7-day Group Research Articles

Development of a Quantitative Colour-Based Software Method to Evaluate the Effectiveness of Active Antioxidant Packaging on Fresh Sliced Mushrooms

A software-based procedure consisting of colour measurement of mushrooms was developed for assessing the effectiveness of a new antioxidant active packaging. As active agents, sodium metabisulphite combined with citric acid, green tea extract combined with α-tocopherol and purple carrot extract were evaluated. After obtaining the image of mushrooms with a conventional flatbed scanner, a MATLAB code was specially designed to obtain and compare histograms. Then, data were processed using principal component analysis (66% of the accumulated variance explained) and a successful classification of samples according to their age and antioxidant system was obtained. The developed procedure greatly exceeded the discrimination capabilities of other commonly used methods such as CIE L*a*b* (which was unable to find any significant difference between blank and antioxidant-treated mushrooms; L*blank = 70 ± 3; L*metabisulphite = 75 ± 5; L*green tea = 75 ± 5; L*carrot = 69 ± 5) and visual panel (where only sodium metabisulphite sample was perceived to be significantly different from the rest of the samples, with 27 positive votes out of 50). The developed method classified correctly up to 90% of blank samples according to their age. Besides, 100% and 70% of the mushrooms treated with sodium metabisulphite and green tea, respectively, were found to be fresher than their corresponding blanks. Among samples with sodium metabisulphite, 33% behaved as one-day blank samples, and 67% acted as 4-day blank samples, while among samples with green tea, 10% were found in the 1-day group, and 60% were found in the 4-day group. In contrast, purple carrot proved to be inefficient as an antioxidant. Thus, the difference between blank mushroom samples and those treated with antioxidants was objectively measured.

The cure rate of 10-day bismuth-containing quadruple therapy for Helicobacter pylori eradication is equivalent to 14-day: a systematic review and meta-analysis.

Helicobacter pylori (H. pylori) infection is a major cause of duodenal ulcers, gastric ulcers, and gastric cancer. However, the optimal duration for H. pylori eradication therapy remains controversial. Most studies have mainly focused on triple therapy, and there is insufficient research on bismuth-containing quadruple therapy. The aim of this study was to compare the clinical effect of the 10-day bismuth-containing quadruple treatment regimen with the 14-day regime in eradicating H. pylori. We searched PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials published in English until May 2022 according to the eligibility criteria. Summary risk ratios (RRs) and 95% confidence intervals (CIs) for eradication rates, adverse effects, and compliance were calculated for included studies. Four studies, involving 1173 patients, were eligible for inclusion. The eradication rate was similar in the 10-day treatment group and the 14-day treatment group in the intention-to-treat analysis (RR 0.97, 95% CI 0.93 to 1.01). Meanwhile, the incidence of adverse effects was lower in patients who received 10days of treatment than in those who received 14days of treatment and patients' compliance was almost the same between two groups. Compared to the 14-day bismuth-containing quadruple regimens, 10-day regimens had similar efficacy and lower incidence of adverse effects. Therefore, the 10-day regimen is safe and well-tolerated and should be recommended for H. pylori infection.

895. Comparing Antibiotic Durations in Acute Appendicitis After Source Control

Abstract Background Community-acquired acute appendicitis is a common intra-abdominal infection that often requires surgical intervention and antibiotics. Despite guideline recommendations for narrow-spectrum regimens and shorter durations, broad-spectrum agents are frequently used for extended durations in community-acquired cases of appendicitis. Methods We conducted a retrospective chart review of 95 adult patients admitted to a community hospital in rural northern Michigan with acute appendicitis with or without perforation who underwent source control and received at least 72 hours of antibiotics after source control. Patients were assigned to a short course group (4-7 days) or a long course group (≥ 8 days). Total antibiotics is the sum of the inpatient duration and outpatient duration after source control. The primary outcome was hospital readmission within 30 days of discharge due to complications related to appendectomy or antibiotic failure. Secondary outcomes included hospital mortality, surgical site infection within 30 days, additional source control needed during initial stay, number of patients receiving piperacillin-tazobactam, and proportion of patients who received guideline concordant duration of therapy. Baseline characteristics between treatment groups Results The primary outcome was met in 1/32 patients (3.13%) from the 4–7 day group and 4/63patients (6.35%) in the ≥8-day group (P = 0.66). There were no cases of mortality. Surgical site infection occurred in 1/63 patients (1.6%) in the ≥8-day group (P = 1). Additional source control was needed in 1/32 patients (3.13%) from the 4-7 day group and 3/63 patients (4.76%) in the ≥ 8 day group (P = 1). Piperacillin-tazobactam was prescribed to 21/32 patients (65.6%) in the 4-7-day group and 42/63 patients (67%) in the ≥ 8day group (P =0.91) Piperacillin-tazobactam was appropriately used in 1/21 patient (4.76%) in the 4-7 day group and 6/42 patients (9.5%) in the ≥ 8 day group (P = 0.41). Outcomes Results of the primary outcome and the piperacillin/tazobactam based secondary outcomes Treatment Duration Between Groups Comparison of total treatment duration between groups with inpatient and outpatient averages Total Antibiotic Duration Frequency Distribution of total antibiotic days of patients analyzed in this study Conclusion In patients with community-acquired acute appendicitis with or without perforation who had undergone adequate source control, outcomes were similar between a 4-7 day course of antibiotics and ≥ 8 day course. Piperacillin-tazobactam was often prescribed for community-acquired appendicitis cases despite guideline recommendations. Disclosures All Authors: No reported disclosures.

