Tag: pubmed

J Endourol. 2022 Nov 18. doi: 10.1089/end.2022.0386. Online ahead of print.

ABSTRACT

PURPOSE: Ureteral stenting following uncomplicated ureteroscopy is common practice. Several studies have proven the safety of omitting routine stent placement following distal ureteral stone treatment. However, there is a paucity of data regarding the utility of stent placement for proximal ureteroscopy. We designed a prospective, randomized controlled trial to evaluate the role of ureteral stent placement following ureteroscopy for proximal ureteral and renal stones.

METHODS: Seventy-two patients with proximal ureteral or renal stones measuring up to 1.5cm were prospectively randomized into stented (37) or unstented (35) groups. The surgeon was blinded to the treatment group until after stone treatment. Patients tracked postoperative pain medications and completed validated pain questionnaires on postoperative days 0, 3, 7 and 28. Stents were removed on postoperative day 7. Postoperative follow up imaging was obtained at four weeks.

RESULTS: No statistical differences between the two groups in terms of demographics or stone characteristics. Operative time was longer in the stented group (p<0.03). Patients in the stented group had more irritative urinary symptoms (p <.0001) and pain (p<.0001), lower quality of life scores (p<0.001) and used more narcotics (p<.0005) during the first week but no differences at 30 days. Emergency room visits and overall complication rates were similar between the two groups. 3 nonstented patients required stent placement. 2 stented patients required early stent removal. Urinary tract infections developed in 3 stented but in no unstented patients. Postoperative imaging did not reveal any hydronephrosis in either group and the total stone free rate (SFR) was 94%.

CONCLUSION: For the majority of uncomplicated ureteroscopic treatment of proximal ureteral and kidney stones, it may be safe to omit ureteral stents in order to potentially decrease urinary symptoms and pain while improving short-term quality of life. Further studies with larger patient cohorts may be warranted to confirm our results.

PMID:36401514 | DOI:10.1089/end.2022.0386

J Endourol. 2022 Nov 18. doi: 10.1089/end.2022.0234. Online ahead of print.

ABSTRACT

AIM: To conduct a comparative, non-randomised study to assess the feasibility of mini-Endoscopic combined Intra Renal Surgery(ECIRS) using supine Mini-Percutaneous nephrolithotomy (PCNL) access (16 Fr) in Galdakao Modified Supine Valdivia(GMSV) position for managing proximal large volume impacted ureteral calculi as ambulatory day-care surgery vis-a-vis standalone ureteroscopy with push-back PCNL, if needed. The primary aim was to study the outcomes and stone-free rates. Secondary aim was to compare the intra-operative and short-term post-operative complications.

MATERIALS AND METHODS: Data of sixty patients undergoing ECIRS(Group 1) from January 2016 to December 2019 were collected prospectively in a non-randomized fashion from a single centre after ethics committee approval. A matched-paired analysis was performed with retrospectively collated data of 60 patients undergoing standard ureteroscopy / pushback PCNL(Group 2) using analysis of variance, Fisher’s exact test, and Chi-square test. P < 0.05 was considered statistically significant.

OUTCOMES AND RESULTS: GROUP 1 patients had a significantly shorter procedure time vs GROUP 2 (42.1 ± 11.2 minutes vs 52.1 ± 13.7 minutes, p <0.001). GROUP 1 (59/60) patients had an overall single-stage (SFR) of 98.3% which was significantly higher than single-stage SFR of 83% in GROUP 2 (50/60) (p<0.002). GROUP 2 patients had a higher incidence of fever (10 vs 4, p=0.01). However, there were no cases of sepsis in either group. Rest of the complications were comparable for both the need for ancillary procedures was significantly higher in GROUP 2 (10% vs 1.7%, p<0.001). Patients were discharged on same day in both groups.

CONCLUSIONS: The findings of our study suggest that, in large and impacted proximal ureteric stones, combined minimally-invasive endoscopic approach offers the best option to render the patient stone-free by a single intervention. With better intra- and post-operative outcomes and safety profile, Mini-ECIRS may be considered as an ambulatory procedure in this setting.

PMID:36401507 | DOI:10.1089/end.2022.0234

AIDS Res Hum Retroviruses. 2022 Nov 18. doi: 10.1089/AID.2022.0086. Online ahead of print.

