Improve Patient Comfort Research Articles

Advances in Local Anesthesia and Pain Management for Practicing Dentists: A Comprehensive Review

One of the most frequent problems that patients bring to a dental clinic is pain in the orofacial region or within the tooth. To identify and solve the issue, a proficient practitioner needs to be equipped with the necessary information and resources. Comprehending the history of pain control in dentistry can provide valuable understanding into the development of the present techniques. Newer and more effective pain management treatments have been created as dentistry continues to advance. Several modalities have been developed to reduce and eliminate this, including pharmacological and non-pharmacological treatment modalities. The goal of the present review of the literature's findings is to provide dentists with reliable information regarding the application of contemporary local anesthetics, alternative methods, and strategies to reduce pain during anesthesia administration, thereby improving patient comfort. Keywords: Local Anesthesia, Anesthetic Agents, NSAIDS, Lignocaine, Management, Pain Control

Fire dragon cupping in prevention and treatment of chemotherapy-induced nausea and vomiting in breast cancer: a randomized controlled trial

To observe the clinical efficacy and safety of fire dragon cupping in prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in breast cancer. Sixty breast cancer patients receiving medium-high emetogenic chemotherapy regimen were randomly divided into an observation group (30 cases, 3 cases dropped out) and a control group (30 cases, 3 cases dropped out). In both groups, 5 mg tropisetron hydrochloride was given intravenously on the day of chemotherapy and 1st to 3rd days after chemotherapy. In the observation group, fire dragon cupping on the abdomen was applied on 1st, 3rd and 5th days after chemotherapy. The incidence of nausea, vomiting, loss of appetite, abdominal pain, abdominal distension, the severity of nausea, vomiting on 1st to 6th days after chemotherapy, and the duration of nausea, vomiting, loss of appetite were observed in the two groups. The self-rating anxiety scale (SAS) score, general comfort questionnaire scale (GCQ) score before and after treatment and remedy antiemetic medication were observed in the two groups, and the safety was evaluated. On 2nd to 6th days after chemotherapy, the number of patients with nausea, loss of appetite and abdominal distension and nausea scores in the observation group were lower than those in the control group (P<0.05). On 1st to 3rd days after chemotherapy, the number of patients with vomiting and vomiting scores in the observation group were lower than those in the control group (P<0.05). The duration of nausea, vomiting and loss of appetite in the observation group were shorter than those in the control group (P<0.05). In the observation group, there was no significant difference in SAS and GCQ scores before and after treatment (P>0.05). After treatment, the GCQ score in the control group was decreased compared with that before treatment (P<0.05). After treatment, there was no significant difference in SAS and GCQ scores between the two groups (P>0.05). There was no significant difference in the number of patients using remedy medication between the two groups (P>0.05). No adverse reaction occurred during treatment in both groups. Fire dragon cupping can effectively reduce the incidence of nausea, vomiting, loss of appetite and the severity of nausea, vomiting related to chemotherapy in breast cancer, and improve patient comfort, and have good safety.

Enhancing patient comfort in varicose vein treatment through combined lidocaine and ropivacaine tumescent anesthesia.

To compare the analgesic effects of specific tumescent anesthetic solutions composed of lidocaine, ropivacaine, or a combination of lidocaine and ropivacaine during endovenous radiofrequency ablation for the treatment of great saphenous vein varicosities. This study included 149 patients with lower limb varicose veins who were admitted to our department between 2019 and 2023. The patients were randomly assigned to three groups: the lidocaine group (Group I), the ropivacaine group (Group II), and the lidocaine + ropivacaine group (Group III). Intraoperative vital signs, intraoperative and postoperative visual analog scale (VAS) pain scores, and long-term treatment outcomes were assessed using the venous clinical severity score (VCSS) based on clinical performance. There were no significant differences in age, body mass index, operative time, or blood loss among the three groups (P ≥ 0.05). The differences in the mean arterial pressure and heart rate during surgery in Group II were significantly greater than those in Groups I and III (P < 0.05). The intraoperative VAS scores in Group II were higher than those in Groups I and III (P < 0.05) and at 8 and 12 h postoperatively. There were no significant differences in VCSS among the groups (P ≥ 0.05). The use of a tumescent anesthetic solution composed of lidocaine and ropivacaine significantly improved patient comfort during the perioperative period without affecting surgical outcomes. This formulation can be considered safe and reliable for preparing tumescent anesthesia solutions.