Hepatopancreas immune response during different photoperiods in the Chinese mitten crab, Eriocheir sinensis

Photoperiod plays an important role in the growth, development, and metabolism of crustaceans. The growth and reproduction of crabs are closely related to the photoperiod. The hepatopancreas is an important source of innate immune molecules; however, hepatopancreatic patterns of gene expression depending on the photoperiod—which may underlie changes in immune mechanisms—remain unknown. To study the molecular basis of immune regulation in the Chinese mitten crab (Eriocheir sinensis) under different light conditions, a new generation of high-throughput Illumina sequencing technology was used, and functional genes associated with immune function in the hepatopancreas of this crab were explored via assembly of high-quality sequences, gene annotation, and classification. A total of 383,899,798 clean reads from the hepatopancreas of the normal group (12 h/12 h L:D), 387,936,676 clean reads from the continuous light group (24 h/0 h L:D), and 384,872,734 clean reads from the continuous darkness group (0 h/24 h L:D) were obtained. Compared with the normal group, 141, 152, 60, 87, 90, and 101 differentially expressed genes were identified in the groups exposed to continuous light for 2 days, continuous darkness for 2 days, continuous light for 4 days, continuous darkness for 4 days, continuous light for 6 days, and continuous darkness for 6 days, respectively. The results of this study revealed that under continuous light and dark conditions, the crabs were most affected by light on day 2, but the interference gradually decreased with time. We suggest that long-term light or dark treatment makes crabs adaptable to fluctuations in the photoperiod. The expression of genes associated with immune response patterns was found to change during different photoperiods. Prophenoloxidase (proPO) and serine proteinase (kazal-type serine proteinase inhibitor 1 and serine proteinase inhibitor-3) in the proPO-activating system were significantly upregulated in the 2-day continuous light group. Glutathione peroxidase 3 was significantly downregulated under continuous light exposure, while cyclooxygenase was upregulated in the continuous light and dark environments. These results provide insights into the molecular mechanism underlying the effects of the photoperiod on immune regulation and the physiological activity of E. sinensis.

Transcutaneous electrical acupoint stimulation for reducing cognitive dysfunction in lumbar spine surgery: A randomized, controlled trail.

This study aimed to evaluate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive dysfunction (POCD) in older patients with lumbar spine surgery. Older patients (aged 60-80 years old) receiving lumbar spine surgery under general anesthesia were randomly divided into group A, 3-day intervention group; group B, 7-day intervention group; control group C, sham TEAS group, selected "Baihui" (GV 20) and "Dazhui" (GV 14) point was intervened once 30 min before operation with "HANS" transcutaneous electrical stimulation device, and then once a day after operation for 30 min each time. The primary outcome was the incidence of postoperative cognitive impairment assessed by the use of the Mini Mental Rating Scale (MMSE), patients developed POCD according to the Z score method. The secondary outcome was serum interleukin-6 (IL-6), tumor Necrosis factor α (TNF-α), neuron-specific enolase (NSE), and S100β protein levels. Three days after surgery, the incidence of POCD in groups A((22.4%)) and B ((18.3%)) were lower than those in group C ((42.9%)) (P < 0.05). There was no significant difference between groups A and B (P > 0.05). Seven days after surgery, the incidence of POCD in group B (18.3%) was lower than that in groups A (26.5%) and B (42.9%), and the comparison between groups B and C was statistically significant (P < 0.05). On the 3rd and 7th days after surgery, the levels of IL-6, TNF-α, NSE, and S100β in the two TEAS groups were lower than those in the sham TEAS group (P < 0.01), but higher than the preoperative levels in the three groups (P < 0.01). It seems that Perioperative TEAS intervention could reduce the level of inflammatory factors IL-6, TNF-α in the blood of older patients with lumbar spine surgery, and reduce the incidence of POCD. www.chictr.org.cn, identifier ChiCTR2200063030.

