Effect Of Combined Use Research Articles

1580P Effect of combined use of proton pump inhibitors with cisplatin on platinum nephrotoxicity

Cisplatin nephrotoxicity results from renal accumulation of cisplatin via organic cation transporter 2 (OCT2). Since proton pump inhibitors (PPI) are known to inhibit OCT2 activity, it was thought that the combined use of PPI and cisplatin could prevent nephrotoxicity. In this study, we aimed to evaluate the effect of PPI use on nephrotoxicity in patients with head and neck cancer who received concurrent cisplatin with radiotherapy.

Effectiveness of combined use of targeted pressure energy, radiofrequency, and high-intensity focused electromagnetic fields to improve skin quality and appearance of fat and muscle tissue in different body parts.

Inevitable signs of aging are especially noticeable in middle to elder age when stretch marks, loose skin, cellulite, and body-contour changes naturally appear. To verify efficacy of high-intensity focused electromagnetic field (HIFEM), radiofrequency (RF), and Targeted Pressure Energy (TPE) combination treatment to address unfavorable changes in skin, fat, and muscle tissue. The device simultaneously emitting monopolar RF and TPE energies was consecutively combined with simultaneous HIFEM+RF procedure in 32 subjects (21-64 years, 17.4-33.5kg/m2 ) for treatment of thighs (N=15; back, inner, or front), buttocks/saddlebags (N=7), abdomen (N=8), and upper arms (N=2). All patients underwent four weekly, combined treatments of 30-min HIFEM+RF procedure followed by 15-30 min RF+TPE, depending on treatment area. Circumferential measurements, digital photographs, subject satisfaction, and comfort questionnaires were assessed up to 3-months post-treatment. Majority of participants found treatments comfortable, no adverse events occurred. Subjects showed substantial improvement in all treated areas from 1-month follow-up. Combination of HIFEM+RF, monopolar RF, and TPE resulted in significant circumference decrease. Generally, more pronounced results were seen at 3months when subjects showed -5.2cm on abdomen, -3.0cm on thighs, and -5.5cm on saddlebags, respectively. Ninety-four percent of subjects were satisfied with treatment results, most noticed improvement in cellulite, skin laxity, and muscle definition. Results showed high patient satisfaction and efficacy in improving body contour and skin quality. Combining simultaneous HIFEM+RF procedure with simultaneous monopolar RF+TPE treatments considerably enhanced body contour and skin tissue. The procedure proved versatile and may effectively treat multiple body parts.

Effect of combined use of atorvastatin and hormonal therapy on serum prostate-specific antigen, urinary function, and quality of life of early prostate cancer patients in intensive care unit

Purpose: To determine the effects of combined use of atorvastatin and hormonal therapy on serum levels of prostate-specific antigen (PSA), urinary function parameters, and quality of life (QOL) of intensive care unit (ICU) patients with early prostate cancer (PCa).
 Methods: The clinical data for 90 PCa patients treated in ICU of Chenzhou First People's Hospital, Chenzhou, China from July 2019 to July 2020 were retrospectively analyzed. The patients were divided into a reference group given intensity-modulated radiotherapy (n = 45), and a study group treated with intensity-modulated radiotherapy + atorvastatin + hormonal therapy (n = 45) sequentially as they were admitted. After the treatments, serum PSA levels of the patients were measured using enzyme-linked immunosorbent assay (ELISA), while QOL was measured based on Expanded Prostate Cancer Index Composite (EPIC). Urinary parameters were determined by measuring various urodynamic indicators.
 Results: Compared with the reference group, the study group had significantly lower post-treatment serum levels of PSA and blood lipids, higher levels of urinary function indicators (except for residual urine volume), and higher scores in IIEF-5 and EPIC (p < 0.001). 
 Conclusion: These results demonstrate that the combined use of atorvastatin and hormonal therapy is a reliable method for improving urinary function and QOL in early PCa patients. Moreover, the combined treatment has potentials for reducing serum levels of PSA and blood lipids in PCa patients. These findings may be useful in the establishment of improved therapy for early PCa.
 Keywords: Atorvastatin; Hormonal therapy; Early prostate cancer; Serum PSA; Urinary function; Quality of life

Effect of combined use of prednisone and immunosuppressive therapy in patients with systemic lupus erythematosus, and its influence on incidence of adverse reactions

