos
16.
Am J Hematol ; 99(1): 28-37, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37851608

RESUMO

Acquired hemophilia A (AHA) is a rare but serious bleeding disorder. Randomized controlled trial (RCT) comparing the efficacy of immunosuppression therapy for AHA lacks. We conducted the first multicenter RCT aiming to establish whether the single-dose rituximab combination regimen was noninferior to the cyclophosphamide combination regimen. From 2017 to 2022, 63 patients with newly diagnosed AHA from five centers were randomly assigned 1:1 to receive glucocorticoid (methylprednisolone 0.8 mg/kg per day for the first 3 weeks and then tapered) plus single-dose rituximab (375 mg/m2 ; n = 31) or plus cyclophosphamide (2 mg/kg per day until inhibitor becomes negative, for a maximum of 5 weeks; n = 32). The primary outcome was complete remission (CR, defined as FVIII activity ≥50 IU/dL, FVIII inhibitor undetectable, immunosuppression tapered and no bleeding for 24 h without bypassing agents) rate measured within 8 weeks. The noninferiority margin was an absolute difference of 20%. Twenty-four (77.4%) patients in the rituximab group and 22 (68.8%) patients in the cyclophosphamide group achieved CR, which showed the noninferiority of the single-dose rituximab-based regimen (absolute difference = -8.67%, lower limit of the 95% confidence interval = -13.11%; Pnoninferiority = 0.005). No difference was found in the incidence of treatment-related adverse events. Single-dose rituximab plus glucocorticoid regimen showed similar efficacy and safety, without a reported risk of secondary malignancies or reproductive toxicity seen in cyclophosphamide, it might be recommended as a first-line therapy for AHA, especially in China where there is a young age trend in AHA patients. This trial was registered at ClinicalTrials.gov as #NCT03384277.


Assuntos
Glucocorticoides , Hemofilia A , Humanos , Ciclofosfamida/uso terapêutico , Glucocorticoides/uso terapêutico , Hemofilia A/tratamento farmacológico , Metilprednisolona/uso terapêutico , Rituximab/uso terapêutico , Resultado do Tratamento , Quimioterapia Combinada/efeitos adversos
17.
Cureus ; 15(12): e50279, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38089941

RESUMO

Purpose The objective of this study was to investigate whether cryotherapy is effective in reducing pain, opioid consumption, and length of stay (LOS) in hospital following total knee arthroplasty (TKA). Methods This prospective cohort study included 191 consecutive patients who underwent TKA without having access to cryotherapy, followed by 193 consecutive patients who underwent TKA and received automated cryotherapy as part of the recovery phase. All patients had their surgical procedures performed by the same surgeons and received post-operative care by the same nursing, medical, and physiotherapy team. The pain score using the visual analog scale (VAS)and the amount of opioid used on the first three post-operative days were recorded along with the length of hospital stay. Results There was no difference in baseline characteristics between the two groups. The use of cryotherapy was associated with a reduced pain score on all three days compared to when cryotherapy was not used: Day 1 pain score was 5.2 versus 6.1 (p < 0.01), Day 2 was 3.6 versus 4.8 (p = 0.03), and Day 3 was 2.8 versus 3.8 (p < 0.01). Cryotherapy was also associated with a significant reduction in analgesia consumption on all three days. The median amount of Oramorph used on all three days in the cryotherapy group was 15.0 mg compared to 40.0 mg in the control arm (p < 0.01). Additionally, the LOS was shorter in the cryotherapy group, with a mean of 3.86 days versus 4.20 days in the control group (p = 0.02). Conclusion The use of cryotherapy following TKA was associated with decreased pain and opioid consumption along with a reduced time to hospital discharge compared to when no cryotherapy was used.