Effect of Laportea bulbifera extract on CYP450 enzyme activities in rats by Cocktail probe drug method

The Cocktail probe drug method was used to evaluate the effect of Laportea bulbifera extract on the different subtypes of CYP450 enzyme activities in rats, and to provide references for its clinical rational drug use. The rats were randomly divided into a high-dose L. bulbifera group(0.45 g·kg~(-1)·d~(-1)) and a low-dose L. bulbifera group(0.09 g·kg~(-1)·d~(-1)). After continuous gavage for 7 and 14 days, the Cocktail probe mixing solution, including caffeine, midazolam, tolbutamide, omeprazole, metoprolol, and chlorzoxazone, was injected into the tail vein, and the blood sample was obtained from the tail vein at different time points. Ultra-high performance liquid chromatography-mass spectrometry(UPLC-MS) was established to determine the concentration of six probe drugs in rat plasma. DAS 2.0 was used to calculate its pharmacokinetic parameters, and the effect of L. bulbifera extract on CYP1 A2, CYP2 C9, CYP2 C19, CYP2 D6, CYP2 E1, and CYP3 A4 in rats was investigated. As compared with the blank control group, under the omeprazole index, the AUC_(0-t) and AUC_(0-∞) of the 7-day administration groups and the 14-day high-dose group were significantly decreased, and the CLz and Vz were significantly increased. Under the midazolam index, the AUC_(0-t) and AUC_(0-∞) of the 7-day low-dose group and the 14-day administration group were significantly decreased, and the CLz was significantly increased. In addition, the AUC_(0-∞) of the 7-day high-dose group was also significantly decreased. Under the index of metoprolol, the AUC_(0-t) and AUC_(0-∞) of each experimental group were decreased significantly, and the CLz and Vz of the 7-day low-dose group and the 14-day low-dose group were increased significantly. Under the caffeine index, the AUC_(0-t) and AUC_(0-∞) of the 7-day administration groups were increased significantly, the CLz was decreased significantly, and the t_(1/2 z) of the 14-day high-dose group was increased significantly. Under the chlorzoxazone index, the AUC_(0-t) and AUC_(0-∞) of the 7-day low-dose group were increased significantly, and the CLz was decreased significantly. Under the tolbutamide index, there was no statistical difference in the pharmacokinetic parameters. In conclusion, L. bulbifera extract induces the activities of CYP2 C19, CYP3 A4, and CYP2 D6, inhibits the activities of CYP1 A2 and CYP2 E1, and does not affect the activity of CYP2 C9.

Relationship of Circadian Rhythm in Behavioral Characteristics and Lipid Peroxidation of Brain Tissues in Mice.

This study aimed to explore the relationship among several indices of circadian rhythms and lipid peroxidation of brain tissue in mice. After entrainment of 4-week-old mice, one group was disrupted their circadian rhythms for three days and the other group for seven days (n = 10, respectively). After a recovery period, the Y-maze test, the elevated plus maze test, the tail suspension test, and the forced swimming test were conducted. To assess lipid peroxidation in brain tissue, thiobarbituric acid reactive substances were measured in the cortex, hippocampus, and cerebellum. When circadian rhythms were disrupted and adapted back to their original rhythm, the recovery time of the 7-day disruption group (median 3.35 days) was significiantly faster than one of the 3-day disruption group (median 4.87 days). In the group with a 7-day disruption, mice that had recovered their rhythms early had higher malondialdehyde levels in their hippocampus compared to those with delayed recovery. The entrainment of circadian rhythms was negatively correlated with the malondialdehyde level of brain tissue. The behavioral test results showed no differences depending on the disruption durations or recovery patterns of circadian rhythms. These results suggest that disruption types, recovery patterns, and the entrainment of circadian rhythms are likely to affect oxidative stress in adolescents or young adult mice. Future study is needed to confirm and specify these results on the effects of circadian rhythms on oxidative stress and age-dependent effects.