Medication strategies: enhancing symptom management and quality of life in palliative care

Background: Palliative care is integral to addressing suffering during advanced illnesses, and tailored medication is crucial. This study aims to explore medication patterns in palliative care, focusing on understanding their impact on symptom management and patient well-being. Methods: Data collection involves a retrospective approach with patients referred to the Community Support Team in Palliative Care of the Trás-os-Montes and Alto Douro Local Health Unit between April 2022 and March 2023. Data are recorded, including demographic information, medical history, and pain-related details. Medication is administered based on healthcare professionals’ judgment, following established pain management guidelines. Descriptive and cross-tabulation techniques are employed for the statistical analysis. Results: Key findings highlight Morphine and Paracetamol as primary analgesics, constituting 14.6% and 13.8%, respectively. Fentanyl, identified as a potent opioid, addresses severe pain at a rate of 10.0%. The study also reveals that 23.7% of cancer patients receive palliative sedation, emphasising its role in symptom control and dignified care. Conclusions: This research provides significant insights into the intricate relationship between medication administration and palliative care outcomes. The study reveals key findings, such as the prominence of Morphine, Paracetamol, and Fentanyl as essential analgesics in addressing pain and improving patient comfort. Additionally, the high prevalence of palliative sedation among cancer patients underscores its crucial role in symptom control and ensuring dignified care at the end of life. The complexity of medication choices within palliative care settings is emphasised, highlighting the need for careful consideration and tailored approaches.

Simultaneous reduction of number of spots and energy layers in intensity modulated proton therapy for rapid spot scanning delivery.

Reducing proton treatment time improves patient comfort and decreases the risk of error from intrafractional motion, but must be balanced against clinical goals and treatment planquality. To improve the delivery efficiency of spot scanning proton therapy by simultaneously reducing the number of spots and energy layers using the reweighted regularizationmethod. We formulated the proton treatment planning problem as a convex optimization problem with a cost function consisting of a dosimetric plan quality term plus a weighted regularization term. We iteratively solved this problem and adaptively updated the regularization weights to promote the sparsity of both the spots and energy layers. The proposed algorithm was tested on four head-and-neck cancer patients, and its performance, in terms of reducing the number of spots and energy layers, was compared with existing standard and group regularization methods. We also compared the effectiveness of the three methods ( , group , and reweighted ) at improving plan delivery efficiency without compromising dosimetric plan quality by constructing each of their Pareto surfaces charting the trade-off between plan delivery and planquality. The reweighted regularization method reduced the number of spots and energy layers by an average over all patients of and , respectively, with an insignificant cost to dosimetric plan quality. From the Pareto surfaces, it is clear that reweighted provided a better trade-off between plan delivery efficiency and dosimetric plan quality than standard or group regularization, requiring the lowest cost to quality to achieve any given level of deliveryefficiency. Reweighted regularization is a powerful method for simultaneously promoting the sparsity of spots and energy layers at a small cost to dosimetric plan quality. This sparsity reduces the time required for spot scanning and energy layer switching, thereby improving the delivery efficiency of protonplans.

Eye of the future: Unlocking the potential utilization of hydrogels in intraocular lenses.