Purpose: To study the effect of combined use of prednisone and immunosuppressive therapy for systemic lupus erythematosus (SLE), and its impact on the incidence of adverse reactions.Methods: In total, 90 SLE patients treated in Longhui People's Hospital between January 2019 and January 2020 were included in this study, and assigned to receive either prednisone (control group) or immunosuppressive therapy and prednisone (study group) via the sealed envelope method. Outcome measures include immunoglobulin measured by enzyme-linked immunosorbent assay (ELISA), complement component 3 (C3) and C4 determined by immunoturbidimetric method, inflammatory factors such as INF-α, IL-10, and IL-6 levels, and the incidence of drug reactions.Results: After treatment, the treatment group had higher levels of immunoglobulin indices and C3 and C4 levels than the control group (p < 0.05). There were lower serum inflammatory factor levels in the treatment group than in the control group (p < 0.05). Prednisone and immunosuppressive therapy resulted in higher treatment effectiveness and lower SLEDAI scores, versus prednisone alone (p < 0.05).Conclusion: Prednisone and immunosuppressive therapy for SLE is safe, enhances treatment effectiveness, and improves clinical indicators in the patients. However, further trials are required prior to its application in clinical practice.

Efficacy of co-administration of oxiracetam and butylphthalide in the treatment of elderly patients with hypertensive intracerebral hemorrhage, and its effect on NIHSS and ADL scores

Purpose: To investigate the effect of combined use of oxiracetam and butylphthalide on hypertensive intracerebral hemorrhage (HICH) in elderly patients, and its influence on NIHSS and activities of daily living (ADL) scores of patients.Methods: Ninety (90) elderly patients with HICH who were admitted to Renmin Hospital of Wuhan University, Wuhan, China served as study subjects, and were randomly assigned to control and study groups, with 45 patients per group. The patients in the control group were treated with oxiracetam alone, while patients in the study group received a combination of oxiracetam and butylphthalide. Clinical efficacy, undesirable side effects and serum indices were determined. The NIHSS and ADL rating scales were used to evaluate cerebral nerve function and ADL score before and after treatment.Results: There were significantly higher total treatment effectiveness and lower incidence of adverse reactions in the study group than in control group, while tissue inhibitor of metalloproteinase-1 (TIMP-1) index, matrix metalloproteinase-9 (MMP-9) index and NIHSS score were reduced in study patients, relative to controls (p < 0.001). However, ADL score in the study group was higher than that in the control group (p < 0.001).Conclusion: Treatment of elderly patients with HICH using a combination of oxiracetam and butylphthalide improves various serum indices, cerebral nerve function and ADL, as well as clinical efficacy. Further research on the combined medication will help to establish a reliable treatment plan for these patients.

Pentoxifylline and tocopherol for prevention of osteoradionecrosis in patients who underwent oral surgery: A clinical audit.

Osteoradionecrosis (ORN) of the jaw is a severe and debilitating complication of the head and neck radiotherapy which frequently occurrs after oral surgery. This clinical audit aims aevaluate the effectiveness of combined use of pentoxifylline and tocopherol (PENTO) in prevention ORN onset in patient who underwent oral surgery after head and neck radiotherapy (RT). In this clinical audit Pentoxifylline 400mg, twice a day, and Tocopherol 800 IU once a day (PENTO protocol) have been prescribed. Patients started the protocol 1week before the surgical procedure and continued for 8weeks after. Twenty-nine patients were included. They received 75 surgical interventions under PENTO protocol: 71 surgical procedures of dental extraction (single or multiple dental extractions in each session) and four implant placements. A total of 152 dental extractions were carried out: 64 surgical extractions which required the raising of mucoperiosteal flap, and 88 simple extractions. Four out of 29 patients developed ORN after surgical procedures: four cases of ORN occurred after dental extractions (5.6%) and one case of ORN after implant placement (25%). PENTO is a useful ORN preventive protocol, low-cost and clinically feasible, safe and well tolerated by patients. Further studies should focus on better defining the effectiveness PENTO, independently from the antibiotic therapy.