Optimal timing of preoperative intravitreal anti-VEGF injection for proliferative diabetic retinopathy patients.

To analyze concentrations of vascular endothelial growth factor (VEGF) and fibrosis-related factors in vitreous fluid of proliferative diabetic retinopathy (PDR) patients pre-treated with intravitreal anti-VEGF injections (IVI) at different time periods prior to pars plana vitrectomy (PPV), and their correlation with the degree of vitreoretinal fibrosis and explore the optimal timing of preoperative IVI. The prospective case-control study from January 2019 to July 2020 included 31 eyes with PDR-related complications (PDR group) and 21 eyes with non-diabetic ocular disease (control group) requiring PPV. PDR eyes were divided into four groups based on timing of PPV: 3d after IVI (3-day group); 5d after IVI (5-day group); 7 or more days after IVI (≥7-day group); and no IVI. Vitreous fluid samples (0.5-1.0 mL) were collected prior to switching on the infusion before routine 23-G PPV. Concentrations of VEGF, basic fibroblast growth factor (bFGF), periostin (PN), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α were measured by immunoassay, and concentration differences for each cytokine were compared among the groups. The degree of vitreoretinal fibrosis was graded intraoperatively, and the correlation between the changes in cytokine levels and the severity of vitreoretinal fibrosis was analyzed by univariate ordinal logistic regression analysis. PDR eyes without IVI had significantly higher VEGF, bFGF, PN, and IL-6 concentrations than non-diabetic eyes (all P<0.05), and had a significantly higher concentration of VEGF (P<0.05) and a significantly lower concentration of IL-8 (P<0.05) than PDR eyes with IVI. Statistically significant differences were also observed for concentrations of VEGF, bFGF, PN, IL-6, and IL-8 among 3-day, 5-day, and ≥7-day groups (all P<0.05); meanwhile there was no significant difference in TNF-α among groups (P=0.226). The 5-day group had the lowest concentration of VEGF and the ≥7-day group had the highest concentration of bFGF and PN. The degree of vitreoretinal fibrosis was significantly higher in the ≥7-day group compared to the 3-day (P=0.015) and 5-day group (P=0.039), and vitreoretinal fibrosis correlated significantly with concentrations of bFGF, PN, IL-6, and IL-8 (all P<0.05). Univariate ordinal logistic regression analysis showed that bFGF was an independent risk factor for the severity of vitreoretinal fibrosis in PDR patients pre-treated with IVI. The vitreous concentrations of VEGF, bFGF, PN, IL-6, and IL-8 change after pretreatment with IVI before PPV in PDR patients. The degree of vitreoretinal fibrosis is higher in patients with a longer time between IVI treatment and PPV, which may be related to the angio-fibrosis switch. The results suggest that PPV should be performed 5d after IVI administration in PDR patients.

Conversion of External Fixator to Intramedullary Nail in Tibial fractures.

Conversion of provisional external fixation to intramedullary nail (IMN) in femur fractures has been reported to be safe within 14 days of initial surgery. However, there is no current literature guiding this practice in tibial fractures. The purpose of this study was to identify the time period when conversion of external fixation to nail in tibial fractures is safe. After obtaining IRB approval, tibial fractures (OTA 41A, 42, 43A) that received provisional ex-fix and were converted to IMN from 2009 to 2019 were retrospectively reviewed. Skeletally mature patients with minimum 6 months of follow-up were included. The primary outcome was deep infection. External fixation days were categorized as less than 7, 8 to 14, and 15+ days. Risk ratios of infection were estimated using generalized linear regression with a Poisson distribution. A separate regression model evaluated risk factors for infection using both the external fixation and non-external fixation tibial cohorts. Twenty-eight patients (32%) were treated for deep infection. The infection rate for closed fractures was 28% (11 of 39 patients) and for open fractures was 35% (17 of 49 patients) ( P = 0.56). Examining both tibial cohorts, external fixation (odds ratio [OR] = 2.39, P = 0.017), open fracture (OR = 3.13, P = 0.002), and compartment syndrome (OR = 2.58, P = 0.01) were all associated with infection in regression modeling. Median external fixation days for patients with deep infection was 8 days (Inter-quartile range, 3 to 18 days) as compared with 4 days (IQR, 2 to 9 days) in patients without infection ( P = 0.06). While controlling for open fractures, the 8- to 14-day group had RR = 1.81 ( P = 0.2), and the 15+-day group had RR = 2.67 ( P = 0.003) as compared with the <7-day group. Infection rates of tibial fracture patients treated with external fixation and converted to IMN were high. Surgeons should strongly consider the necessity of external fixation for these fractures. Earlier conversion of external fixation to definitive fixation reduced infection rates. Level IV-case series.