ABSTRACT

In the era of combination antiretroviral therapy (ART), people living with HIV (PLHIV) still face an increased risk of cardiovascular disease (CVD). Tenofovir alafenamide fumarate (TAF) is superior to its precursor tenofovir disoproxil fumarate (TDF) regarding bone and renal toxicity, but there are concerns about a negative effect on lipid profile. This observational, single-center study investigates the effects on lipid profile and cardiovascular (CVD) risk of the switch from TDF to TAF, in combination with FTC/EVG/c, in patients with no exposure to other antiretrovirals. Routine laboratory measurements, somatometric characteristics and smoking status were analyzed for the assessment of CVD risk changes, using D:A:D and ATP III scores pre- and post-switch. A total of 62 patients with a mean age of 32.9 years were included in this study. 61 (98.4%) were males, 38 (61.3%) late presenters and 39 (62.9%) active smokers. A year after the switch, there was a significant increase in total cholesterol (178±38 to 194±40 mg/dL, p<0.001), HDL (45±12 to 48±13 mg/dL, p=0.001), LDL (117±32 to 137±36 mg/dL, p<0.001). Mean increase of the 10-year D:A:D score was 1.13% (95% CI 1.05-1.22, p=0,002). Changes were more prominent in non-smokers. Body mass index and average weight showed an upward trend. Switching from TDF to TAF caused significant changes in lipid profile at 14 months of follow-up, in young, otherwise healthy PLHIV. CVD risk, as measured by D:A:D, showed a statistically significant increase, but more data are needed to determine clinical significance. These results point towards a patient-centered approach when selecting an ART regimen.

PMID:36401506 | DOI:10.1089/AID.2022.0086

Medicine (Baltimore). 2022 Nov 18;101(46):e31450. doi: 10.1097/MD.0000000000031450.

ABSTRACT

BACKGROUND: Some patients develop long-term symptoms after Corona virus disease 2019 (COVID-19), and chronic fatigue syndrome (CFS) is one of the main symptoms. CFS is characterized by fatigue lasting for more than 6 months accompanied by sleep disorders, anxiety, and depression, which causes a certain degree of harm to both physiological and psychological aspects of the individual. Traditional Chinese exercises (TCEs) are an ancient Chinese therapy and has recently been reported to be effective for CFS. Therefore, we will conduct a systematic review and meta-analysis aiming to accurately evaluate the efficacy of TCEs on post-COVID-19 CFS and provide an alternative treatment for post-COVID-19 CFS.

METHODS: Seven databases (PubMed, Ovid Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Wanfang) will be searched from establishment to August 2022, and we will only include randomized controlled trials of TCEs for post-COVID-19 CFS. Two reviews will independently include the research according to the inclusion and exclusion criteria. Review Manager 5.2 software will be used to analyze the accepted literature, and the relative risk ratio (RR) and 95% confidence interval (CI) will be used as effect indicators for the outcome indicator dichotomous variables. For continuous variables, weighted mean difference (MD) and 95% CI will be used as effect indicators. The heterogeneity test will be assessed using the I2 statistic and Q statistic. The PEDro scale was used to evaluate the methodological quality of the included studies. Subgroup analysis was performed according to different TCEs, age, gender, and duration of CFS.

RESULTS: This systematic review and meta-analysis will evaluate the efficacy of TCEs in post-COVID-19 CFS.

CONCLUSION: The results of this study will provide reliable evidence for the effects of TCEs for post-COVID-19 CFS on patients’ fatigue, anxiety, depression, sleep, and quality of life.

PMID:36401484 | DOI:10.1097/MD.0000000000031450

Medicine (Baltimore). 2022 Nov 18;101(46):e31406. doi: 10.1097/MD.0000000000031406.