Effect of combined use of ivermectin and colchicine in COVID-19 patients

ABSTRACT Background Despite the great results of the SARS-CoV-2 vaccine, there is an increasing need for effective therapeutics. Increasing viral loads are associated with systemic inflammatory response, more disease progression, and increased mortality, while exaggerated immune responses result in immune overreaction and cytokine storm (CS)-induced acute lung injury. We hypothesize that ivermectin by reducing viral load and colchicine by reducing inflammation when used in combination might improve the outcomes of COVID-19 while offering cheap and safe options. Methods A total of 135 COVID-19 patients were divided into three groups, with 45 patients in each group (colchicine/colchicine and ivermectin/neither of them). Group (A): ivermectin + colchicine + standard care, Group (B): colchicine + standard care, and Group (C): (control group) standard care. Results We found that colchicine was associated with clinically significant decrease in days of oxygen need, length of ICU stay, less need for mechanical ventilation, and less mortality, while ivermectin failed to add any beneficial effect. Conclusion Adding ivermectin to the treatment of moderate cases of COVID-19 is not of clinical value, while we support the use of colchicine in such cases. Trial registration The trial was registered in February 2022 in ClinicalTrials.gov (NCT05246072).

Abstract 6367: Activation of vitamin D/VDR signaling reverses gemcitabine resistance of pancreatic cancer cells through inhibition of MUC1 expression

Abstract Objective: Pancreatic ductal adenocarcinoma (PDA) has a dismal prognosis, largely due to its resistance to currently available therapies. Identifying the determinants of and signaling pathways regulating this resistance is essential for the development of effective therapeutic modalities to improve the outcome of PDA. The purpose of this study is to define the role of vitamin D/VDR signaling and underlying mechanisms in PDA pathogenesis and therapeutic resistance. Materials & Methods: We used an unbiased reverse phase protein array (RPPA) to identify Vitamin D3 downstream molecules; we also used a variety of cellular and molecular biological approaches to determine the impact of vitamin D/VDR signaling on the expression of MUC1 mucin and the cellular response to gemcitabine treatment in PDA cells. We used in vivo experimental systems to determine the effect of combination use of gemcitabine with Vitamin D analogue on pancreatic tumorigenicity. Additionally, we used ultra-high resolution mass spectrometry (HRMS) to analyze the relative abundance of intracellular dFdCTP in tumor tissue samples. Results: We identified that MUC1 protein expression was significantly reduced in AsPC-1 human pancreatic cancer cells after treatment with vitamin D3 or its analogue calcipotriol (Cal) by the RPPA analysis, which was further confirmed in MiaPaca-2 and Colo357 pancreatic cancer cells. VDR negatively regulated MUC1 expression in pancreatic cancer cells in both gain- and loss-of-function assays. We established gemcitabine (Gem) resistant AsPC-1-GemR and Colo357-GemR cells and found that AsPC-1-GemR and Colo357-GemR cells had much lower levels of VDR but higher levels of MUC1 protein expression compared to their parental cells, Vitamin D3 or its analogue significantly induced VDR and inhibited MUC1 expression in AsPC-1-GemR and Colo357-GemR cells, and sensitized the resistant cells to gemcitabine treatment. The results of siRNA knockdown experiments indicated that inhibition of MUC1 expression was essential for Cal’s sensitization of PDA cells to Gem treatment in vitro. In keeping with these findings, administration of the Vitamin D3 analogue, paricalcitol (PA) significantly enhanced the therapeutic efficacy of Gem compared to chemotherapy alone in xenograft and syngeneic mouse models of pancreatic cancer without any significant systemic toxicity. The improved combination treatment correlated with increased intratumoral concentration of dFdCTP, the biological active metabolite of gemcitabine. Conclusions: This study reveals a previously unidentified vitamin D/VDR-MUC1 signaling pathway involved in the regulation of gemcitabine resistance of PDA. Our results suggest that combinational therapies which include targeted activation of vitamin D/VDR signaling may improve the outcomes of patients with PDA. Citation Format: Daoyan Wei, Margarete Hafley, Liang Wang, Yi Liu, Peiying Yang, Xiangsheng Zuo, Robert S. Bresalier. Activation of vitamin D/VDR signaling reverses gemcitabine resistance of pancreatic cancer cells through inhibition of MUC1 expression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6367.