Treatment of erythema migrans with doxycycline for 7 days versus 14 days in Slovenia: a randomised open-label non-inferiority trial

Lyme borreliosis is the most prevalent vector-borne disease in Europe and the USA. Doxycycline for 10 days is the primary treatment recommendation for erythema migrans. To reduce potentially harmful antibiotic overuse by identifying shorter effective treatments, we aimed to assess whether oral doxycycline for 7 days is non-inferior to 14 days in adults with solitary erythema migrans. In this randomised open-label non-inferiority trial, we enrolled patients with a solitary erythema at the University Medical Centre in Ljubljana, Slovenia. Patients were excluded if they were pregnant or lactating, immunosuppressed, allergic to doxycycline, or had received antibiotics with anti-borrelial activity within 10 days preceding enrolment or had additional manifestations of Lyme borreliosis Adults were randomly allocated 1:1 to receive oral doxycycline 100 mg twice a day for 7 days or 14 days. The primary efficacy endpoint was the difference in proportion of patients with treatment failure, defined as persistent erythema, new objective signs of Lyme borreliosis, or borrelial isolation on skin re-biopsy at 2 months, in a per-protocol analysis (the population that completed the assigned doxycycline regimen according to the study protocol and did not receive any other antibiotics with anti-borrelial activity until the 2-month visit). The non-inferiority margin was 6 percentage points. Safety was assessed in all randomly assigned patients who followed the study protocol and were evaluable at the 14-day visit. This study is registered with ClinicalTrials.gov, NCT03153267. Between July 3, 2017, and Oct 2, 2018, we enrolled 300 patients (150 per group: median age 56 years [IQR 47-65]; 126 [45%] of 300 male; skin culture positive 72 [30%] of 239 assessed). 295 patients completed antibiotic therapy as per protocol and 294 (98%) patients were evaluable 2 months post-enrolment. Five (3%) of 147 patients from the 7-day group versus 3 (2%) of 147 patients from the 14-day group (one patient did not attend the 2-month visit and was unreachable by telephone) had treatment failure manifesting as persistence of erythema (difference 1·4 percentage points; upper limit of one-sided 95% CI 5·2 percentage points; p=0·64). No patients developed new objective manifestations of Lyme borreliosis during follow-up or had positive repeat skin biopsies. Two (1%) of 150 patients in the 7-day and one (1%) of 150 patients in the 14-day group discontinued therapy due to adverse events. Our data support 7 days of oral doxycycline for adult European patients with solitary erythema migrans, permitting less antibiotic exposure than current guideline-driven therapy. Slovenian Research Agency and the University Medical Centre Ljubljana.

A randomised controlled trial of 1- versus 2-day per week formats of Nordic hamstring training on explosive athletic tasks in prepubertal soccer players

ABSTRACT This randomised controlled trial examined the effect of volume-equated programmes of Nordic hamstring exercise (NHE) training, executed at frequencies of 1- or 2-days per week, on explosive athletic tasks (30 m sprint, 15 m manoeuvrability and standing long jump [SLJ]) in male youth soccer players (mean age: 10.3 ± 0.5 years). Players were divided into an experimental group (n = 31) which was further subdivided into 1-day (n = 16) and 2-days (n = 15) per week training conditions, and a control group (n = 14). There were significant group-by-time interactions for 30-m sprint (p < 0.001, d = 0.6), SLJ (p = 0.001, d = 1.27) and 15 m manoeuvrability (p < 0.001, d = 0.61). The experimental group demonstrated small to moderate effect sizes in 30-m sprint (d = 0.42, p = 0.077), SLJ (d = 0.97, p < 0.001) and 15 m manoeuvrability (d = 0.61, p < 0.001). The control group showed small significant performance decrements or no change in these variables. There were no significant differences between the 1-day and 2-day training groups. In two of the three tests (30 m sprint, SLJ) the 2-day group demonstrated larger effect sizes. The NHE enhances explosive athletic task performance in prepubertal youth soccer players and there may be only small advantages to spreading training over two days instead of one.