Hydrogels are distinguished by their exceptional ability to absorb and retain large volumes of water within their complex three-dimensional polymer networks, which is advantageous for the development of intraocular lenses (IOLs). Their innate hydrophilicity offers an optimal substrate for the fabrication of IOLs that simulate the natural lens' accommodation, thereby reducing irritation and facilitating healing after surgery. The swelling and water retention characteristics of hydrogels contribute to their notable biocompatibility and versatile mechanical properties. However, the clinical application of hydrogels faces challenges, including managing potential adverse postimplantation effects. Rigorous research is essential to ascertain the safety and effectiveness of hydrogels. This review systematically examines the prospects and constraints of hydrogels as innovative materials for IOLs. Our comprehensive analysis examines their inherent properties, various classification strategies, cross-linking processes, and sensitivity to external stimuli. Additionally, we thoroughly evaluate their interactions with ocular tissues, underscoring the potential for hydrogels to be refined into seamless and biologically integrated visual aids. We also discuss the anticipated technological progress and clinical uses of hydrogels in IOL manufacturing. With ongoing technological advancements, the promise of hydrogels is poised to evolve from concept to clinical reality, marking a significant leap forward in ophthalmology characterized by improved patient comfort, enhanced functionality, and reliable safety.

Nanozyme-reinforced hydrogel coatings for prevention of catheter-associated urinary tract infection

Catheter-associated urinary tract infection (CAUTI) presents a significant clinical challenge globally, given its elevated infection risk, substantial treatment costs, and the emergence of drug-resistant strains. Despite extensive clinical endeavors, such as the development of antimicrobial catheters and prophylactic approaches, addressing CAUTI remains intricate due to the microenvironment complexity, sustained antimicrobial requirements, the necessity for antibiofilm strategies, and concurrent inflammatory responses. Herein, an innovative solution involving an ultra-low loading gold/iron co-doped silver peroxide nanozyme-reinforced hydrogel coating is introduced for the prevention of CAUTI. The silicone urinary catheter is modified through a straightforward and cost-effective chemical process to impart multienzyme-like activities, including peroxidase- and catalase-like functions, which exhibit antimicrobial, antibiofilm, and anti-inflammatory properties tailored to the unique urinary tract microenvironment. Additionally, the hydrogel coating enhances the hydrophilicity of catheter, thereby improving patient comfort. In vitro and in vivo experiments substantiate the efficacy of the modified catheter in inhibiting bacterial colonization, curtailing biofilm formation, enhancing oxygen supply, and modulating immune responses. This study not only proposes an alternative strategy for prevention and treatment of CAUTI but also provides a promising therapy that addresses multifaceted therapeutic needs through the utilization of multienzyme-like nanozymes.

Simple Method for Re-tightening IMF Wires without Breakage.

This clinical technique aims to retighten intermaxillary fixation (IMF) wires when loosened intra/postoperatively. Intermaxillary fixation is one of the most important steps to obtain stable and functional occlusion in maxillofacial trauma. However, IMF wires tend to loosen over time. This loosened wire is generally removed and a new wire is used for IMF. Removal and refixation is time-consuming for surgeon and unconformable for the patient. We recommend a simple technique for re-tightening IMF wires without breakage, with the use of shepherd's crook explorer by making a small circular loop. This technique of re-tightening by looping further stretches and tightens the wire to regain stabilized occlusion with maximal intercuspation. This technique eliminates the need for removal and refixation of IMF wires, thereby improving patient comfort, yet obtaining stable occlusion over a long period of time. How to cite this article: Madhu SK, Dominic S, Baptist J, et al. Simple Method for Re-tightening IMF Wires without Breakage. J Contemp Dent Pract 2024;25(3):289-291.

Recommendations for Pain Management in Cancer Patients

Pain is a symptom that is reported in cancer patients with the prevalence varying from 33% to 64%. Addressing pain remains a critical aspect of cancer treatment with research showing that pain management in this population remains inadequate. Addressing pain is instrumental because of the impact it has on a patient’s life. It affects clinical outcomes, contributes to poor quality of life, and leads to psychological distress. Barriers remain the key challenge that contributes to inadequate management. Addressing these barriers can lead to better outcomes. Carrying out a comprehensive patient assessment and screening is recommended before beginning pain management. Pain is multidimensional in nature and for many patients, different factors may be contributing to pain. Conducting a comprehensive assessment helps to identify these factors. Comprehensive assessment also helps to capture important information that can contribute to better pain management. After conducting an assessment, pain management should begin. Cancer pain can be managed using pharmacological and non-pharmacological interventions. The interventions should aim to improve patient comfort and function. The interventions should also provide more benefits than adverse effects. One of the mainstay interventions in managing cancer pain is opioids. Opioids should be given in accordance with recommendations from different guidelines to ensure they are effective.