Halophilic bacteria as starter cultures: A new strategy to accelerate fermentation and enhance flavor of shrimp paste

Retaining the traditional flavor while shortening the fermentation cycle is the current research focus for shrimp paste fermentation technology. The present study investigated the effect of combined use of halophilic bacteria as starters on the sensory and flavor characteristics of rapidly fermented shrimp paste. Sensory evaluation indicated that the starter-inoculated samples had high texture, appearance, and overall quality scores. Headspace gas chromatography-ion mobility spectrometry/mass spectrometry (HS-GC-IMS/MS) identified 95 volatile compounds, the fingerprint profiles of the starter-inoculated samples were similar to those of the traditional sample. Notably, the content of benzaldehyde, phenylethylaldehyde, and 3-methylbutyraldehyde increased significantly in the starter-inoculated samples (p < 0.05), which may provide an intense malt, caramel, and pleasant odor. Although the content of certain flavor substances in the starter-inoculated samples was lower than those of traditional sample, the use significantly reduced the fermentation time and mimicked the flavor profile of traditional shrimp paste to some extent.

Application of Fluorescence Dye in Combination with Methylene Blue for Axillary Reverse Mapping in Patients with Modified Radical Mastectomy for Breast Cancer.

Background Axillary reverse mapping (ARM) is a novel intraoperative technique developed in recent years. This study was aimed at determining the effect of combined use of fluorescence dye and methylene blue, as well as its feasibility of ARM in patients with breast cancers who undergo modified radical mastectomy. Method From January 2016 to June 2017, 46 patients with primary breast cancer at stage I-IV (Tis-T3, N0-N3, and M0) who received modified radical mastectomy were enrolled in this study. The exclusion criteria included preoperative radiotherapy/chemotherapy or bilateral disease. Patients were divided into 2 groups: methylene blue group (22 patients, 47.8%) and methylene blue+indocyanine green (ICG) group (24 patients, 52.2%). ARM was performed before surgery. Results The overall visualization rate of ARM nodes was 80.4% (37/46). The visualization rate was significantly increased in methylene blue+ICG group (91.67%, 22/24) than that in methylene blue group (63.64%, 14/22) (P = 0.032). There was a statistical difference of visualization rate between clinical groups of N0-N1 and N3-N4 (t = 2.431, P = 0.19 < 0.05). Although there was no significant difference found in the total drainage volume and arm perimeter of patients between the two groups (P > 0.05), the harden diameter of the injection site in methylene blue+ICG group was significantly longer than that in methylene blue group (P < 0.05). Among the 44 patients with different molecular profiling of breast cancer, there was no significant difference of visualization rate of ARM nodes in luminal A group (100%,5/5), luminal B group (75.0%, 18/24, P = 0.21), HER2 group (75.0%, 6/8, P = 0.22), and basal-like group (85.7%, 6/7, P = 0.37). Conclusions ARM using methylene blue+ICG presented greater identification rate than that with methylene blue alone, especially in patients with more invasive breast cancer. Our finding offers support for the improvement of ARM in future breast cancer management.

