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The effect of COVID-19 on pain control in patients with a neurostimulator in situ- a retrospective study

Acta Neurochir (Wien). 2024 Apr 11;166(1):175. doi: 10.1007/s00701-024-06014-0.

ABSTRACT

BACKGROUND: De-novo chronic neuropathic pain following COVID-19 is widely recognised. However, there are currently no published studies investigating the effect of SARS-CoV-2 infection on patients with pre-existing neuropathic pain who have required spinal cord stimulator (SCS) implantation. Here, the authors aimed to analyse outcomes in their institution’s patients who had spinal cord stimulator (SCS) implantation or revision procedures to the system over a 5-year period. Specifically, the short-term and long-term outcomes of patients who contracted COVID-19 during the follow-up period were compared to the control group of patients who did not.

METHOD: Patients included in this study had spinal cord stimulator implantation (de-novo and revision procedures) between 1 January 2017 and 31 January 2022, for neuropathic pain of any aetiology. Patients deemed eligible for the study were invited to participate in a telephone survey through which clinical outcome data were collected. Pain scores were assessed with a modified form of the Brief Pain Inventory (BPI).

RESULTS: Of 91 patients, 48 (52.7%) had contracted COVID-19 by the time of the survey. Patients who contracted COVID-19 had significantly worse BPI scores in the ‘Least pain’ domain following their infection and at time of the survey, when compared to their score 6 months after the operation. 22.9% (n = 11) of the patients who contracted COVID-19 experienced a change in their symptoms following their infection. Within this sub-group, there was a statistically significant deterioration in BPI scores in 10/11 domains following their infection and in 2/11 domains at time of the survey. Worsening severity of COVID-19 symptoms was not associated with worse BPI scores.

CONCLUSIONS: Infection with SARS-CoV-2, in a significant proportion of patients with an SCS in situ, causes at least a transient deterioration in pain control. Further prospective multicentre studies are indicated to establish the prevalence of this phenomenon.

PMID:38602610 | DOI:10.1007/s00701-024-06014-0

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Comparative analysis of metacyclogenesis and infection curves in different discrete typing units of Trypanosoma cruzi

Parasitol Res. 2024 Apr 11;123(4):181. doi: 10.1007/s00436-024-08183-4.

ABSTRACT

Chagas disease (CD), caused by the complex life cycle parasite Trypanosoma cruzi, is a global health concern and impacts millions globally. T. cruzi’s genetic variability is categorized into discrete typing units (DTUs). Despite their widespread presence in the Americas, a comprehensive understanding of their impact on CD is lacking. This study aims to analyze life cycle traits across life cycle stages, unraveling DTU dynamics. Metacyclogenesis curves were generated, inducing nutritional stress in epimastigotes of five DTUs (TcI (MG), TcI (DA), TcII(Y), TcIII, TcIV, and TcVI), resulting in metacyclic trypomastigotes. Infection dynamics in Vero cells from various DTUs were evaluated, exploring factors like amastigotes per cell, cell-derived trypomastigotes, and infection percentage. Statistical analyses, including ANOVA tests, identified significant differences. Varying onset times for metacyclogenesis converged on the 7th day. TcI (MG) exhibited the highest metacyclogenesis potential. TcI (DA) stood out, infecting 80% of cells within 24 h. TcI demonstrated the highest potential in both metacyclogenesis and infection among the strains assessed. Intra-DTU diversity was evident among TcI strains, contributing to a comprehensive understanding of Trypanosoma cruzi dynamics and genetic diversity.

PMID:38602595 | DOI:10.1007/s00436-024-08183-4

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Piroplasmid Infections Among Domestic Dogs in the Mountain City of Rio de Janeiro, Brazil

Acta Parasitol. 2024 Apr 11. doi: 10.1007/s11686-024-00843-w. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the present study was to analyze the frequency of the piroplasmids in blood from dogs and ticks recovered from these animals in Teresópolis city, located in the mountain region of Rio de Janeiro state, Brazil. In addition to the clinical and hematological profile.

METHODS: A total of 400 dogs attended in a veterinary clinic in this city between 2020 and 2021 were included. The blood was collected from the dogs, along with ticks and information on these dogs was obtained through a questionnaire applied to the owners. Thin-smear analyses and complete blood counts were performed. All forms characteristic of piroplasmids were measured and classified morphologically. The blood was also subjected to PCR assays based on the genes 18S rRNA and hsp70. In addition, the ixodid ticks were classified morphologically and subjected to PCR for piroplasmids research. The amplified products were sent for gene sequencing.