ABSTRACT

Advances in the biology of Ewing sarcoma, which continues to be an important cause of mortality, have caused an increase in information in the literature related to the underlying molecular base of the disease and discussions of new treatment approaches. In this study, we aimed to comprehensively analyze the published scientific articles on Ewing sarcoma. The Web of Science database was used to obtain and statistically analysis articles on Ewing sarcoma that were published between 1980 and 2021. Maps of network visualization were used to reveal trending topics, global collaborations, and the most effective studies. Correlation analysis was performed using Spearman’s correlation coefficient. A total of 3236 articles were analyzed. The first 3 countries that contributed the most to the literature and cooperated most intensively were USA (1194, 36.8%), Germany (293, 9%), Italy (254, 7.8%). Pediatric Blood & Cancer (n = 122), Cancer (87), Journal of Pediatric Hematology Oncology (71) were among the top 3 journals with the most articles. The most active author was Piero Picci (n = 94). High-income countries have a great effect on the literature on this subject. The most studied trend topics in recent years were pediatric oncology, EWS RNA Binding Protein 1 (EWSR1), EWSR1-FL1, epigenetics, bioinformatics, microRNA, gene expression, metastasis, migration, biomarker, immunotherapy, survival, outcomes, surveillance epidemiology and end results (SEER), nomogram, temozolomide, irinotecan, and drug resistance. Genetic studies, metastasis, immunotherapy, life analyses/nomogram based on new data obtained from SEER, and chemotherapy with irinotecan and temozolomide combination, were seen to be the topics researched in recent years.

PMID:36401481 | DOI:10.1097/MD.0000000000031406

Medicine (Baltimore). 2022 Nov 18;101(46):e31218. doi: 10.1097/MD.0000000000031218.

ABSTRACT

INTRODUCTION: Orofacial pain and tensional cephalea were symptoms commonly reported in COVID-19 patients, even after recovery, and were considered chronic pain in these cases. The aim of this research is to evaluate the effect of the application of photobiomodulation with red and infrared lasers applied locally and systemically.

METHODS AND ANALYSIS: For this purpose, individuals who have been diagnosed with COVID-19 and have had a tension headache and/or orofacial pain for more than 3 months will be selected by convenience. The participants will be divided into two different groups: G1-photobiomodulation with red and infrared laser with local application on the pain points (808 nm and 660 nm, 100 mW, 6 J per point) and G2-photobiomodulation with red laser with transcutaneous application on the radial artery (660 nm, 100 mW, 30 minutes). All participants will be treated for a period of 4 weeks, with 8 application sessions. The effects will be measured by means of blood lactate level, Brief Pain Inventory, Visual Analog Scale (VAS), and Cephalea Impact Test. The data will be collected weekly before and after the treatment, and the following tests will be applied: Analysis of variance (ANOVA), Tukey paired t test, Kruskal-Wallis, or Wilcoxon, according to data distribution. α = 0.05 will be considered as the level of statistical significance.

ETHICS AND DISSEMINATION: This study was approved by the Research Projects Committee of the Nove de Julho University (approval number 4.673.963). Results will be disseminated through peer-reviewed journals and events for the scientific and clinical community, and the general public. It is registered in the ClinicalTrials.gov database with the number NCT05430776.

PMID:36401476 | DOI:10.1097/MD.0000000000031218

Medicine (Baltimore). 2022 Nov 18;101(46):e31636. doi: 10.1097/MD.0000000000031636.

ABSTRACT

BACKGROUND: Cough variant asthma (CVA), also called concealed asthma or allergic asthma, is the most common cause of chronic cough in children. The disorder is mainly characterized by a nonproductive dry cough associated with a high recurrence rate that is conventionally treated with antibiotics, anti-inflammatory medications, cough suppressants, or expectorants. For millennia, Chinese herbal medicine (CHM) has been used widely in China to treat pediatric CVA cases, although high-quality evidence of CHM efficacy is lacking. In this study, the effectiveness and safety of Xiehuangjiejing (XHJJ) granule will be evaluated when used alone to treat children with CVA.

METHODS AND ANALYSIS: A randomized, double-blind, parallel, placebo-controlled multicenter trial will be conducted over the course of 2 weeks. A total of 180 CVA patients of ages between 4 and 7 years old will be randomly assigned to the experimental group (XHJJ granules, 4.5 g administered 3 times daily) or control group (matched placebo, 4.5 g administered 3 times daily) in a 2:1 ratio based on subject number per group, respectively. The trial will consist of a 7-day medical interventional stage and a 7-day follow-up stage. On day 7 of the follow-up stage, an evaluation of all subjects will be carried out to assess cough symptom score as the primary outcome and several secondary outcomes, including TCM (traditional Chinese medicine) syndrome score, lung function, and dosage of salbutamol aerosol inhaler therapy. Safety assessments will also be evaluated during the trial.

DISCUSSION: The aim of this study was to examine the effectiveness and safety of Xiehuangjiejing (XHJJ) granule using a trial protocol designed to yield high-quality, statistically robust results for use in evaluating CHM as a treatment for CVA in children.