Evolution of localization methods for non-palpable breast lesions: a literature review from a translational medicine perspective.

With an increasing number of non-palpable breast lesions detected due to improved screening, accurate localization of these lesions for surgery is crucial. This literature review explores the evolution of localization methods for non-palpable breast lesions, highlighting the translational journey from concept to clinical practice. A comprehensive search of PubMed, Embase, and Scopus databases until September 2023 was conducted. Multiple methods have been developed throughout the past few decades. (I) Wire-guided localization (WGL) introduced in 1966, has become a reliable method for localization. Its simplicity and cost-effectiveness are its key advantages, but challenges include logistical constraints, patient discomfort, and potential wire migration. (II) Intraoperative ultrasound localization (IOUS) has shown promise in ensuring complete lesion removal with higher negative margin rates. However, its utility is limited to lesions visible on ultrasound (US) imaging. (III) Breast biopsy marker localization: the use of markers has improved the precision of localization without the need for wire. However, marker visibility remains a challenge despite improvements in their design. (IV) Radioactive techniques: radio-guided occult lesion localization (ROLL) and radioactive seed localization (RSL) offer flexibility in scheduling and improved patient comfort. However, they require close multidisciplinary collaboration and specific equipment due to radioactive concerns. (V) Other wireless non-radioactive techniques: wireless non-radioactive techniques have been developed in recent three decades to provide flexible and patient-friendly alternatives. It includes magnetic seed localization, radar techniques, and radiofrequency techniques. Their usage has been gaining popularity due to their safety profile and allowance of more flexible scheduling. However, their high cost and need for additional training remain a barrier to a wider adoption. The evolution of breast lesion localization methods has progressed to more patient-friendly techniques, each with its unique advantages and limitations. Future research on patient-reported outcomes, cosmetic outcomes, breast biopsy markers and integration of augmented reality with breast lesion localization are needed.

Evaluating Sedation Strategies for Magnetic Resonance Imaging: A Comprehensive Review of Intravenous Fentanyl, Butorphanol, and Midazolam in Adult and Pediatric Populations.

Magnetic resonance imaging (MRI) is a critical diagnostic tool that often requires patient sedation to ensure optimal image quality and patient comfort, particularly in those with anxiety or an inability to remain still. This comprehensive review examines the efficacy, safety, and practical considerations of three commonly used intravenous sedatives, namely, fentanyl, butorphanol, and midazolam, in adult populations undergoing MRI procedures. This review highlights the pharmacological profiles, advantages, and limitations associated with each sedative agent through a detailed analysis of current literature, clinical guidelines, and practice-based evidence. Fentanyl is noted for its potent analgesic properties and rapid onset of action, making it suitable for painful procedures. Butorphanol, with its unique opioid agonist-antagonist activity, presents an alternative with a balance between analgesia and sedation, potentially offering a safer profile for certain patient populations. Midazolam, widely recognized for its anxiolytic and amnestic effects, remains a staple in managing procedure-related anxiety. The review further discusses patient selection criteria, dosing strategies, and the importance of individualized sedation planning to enhance patient experience and procedural outcomes. Future directions highlight the potential of emerging sedation agents and non-pharmacological approaches to improve patient comfort and compliance. The findings underscore the necessity for healthcare providers to adapt sedation practices to the specific needs of each patient, considering both the clinical context and the inherent characteristics of the sedative agents. This review aims to guide clinicians in selecting the most appropriate sedation strategy for adult patients undergoing MRI, optimizing patient care and diagnostic efficacy.

Exploring the Horizons of Four-Dimensional Printing Technology in Dentistry.