RESULTS: Piroplasmids were detected in 2.3% of the dogs. The variables statistically associated with infections in these animals were hemorrhage/bleeding, jaundice, anisocytosis, activated monocytes and macroplatelets (p ≤ 0.05). Piriform, ring-shaped, oval and aberrant structures were viewed in erythrocytes, neutrophils and monocytes, with lengths greater than and less than 2.5 µm. The nine positive samples from these dogs were characterized as due to Rangelia vitalii. However, one sequence from B. vogeli was detected in a single adult specimen of R. sanguineus.

CONCLUSION: Although circulation of two species of piroplasmids potentially infective for domestic dogs has been observed in the mountain city of Rio de Janeiro, infection due to R. vitalii was mostly seen in the dogs of the present study.

PMID:38602588 | DOI:10.1007/s11686-024-00843-w

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The effect of ginger (Zingiber officinale L.) liquid extract on growth, immune response, antioxidant defence mechanism, and general health of Holstein calves

Trop Anim Health Prod. 2024 Apr 11;56(3):119. doi: 10.1007/s11250-024-03972-6.

ABSTRACT

This study was carried out to examine the effects of ginger liquid extract (GLE) on the growth, immune response, antioxidative defence mechanism, and general health of Holstein calves. Sixteen calves (4-d old) were included in the experiment and randomly assigned to groups, and they were fed whole milk containing GLE at a rate of 0, 0.50, 0.72, and 1% of the milk amount consumed. Calves consuming 1% GLE were weaned at an earlier age and gained better body weight (BW) compared to the other groups. The group fed with 0.50% GLE consumed less daily starter than the other groups. The administration of GLE resulted in a non-significant decrease in fecal score (FS), the number of days with diarrhea (DDN), and illness (IDN) among the calves. Notably, the 1% GLE exhibited a significant inhibitory effect on the growth of E. coli, while its effect on the growth of other pathogenic bacteria was not statistically significant. Despite the non-significant reduction in malondialdehyde (MDA), total oxidative status (TOS), and oxidative stress index (OSI) values, the 1% GLE demonstrated support for antioxidative defence mechanism and immune response. The results indicated that 1% GLE can be effective in promoting the health of calves by enhancing their immune response and antioxidant capacity. This suggests that incorporating 1% GLE into their overall well-being, potentially leading to improved health outcomes and performance in calf rearing operations.

PMID:38602560 | DOI:10.1007/s11250-024-03972-6

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Comparative Analysis of Low-Dose Bupivacaine and Ropivacaine Combined with Spinal-epidural Anesthesia in Cesarean Sections for Pregnant Women with Coexisting Mental Illness

Int J Neurosci. 2024 Apr 11:1-10. doi: 10.1080/00207454.2024.2342980. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the application effects of low-dose bupivacaine and ropivacaine combined with epidural anesthesia.

METHODS: The primary outcome measure was the anesthesia effect, assessed by the excellent anesthesia rate. Secondary outcomes included the occurrence of adverse reactions, blood pressure, and serum prolactin levels at different time points. The anesthesia effect, serum prolactin levels, occurrence of adverse reactions, and MAP at various time points [before anesthesia (T0), 5 minutes after anesthesia (T1), at the start of surgery (T2), at delivery of the fetus (T3), and at closure of the abdomen (T4)] were compared between the two groups.

RESULTS: ① Anesthesia effect: The excellent anesthesia rate was 71.88% in the control group and 93.94% in the observation group, with a significantly higher rate in the observation group than in the control group (P = 0.017). ② Serum prolactin levels: The serum prolactin levels in both groups increased significantly after surgery compared to before surgery (P < 0.001); however, there was no statistically significant difference in serum prolactin levels between the two groups before and after surgery (P = 0.651). ③ Occurrence of adverse reactions: The occurrence rate of adverse reactions was 28.13% in the control group and 9.09% in the observation group, with a significantly lower rate in the observation group than in the control group (P = 0.048).

CONCLUSION: In cesarean sections for pregnant women with coexisting mental illness, low-dose ropivacaine demonstrates significantly better anesthesia efficacy, blood pressure stability, and anesthesia safety compared to low-dose bupivacaine. Both low-dose bupivacaine and ropivacaine result in increased prolactin levels postpartum.

PMID:38602557 | DOI:10.1080/00207454.2024.2342980

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Beyond expectations: safinamide’s unprecedented neuroprotective impact on acute spinal cord injury

Eur J Trauma Emerg Surg. 2024 Apr 11. doi: 10.1007/s00068-024-02513-y. Online ahead of print.