PD46-08 COMBINED TREATMENT WITH ULTRASOUND AND IMMUNE CHECKPOINT INHIBITORS FOR PROSTATE CANCER

You have accessJournal of UrologyCME1 May 2022PD46-08 COMBINED TREATMENT WITH ULTRASOUND AND IMMUNE CHECKPOINT INHIBITORS FOR PROSTATE CANCER Fuuka Hayashi, Katsumi Shigemura, Koichi Kitagawa, Noriaki Maeshige, Koki Maeda, and Masato Fujisawa Fuuka HayashiFuuka Hayashi More articles by this author , Katsumi ShigemuraKatsumi Shigemura More articles by this author , Koichi KitagawaKoichi Kitagawa More articles by this author , Noriaki MaeshigeNoriaki Maeshige More articles by this author , Koki MaedaKoki Maeda More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002614.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ultrasound (US) is mostly used for diagnostic purpose but could be used for cancer treatments if the US intensity or frequency fits to such purpose. Prostate cancer (PC) has the highest prevalence in the urological field, but indications of immune checkpoint inhibitors (ICI) for PC are limited to very few cases. Therefore, we verified the antitumor effect of US irradiation alone and the combined use of US and ICI in vitro and in vivo. METHODS: Human-derived PC cell line LNCaP and PC-3, and mouse-derived PC cell line TRAMP-C2 were used in experiments. US (3.0 W/cm2, 3 MHz, irradiation time rate: 20 %) was irradiated with repeated frequency of 1, 10, and 100 Hz. Cell proliferation was evaluated by MTS assay and apoptotic cells were analyzed by flow cytometry. We transplanted LNCaP, PC-3 cells into nude mice, and TRAMP-C2 cells into Balb/c nu/nu mice. US was irradiated on mice at 10 Hz and 100 Hz 3 times a week for 6 weeks. We also administered anti-PD-1 antibody to TRAMP-C2-bearing mice 5 times to verify the effect of combined use of US and ICI. After tumor collection, Immunohistochemical (IHC) stain with Ki-67, caspase-3, CD31 and CD3 were conducted. RESULTS: Cell proliferation assay showed US irradiation suppressed cell growth in LNCaP (at 10 Hz and 100 Hz, p<0.0001, respectively), PC-3 (at 1, 10, and 100 Hz, p=0.0002, p<0.0001, and p=0.0132), and TRAMP-C2 (at 1 Hz and 10 Hz, p<0.0001, respectively). In addition, US irradiation induced apoptosis in LNCaP (at 100 Hz, p=0.0368), PC-3 (at 1 Hz and 10 Hz, p=0.0447, p=0.0137), and TRAMP-C2 (at 1, 10, and 100 Hz, p=0.0129, p=0.0150, p=0.0017). In animal experiments, US irradiation at 100 Hz inhibited tumor growth in both LNCaP and PC-3-bearing mice (p=0.0419, p=0.0064). From IHC analysis, the expression level of Ki-67 was decreased at 100Hz in PC-3 (p=0.0467), and caspase-3 was decreased at 10 Hz and 100 Hz in both LNCaP (p=0.0007, p=0.0297) and PC-3 (p=0.0061, p=0.0115). In addition, the number of vessels was reduced at 10Hz and 100 Hz in both LNCaP (p=0.0290, p=0.0102) and PC3 (p=0.0026, p=0.0007). In TRAMP-C2 in vivo experiments, an antitumor effect was observed at 10 Hz, 100 Hz, and the combined use of ICI and 100 Hz of US (p=0.0365, p=0.0364, p=0.0393) compared to control. IHC stain revealed the number of CD3-positive cells increased at 100 Hz (p=0.0499). CONCLUSIONS: We found that US irradiation induces apoptosis and reduces cell growth. Moreover, tumor growth was suppressed by combined use of US and ICI. Further research on immune system activation will lead to a less invasive and more efficient treatment for PC. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e791 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fuuka Hayashi More articles by this author Katsumi Shigemura More articles by this author Koichi Kitagawa More articles by this author Noriaki Maeshige More articles by this author Koki Maeda More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement PDF DownloadLoading ...

Effect of a combination of donepezil tablets and butylphthalide soft capsules on neurological function in dementia patients, and its effect on serum inflammatory factors

Purpose: To determine the effect of combined use of donepezil tablets and butylphthalide soft capsules in the treatment of patients with vascular dementia, and its effect on serum inflammatory factor levels and neurological functional recovery of patients.Methods: 120 patients with vascular dementia were selected and assigned to group A (n = 60) and group B (n = 60). All patients were treated with donepezil tablets, while patients in group A were, in addition, treated with butylphthalide soft capsules. Mini mental state examination (MMSE) scores, clinical dementia rating scale (CDRS) scores, activities of daily living (ADL) scores, incidence of adverse reactions, serum inflammatory factor levels and neurological functional recovery were determined.Results: There was significantly higher MMSE score in group A than in B, while CDRS score was lower in group A. The ADL scores and inflammatory factor levels were lower in group A than in B (p &lt; 0.001), while neurological functional recovery was markedly better in A (p &lt; 0.001). Incidents of unwanted events were comparable in groups A and B, and there were no serious complications in the patients.Conclusion: The combination therapy of donepezil tablets and butylphthalide soft capsules reduces inflammatory factor levels and improved cognitive level and quality of life of patients with vascular dementia. It also produces good neurological functional recovery and low incidence of adverse reactions. Therefore, this treatment strategy has potentials for the management of vascular dementia.