Allopurinol treatment reduced vascular remodeling and improved vascular functions in monocrotaline-induced pulmonary hypertensive rats

Increased oxidative stress and high uric acid are implicated in the pathogenesis of pulmonary hypertension (PH). This provides opportunity to benefit from drugs like allopurinol which suppresses both contributing factors. Therefore, we aimed to investigate the effects of allopurinol in preventing as well as reversing the pathological changes occurring in monocrotaline (MCT)-induced rat model of PH. Male rats were assigned into three groups based on the follow-up time: 7, 21 and 35 days. Time-matched controls of each group received single injections of MCT (60 mg/kg) intraperitoneally. Test groups consisted of rats who were treated with MCT on day 0 plus oral allopurinol (60 mg/kg) daily for 7 or 21 days. 35-day group received allopurinol for two weeks starting on the 22nd day following MCT injection. At the end of all-time points, rats were killed and basal pulmonary perfusion pressure, Fulton index, pulmonary arterial wall thickness and pulmonary arterial relaxations along with oxidative stress markers (MDA, SOD, XO), NO and uric acid levels were measured in all groups. MCT-injected rats had evidence of raised oxidative stress (high MDA and XO, low SOD levels) which was reversed by allopurinol co-treatment in all-time groups. Marked elevation of uric acid seen in 21- and 35 day-groups was also reversed by allopurinol. Reduced NO levels of 21 and 35 days were unchanged in allopurinol treated groups. Apart from an increase in arterial wall thickening which was maintained in all-time groups, no alterations in other cardiovascular parameters were observed in 7-day group. However, basal lung perfusion pressure and Fulton index significantly increased, while arterial relaxations decreased in 21- and 35-day groups. Co-treatment with allopurinol for 21 days improved these functional alterations, whereas late allopurinol treatment failed to affect them. Our results indicate that early treatment of MCT-induced PH with allopurinol ameliorated the impaired functional characteristics via suppressing the increased oxidative stress and uric acid, while treatment started after progression of the disease had no significant effect.

14-day famciclovir treatment significantly reduces the incidence of postherpetic neuralgia in elderly patients with herpes zoster.

Pain is the main symptom of herpes zoster (HZ), whilst postherpetic neuralgia (PHN) is a long-term unbearable pain, which seriously affects the quality of life of patients and is also the most intractable problem for clinicians. Early antiviral treatment is considered as a key measure to reduce acute pain and PHN. Nevertheless, most patients still have long-term pain after 7 days of antiviral treatment, and some patients will develop PHN. This study aimed to investigate whether prolonged duration of antiviral therapy could reduce HZ acute pain and the occurrence of PHN. The outpatient data of HZ patients over 50 years old who visited the Dermatology Department from January 2016 to May 2018 were retrospectively analysed. According to the different courses of treatment of famciclovir (FCV), the patients were divided into 7-day FCV group and 14-day FCV group. The numerical rating scale (NRS) score at the first visit and on the 7th, 14th and 21st days after the start of treatment, the adverse drug reactions and the incidence of PHN were compared between the two groups. A total of 219 patients were involved in the analysis. For acute pain control, the 14-day FCV group was better than the 7-day FCV group. For patients with mild initial pain, there was no significant difference in NRS between the two treatments. For patients with moderate-to-severe initial pain, the NRS in the 14-day FCV group was significantly lower than that of the 7-day FCV group on the 14th and 21st days after starting treatment. PHN occurred in patients with moderate-to-severe initial pain, and the incidence was significantly lower in the 14-day FCV group than in the 7-day FCV group. There was no significant difference in the number of adverse reactions between the two groups. Compared with the traditional 7-day antiviral therapy, the 14-day course of FCV can reduce the acute pain and the incidence of PHN in elderly patients with HZ, especially in patients with moderate to severe initial pain. Prolonging the course of medication did not increase the side effects.

Intra-arterial injection of mesenchymal stem cells to accelerate neointima formation after endovascular stenting in a rabbit model.