ABSTRACT

BACKGROUND: Traumatic spinal cord injury (SCI) is the most common preventable cause of morbidity. Despite rapid advances in medicine, effective pharmacological treatment against SCI has not yet been confirmed. This study aimed to investigate the possible anti-inflammatory, antiapoptotic, and neuroprotective effects of safinamide after SCI in a rat model.

METHODS: A total of 40 male Wistar albino rats were randomly divided into four groups. Group 1 underwent only laminectomy. Group 2 underwent SCI after laminectomy. In group 3, SCI was performed after laminectomy, and immediately afterward, intraperitoneal physiological saline solution was administered. In group 4, SCI was performed after laminectomy, and 90 mg/kg of safinamide was given intraperitoneally immediately afterward. Moderate spinal cord damage was induced at the level of thoracic vertebra nine (T9). Neuromotor function tests were performed and levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β) were measured. In both serum and spinal cord tissue, immunohistochemistry and histopathology studies were also conducted.

RESULTS: TNF-α, IL-1β, and IL-6 levels were found to be significantly increased in group 2 and group 3. In group 4, these levels were statistically significantly decreased. Group 4 also exhibited significant improvement in neuromotor function tests compared to the other groups. Histopathologically, it was found that group 4 showed significantly reduced inflammation and apoptosis compared to the other groups.

CONCLUSION: This study revealed that safinamide has neuroprotective effects against SCI due to its anti-inflammatory, antiapoptotic, and antioxidant activities.

PMID:38602541 | DOI:10.1007/s00068-024-02513-y

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Anterolateral versus anteromedial plate osteosynthesis of midshaft humeral fractures; is there a difference in the rates of iatrogenic radial nerve palsy?

Eur J Trauma Emerg Surg. 2024 Apr 11. doi: 10.1007/s00068-024-02525-8. Online ahead of print.

ABSTRACT

PURPOSE: The anterolateral (AL) and anteromedial (AM) surfaces of the humerus are typically used for plate placement during plate osteosynthesis of midshaft humeral fractures via the anterolateral approach. The purpose of this study was to determine if a significant difference exists in the rates of iatrogenic radial nerve palsy (IRNP) following either AL or AM humeral fracture plating. The research question is stated as follows: is anteromedial plating of humeral fractures associated with lower rates of IRNP when compared with anterolateral plating?

METHODS: This multicenter prospective randomized study was undertaken following ethical review and approval with eligible patients who had midshaft humeral fractures or nonunions randomized into 2 groups, viz AL plate osteosynthesis group and AM plate osteosynthesis group. Following diagnostic and preoperative evaluation, patients had open plate osteosynthesis through the anterolateral approach with plate placement according to their study groups. Post-operatively, they were assessed for IRNP while obtained data was analyzed with SPSS version 23 and inter-group differences with P values less than 0.05 were considered statistically significant.

RESULTS: Eighty-five eligible patients participated in the study with 43 patients in Group A (AL plate osteosynthesis group) and 42 patients in Group B (AM plate osteosynthesis group). The observed inter-group differences with regard to gender distribution, mean age and clinical diagnosis; acute fracture (AF) versus nonunion were not statistically significant. Furthermore, four (9.3%) patients amongst the 43 patients in Group A (AL plate osteosynthesis group) developed IRNP while two (4.8%) patients amongst the 42 patients in Group B (AM plate osteosynthesis group) had IRNP. The inter-group difference with regard to rates of IRNP was not statistically significant (P = 0.694).

CONCLUSION: This study found that (in contrast to previous studies) there was no significant difference in the rates of IRNP following either open anterolateral or anteromedial plate osteosynthesis of midshaft humeral fractures through the anterolateral approach. Orthopaedic surgeons should therefore remain cautious when obtaining consent for surgery as well as when performing internal fixation of midshaft humeral fractures to limit medicolegal disputes that may arise from IRNP.

PMID:38602540 | DOI:10.1007/s00068-024-02525-8

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Dynamic compaction of cohesive granular materials: scaling behavior and bonding structures

Soft Matter. 2024 Apr 11. doi: 10.1039/d3sm01116j. Online ahead of print.