In dentistry, the integration of additive manufacturing, particularly 3D printing, has marked significant progress. However, the emergence of 4D printing, which allows materials to change shape dynamically in response to stimuli, opens up new avenues for innovation. This review sheds light on recent advancements and potential applications of 4D printing in dentistry, delving into the fundamental principles and materials involved. It emphasizes the versatility of shape-changing polymers and composites, highlighting their ability to adapt dynamically. Furthermore, the review explores the challenges and opportunities in integrating 4D printing into dental practice, including the customization of dental prosthetics, orthodontic devices, and drug delivery systems and also probing into the potential benefits of utilizing stimuli-responsive materials to improve patient comfort, treatment outcomes, and overall efficiency and the review discusses current limitations and future directions, emphasizing the importance of standardized fabrication techniques, biocompatible materials, and regulatory considerations. Owing to its diverse applications and advantages, 4D printing technology is poised to transform multiple facets of dental practice, thereby fostering the development of healthcare solutions that are more tailored, effective, and centered around patient needs.

Preoperative Temporary Fixation for Fractures around the Ankle Using a Simple Extensible External Fixator Significantly Improves Patient Comfort

BackgroundThe authors developed a simple extensible external fixator, which has the advantages of easy application and inexpensiveness. The present study aimed to make a comparison between this external fixator and calcaneal traction in preoperative temporary fixation for malaligned ankle fractures and pilon fractures. MethodsFrom May 2020 to February 2022, patients with malaligned ankle fractures or Rüedi-Allgöwer type 2 or 3 pilon fractures with obvious soft tissue swelling were retrospectively reviewed and divided into the calcaneal traction group and the external fixation group. The two groups of patients were matched 1:1 before making comparisons. ResultsA total of 38 patients were included. Higher General Comfort Questionnaire score and lower visual analog scale score were noticed in the external fixation group during hospitalization (p<0.05), while the operation latency time, total cost, patient satisfaction, and functional outcomes one year after surgery were not significantly different between the two groups. No wound complications were observed. ConclusionPreoperative temporary fixation for fractures around the ankle using this simple extensible external fixator significantly improves patient comfort when compared to calcaneal traction. Level of EvidenceIII, retrospective comparative study.

Implementing Aromatherapy in Perioperative Setting to Improve Patient Comfort

Implementing Aromatherapy in Perioperative Setting to Improve Patient Comfort

Cooled Radiofrequency Ablation of the Glenohumeral Joint in lateral Position: A Case Report

Background: Shoulder pain due to adhesive capsulitis is a prevalent musculoskeletal condition, necessitating innovative treatments. Radiofrequency ablation (RFA) offers an effective approach to alleviate chronic shoulder pain. This case report focuses on Cooled Radiofrequency ablation of articular branches of the glenohumeral joint, performed with hybrid technique using fluoroscopy and ultrasonography, while the patient remains in a lateral position. Case Presentation: A 56-year-old female presented with chronic right shoulder pain and restricted motion diagnosed with right shoulder adhesive capsulitis. Diagnostic blocks of sensory articular nerves provided significant pain relief, leading to Glenohumeral joint sensory articular nerve denervation via Cooled Radiofrequency Ablation. The procedure was performed with the patient in a lateral position, as lying prone was intolerable due to pain. The patient showed substantial pain relief and improved range of motion post-procedure. Discussion: Cooled radiofrequency ablation (CRFA) has shown promise in treating Adhesive Capsulitis and Glenohumeral joint osteoarthritis. While the traditional approach involves changing the patient's position from prone to supine, this case report introduces a novel lateral position technique. Benefits include improved patient comfort, strict asepsis maintenance, reduced procedure time, and decreased radiation exposure. However, challenges in C-arm positioning were encountered. Additionally, hydrodilatation of the glenohumeral joint was performed, resulting in further pain reduction and range of motion improvement. Conclusion: This case report demonstrates the efficacy and safety of Cooled Radiofrequency Ablation for the Glenohumeral joint, utilizing a lateral position approach. The findings support its potential advantages over traditional methods, offering a valuable addition to the management of chronic shoulder pain. Further research and clinical experience will refine its role in addressing this common and debilitating condition.