PMID:36401471 | DOI:10.1097/MD.0000000000031636

Medicine (Baltimore). 2022 Nov 18;101(46):e31473. doi: 10.1097/MD.0000000000031473.

ABSTRACT

BACKGROUND: Influenza is a common disease. If it is not treated in time, it may induce related chronic respiratory diseases and seriously endanger people’s health. Porridge, as a food of the East, has been recorded by doctors of all ages to treat influenza with porridge. However, due to insufficient research, there is a certain controversy about porridge in the treatment of influenza. We therefore plan to conduct a systematic review and meta-analysis to collect data from all published studies on this issue in order to obtain reliable evidence.

METHOD AND ANALYSIS: We will search for relevant trials in various databases published by December 2022. To study the efficacy and safety of a RCT of porridge in the treatment of influenza. Standardized data tables will be used to complete data search and extraction in duplicate. All differences will be resolved by consensus. The main result was to observe the symptom score of influenza patients, and the secondary results included body temperature, nasal secretions, nasal resistance and viral culture titers in the nasal secretions. Data synthesis and statistical analysis will be performed for each outcome with Stata V.14.0.

RESULTS: Our study will be a systematic review and meta-analysis to evaluate the efficacy and safety of porridge in the treatment of influenza.

CONCLUSION: The conclusion of this study has a certain reference value for the clinical use of porridge in the treatment of influenza.

PMID:36401469 | DOI:10.1097/MD.0000000000031473

Medicine (Baltimore). 2022 Nov 18;101(46):e31818. doi: 10.1097/MD.0000000000031818.

ABSTRACT

BACKGROUND: The effects of dexmedetomidine on the circulatory system are complex. It is difficult to predict its effects on intrapulmonary shunts and hypoxic pulmonary vasoconstriction in patients with one-lung ventilation. This study aimed to investigate the effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane during one-lung ventilation.

METHODS: Forty patients requiring thoracoscopic lobectomy were randomly divided into the dexmedetomidine group (Group D, n = 20) and the normal saline group (Group N, n = 20). The arterial partial pressure of oxygen (PaO2), pulmonary shunt fraction (Qs/Qt), mean end-tidal sevoflurane concentration, mean arterial pressure, and heart rate were compared between the 2 groups at 3 time points: (i) after 5 minutes of two-lung ventilation (T0), (ii) after 30 minutes of one-lung ventilation (OLV) (T1), and (iii) after 45 minutes of OLV (T2). The dosage of sevoflurane from the beginning of OLV to T2 was calculated.

RESULTS: There were no significant differences in age, body mass index, and FEV1/FVC between Groups D and N (P > .05). At T0, T1, and T2, the PaO2 levels of Group D and Group N were similar (P > .05), and the PaO2 levels of Group D and Group N decreased after OLV. The Qs/Qt level of Groups D and N were similar at T0 (P > .05), and the level of Groups D and N at T1 and T2 was higher than that at T0. The Qs/Qt of Group D was statistically significantly lower than that of Group N at T1 and T2 (P < .05).

CONCLUSION: Compared with the control group, we found that dexmedetomidine can reduce the intrapulmonary shunt fraction and improve the body’s status during OLV.

PMID:36401465 | DOI:10.1097/MD.0000000000031818

Medicine (Baltimore). 2022 Nov 18;101(46):e28397. doi: 10.1097/MD.0000000000031519.

ABSTRACT

BACKGROUND: The use of lung ultrasound for the diagnosis of pulmonary atelectasis remains controversial. Therefore, we performed a protocol for systematic review and meta-analysis to evaluate the diagnostic accuracy of lung ultrasound for the diagnosis of pulmonary atelectasis both in adults and pediatrics.

METHODS: A comprehensive search of several databases from 1966 to October 2022 will be conducted. The databases include Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and PubMed. After screening and diluting out the articles that met inclusion criteria to be used for statistical analysis, the pooled evaluation indexes including sensitivity and specificity as well as hierarchical summary receiver operating characteristic curves with 95% confidence interval were calculated. All statistical analyses were calculated with STATA, version 12.0 (StataCorp, College Station, TX).

RESULT: We will synthesize the current studies to evaluate the diagnostic accuracy of lung ultrasound for the diagnosis of pulmonary atelectasis.

CONCLUSION: The result of this review will provide more reliable references to help clinicians make decisions for the diagnosis of pulmonary atelectasis.

PMID:36401459 | DOI:10.1097/MD.0000000000031519