ABSTRACT

The compaction of cohesive granular materials is a common operation in powder-based manufacture of many products. However, the influence of particle-scale parameters such as bond strength on the packing structure and the general scaling of the compaction process are still poorly understood. We use particle dynamics simulations to analyze jammed configurations obtained by dynamic compaction of sticky particles under a fixed compressive pressure for a broad range of system parameter values. We show that relative porosity, representing the relative importance of porosity with respect to its minimum and maximum values, is a unique function of a modified cohesion number that combines adhesion force, confining pressure, and particle size, as well as contact stiffness, which is often assumed to be ineffective but is shown here to play an essential role in compaction. An asymmetric sigmoidal form based on two power laws provides an excellent fit to the data. The statistical properties of the bond network reveal self-balanced force structures and an exponential fall-off of the number of both tensile and compressive forces. Remarkably, the properties of the bond network depend on the cohesion number rather than the modified cohesion number, implying that similar bond network characteristics are compatible with a broad range of porosities mainly due to the effect of contact stiffness. We also discuss the origins of data points escaping the general scaling of porosity and show that they reflect either finite system size or rigid confining walls.

PMID:38602178 | DOI:10.1039/d3sm01116j

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Hematological Trends in Severe Burn Patients: A Comprehensive Study for Prognosis and Clinical Insights

J Burn Care Res. 2024 Apr 11:irae057. doi: 10.1093/jbcr/irae057. Online ahead of print.

ABSTRACT

Severe burn injuries pose diagnostic challenges, contributing to increased fatality rates with delayed diagnoses. This study aims to identify early risk factors and understand their impact on clinical outcomes by examining hematological dynamics in severe burn cases. The focus includes age-related patterns, Total Body Surface Area (TBSA) affected by burns, hospital stay duration, and changes in hematological markers during burn injuries. An analytical cross-sectional study at the Burn Care Centre involved 135 participants hospitalized between January 2018 and December 2021. Demographic data and hematological markers were recorded, with statistical analysis using IBM SPSS 25.0. Non-survivors exhibited a greater mean TBSA, shorter hospital stay, and an enhanced early immune response indicated by WBC count on the first day. Hematological markers, including HGB, RCC, and PLT, showed dynamic patterns over the study period. Marginal variations in platelet counts and intriguing patterns in RCC suggested potential consequences like disseminated intravascular coagulation. The study provides crucial insights into hematological responses to severe burn injuries. Early identification of risk factors, particularly age-related patterns and immune responses, informs clinicians about predicting outcomes and guiding therapeutic interventions. Despite limitations, this work underscores the need for further multi-center research to comprehensively understand the complex relationships between burn injuries, hematological responses, and clinical outcomes.

PMID:38602154 | DOI:10.1093/jbcr/irae057

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Prophylactic ureteric catheterisation during complex gynaecological surgery: A systematic review and meta-analysis

BJOG. 2024 Apr 11. doi: 10.1111/1471-0528.17823. Online ahead of print.

ABSTRACT

BACKGROUND: There is a lack of robust evidence to recommend the use of perioperative ureteric catheterisation or stenting in complex gynaecological surgery.

OBJECTIVES: To evaluate the evidence on the benefits and risks of perioperative ureteric catheterisation or stenting in complex gynaecological surgery.

SEARCH STRATEGY: A literature search was performed in CINAHL, the Cochrane Library, Embase and MEDLINE, from 1946 to January 2024, using a combination of keywords and Medical Subject Headings (MeSH) terminology.

SELECTION CRITERIA: Randomised controlled trials (RCTs) and observational studies were included.

DATA COLLECTION AND ANALYSIS: Meta-analysis of the RCTs and observational studies were performed separately. Cochrane RevMan 6.5.1 was used to undertake meta-analysis. Risk ratios with 95% CIs were calculated for the outcome measures.

MAIN RESULTS: Ten studies were included: three RCTs and seven observational studies, comprising 8661 patients. The three RCTs, comprising a total of 3277 patients, showed no difference in the risk of immediate complications in the form of ureteric injury between the ureteric stent and the control groups (RR 0.9, 95% CI 0.49-1.65). The observational studies included 5384 patients. Four studies that explored the ureteric injury as an outcome did not show any difference between the two groups (RR 0.76, 95% CI 0.27-2.16). One case-control study with 862 participants found that the rate of ureteric injury was higher in the non-stented group, although this was observed in only three patients. The risk of urinary tract infection (UTI) was increased in the stent group, although not with statistical significance (RR 1.84, 95% CI 0.47-7.17). There was no significant difference in the risk of ureteric fistulae (RR 1.91, 95% CI 0.62-5.83), although the number of studies was limited.

CONCLUSIONS: Prophylactic ureteric catheterisation or stenting for complex gynaecological surgery is not associated with a lower risk of ureteric injury.

PMID:38602151 | DOI:10.1111/1471-0528.17823