Study on the biomechanical properties of 3D printed blended esophageal stents with different structural parameters based on patient CT

Introduction: Esophageal stenting is a widely used treatment for esophageal diseases, which can also be used for adjuvant therapy and feeding after chemotherapy for esophageal cancer. The structural parameters of the stent have a significant impact on its mechanical properties and patient comfort.Methods: In the present work, we reconstructed the esophagus model based on the patient’s computed tomography (CT) data, and designed stents with different structural parameters. We used 3D printing technology to achieve rapid production of the designed stents by using Thermoplastic polyurethane (TPU)/Poly-ε-caprolactone (PCL) blends as the materials. The mechanical properties and effects on the esophagus of polymer stents with four different structural parameters of diameter, wall thickness, length and flaring were investigated by in vitro tests of radial compression and migration of the stents, as well as by finite element simulations of the stent implantation process in the esophagus and of the stent migration process. An artificial neural network model was established to predict the radial force of the stent and the maximum equivalent stress of the esophagus during implantation based on these four structural parameters.Results: The results show that wall thickness was the structural parameter that had the greatest impact on the radial force of the stent (statistically significant, p &amp;lt; 0.01), and flaring was the structural parameter that had the greatest impact on the maximum equivalent stress of the esophageal wall after stent implantation (statistically significant, p &amp;lt; 0.01). No. 6 stent had a maximum radial force of 18.07 N, which exceeded that of commercial esophageal stents and had good mechanical properties. And the maximum equivalent force on the esophagus caused by its implantation was only 30.39 kPa, which can improve patient comfort. The predicted values of the constructed back propagation (BP) neural network model had an error of less than 10% from the true values, and the overall prediction accuracies were both above 97%, which can provide guidance for optimizing the design of the stent and for clinical research.Discussion: 3D printing technology presents a wide range of applications for the rapid fabrication of personalized TPU/PCL blend stents that are more suitable for individual patients.

Hospice Care for Stroke Patients: Analysis of Issues and Challenges in the Hospice Care Model for Chronic Stroke Patients

Background: The lives of stroke patients are often marked by changes in function and cognition that alter their lives, along with exacerbating symptoms. Hospice care emphasizes quality care that focuses on improving patient comfort, reducing pain, and providing emotional support to patients and their families. Objective: This study aims to discuss the hospice care model for chronic stroke patients. Method: The research methodology is conducted qualitatively through a literature review method, referring to printed materials such as journals, newspapers, magazines, and relevant books to elucidate the hospice care model and elements related to the care of chronic stroke patients. This article analyzes data from documents and selected texts, followed by a thematic coding process. Result: The study finds that the hospice care model has become an increasingly popular alternative in providing comprehensive and holistic care for chronic stroke patients. However, the implemented hospice care model has its own limitations and challenges. Conclusion: Overall, this article will provide a deeper understanding of the hospice care model for chronic stroke patients. A precise understanding of this model's provision will enhance the quality of hospice care for chronic stroke patients and improve overall well-being. Nursing Implications: The importance of this study lies in gaining a deeper understanding of the effectiveness of the hospice care model for chronic stroke patients and enhancing the provision of quality care for them. By understanding existing models and assessing strengths and weaknesses, we can identify aspects that need improvement in providing better and more appropriate care.