Delayed neointima formation over a neurovascular stent is associated with thrombotic complications that can lead to stroke. The purpose of this study was to evaluate whether an intra-arterial injection of mesenchymal stem cells (MSCs) after stent placement leads to improved neointima and reduced thrombus formation over the device. Solitaire stents were placed into the aortas of rabbits that were divided into MSC and control groups. The MSC group received an intra-arterial injection of MSCs through the same microcatheter used for stent deployment. Optical coherence tomography (OCT) was used to evaluate and compare neointima and thrombus formation in a blinded fashion. Explanted specimens were also imaged with scanning electron microscopy (SEM) and evaluated by observers blinded to group allocation using an endothelialization scoring system. The 3-day MSC group was similar to the 7-day controls in terms of stent strut coverage ratio and maximum neointimal thickness, but these values were significantly higher than the 3-day control group based on a hierarchical mixed-effects linear regression analysis. SEM revealed a significantly higher endothelialization score for the MSC group compared with controls at the same time point. There was no difference in thrombus formation between any of the groups. The intra-arterial injection of MSCs after endovascular stenting accelerated early neointima formation but had no effect on thrombus formation in this study. Larger studies are required to verify these findings and determine the durability and mechanism of this effect.

What’s New in Hip Replacement

What’s New in Hip Replacement

Evaluation of Complications of Short-term and Long-term Drainage Following Mastectomy with Removal of Axillary Lymph Nodes: A Randomized Clinical Trial.

Breast cancer is one of the most common cancers in Iran and round the globe. Seroma formation is the most common primary complication after mastectomy (partial/radical). Nowadays, drainage is used as a routine method to reduce seroma formation after mastectomy, although there is no consensus about the appropriate time to perform drainage after this surgery. This study evaluated the effects of short-term and long-term drainage after mastectomy along with removal of axillary lymph nodes. This randomized clinical trial was performed on 88 women who underwent mastectomy with ALND in hospitals in Yazd (were randomly divided into two groups). Suction drains were inserted for all patients at completion of surgery. The data collection tool was a researcher-made form based on variables. In the first group, the drain was removed 24 hours after surgery and the patients were discharged, but the second group was discharged with the drain in place after 24 hours and the drain was removed 5 days after surgery. Data were analyzed with SPSS18 using T-Test, Chi square, and Mann-Whitney U test. The results showed that 28 (31.8%) participants had formed seroma, of whom 22 (50%) were in the 1-day drainage group and 6 (13.6%) were in the 5-day drainage group. There was a statistically significant correlation among seroma frequency, mean aspiration volume, mean number of aspirations, mean seroma volume in sonography one week after surgery, and mean seroma volume in sonography between the two groups three weeks after surgery (P<0.05). Based on the results, it can be concluded that long-term drainage reduces the risk of seroma formation after mastectomy with removal of axillary lymph nodes compared to short-term drainage. Complementary study be performed by considering other underlying factors such as comorbidities to obtain the best drain removal time in breast cancer patients.

Seven Days of Bismuth-Based Quadruple Therapy Is as Effective for the First-Line Treatment of Clarithromycin-Resistant Confirmed Helicobacter pylori Infection as 14 Days of Bismuth-Based Quadruple Therapy.

Background/Aims: Point mutations in the 23S ribosomal RNA gene have been associated with Helicobacter pylori (H. pylori) clarithromycin resistance and bismuth-based quadruple therapy (BQT) is one of the options for the treatment of clarithromycin-resistant H. pylori. Current H. pylori treatment guidelines recommend BQT for 10–14 days. This study aims to compare the eradication extents according to 7-day and 14-day BQT treatment for treatment-naïve clarithromycin-resistant confirmed H. pylori infection. Methods: We retrospectively investigated treatment-naïve H. pylori infection cases from March 2019 to December 2020, where patients were treated with BQT. Clarithromycin resistance was identified with a dual-priming oligonucleotide-based multiplex polymerase chain reaction method. We reviewed a total of 126 cases. Fifty-three subjects were treated with a 7-day BQT regimen (7-day group), and 73 subjects were treated with a 14-day BQT regimen (14-day group). We evaluated the total eradication extent of the BQT and compared the eradication extents of the two study groups. Results: Total eradication extent of H. pylori was 83.3% (105/126). The eradication extents of the two groups were as follows: 7-day group (81.1% (43/53)), 14-day group (84.9% (62/73), p = 0.572) by intention-to-treat analysis; 7-day group (95.6% (43/45)), 14-day group (92.5% (62/67), p = 0.518) by per-protocol analysis. The moderate or severe adverse event extents during the eradication were 30.2% (16/53) in the 7-day group and 19.2% (14/73) in the 14-day group (p = 0.152). Conclusions: The 7-day BQT regimen was as effective as the 14-day BQT regimen in the eradication of treatment-naïve clarithromycin-resistant H. pylori infection.