Effects of combination treatment with metformin and berberine on hypoglycemic activity and gut microbiota modulation in db/db mice

BackgroundGut microbiota alterations could influence the metabolism of administered drugs, leading to their altered pharmacokinetics and pharmacodynamics. Despite that metformin and berberine has individually demonstrated their impacts on hypoglycemic activities and gut microbiota alterations in diabetic mice, investigation regarding the impact of their combination treatment in diabetic treatment has never been conducted. PurposeOur current study was proposed aiming to investigate the effect of combination use of metformin with berberine on hypoglycemic activity and identify the possible intestinal bacteria involved in their microbiota-medicated drug-drug interactions in db/db mice. Study DesignPharmacodynamics interactions between metformin and berberine were evaluated in six groups of db/db mice (db, M250, B250, B125, B250+M250, and B125+M250) with its wild type (WT) as control to receive 14 days treatment of vehicle, metformin at 250 mg/kg, berberine at 250/125 mg/kg, and metformin (250 mg/kg) 2 h after dosing berberine (250/125 mg/kg). MethodsOn day 13, insulin tolerance test (ITT) was conducted. On day 15, fasting serum samples were obtained for insulin concentration determination followed by intraperitoneal glucose tolerance test (ipGTT), homeostatic model assessment for insulin resistance (HOMA-IR) calculation, and feces collection for microbial 16S rRNA sequencing analyses. In addition, metformin steady state plasma concentrations on day 15 were measured by validated LC-MS/MS method. ResultsCombination treatment of metformin with berberine could further reduce in blood glucose in comparison to that of db/db diabetic control. Further microbial 16S rRNA sequencing analyses revealed that gut microbiota compositions were significantly changed with the abundance of Proteobacteria and Verrucomicrobia altered the most after metformin and berberine co-treatment compared to their monotherapy. In addition, steady state metformin concentrations in their combination treatment were significantly higher than that from metformin monotherapy. ConclusionCo-administration of metformin (250 mg/kg) with berberine (125 mg/kg) could not only further improve insulin sensitivity, but also demonstrate different alterations on gut microbial communities than that of their individual treatment in db/db mice.

Effect of combined use of tolterodine and continuous positive airway pressure vs continuous positive airway pressure only treatment on overactive bladder symptoms in women with moderate-to-severe obstructive sleep apnea syndrome: a randomized clinical trial.

Obstructive sleep apnea syndrome is associated with urological symptoms, including overactive bladder (OAB). This study aims to determine whether combined tolterodine and CPAP therapies are more effective for patients with OSAS than CPAP treatment only. Women who underwent polysomnography test and were diagnosed with moderate-to-severe OSAS with apnea-hypopnea index (AHI) were included in the study. Data were collected on AHI, OAB awareness-8-item tool (OAB-V8), incontinence questionnaire-urinary incontinence short form (ICIQ-UI-SF), total daily urine volume (DUV), and the Benefit, satisfaction with treatment and willingness (BSW) tool. Eligible patients were randomized to receive either CPAP treatment only or combined CPAP and tolterodine treatment for 3 months. Among 103 participants, a total of 60 were included. Patients in both treatment arms showed significant improvements in OAB-V8, ICIQ-UI-SF, and total DUV compared to their baseline. The mean OAB-V8 was 15.7 at baseline and 5.6 at 3 months for the combined treatment arm and 16.6 and 7.6 at 3 months for the CPAP group only (mean baseline-adjusted between-group difference -1.1 [95% CI, -12.3 to -7.4]; p < 0.001). The improvement in the mean ICIQ-UI-SF was also statistically more significant in the combined therapy group than in the CPAP only arm (mean baseline-adjusted between-group difference -3.27 [95% CI, -4.6 to -1.59]; p < 0.001). No statistical significance was found in the improvement of total DUV between the groups. In this study, combined use of tolterodine with CPAP provides beneficial effects to CPAP treatment only regarding OAB symptoms. Further research is required to confirm these findings in a large cohort.

Analgesic benefit of metamizole and ibuprofen vs. either medication alone: a randomized clinical trial.

Postoperative pain relief remains a key problem after surgery. Multimodal pain therapy has proven beneficial in alleviating pain to a certain extent. However, when combining non-opioids, the focus has been on NSAIDs and paracetamol, but effects of combined use are only moderate. Metamizole could be a potent adjunct, due to its preclusion in several countries, data on its combined use are sparse, despite its common use in many countries. The aim of this study was to examine whether the combination of metamizole and ibuprofen is superior in relieving postoperative pain to either drug alone. For this randomized, placebo-controlled, cross-over study, 35 patients undergoing bilateral lower third molar extraction were randomized. Each patient received three applications of 1000 mg metamizole + 400 mg ibuprofen for surgery on one side and either 1000 mg metamizole + placebo or 400 mg ibuprofen + placebo on the other side. Pain ratings, rescue-medication (tramadol), and sleep were assessed for 18 hours. The combined treatment of metamizole and ibuprofen showed lower mean pain scores over 12 hours than ibuprofen (2.4±1.3 vs 3.8±1.6; P=0.005). Further, combined treatment showed lower mean pain scores over 6 hours than ibuprofen (2.0±1.2 vs. 3.1±1.6; P=0.022) or metamizole alone (2.0±1.2 vs. 3.3±1.7; P=0.015). Consumption of rescue medication was lowest in the combination-group (25% vs. 46%-metamizole; 50%-ibuprofen). The trial was stopped prematurely as the COVID-pandemic halted elective surgeries. Combined use enables superior pain control compared to ibuprofen after molar extraction and tends to be superior to metamizole alone. The premature study-termination may overestimate this effect.