MULTIMODAL ANESTHESIA AS AN IMPORTANT COMPONENT OF ERAS

Introduction. The ideology of Fast Track-Surgery (FTS) and Enhanced Recovery After Surgery (ERAS) represents modern trends in global surgical practice. Anesthesiology aims to provide ideal and universal solutions for protecting patients from surgical aggression. A multimodal approach, which includes multilevel, multifaceted antinociception, is well-founded, where maximum effectiveness is combined with minimal side effects.&#x0D; The aim. To analyze the issue of multimodal pain management as an important component of ERAS (Enhanced Recovery After Surgery) from modern sources of literature for optimizing perioperative care in the minimally invasive surgery department.&#x0D; Materials and methods. Bibliosemantic, comparative, and systemic analysis methods were employed. The proposed recommendations were developed based on an analysis of modern literature, the results of randomized trials and meta-analyses, as well as our own studies dedicated to the study of perioperative pain issues.&#x0D; The results. It has been proven that the use of opioids in anesthesia practice is decreasing. New and modern methods of continuous monitoring of vital organs in patients are being introduced as supplements to classical monitoring protocols. These methods are used to avoid excessive or inadequate dosing of anesthetics, adjust the concentration of substances used, reduce post-anesthesia complications, and improve patient comfort. The method of perioperative energy monitoring significantly complements the "International Standards for Safe Anesthetic Practice", WFSA (2010), and enhances perioperative patient safety by detecting metabolic disturbances and implementing appropriate pathogenetic correction. The importance of regional anesthesia under ultrasound control, nociception-antinociception balance management, and the impact of these methods on opioid consumption, patient satisfaction, and postoperative recovery have been proven.&#x0D; Conclusions. The most commonly used combination of drugs for multimodal analgesia often includes acetaminophen and NSAIDs (strong recommendation). It has been proven that deep and prolonged sedation in intensive care unit (ICU) patients is associated with worse outcomes, longer mechanical ventilation duration, extended ICU and hospital stays, and higher rates of complications, including infections and sometimes even death.

Tolerability of a piezoelectric microneedle electroporator in human subjects.

Electroporation, or the use of electric pulses to facilitate the intracellular delivery of DNA, RNA, and other molecules, is a well-established technique, that has been demonstrated to significantly augment the immunogenicity of DNA/mRNA vaccines and therapeutics. However, the clinical translation of traditional electroporators has been limited due to high costs, large size, complex user operation, and poor tolerability in humans due to nerve stimulation. In prior work, we introduced ePatch: an ultra-low-cost, handheld, battery-free electroporator employing a piezoelectric pulser coupled with a microneedle electrode array that showed enhanced immunogenic responses to an intradermal SARS-CoV-2 DNA vaccine in mice. The current study shifts focus from efficacy to tolerability, hypothesizing that ePatch's microneedle array, which localizes the electric field to the superficial skin strata, will minimize nerve stimulation and improve patient comfort. We tested this hypothesis in 14 healthy adults, monitoring pain and other potential adverse effects associated with electroporation. Compared to the insertion of a traditional hypodermic needle, the ePatch was less painful. Adverse effects such as pain, tenderness, erythema and swelling at the application sites were minimal, transient, and statistically indistinguishable between the experimental and placebo ePatch application, suggesting excellent tolerability towards electroporation. In summary, ePatch has a favorable tolerability profile in humans and offers the potential for the safe use of electroporation in a variety of clinical settings, including DNA and mRNA vaccination.

Unraveling Light-Activated Insulin Action in Regulating Blood Glucose: New Photoactivatable Insight as a Novel Modality in Diabetes Management.

Diabetes, particularly type 2 diabetes (T2D), is the main component of metabolic syndrome. It is highly prevalent and has drastically increased with sedentary lifestyles, notably behaviors linked to ease of access and minimal physical activity. Central to this condition is insulin, which plays a pivotal role in regulating glucose levels in the body by aiding glucose uptake and storage in cells, and what happens to diabetes? In diabetes, there is a disruption and malfunction in insulin regulation. Despite numerous efforts, effectively addressing diabetes remains a challenge. This article explores the potential of photoactivatable drugs in diabetes treatment, with a focus on light-activated insulin. We discuss its advantages and significant implications. This article is expected to enrich the existing literature substantially, offering a comprehensive analysis of potential strategies for improving diabetes management. With its minimal physical intrusion, light-activated insulin promises to improve patient comfort and treatment adherence. It offers precise regulation and localized impact, potentially mitigating the risks associated with conventional diabetes treatments. Additionally, light-activated insulin is capable of explicitly targeting RNA and epigenetic factors. This innovative approach may pave the way for more personalized and effective diabetes treatments, addressing not only the symptoms but also the underlying biological causes of the disease. The advancement of light-activated insulin could revolutionize diabetes management. This study represents a pioneering introduction to this novel modality for diabetes management.