7-day versus 14-day tegoprazan-based triple therapy to treat Helicobacter pylori infection: Real-world evidence.

Potassium-competitive acid blockers (P-CABs) can be used to eradicate Helicobacter pylori infection. We aimed to evaluate the impact of treatment duration (7 vs 14days) on successful H. pylori eradication with P-CAB-based triple therapy in Korea, where clarithromycin resistance rate is high. We retrospectively reviewed the data of patients who received first-line treatment for H. pylori infection with tegoprazan-based triple therapy (50mg tegoprazan+1000mg amoxicillin+500mg clarithromycin twice daily for 1 or 2weeks). The primary endpoint was the eradication rate in intention-to-treat (ITT) analysis. Of the 948 patients included in the study, 435 and 513 received 7-day and 14-day tegoprazan-based triple therapy, respectively. The eradication rate was higher in the 14-day therapy group than in the 7-day therapy group (ITT, 63.9%; 95% confidence interval [CI], 59.3-68.3%] vs 78.6% [95% CI, 74.9-81.9%], respectively, P<0.001; per-protocol, 70.5% [95% CI, 65.8-74.8%] vs 85.1% [81.7-88.1%], respectively, P<0.001). Overall adverse event rates did not differ between the two groups. Although six patients in the 14-day treatment group discontinued the prescribed medications due to adverse events, four of them (67%) discontinued the medication within 4days. The 14-day tegoprazan-based triple therapy showed a superior eradication rate and acceptable adverse events compared with the 7-day tegoprazan-based triple therapy. A 14-day treatment regimen may be required when H. pylori infection is treated with tegoprazan-based triple therapy in regions with high clarithromycin resistance.

Time of Resumption of Antiplatelet Drugs After Upper Gastrointestinal Hemorrhage.

BackgroundThis study aimed to investigate the optimum time to reintroduce the original antiplatelet drugs after upper gastrointestinal hemorrhage in patients as secondary prevention for cardiovascular and cerebrovascular diseases.Material/MethodsAfter the upper gastrointestinal bleeding stopped, patients were randomly divided according to the oral antiplatelet drugs administered. The aspirin group was further divided into 3-day and 7-day aspirin groups. The patients who took aspirin and clopidogrel were randomly divided into 3 groups: 0-day aspirin+3-day clopidogrel; 0-day aspirin+7-day clopidogrel; and 3-day aspirin+7-day clopidogrel. The recovery time, rebleeding rate, incidence of cardiovascular and cerebrovascular events, and death were observed.ResultsThe 3-day aspirin group had more rebleeding, reduced risk of cardiovascular and cerebrovascular events, and a similar mortality rate compared to the other groups. In the aspirin+clopidogrel group, the 0-day aspirin+3-day clopidogrel group had the highest rebleeding rate and the lowest risk of cardiovascular and cerebrovascular events. The 3-day aspirin+7-day clopidogrel group had the highest risk of cardiovascular and cerebrovascular events and increased hospitalization time. The risk of rebleeding and cardiovascular and cerebrovascular events was lower in the 0-day aspirin+7-day clopidogrel group, and the overall mortality rate was the lowest in this group.ConclusionsIn patients receiving only aspirin, this drug should be reintroduced as soon as possible after peptic ulcer hemorrhage. Aspirin and clopidogrel are dual antiplatelet drugs used for the secondary prevention of cardiovascular diseases. In patients under dual-drug therapy, aspirin should not be stopped, while clopidogrel should be restarted in about 7 days.

Attentional Demand of a Movement Sequence Guided by Visual-Spatial and by Motor Representations

The objective of the experiment was to assess the change in attentional demands of a movement sequence guided by visual-spatial and motor representations across practice sessions in a dual-task probe paradigm. Participants were randomly assigned to either a 1-day or 2-day practice group. Following acquisition of the motor sequence task, participants first conducted a retention test and then four inter-manual transfer tests under single and dual-task conditions. The probe task was a simple reaction time. The inter-manual transfer tests, consisting of a mirror and non-mirror test, examined the development of the motor and visual-spatial representation, respectively. The results indicated that both representations guided the movement sequence and required attention. The attentional demands did not change with additional practice.