Methylprednisolone and Hyaluronic Acid versus Each Agent Alone to Control Complication of Impacted Wisdom Removal.

Introduction Extraction of impacted molars is commonest operation in oral cavity and associated with complications disturbing patient's quality of life. Hyaluronic acid is a nontoxic agent recommended for wound management due to its anti-inflammatory effects. Also, methylprednisolone sodium is used to reduce pain and edema. The aim this study was to compare the effect of combined use of corticosteroid and hyaluronic acid versus each agent alone in controlling postextraction complications of impacted mandibular third molars. Materials and Methods This prospective randomized trial included patients suffering from impacted mandibular third molar. Patients were divided into four groups. Group I, control, and group II received methylprednisolone sodium succinate injection preoperatively, group III received hyaluronic acid applied in extraction socket, and group IV received preoperative methylprednisolone sodium succinate injection and topical hyaluronic acid in the socket. All patients were evaluated preoperatively and postoperative day to assess swelling, pain, mouth opening, and total analgesic dose. Results Group IV showed insignificant edema along the study period, and other groups showed significant edema on third postoperative day that improved on seventh postoperative in group II and III and tenth postoperative day in group I. Significant decreased mouth opening occurred on second postoperative day in group I, while in other groups, it occurred in third postoperative day. Significant improvement occurred on seventh postoperative day in all groups except in group I which occurred on tenth postoperative day. There was less pain and analgesic dose reported in group IV than other groups. Conclusion Combined use of methylprednisolone sodium succinate and hyaluronic acid significantly decrease postoperative complications than using each agent alone.

Increasing the the efficiency of the collective action of amines by the use of foaming agents combination

A research on the process of enrichment of potash ore using a collective mixture based on higher aliphatic amines, pine oil, and polyethylene glycol (PEG-400) has been carried out. Comparative flotation studies using pine oil and PEG-400 have shown the effectiveness of combined use of these reagents. The effect of adding foaming agents on the micellar structure of amine solutions and the adsorption of amine on the surface of potassium chloride was proved by colloidalchemical methods. It was shown that the introduction of a combination of pine oil and PEG-400 makes it possible to extract 90.3% of potassium chloride into a concentrate at content 87.0 % of potassium chloride. Recovery rates when using a combination of foaming agents are higher than those for adding only one of the foaming agents to the collective mixture. Thus, the best performance was achieved by using a combination of foaming agents. The optimal consumption in laboratory conditions for pine oil and PEG-400 was 10 g/t of ore.

Effect of drug combination on tacrolimus target dose in renal transplant patients with different CYP3A5 genotypes