18.
Insects ; 14(11)2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-37999052

RESUMO

The aphid, Aphis gossypii Glover, is identified as a significant pest that causes severe damage to goji berries in China. To analyze the ladybird consumption of aphids, the functional responses of three ladybird species, Harmonia axyridis, Coccinella septempunctata, and Hippodamia variegata, and intraspecific competition among ladybird individuals were evaluated under laboratory conditions. Moreover, the practical impact of ladybirds on aphid population reduction was investigated in semi-field conditions. We found that all adult ladybirds of the three species exhibited a type II functional response toward aphids. According to Holling's disc equation, H. axyridis exhibited the highest searching efficiency (a = 0.79), while C. septempunctata had the shortest handling time (Th = 5.07 min) among the three ladybird species studied. Additionally, intraspecific competition had a greater impact on H. variegata (m = 0.41) compared to the other two ladybird species. The semi-field study demonstrated that H. axyridis (83.9% reduction) and C. septempunctata (78.7% reduction) exhibited higher efficacy in reducing aphid populations compared to H. variegata (27.3% reduction). This study suggests that H. axyridis and C. septempunctata exhibit potential as effective biological control agents against aphids on goji berry plants and highlights the importance of considering intraspecific competition. However, the results obtained from laboratory and semi-field studies cannot be directly extrapolated to field conditions due to the simplification of these experimental systems. Future field studies are crucial in ensuring the effective implementation of a biological control program.

19.
BMC Musculoskelet Disord ; 24(1): 840, 2023 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-37880642

RESUMO

BACKGROUND: Despite the existing evidence regarding the interrelated relationship between pain and obesity, knowledge about patients' perspectives of this relationship is scarce, especially from patients with chronic pain and obesity after completing Interdisciplinary Pain Rehabilitation Program (IPRP). AIMS: This qualitative study expands the understanding of patients' perspectives on how chronic pain and obesity influence each other and how the two conditions affect the ability to make lifestyle changes. METHOD: A purposive sample of patients with Body Mass Index (BMI) ≥ 30 kg/m2 and who had completed an IPRP were recruited for individual semi-structured interviews. The transcribed interviews were analysed using latent content analysis and a pattern of theme and categories was constructed based on the participants' perspectives. RESULTS: Sixteen patients (aged 28-63 years, 11 female, BMI 30-43 kg/m2) shared their experiences of chronic pain, obesity and lifestyle changes after IPRP. The analysis revealed one overall theme (lifestyle changes are burdensome with a body broken by both pain and obesity) and four categories (pain disturbing days and nights worsens weight control, pain-related stress makes lifestyle changes harder, a painful and obese body intertwined with negative emotions and the overlooked impact of obesity on chronic pain). Most participants perceived that their pain negatively impacted their obesity, but they were uncertain whether their obesity negatively impacted their pain. Nevertheless, the participants desired and struggled to make lifestyle changes. CONCLUSION: After IPRP, patients with chronic pain and obesity perceived difficulties with self-management and struggles with lifestyle changes. They experienced a combined burden of the two conditions. Their perspective on the unilateral relationship between pain and obesity differed from the existing evidence. Future tailored IPRPs should integrate nutritional interventions and address the knowledge gaps as well.


Assuntos
Dor Crônica , Humanos , Feminino , Obesidade/complicações , Estilo de Vida , Índice de Massa Corporal , Manejo da Dor , Pesquisa Qualitativa
20.
Dalton Trans ; 52(41): 14917-14927, 2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37796033

RESUMO

The development of photocatalysis is hindered, in part, by the quick recombination of photogenerated carriers and the instability of light sources. In this study, the problem of too-fast electron-hole pair compounding in photocatalysis is effectively regulated by the polarization field of pyroelectric materials using the pyroelectric method. Self-polarized pyroelectric materials that depend on temperature variations can generate usable electrical energy and polarized charge carriers to degrade organic pollutants. Pb(Mg1/3Nb2/3)O3-PbTiO3 (PMN-PT) is a relaxor ferroelectric material with spontaneous polarization characteristics. The PMN-0.30PT:1 mol%Sm3+ catalyst was prepared by applying the high-temperature solid-state reaction method. Under the dark condition and nine cold-hot cycles of 23 °C-68 °C, using H2O2-assisted PMN-0.30PT:1 mol%Sm3+ as a catalyst, the degradation rate of rhodamine 6G (10 mg L-1) was 94.3 ± 2.5%. In addition, the degradation rates of 88.52% and 64.32% were obtained for rhodamine B (10 mg L-1) and methylene blue (10 mg L-1), respectively. This study provides a new approach to the pyroelectric catalytic degradation of organic pollutants.

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