Various factors, including genetic polymorphisms, drug–drug interactions, and patient characteristics influence the blood concentrations of tacrolimus in renal transplant patients. In the present study, we established a population pharmacokinetic model to explore the effect of combined use of Wuzhi capsules/echinocandins and the patients’ biochemical parameters such as haematocrit on blood concentrations and target doses of tacrolimus in renal transplant patients with different CYP3A5 genotypes. The aim of the study was to propose an individualised tacrolimus administration regimen for early renal transplant recipients. In this retrospective cohort study, we included 240 renal transplant recipients within 21 days of surgery (174 males and 66 females, mean age 39.4 years), who received tacrolimus alone (n = 54), in combination with Wuzhi capsules (99) or caspofungin (57) or micafungin (30). We collected demographic characteristics, clinical indicators, CYP3A5 genotypes, and 1950 steady-state concentrations of tacrolimus and included them in population pharmacokinetic model. An additional 110 renal transplant recipients and 625 steady-state concentrations of tacrolimus were included for external validation of the model. The population pharmacokinetic model was established and Monte Carlo was used to simulate probabilities for achieving the target concentration for individual tacrolimus administration. A two-compartment model of first-order absorption and elimination was developed to describe the population pharmacokinetics of tacrolimus. CYP3A5 genotypes and co-administration of Wuzhi capsules, as well as time after renal transplantation and haematocrit, were important factors affecting the clearance of tacrolimus. We found no obvious change in trend in the scatter plot of tacrolimus clearance rate vs. haematocrit. The Monte Carlo simulation indicated the following recommended doses of tacrolimus alone: 0.14 mg⋅kg−1⋅d−1 for genotype CYP3A5*1*1, 0.12 mg⋅kg−1⋅d−1 for CYP3A5*1*3, and 0.10 mg⋅kg−1⋅d−1 for CYP3A5*3*3. For patients receiving the combination with Wuzhi capsules, the recommended doses of tacrolimus were 0.10 mg⋅kg−1⋅d−1 for CYP3A5*1*1, 0.08 mg⋅kg−1⋅d−1 for CYP3A5*1*3, and 0.06 mg⋅kg−1⋅d−1 for CYP3A5*3*3 genotypes. Caspofungin or micafungin had no effect on the clearance of tacrolimus in renal transplant recipients. The population pharmacokinetics of tacrolimus in renal transplant patients was evaluated and the individual administration regimen of tacrolimus was simulated. For early kidney transplant recipients receiving tacrolimus treatment, not only body weight, but also CYP3A5 genotypes and drugs used in combination should be considered when determining the target dose of tacrolimus.

Effect of combined use of potassic fertilizer and gliricidia green leaves on soil fertility, nutrient balance and yield of rainfed cotton in Vertisols

A field experiment was conducted at research farm of AICRP for Dryland Agriculture, Dr. Panjabrao Deshmukh Krishi Vidyapeeth, Akola (Maharashtra), to assess the effect of potash management through gliricidia green leaves on soil fertility, nutrient balance and yield of rainfed cotton (Gossypium spp.) in Vertisols during kharif season of 2020. The results revealed that there was significant increase in hydraulic conductivity, organic carbon and available N, P, K of soil and decrease in soil pH, EC and bulk density in the gliricidia incorporated treatments as compared to control. The highest available N (211.1 kg ha-1), P (16.7 kg ha-1) and K (361.5 kg ha-1) was observed with the application of 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia which increased by 16, 31.7 and 13.7% respectively over control. Similarly, the nutrient balance after six years of experiment was also higher with the application of 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia being 25.4 kg ha-1 for available N, 2.15 kg ha-1 for available P and 39.6 kg ha-1 for available K. There was significant reduction in the bulk density of soil, being lowest (1.40 Mg m-3) in the treatment 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia as compared to control. Significant improvement in the seed and stalk yield of cotton was recorded with the application of 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia, with increment of 60, 18% and 64, 22% over control and 100% RDF, respectively

Effect of combined use of potassic fertilizer and gliricidia green leaves on soil fertility, nutrient balance and yield of rainfed cotton in Vertisols

A field experiment was conducted at research farm of AICRP for Dryland Agriculture, Dr. Panjabrao Deshmukh Krishi Vidyapeeth, Akola (Maharashtra), to assess the effect of potash management through gliricidia green leaves on soil fertility, nutrient balance and yield of rainfed cotton (Gossypium spp.) in Vertisols during kharif season of 2020. The results revealed that there was significant increase in hydraulic conductivity, organic carbon and available N, P, K of soil and decrease in soil pH, EC and bulk density in the gliricidia incorporated treatments as compared to control. The highest available N (211.1 kg ha-1), P (16.7 kg ha-1) and K (361.5 kg ha-1) was observed with the application of 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia which increased by 16, 31.7 and 13.7% respectively over control. Similarly, the nutrient balance after six years of experiment was also higher with the application of 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia being 25.4 kg ha-1 for available N, 2.15 kg ha-1 for available P and 39.6 kg ha-1 for available K. There was significant reduction in the bulk density of soil, being lowest (1.40 Mg m-3) in the treatment 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia as compared to control. Significant improvement in the seed and stalk yield of cotton was recorded with the application of 100 % NP + 10 kg K (inorganic) + 20 kg K through gliricidia, with increment of 60, 18% and 64, 22% over control and 100% RDF, respectively.